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Ürün Ünal B, Marakoğlu K. Smoking and Depression among Medical School Students: A Cross-Sectional Study from Turkey's Largest Province. Healthcare (Basel) 2024; 12:1130. [PMID: 38891206 PMCID: PMC11172013 DOI: 10.3390/healthcare12111130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 05/23/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND To examine the prevalence of smoking among medical faculty students in Turkey, and to explore the associations between smoking, depression, and other factors. METHODS This cross-sectional study was carried out among medical students in Konya, Turkey, from November 2018 to February 2019. The first section included eight questions pertaining to sociodemographic details. The second comprised nine questions addressing smoking and other harmful habits. The third section involved the Fagerstrom Test for Nicotine Dependence while the fourth was the Beck Depression Inventory (BDI). RESULTS The study was completed with a total of 1117 participants (90.2% of all students). In regard to smoking, 813 (72.78%) were non-smokers, 98 (8.77%) were ex-smokers, and 222 (19.87%) were active smokers. Notably, 16.29% of students (n = 182) had a high BDI score (≥17). Male sex, good economic status, depression diagnosis at any time in life, and alcohol use were independently associated with active smoking. Being a senior student and regular exercise were independently associated with a low (<17) BDI score, whereas depression diagnosis at any time in life and drug use were independently associated with high (≥17) BDI. CONCLUSIONS Almost 20% of medical school students were active smokers, with about a 2.5-fold higher prevalence among males compared to females. There is a significant association between smoking frequency and symptoms of depression. Policies targeting modifiable risk factors can reduce smoking and depression among future physicians, which can have a strong impact on population-wide smoking.
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Affiliation(s)
- Bahar Ürün Ünal
- Department of Family Medicine, Faculty of Medicine, Selcuk University, Konya 42130, Turkey;
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Vicente-Gabriel S, Lugones-Sánchez C, Tamayo-Morales O, Vicente Prieto A, González-Sánchez S, Conde Martín S, Gómez-Sánchez M, Rodríguez-Sánchez E, García-Ortiz L, Gómez-Sánchez L, Gómez-Marcos MA. Relationship between addictions and obesity, physical activity and vascular aging in young adults (EVA-Adic study): a research protocol of a cross-sectional study. Front Public Health 2024; 12:1322437. [PMID: 38344236 PMCID: PMC10853417 DOI: 10.3389/fpubh.2024.1322437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 01/08/2024] [Indexed: 02/15/2024] Open
Abstract
Background Behavioral and substance addictions are prevalent health problems that, alongside obesity, are linked to reduced physical activity and increased sedentary time. Similarly, arterial stiffness and vascular aging are processes that begin gradually at an early age and are closely associated with morbidity and mortality from cardiovascular diseases. The main objective of this study is to analyze how addictions are related to obesity and body fat distribution, physical activity, sedentary time, arterial stiffness and vascular aging, as well as sleep quality, cognitive function and gender differences in young adults aged between 18 and 34 years. Methods This cross-sectional descriptive observational study will analyze data from 500 subjects (250 men and 250 women) aged 18-34 without cardiovascular disease, selected by simple random sampling with replacement from the urban population of the city center of Salamanca (34,044 people aged 18-34, with 18,450 women and 15,594 men). Behavioral and substance addictions, as well as sleep quality and cognitive impairment will be assessed using questionnaires. The Pittisburg Sleep Quality Index (PSQI) will be used to measure sleep quality and the Ford questionnaire will be used to measure insomnia in response to stress. For obesity, weight, height, waist and hip circumference, body composition will be measured with the Inbody 230® impedance meter. For physical activity and sedentary time, we will use the Actigraph® accelerometer alongside the international physical activity questionnaire (IPAQ) and the Marshall questionnaire. The Sphygmocor System® will be used for pulse wave analysis and carotid-femoral pulse wave velocity (cfPWV), while the Vasera VS-2000® will measure cardio ankle vascular index (CAVI) and brachial-ankle pulse wave velocity (baPWV). Vascular aging will be calculated with the 10th and 90th percentiles of cfPWV or baPWV. Demographic, analytical variables will be collected, as will data to assess vascular, cardiac, renal, and brain injury. Discussion Addictions are on the rise in today's society, affecting the mental health and well-being of those who suffer from them, generating important social problems such as job loss, family dysfunction, debt and social isolation. Together with obesity, they are prevalent health problems in young adults and are associated with lower physical activity and higher sedentary time. Meanwhile, arterial stiffness and vascular aging are processes that begin gradually at an early age and determine morbidity and mortality caused by cardiovascular diseases. The results of this project will allow us to understand the situation regarding behavioral and substance addictions in young adults. Better understanding of these addictions will in turn facilitate the development of more effective prevention strategies and intervention programs, which can then reduce the negative impact at both the individual and societal levels. Clinical trial registration [ClinicalTrials.gov], identifier [NCT05819840].
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Affiliation(s)
- Sara Vicente-Gabriel
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Intensive Care Unit, Salamanca University Hospital, Salamanca, Spain
| | - Cristina Lugones-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
- Salamanca Primary Care Management, Castilla and León Health Service–SACYL, Salamanca, Spain
| | - Olaya Tamayo-Morales
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
| | - Alberto Vicente Prieto
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Salamanca Primary Care Management, Castilla and León Health Service–SACYL, Salamanca, Spain
| | - Susana González-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
| | - Sandra Conde Martín
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Salamanca Primary Care Management, Castilla and León Health Service–SACYL, Salamanca, Spain
| | - Marta Gómez-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Home Hospitalization Unit, Marqués de Valdecilla University Hospital, Santander, Spain
| | - Emiliano Rodríguez-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
- Salamanca Primary Care Management, Castilla and León Health Service–SACYL, Salamanca, Spain
- Department of Medicine, University of Salamanca, Salamanca, Spain
| | - Luis García-Ortiz
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
- Salamanca Primary Care Management, Castilla and León Health Service–SACYL, Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
| | - Leticia Gómez-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Emergency Department, La Paz University Hospital, Madrid, Spain
| | - Manuel A. Gómez-Marcos
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
- Salamanca Primary Care Management, Castilla and León Health Service–SACYL, Salamanca, Spain
- Department of Medicine, University of Salamanca, Salamanca, Spain
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Flores-Curiel WA, Carrazco-Peña KB, Mendoza-Cano O. Frequency of Spinal Segmental Sensitization Syndrome and Associated Social Determinants of Health. Arch Phys Med Rehabil 2024; 105:131-137. [PMID: 37236497 DOI: 10.1016/j.apmr.2023.04.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/21/2023] [Accepted: 04/24/2023] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To determine the frequency of spinal segmental sensitization (SSS) syndrome and its association with socioeconomic and educational levels, Depression, smoking, and alcoholism. DESIGN Analytic cross-sectional study conducted within the time frame of February-August 2022. SETTING Outpatient consultation area of the Hospital Regional Universitario de Colima, a public health care institution in Mexico PARTICIPANTS: Ninety-eight patients over 18 years of age were selected that presented with chronic musculoskeletal pain of at least 3-month progression (N=98). The patients were initially selected through simple random sampling, complementing 60% of the calculated sample with consecutive cases due to the pandemic status. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE(S) The subjects gave their informed consent, authorizing the clinical history interview and physical examination that applied the 2019 diagnostic criteria of Nakazato and Romero, as well as the AMAI test, the Mexican National Education System, the Beck Depression Inventory, Fagerstrom Test, and Alcohol Use Disorders Identification Test instrument, to collect the data on socioeconomic and educational levels, Depression, smoking, and alcoholism, respectively. Frequencies and percentages were obtained for the statistical analysis, using the chi-square test, multiple logistic regression, and bivariate/multivariate analyses with the prevalence odds ratio. RESULTS SSS had a 22.4% frequency and was significantly associated (P<.05) with moderate Depression and severe Depression, signifying that a patient with moderate depression had 5.57 times more probability of presenting with SSS (95% CI, 1.27-30.16, P<.05), whereas a patient with severe Depression had 8.68 times more probability of presenting with SSS (95% CI, 1.99-47.77, P<.05). The results of the remaining variables were not statistically significant. CONCLUSIONS There is a need for a biopsychosocial focus on SSS, in which the detection of and approach to moderate and severe Depression favors patient awareness of aspects associated with the phenomenon of chronic pain and the creation of coping strategies for that pain.
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Affiliation(s)
- Wendy Alejandra Flores-Curiel
- Posgrado en Ciencias Médicas, Facultad de Medicina, Universidad de Colima, Colima, México; Colegio Mexicano de Medicina de Electrodiagnóstico, Medicina Física y Rehabilitación A.C., Oaxaca, Mexico.
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Daniels TE, Zitkovsky EK, Laumann LE, Kunicki ZJ, Price DJ, Peterson AL, Dennery PA, Kao HT, Parade SH, Price LH, Abrantes AM, Tyrka AR. Circulating Cell-Free Mitochondrial DNA and Depressive Symptoms Among Low-Active Adults Who Smoke. Psychosom Med 2024; 86:37-43. [PMID: 37769227 PMCID: PMC10843087 DOI: 10.1097/psy.0000000000001254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
OBJECTIVES Mitochondrial dysfunction is implicated in the pathophysiology of psychiatric disorders. Levels of circulating cell-free mitochondrial DNA (cf-mtDNA) are observed to be altered in depression. However, the few studies that have measured cf-mtDNA in depression have reported conflicting findings. This study examined cf-mtDNA and depressive symptoms in low-active adults who smoke. METHODS Participants were adults 18 to 65 years old ( N = 109; 76% female) with low baseline physical activity and depressive symptoms recruited for a smoking cessation study. Self-report measures assessed depression severity, positive and negative affect, and behavioral activation. Blood was collected and analyzed for cf-mtDNA. Relationships between depressive symptoms and cf-mtDNA were examined with correlations and linear regression. RESULTS Levels of cf-mtDNA were associated with categorically defined depression (Center for Epidemiologic Studies Depression Scale score >15), lower positive affect, and decreased behavioral activation ( p < .05). Relationships remained significant after adjustment for age, sex, and nicotine dependence. In a linear regression model including all depressive symptom measures as predictors, Center for Epidemiologic Studies Depression Scale group and lower positive affect remained significant. CONCLUSIONS This work suggests that mitochondrial changes are associated with depressive symptoms in low-active adults who smoke. Higher levels of cf-mtDNA in association with depression and with lower positive affect and decreased behavioral activation are consistent with a possible role for mitochondrial function in depressive symptoms.
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Affiliation(s)
- Teresa E. Daniels
- Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, 345 Blackstone Boulevard, Providence, RI, 02906, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, 345 Blackstone Boulevard, Providence, RI, 02906, USA
- Initiative on Stress, Trauma, and Resilience (STAR), Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Emily K. Zitkovsky
- Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, 345 Blackstone Boulevard, Providence, RI, 02906, USA
- Warren Alpert Medical School of Brown University, 222 Richmond St, Providence, RI, 02903, USA
| | - Laura E. Laumann
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269, USA
| | - Zachary J. Kunicki
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, 345 Blackstone Boulevard, Providence, RI, 02906, USA
| | - Destiny J. Price
- Department of Psychiatry, New York State Psychiatric Institute and Columbia University Irving Medical Center, 1051 Riverside Dr, New York, NY 10032, USA
| | - Abigail L. Peterson
- Department of Molecular Biology, Cell Biology, and Biochemistry, Brown University, Providence, Rhode Island, USA
| | - Phyllis A. Dennery
- Department of Molecular Biology, Cell Biology, and Biochemistry, Brown University, Providence, Rhode Island, USA
- Department of Pediatrics, Warren Alpert Medical School of Brown University, 593 Eddy St, Providence, RI, 02903, USA
| | - Hung-Teh Kao
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, 345 Blackstone Boulevard, Providence, RI, 02906, USA
| | - Stephanie H. Parade
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, 345 Blackstone Boulevard, Providence, RI, 02906, USA
- Initiative on Stress, Trauma, and Resilience (STAR), Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Bradley/Hasbro Children’s Research Center, E.P. Bradley Hospital, East Providence, RI, USA
| | - Lawrence H. Price
- Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, 345 Blackstone Boulevard, Providence, RI, 02906, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, 345 Blackstone Boulevard, Providence, RI, 02906, USA
| | - Ana M. Abrantes
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, 345 Blackstone Boulevard, Providence, RI, 02906, USA
- Behavioral Medicine and Addictions Research Department, Butler Hospital, 345 Blackstone Boulevard, Providence, RI, 02906, USA
| | - Audrey R. Tyrka
- Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, 345 Blackstone Boulevard, Providence, RI, 02906, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, 345 Blackstone Boulevard, Providence, RI, 02906, USA
- Initiative on Stress, Trauma, and Resilience (STAR), Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
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Eghdami S, Ahmadkhaniha HR, Baradaran HR, Hirbod-Mobarakeh A. Ecological momentary interventions for smoking cessation: a systematic review and meta-analysis. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1431-1445. [PMID: 37269310 DOI: 10.1007/s00127-023-02503-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 05/25/2023] [Indexed: 06/05/2023]
Abstract
BACKGROUND AND OBJECTIVES Tobacco use is an important cause of preventable mortality and morbidity worldwide. Only 7% of smokers successfully quit annually, despite numerous evidence-based smoking cessation treatments. An important reason for failure is barriers to accessing appropriate smoking cessation interventions, which can be minimized by technology-delivered interventions, such as ecological momentary interventions. Ecological momentary interventions provide the right type and intensity of treatment in real time, based on ecological momentary assessments of relevant variables. The aim of this review was to assess the effectiveness of ecological momentary interventions in smoking cessation. METHODS We searched MEDLINE, Scopus, CENTRAL, psychINFO, and ProQuest without applying any filters on 19 September, 2022. One author screened search results for obvious irrelevant and duplicate studies. The remaining studies were independently reviewed by two authors to exclude irrelevant studies, and then they extracted data from the included studies. We collated study findings, transformed data into a common rubric, and calculated a weighted treatment effect across studies using Review Manager 5. FINDINGS We analyzed 10 studies with a total of 2391 participants. Assessment methods included exhaled CO analyzers, bidirectional SMS, data input in apps, and hand movement detection. Interventions were based on acceptance and commitment therapy and cognitive behavioral therapy. Smoking abstinence was significantly higher in participants of intervention groups compared to control groups (RR = 1.24; 95% CI 1.07-1.44, P = 0.004; I2 = 0%). CONCLUSION Ecological momentary intervention is a novel area of research in behavioral science. The results of this systematic review based on the available literature suggest that these interventions could be beneficial for smoking cessation.
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Affiliation(s)
- Shayan Eghdami
- Research Committee, School of Medicine, Iran University of Medical Sciences, Hemat Highway, Next to Milad Tower, Tehran, 14535, Iran.
| | - Hamid R Ahmadkhaniha
- Research Center for Addiction and Risky Behaviors, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid R Baradaran
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
- Ageing Clinical and Experimental Research Team, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Armin Hirbod-Mobarakeh
- Research Center for Addiction and Risky Behaviors, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Hirbod Psychiatric and Psychologic Club (BAVAR), Tehran, Iran
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Boumparis N, Noroozi A, Naghizadeh E, Meyer A, Wenger A, Rahimi-Movaghar A, Schaub MP. Blended smartphone intervention for patients in opioid maintenance treatment in Iran: protocol for a randomized controlled trial. BMC Psychiatry 2023; 23:518. [PMID: 37464337 DOI: 10.1186/s12888-023-05007-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 07/06/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND The pattern of substance use in Iran is characterized by a high prevalence of opioid use and opioid use disorder (OUD). Although opioid maintenance therapy (OMT) has been introduced in Iran, approximately 50% of people with opioid use disorder remain unreached. Moreover, psychosocial treatment of OUD and common mental health symptoms during OMT is limited. Digital interventions have been shown to improve psychological distress, depression, anxiety, and post-traumatic stress disorder symptoms. In addition, providing psychoeducation and risk reduction counseling to prevent communicable diseases like HIV and infectious hepatitis is common via the Internet. However, despite these promising advances, no smartphone intervention in OMT has been investigated for the treatment of OUD and common comorbid mental health symptoms. OBJECTIVE We examine the effectiveness of adding a blended smartphone intervention based on community reinforcement approach, motivational interviewing- and cognitive behavioral therapy compared to OMT as usual that aims to improve OMT outcomes and addresses common mental health symptoms in OMT patients in Iran. METHOD Adults with opioid dependence entering 8 treatment centers in Tehran, Iran will be randomly assigned to receive either OMT plus a smartphone intervention or OMT as usual. The primary outcomes will be the percentage of negative urine tests for illicit, non-prescribed use of opioids (opium, heroin, tramadol) and treatment retention. Secondary outcomes will include the longest period of abstinence from the illicit, non-prescribed use of opioids (opium, heroin, and tramadol) confirmed by urine samples, changes in communicable disease risk-taking behaviors, changes in stress and common mental health symptoms, and client satisfaction. Data analysis will follow the intention-to-treat principle and employ (generalized) linear mixed models. DISCUSSION This study will provide substantial knowledge for designing effective blended interventions for OUD. Moreover, it will investigate if treatment retention and OMT-related outcomes and common mental health symptoms can be improved by adding a smartphone intervention to OMT. TRIAL REGISTRATION https://en.irct.ir/trial/53578 .
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Affiliation(s)
- Nikolaos Boumparis
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Konradstrasse 32, 8005, Zurich, Switzerland.
| | - Alireza Noroozi
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Eisa Naghizadeh
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Andreas Meyer
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Konradstrasse 32, 8005, Zurich, Switzerland
| | - Andreas Wenger
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Konradstrasse 32, 8005, Zurich, Switzerland
| | - Afarin Rahimi-Movaghar
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Michael P Schaub
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Konradstrasse 32, 8005, Zurich, Switzerland
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dos Santos Maximino G, Andrade ALM, de Andrade AG, de Oliveira LG. Profile of Brazilian Undergraduates Who Use Electronic Cigarettes: a Cross-Sectional Study on Forbidden Use. Int J Ment Health Addict 2023:1-14. [PMID: 37363763 PMCID: PMC10202068 DOI: 10.1007/s11469-023-01074-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/04/2023] [Indexed: 06/28/2023] Open
Abstract
The use of electronic cigarettes (e-cigarettes) persists in Brazil, despite restrictions on sales, imports, and advertising. This study aimed to identify the prevalence of e-cigarette use and user profiles among university students. This cross-sectional study used a convenience sample of 3083 university students (female = 2253, male = 830; M=26.1; SD =8.43) who completed an online survey. We employed logistic regression models and network analysis to determine the profile of e-cigarette users. The prevalence of e-cigarette use in the past year was 12.2% (n =377). Men, single individuals, Caucasians, secular individuals, and non-heterosexual individuals were more likely to engage in e-cigarette use. Intense use of alcohol, tobacco products, and illicit drugs increased the likelihood of e-cigarette use. Brazilian college students continue to use electronic cigarettes despite the prohibition. The pattern of alcohol abuse and tobacco product use among e-cigarette users is concerning. These risky behaviors render young and highly educated individuals targets for public policies to control and regulate electronic cigarettes in the country.
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Affiliation(s)
- Gabriella dos Santos Maximino
- Department of Neuroscience, School of Medicine, Fundaçao do ABC, Av. Lauro Gomes, 2000, Santo Andre, Sao Paulo, 09060-870 Brazil
| | - André Luiz Monezi Andrade
- Center of Life Sciences, Pontifical Catholic University of Campinas, Address: John Boyd Dunlop st, S/N - Jardim Ipajussara, Campinas, SP Zip Code: 13034-685 Brazil
| | - Arthur Guerra de Andrade
- Department of Neuroscience, School of Medicine, Fundaçao do ABC, Av. Lauro Gomes, 2000, Santo Andre, Sao Paulo, 09060-870 Brazil
| | - Lucio Garcia de Oliveira
- Department of Neuroscience, School of Medicine, Fundaçao do ABC, Av. Lauro Gomes, 2000, Santo Andre, Sao Paulo, 09060-870 Brazil
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Thawal VP, Tzelepis F, Bagade T, Paul C. Psychometric properties of smokeless tobacco dependence measures: A COSMIN systematic review. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 147:208978. [PMID: 36889219 DOI: 10.1016/j.josat.2023.208978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/19/2022] [Accepted: 02/05/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND A comprehensive assessment of the quality of the psychometric properties of smokeless tobacco (SLT) dependence measures is necessary to help researchers and health professionals decide on the most appropriate measure to use when assessing dependence and planning cessation treatment. The aim of this systematic review was to identify and critically appraise measures for assessing dependence on SLT products. METHODS The study team searched MEDLINE, CINAHL, PsycINFO, EMBASE and SCOPUS databases. We included English-language studies describing the development or psychometric properties of an SLT dependence measure. Two reviewers independently extracted data and appraised risk of bias using the rigorous Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidelines. RESULTS Sixteen studies assessing 16 unique measures were eligible for assessment. Eleven studies were conducted in the United States; two in Taiwan and one each in Sweden, Bangladesh, and Guam. Of the sixteen measures, none of the measures was rated as "A" (can be recommended for use) as per COSMIN standards primarily due to limitations in structural validity and internal consistency. Nine measures (FTND-ST, FTQ-ST-9, FTQ-ST-10, OSSTD, BQDS, BQDI, HONC, AUTOS and STDS) were rated as "B": having potential for assessing dependence, although further assessment of psychometric properties is needed. Four measures, MFTND-ST, TDS, GN-STBQ and SSTDS having high quality evidence for an insufficient measurement property were rated as "C" and were not supported for use as per COSMIN standards. The remaining three brief measures HSTI, ST-QFI and STDI (consisting of <3 items) were rated inconclusive due to the inability of assessment of structural validity (minimum 3 items required for factor analysis), which is a prerequisite for assessment of internal consistency per the recommendations by the COSMIN framework. CONCLUSION Further validation is required for the current tools that assess dependence on SLT products. Given the concerns related to the structural validity of these tools, a need may also exist to develop new measures for use by clinicians and researchers for assessing dependence on SLT products. PROSPERO CRD42018105878.
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Affiliation(s)
- Vaibhav P Thawal
- School of Medicine and Public Health (SMPH), University of Newcastle, Newcastle, Australia; Hunter Medical Research Institute, New Lambton Heights, Newcastle, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, Australia.
| | - Flora Tzelepis
- School of Medicine and Public Health (SMPH), University of Newcastle, Newcastle, Australia; Hunter Medical Research Institute, New Lambton Heights, Newcastle, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, Australia; Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia.
| | - Tanmay Bagade
- School of Medicine and Public Health (SMPH), University of Newcastle, Newcastle, Australia; Hunter Medical Research Institute, New Lambton Heights, Newcastle, Australia.
| | - Christine Paul
- School of Medicine and Public Health (SMPH), University of Newcastle, Newcastle, Australia; Hunter Medical Research Institute, New Lambton Heights, Newcastle, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, Australia; Priority Research Centre for Cancer Research, Innovation and Translation, University of Newcastle, Newcastle, Australia.
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Bonilla-Escribano P, Ramírez D, Baca-García E, Courtet P, Artés-Rodríguez A, López-Castromán J. Multidimensional variability in ecological assessments predicts two clusters of suicidal patients. Sci Rep 2023; 13:3546. [PMID: 36864070 PMCID: PMC9981613 DOI: 10.1038/s41598-023-30085-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 02/15/2023] [Indexed: 03/04/2023] Open
Abstract
The variability of suicidal thoughts and other clinical factors during follow-up has emerged as a promising phenotype to identify vulnerable patients through Ecological Momentary Assessment (EMA). In this study, we aimed to (1) identify clusters of clinical variability, and (2) examine the features associated with high variability. We studied a set of 275 adult patients treated for a suicidal crisis in the outpatient and emergency psychiatric departments of five clinical centers across Spain and France. Data included a total of 48,489 answers to 32 EMA questions, as well as baseline and follow-up validated data from clinical assessments. A Gaussian Mixture Model (GMM) was used to cluster the patients according to EMA variability during follow-up along six clinical domains. We then used a random forest algorithm to identify the clinical features that can be used to predict the level of variability. The GMM confirmed that suicidal patients are best clustered in two groups with EMA data: low- and high-variability. The high-variability group showed more instability in all dimensions, particularly in social withdrawal, sleep measures, wish to live, and social support. Both clusters were separated by ten clinical features (AUC = 0.74), including depressive symptoms, cognitive instability, the intensity and frequency of passive suicidal ideation, and the occurrence of clinical events, such as suicide attempts or emergency visits during follow-up. Initiatives to follow up suicidal patients with ecological measures should take into account the existence of a high variability cluster, which could be identified before the follow-up begins.
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Affiliation(s)
- Pablo Bonilla-Escribano
- Department of Signal Theory and Communications, Universidad Carlos III de Madrid, Leganés, Spain.
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
| | - David Ramírez
- Department of Signal Theory and Communications, Universidad Carlos III de Madrid, Leganés, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Enrique Baca-García
- Department of Psychiatry, Centre Hospitalier Universitaire de Nîmes, Nîmes, France
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
- Universidad Autónoma de Madrid, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Central de Villalba, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Infanta Elena, Valdemoro, Madrid, Spain
- Universidad Católica del Maude, Talca, Chile
- CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - Philippe Courtet
- IGF, CNRS-INSERM, Université de Montpellier, Montpellier, France
- Department of Emergency Psychiatry and Acute Care, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Antonio Artés-Rodríguez
- Department of Signal Theory and Communications, Universidad Carlos III de Madrid, Leganés, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
- Evidence-Based Behavior, Madrid, Spain
| | - Jorge López-Castromán
- Department of Psychiatry, Centre Hospitalier Universitaire de Nîmes, Nîmes, France
- CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
- IGF, CNRS-INSERM, Université de Montpellier, Montpellier, France
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10
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Ripoll Perelló J, Barrés Fernández PC, Pick Martín J. [Study of correlation between different scales that measure smoking dependence]. Aten Primaria 2023; 55:102581. [PMID: 36796179 PMCID: PMC9958443 DOI: 10.1016/j.aprim.2023.102581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/29/2022] [Accepted: 01/16/2023] [Indexed: 02/16/2023] Open
Abstract
OBJECTIVE To analyze the correlation between the degrees of smoking dependence, measured with the Fagerström Test Nicotine Dependence (FTND), Glover-Nilsson Smoking Behavioral Dependence (GN-SBQ) and a measure of self-perceived-dependence (SPD). DESIGN Cross-sectional descriptive observational study. SITE: Urban primary health-care center. PARTICIPANTS Men and women between 18 and 65 years old, daily smokers, selected by non-random consecutive sampling. INTERVENTIONS Self-administration of various questionnaires though an electronic device. MAIN MEASUREMENTS Age, sex and nicotine dependence assessed by: FTND, GN-SBQ and SPD. Statistical analysis, with SPSS 15.0: descriptive statistics, Pearson correlation analysis and conformity analysis. RESULTS Two hundred fourteen smokers were included, 54.7% were women. Median age 52 years (range: 27-65). Depending on the test used, different results of the high/very high degree of dependence were found: FTND 17.3%, GN-SBQ 15.4% and SPD 69.6%. A moderate magnitude (r≈0.5) correlation between the 3 test was found. When assessing concordance, comparing the FTND with SPD, 70.6% of smokers didn't coincide in the severity of dependence, reporting a milder degree of dependence with the FTND than with SPD. Comparing GN-SBQ versus FTND, showed conformity in 44.4% of patients while in 40.7%, the FTND underestimated the severity of dependence. Likewise, when comparing SPD with the GN-SBQ, in the 64% GN-SBQ underestimates, while in 34.1% smokers conformity was demonstrated. CONCLUSIONS The number of patients who consider their SPD to be high/very high was four times higher compared to the GN-SBQ or the FNTD; the latter, being the most demanding, categorizing patients with very high dependence. Requiring a FTND score greater than 7 to prescribe drugs for smoking cessation may exclude subsidiary patients from receiving treatment.
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Affiliation(s)
- Jazmin Ripoll Perelló
- Centro de Salud Fuente de San Luis, UDMAFYC Valencia, Hospital Universitario Doctor Peset, Valencia, España; Universidad de Valencia, Valencia, España.
| | - Paula C Barrés Fernández
- Centro de Salud Fuente de San Luis, UDMAFYC Valencia, Hospital Universitario Doctor Peset, Valencia, España
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De Zylva R, Mortimer E, Miller E, Tsourtos G, Lawn S, Wilson C, Karnon J, Woodman R, Ward P. Efficacy of mindfulness and goal setting interventions for increasing resilience and reducing smoking in lower socio-economic groups: randomised controlled trial protocol. Addict Sci Clin Pract 2023; 18:7. [PMID: 36747294 PMCID: PMC9900553 DOI: 10.1186/s13722-022-00355-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 12/05/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Smoking and resulting health problems disproportionately impact low socioeconomic status (SES) individuals. Building resilience presents an approach to 'closing the gap'. Mindfulness-based interventions and setting realistic goals are preferred in low socioeconomic communities. We aim to test if these interventions, delivered online and consolidated with peer support offered via ex-smokers, are successful in promoting smoking cessation and resilience. Our conceptualisation of resilience encompasses the inner capacity/skills and external resources (e.g., social support) which smokers utilise to bounce back from adversity. We include a process evaluation of barriers/facilitators to interventions and cost-effectiveness analysis (from health system perspective). METHODS We plan a four-arm parallel 12-month RCT with a 6-month follow-up to test the efficacy of three group-based interventions each followed by peer support. Arm 1: mindfulness-integrated cognitive behavioural therapy; Arm 2: mindfulness training; Arm 3: setting realistic goals; Arm 4: active control group directed to quit services. All interventions will be administered online. Participants are adult smokers in Australia (N = 812) who have an average weekly household income less than $457AUD or receive welfare benefits. Group-based interventions will occur over 6 months, followed by 6 months of forum-based peer support. PRIMARY OUTCOME self-reported 14-day period prevalence of smoking abstinence at 6 months, with remote biochemical verification of saliva cotinine (< 30 ng/mL). Secondary outcomes include: internal resilience (Connor-Davidson Resilience Scale-25); external resilience (ENRICHD social support tool); quality adjusted life years (EQ-5D-5L); self-efficacy for smoking abstinence (Smoking-Abstinence Self-Efficacy Questionnaire); motivation to quit smoking (Biener and Abrams Contemplation Ladder); nicotine dependence (Fagerstrom Test for Nicotine Dependency); equanimity (Equanimity Scale-16); stress (Perceived Stress Scale-10); goal assessment/attainment (Problems and Goals Assessment Scale). DISCUSSION This study is the first to compare resilience interventions for low SES smokers which have been identified by them as acceptable. Our various repeated measures and process evaluation will facilitate exploration of mechanisms of impact. We intervene within the novel framework of the Psychosocial Model of Resilience, applying a promising paradigm to address a critical and inequitable public health problem. Trial registration Australian New Zealand Clinical Trials Registry ID: ACTRN12621000445875, registered 19 April 2021 ( https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=381007&isReview=true ). The Universal Trial Number is U1111-1261-8951.
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Affiliation(s)
- Reece De Zylva
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, 88 Wakefield St, Adelaide, SA, 8000, Australia.
| | - Elissa Mortimer
- grid.449625.80000 0004 4654 2104Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, 88 Wakefield St, Adelaide, SA 8000 Australia ,grid.1014.40000 0004 0367 2697College of Medicine and Public Health, Flinders University, Bedford Park, SA Australia
| | - Emma Miller
- grid.1010.00000 0004 1936 7304The Stretton Institute, The University of Adelaide, Adelaide, SA Australia
| | - George Tsourtos
- grid.1014.40000 0004 0367 2697College of Medicine and Public Health, Flinders University, Bedford Park, SA Australia
| | - Sharon Lawn
- grid.1014.40000 0004 0367 2697College of Medicine and Public Health, Flinders University, Bedford Park, SA Australia
| | - Carlene Wilson
- grid.1014.40000 0004 0367 2697College of Medicine and Public Health, Flinders University, Bedford Park, SA Australia ,grid.1018.80000 0001 2342 0938School of Psychology and Public Health, La Trobe University, Bundoora, VIC Australia ,grid.410678.c0000 0000 9374 3516Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Heidelberg, VIC Australia
| | - Jonathan Karnon
- grid.1014.40000 0004 0367 2697College of Medicine and Public Health, Flinders University, Bedford Park, SA Australia
| | - Richard Woodman
- grid.1014.40000 0004 0367 2697College of Medicine and Public Health, Flinders University, Bedford Park, SA Australia
| | - Paul Ward
- grid.449625.80000 0004 4654 2104Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, 88 Wakefield St, Adelaide, SA 8000 Australia
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12
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Xu Y, Xu S, Wu Q, Chen H, Yao D, Hu X, Zhang X. Analysis of nicotine dependence among daily smokers in China: evidence from a cross-sectional study in Zhejiang Province. BMJ Open 2022; 12:e062799. [PMID: 36229149 PMCID: PMC9562707 DOI: 10.1136/bmjopen-2022-062799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The current study aimed to assess the level of nicotine dependence and its influencing factors among daily smokers in Zhejiang, China. SETTING The 2020 Global Adult Tobacco Survey was conducted in Zhejiang, China. PARTICIPANTS 1244 daily smokers aged ≥15 years. MEASURES Respondents were asked questions regarding their age, sex, residence, education level, occupation, household income, age of starting daily smoking and nicotine dependence. RESULTS The findings revealed that 17.4% of daily smokers were highly dependent on nicotine, and the mean Fagerström Test for Nicotine Dependence score of daily smokers was (3.1±2.4). Age, educational level, occupation and age of starting daily smoking had significant effects on high nicotine dependence, whereas residence, sex and yearly household income were not significant factors. Compared with the age group ≥60 years, the proportion of respondents with a higher nicotine dependence level was lower in the age group of 15-39 years (OR=0.45). Daily smokers with a higher education level had a lower nicotine dependence level than those with a lower education level: primary or less (OR=3.07) and secondary (OR=2.62). Government institution staff (OR=4.02), unemployed persons (OR=3.08) and industrial workers (OR=2.46) had significantly higher nicotine dependence levels than did workers in the other occupation categories. People who started daily smoking at ≤18 years of age had a higher nicotine dependence level (OR=2.25) than those who started later. CONCLUSIONS This study elucidated that nearly one-fifth of daily smokers in Zhejiang, China, have high nicotine dependence levels. Improved health information on tobacco smoking is needed to encourage daily smokers to quit smoking, particularly among young males, unemployed persons and those with lower education levels.
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Affiliation(s)
- Yue Xu
- Department of Health Education, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Shuiyang Xu
- Department of Health Education, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Qingqing Wu
- Department of Health Education, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Heni Chen
- Department of Health Education, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Dingming Yao
- Department of Health Education, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - XiuJing Hu
- Department of Health Education, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Xuehai Zhang
- Department of Health Education, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
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13
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Daniels TE, Zitkovsky EK, Kunicki ZJ, Price DJ, Peterson AL, Dennery PA, Kao HT, Price LH, Tyrka AR, Abrantes AM. Associations of circulating cell-free DNA, C-reactive protein, and cardiometabolic risk among low-active smokers with elevated depressive symptoms. Brain Behav Immun Health 2022; 25:100519. [PMID: 36164463 PMCID: PMC9508337 DOI: 10.1016/j.bbih.2022.100519] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/13/2022] [Accepted: 09/18/2022] [Indexed: 01/31/2023] Open
Abstract
Background and aims Cell-free DNA (cfDNA) is elevated in several disease states. Metabolic syndrome is a constellation of factors associated with poor cardiometabolic outcomes. This study examined associations of cfDNA from the nucleus (cf-nDNA) and mitochondria (cf-mtDNA), C-reactive protein (CRP), and metabolic syndrome risk, in low-active smokers with depressive symptoms. Methods Participants (N = 109; mean age 47) self-reported medical history. Physical activity was determined by accelerometry and anthropometrics were measured. Blood was collected and analyzed for cf-nDNA, cf-mtDNA, CRP, triglycerides, high-density lipoprotein, hemoglobin A1c. A continuous metabolic syndrome composite risk score was calculated. Relationships of cf-nDNA, cf-mtDNA, CRP, and cardiometabolic risk were examined with correlations and linear regression. Results CRP and cf-nDNA were significantly associated with metabolic syndrome risk (r = .39 and r = .31, respectively), cf-mtDNA was not (r = .01). In a linear regression, CRP and cf-nDNA significantly predicted the metabolic syndrome risk score, findings that remained significant controlling for age, gender, nicotine dependence, and physical activity. Conclusions Associations of cf-nDNA with both CRP and metabolic risk suggest a role for cf-nDNA in inflammatory processes associated with metabolic syndrome. The negative findings for cf-mtDNA suggest distinct roles for cf-nDNA and cf-mtDNA in these processes.
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Affiliation(s)
- Teresa E. Daniels
- Mood Disorders Research Program and Laboratory for Clinical and Translational, Neuroscience, Butler Hospital, 345 Blackstone Boulevard, Providence, RI, 02906, USA,Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, 345 Blackstone Boulevard, Providence, RI, 02906, USA,Initiative on Stress, Trauma, and Resilience (STAR), Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA,Corresponding author. 1011 Veterans Memorial Parkway, Riverside, RI, 02915, USA.
| | - Emily K. Zitkovsky
- Mood Disorders Research Program and Laboratory for Clinical and Translational, Neuroscience, Butler Hospital, 345 Blackstone Boulevard, Providence, RI, 02906, USA,Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Zachary J. Kunicki
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, 345 Blackstone Boulevard, Providence, RI, 02906, USA
| | - Destiny J. Price
- Department of Psychiatry, New York State Psychiatric Institute and Columbia University Irving Medical Center, 1051 Riverside Dr, New York, NY, 10032, USA
| | - Abigail L. Peterson
- Department of Molecular Biology, Cell Biology, and Biochemistry, Brown University, Providence, RI, USA
| | - Phyllis A. Dennery
- Department of Molecular Biology, Cell Biology, and Biochemistry, Brown University, Providence, RI, USA,Department of Pediatrics, Warren Alpert Medical School of Brown University, 593 Eddy St, Providence, RI, 02903, USA
| | - Hung-Teh Kao
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, 345 Blackstone Boulevard, Providence, RI, 02906, USA
| | - Lawrence H. Price
- Mood Disorders Research Program and Laboratory for Clinical and Translational, Neuroscience, Butler Hospital, 345 Blackstone Boulevard, Providence, RI, 02906, USA,Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, 345 Blackstone Boulevard, Providence, RI, 02906, USA
| | - Audrey R. Tyrka
- Mood Disorders Research Program and Laboratory for Clinical and Translational, Neuroscience, Butler Hospital, 345 Blackstone Boulevard, Providence, RI, 02906, USA,Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, 345 Blackstone Boulevard, Providence, RI, 02906, USA,Initiative on Stress, Trauma, and Resilience (STAR), Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Ana M. Abrantes
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, 345 Blackstone Boulevard, Providence, RI, 02906, USA,Behavioral Medicine and Addictions Research Department, Butler Hospital, 345 Blackstone Boulevard, Providence, RI, 02906, USA
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Gutenkunst SL, Bell ML. Managing missing items in the Fagerström Test for Nicotine Dependence: a simulation study. BMC Med Res Methodol 2022; 22:145. [PMID: 35596136 PMCID: PMC9121580 DOI: 10.1186/s12874-022-01637-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 05/11/2022] [Indexed: 11/12/2022] Open
Abstract
Background The Fagerström Test for Nicotine Dependence (FTND) is frequently used to assess the level of smokers’ nicotine dependence; however, it is unclear how to manage missing items. The aim of this study was to investigate different methods for managing missing items in the FTND. Methods We performed a simulation study using data from the Arizona Smokers’ Helpline. We randomly sampled with replacement from the complete data to simulate 1000 datasets for each parameter combination of sample size, proportion of missing data, and type of missing data (missing at random and missing not at random). Then for six methods for managing missing items on the FTND (two involving no imputation and four involving single imputation), we assessed the accuracy (via bias) and precision (via bias of standard error) of the total FTND score itself and of the regression coefficient for the total FTND score regressed on a covariate. Results When using the total FTND score as a descriptive statistic or in analysis for both types of missing data and for all levels of missing data, proration performed the best in terms of accuracy and precision. Proration’s accuracy decreased with the amount of missing data; for example, at 9% missing data proration’s maximum bias for the mean FTND was only − 0.3%, but at 35% missing data its maximum bias for the mean FTND increased to − 6%. Conclusions For managing missing items on the FTND, we recommend proration, because it was found to be accurate and precise, and it is easy to implement. However, because proration becomes less accurate with more missing data, if more than ~ 10% of data are missing, we recommend performing a sensitivity analysis with a different method of managing missing data. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-022-01637-2.
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Affiliation(s)
- Shannon L Gutenkunst
- University of Arizona, Statistics Graduate Interdisciplinary Program, Tucson, AZ, USA. .,University of Arizona, Statistics Consulting Lab, Health Sciences & Bio5 Institute, Tucson, AZ, USA.
| | - Melanie L Bell
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Heath, University of Arizona, Tucson, AZ, USA
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Ismaiel A, Spinu M, Leucuta DC, Popa SL, Chis BA, Fadgyas Stanculete M, Olinic DM, Dumitrascu DL. Anxiety and Depression in Metabolic-Dysfunction-Associated Fatty Liver Disease and Cardiovascular Risk. J Clin Med 2022; 11:jcm11092488. [PMID: 35566616 PMCID: PMC9102968 DOI: 10.3390/jcm11092488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/21/2022] [Accepted: 04/24/2022] [Indexed: 02/04/2023] Open
Abstract
(1) Background: The relationship between anxiety and depression in metabolic-dysfunction-associated fatty liver disease (MAFLD) and cardiovascular (CV) risk remains uncertain. Therefore, we aimed to assess whether anxiety and depression are associated with increased CV risk in MAFLD. (2) Methods: We conducted a cross-sectional observational study involving 77 subjects (39 MAFLD patients, 38 controls), between January and September 2020. Hepatic steatosis was assessed using a combination of hepatic ultrasonography and SteatoTestTM. CV parameters were evaluated using echocardiography and Doppler ultrasound. Self-reported questionnaires pertaining to symptoms of anxiety and depression were used. Anxiety was evaluated using Lehrer Woolfolk Anxiety Symptom Questionnaire (LWASQ), further divided into somatic, behavioral, and cognitive factors, as well as a global score, and depression using Beck Depression Inventory (BDI). (3) Results: MAFLD patients presented significantly higher BDI scores (p-value 0.009) and LWASQ global scores (p-value 0.045) than controls. LWASQ somatic factor was significantly associated with global longitudinal strain (GLS) in linear analysis (−0.0404, p-value = 0.002), while it lost significance following multivariate analysis (−0.0166, p-value = 0.124). Although group (MAFLD vs. controls) predicted BDI, LWASQ global score, and LWASQ somatic factor in linear regression, they lost significance in multivariate analysis. Moreover, the relationship between interventricular septal wall thickness (IVSWT) and BDI, LWASQ global score, and LWASQ somatic factor was significant in linear analysis, but statistical significance disappeared after multivariate analysis. (4) Conclusions: Although MAFLD patients presented increased anxiety and depression risk in univariate analysis, this association lost significance in multivariate analysis. A significant association between GLS levels and LWASQ somatic factor, in addition to IVSWT in anxiety and depression in univariate analysis, was observed, but was lost after multivariate analysis.
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Affiliation(s)
- Abdulrahman Ismaiel
- 2nd Department of Internal Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania; (A.I.); (S.-L.P.); (B.A.C.); (D.L.D.)
| | - Mihail Spinu
- Medical Clinic No. 1, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania; (M.S.); (D.M.O.)
| | - Daniel-Corneliu Leucuta
- Department of Medical Informatics and Biostatistics, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania;
| | - Stefan-Lucian Popa
- 2nd Department of Internal Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania; (A.I.); (S.-L.P.); (B.A.C.); (D.L.D.)
| | - Bogdan Augustin Chis
- 2nd Department of Internal Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania; (A.I.); (S.-L.P.); (B.A.C.); (D.L.D.)
| | - Mihaela Fadgyas Stanculete
- Department of Neurosciences, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Institute of Advanced Studies in Science and Technology, Babes-Bolyai University, 400084 Cluj-Napoca, Romania
- Correspondence: ; Tel.: +40-740-091-110
| | - Dan Mircea Olinic
- Medical Clinic No. 1, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania; (M.S.); (D.M.O.)
- Interventional Cardiology Department, Emergency Clinical Hospital, 400006 Cluj-Napoca, Romania
| | - Dan L. Dumitrascu
- 2nd Department of Internal Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania; (A.I.); (S.-L.P.); (B.A.C.); (D.L.D.)
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Wittekind CE, Takano K, Sckopke P, Winkler MH, Werner GG, Ehring T, Rüther T. Efficacy of approach bias modification as an add-on to smoking cessation treatment: study protocol for a randomized-controlled double-blind trial. Trials 2022; 23:223. [PMID: 35313949 PMCID: PMC8935694 DOI: 10.1186/s13063-022-06155-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 03/07/2022] [Indexed: 11/18/2022] Open
Abstract
Background Although effective treatments for smoking cessation are available, long-term abstinence is the exception rather than the norm. Accordingly, there is a need for novel interventions that potentially improve clinical outcome. Although implicit information processing biases, for example approach biases for smoking-related stimuli, are ascribed a dominant role in the maintenance of tobacco dependence, these biases are hardly targeted in current treatment. Past research has shown that so-called Approach Bias Modification (AppBM) trainings, aiming to modify this bias, lead to improved long-term abstinence in abstinent alcoholic inpatients when delivered as an add-on to treatment-as-usual. Findings on the efficacy of AppBM in smoking have been inconsistent. The present large-scale clinical trial pursues two goals. First, it aims to investigate the efficacy of AppBM as an add-on to treatment-as-usual in a representative sample of adult smokers. Second, possible mechanisms of change are investigated. Methods The study is a randomized-controlled, double-blind, parallel-group superiority trial. We aim at a final sample of at least 336 adult smokers. Participants are allocated with a 1:1:1 allocation ratio to one of the following conditions: (1) treatment-as-usual + AppBM, (2) treatment-as-usual + Sham, (3) treatment-as-usual only. During the add-on training, participants are presented smoking-related and positive pictures and are instructed to respond by either pushing or pulling a joystick, depending on the tilt of the pictures (5○ to the left/right). During AppBM, all smoking-related pictures are tilted in the direction that is associated with pushing, thereby aiming to train an avoidance bias for smoking. All positive pictures are tilted in the direction associated with pulling. During Sham, the contingency is 50/50. Participants are assessed before and after the intervention and at a 6-month follow-up. The primary outcome is prolonged abstinence, and secondary outcomes include smoking-related variables and psychological distress. Additionally, the motivational significance of smoking-related stimuli (i.e., approach bias, valence) is assessed with different experimental tasks (Approach-Avoidance Task; Single Target Implicit Association Test) and psychophysiological measures. Discussion This is the first large-scale clinical trial investigating the efficacy of AppBM as an add-on in smokers including a TAU only condition. Additionally, it is the first study to systematically investigate potential mechanisms mediating the effects of treatment on clinical outcome. Trial registration German Clinical Trials Register, DRKS00019221, 11/11/2019 Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06155-6.
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ADHD and addictive behavior in crack-cocaine users. Encephale 2022; 49:284-288. [DOI: 10.1016/j.encep.2022.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 12/21/2021] [Accepted: 01/05/2022] [Indexed: 11/20/2022]
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Gill VS, Chaudhary N, Randhawa A, Verma M, Rai GK, Mishra S. A Prospective Study to Assess the Outcome of Motivational Interviewing Among Male Students of Haryana, India: A Strive Towards Smoking Cessation in the Youth. Cureus 2022; 14:e22642. [PMID: 35371670 PMCID: PMC8964476 DOI: 10.7759/cureus.22642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2022] [Indexed: 12/03/2022] Open
Abstract
Background The brown plague is a classic example of the modern-day epidemic.Motivational interviewing has been found to increase smokers' readiness to quit, attempts to quit, and reduce smoking levels.Thus, this study, attempts to find out the prevalence of smoking and assess the impact of motivational interviewing on male smoker students (18-30 years). Methodology The study was conducted among the male students of educational institutes in Maharishi Markandeshwar University in Haryana. A cross-sectional study to estimate the prevalence of smoking was carried out. With motivational interviewing of the smokers a prospective cohort study was conducted following the smokers for six months. The probability proportionate to size (PPS) sampling method was applied to recruit 830 participants in the study. A self-designed, semi-structured proforma was used to collect data on smoking behavior, level of dependence, and level of motivation to quit. A modified Fagerstrom questionnaire was used to assess the nicotine dependence level. The motivation to quit smoking was measured by the 10 point scale of Contemplation Ladder, Prochaska, and DiClemente transtheoretical model was used to categorize smokers into stages of readiness to change. Statistical analysis was done using SPSS version 16.0 (IBM Inc., Armonk, New York). Results The prevalence of smoking was 20.4%. Following motivational interview on the first contact, more than half of the current smokers (66.2%) had high motivation which further increased to 88.13% on the third visit at six months (p < 0.001). Likewise, at first contact, 47% had low nicotine dependence; this increased to 52.5 % at two weeks, and finally, at six months, 53.4% had low nicotine dependence. But this finding was statistically insignificant (p=0.23). It was noted that 21 (16.5%) smokers out of 127 quit smoking. A high degree of motivation, support from family and friends, and a low degree of nicotine dependence were identified as significant independent predictors for smoking cessation. Conclusion A satisfying proportion of smokers could attain a high level of motivation for quitting smoking, but less than one-fourth of the current smokers were able to abstain from smoking at the end of the study period. However, the impact of motivational interviewing was not very promising and calls for multi-pronged approach for discouraging smoking.
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Novi M, Paraskevopoulou M, Van Rooij D, Schene AH, Buitelaar JK, Schellekens AFA. Effects of substance misuse and current family history of substance use disorder on brain structure in adolescents and young adults with attention-deficit/hyperactivity disorder. Drug Alcohol Depend 2021; 228:109032. [PMID: 34555690 DOI: 10.1016/j.drugalcdep.2021.109032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 07/03/2021] [Accepted: 07/26/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Alterations in brain structure in attention-deficit/hyperactivity disorder (ADHD) show considerable overlap with those observed in substance use disorder (SUD). These overlapping structural alterations in ADHD and SUD might be explained by family history (FH-trait) effects of SUD, and/or substance misuse (state) effects. Our aim was to investigate effects of 1) current parental SUD (SUD-FH) and 2) recent substance misuse (SM) on brain structure in a cohort of ADHD patients and controls. DESIGN Cortical thickness and subcortical volumes were measured using structural MRI. We compared ADHD subjects and controls with or without SUD-FH (aim 1) and additionally explored differences between SUD-FH- and SUD-FH + subjects with one versus two parents with SUD. We also compared ADHD groups with and without SM (ADHD + SM and ADHD-only, respectively) and controls (aim 2). FINDINGS There was no association between SUD-FH and brain structure. Exploratory analysis on SUD-FH showed decreased IFG thickness (p = 0.032) and nucleus accumbens (NAcc) volume (p = 0.017) in subjects with two versus one SUD parent, regardless of ADHD. ADHD + SM showed decreased inferior frontal gyrus (IFG) thickness compared to controls (pars opercularis p = 0.025, pars orbitalis p = 0.010, pars triangularis p = 0.049), while no difference was found between ADHD-only and either ADHD + SM or controls. CONCLUSIONS Despite negative findings in the primary trait-analysis, exploratory trait-analysis on SUD-FH loading suggested potential SUD trait-effects on IFG thickness and NAcc volume. Substance misuse state effects in ADHD were linked to lower IFG thickness. Future studies should confirm these findings and investigate their clinical relevance, including the functional consequences of decreased IFG thickness.
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Affiliation(s)
- Martina Novi
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa, 56100, Italy; Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - Maria Paraskevopoulou
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Daan Van Rooij
- Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands
| | - Aart H Schene
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands; Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, the Netherlands
| | - Arnt F A Schellekens
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; Nijmegen Institute for Scientist Practitioners in Addiction, Nijmegen, the Netherlands
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A Pilot Study on Approach Bias Modification in Smoking Cessation: Activating Personalized Alternative Activities for Smoking in the Context of Increased Craving. Int J Behav Med 2021; 29:480-493. [PMID: 34697780 PMCID: PMC9338119 DOI: 10.1007/s12529-021-10033-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2021] [Indexed: 11/21/2022]
Abstract
Background The act of smoking has been associated with the automatic activation of approach biases towards smoking-related stimuli. However, previous research has produced mixed findings when smokers are trained to avoid such smoking-related stimuli through the application of Approach Bias Modification (ApBM). As such, this study aimed to test an improved ApBM (ApBM +), where smokers were trained to approach personalized alternative activities for smoking in the context of increased craving, in addition to training smoking-avoidance responses. Methods Sixty-seven daily smokers motivated to quit (M age = 29.27, 58.2% female) were randomly assigned to seven sessions of either ApBM + (n = 26), standard-ApBM (n = 19), or sham-ApBM (n = 22), after a brief motivational smoking intervention. Primary outcomes of approach biases for smoking and for alternative activities and secondary outcomes of smoking-related behaviors were assessed at pre-test, post-test, and 1-month follow-up. Results Overall, no group differences by condition were demonstrated in changing approach biases or smoking-related behaviors at post-test and 1-month follow-up. A trend level indication for differences in changes of smoking-approach biases between sham-ApBM and ApBM + for relatively heavy smokers was found at post-test. This was primarily driven by a significant increase in smoking-approach biases within the sham-ApBM condition and a trend decrease in smoking-approach biases within the ApBM + condition. Conclusions Our findings did not provide support for the current ApBM + concerning improved effects across the whole sample. Diverging training effects on approach biases for smoking in relatively heavy smokers warrants further research, for which we provide some suggestions. Supplementary Information The online version contains supplementary material available at 10.1007/s12529-021-10033-x.
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From planning to action in smoking cessation: Demographic and psychological symptom dimensions related to readiness to quit smoking. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-020-00271-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Gwon SH, Jeong S, Bullock L. Cotinine Fluctuation in Maternal Saliva During and After Pregnancy: Implications for Perinatal Outcomes. MCN Am J Matern Child Nurs 2021; 46:293-298. [PMID: 34162791 PMCID: PMC8373790 DOI: 10.1097/nmc.0000000000000743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to determine maternal cotinine levels in saliva at the first (T-1) and third trimesters of pregnancy (T-2), and postpartum (T-3) among women who reported smoking a consistent number of cigarettes. The goal was to generate data to provide suggestions about how nurses can improve patient outcomes for women who smoke. METHODS Saliva cotinine values obtained from the randomized controlled trial (BabyBEEP) were used for this secondary analysis. We examined variations in saliva cotinine between the first and third trimesters of pregnancy and postpartum among light and heavy smokers. Cotinine values for pregnant smokers who were in the control group (not randomized to any intervention) and reported smoking the same range of cigarettes during and after pregnancy were used for the analyses (n = 43). Descriptive statistics and repeated-measures ANOVA were used for analyses. RESULTS There were differences in maternal saliva cotinine levels across the different time points and between the groups. There was a significant interaction effect between time and group. Cotinine decreased from T-1 to T-2 in heavy smokers and increased from T-2 to T-3 among both light and heavy smokers. Cotinine at T-3 was higher than T-1 among light smokers. CLINICAL IMPLICATIONS Findings support accelerated nicotine metabolism during pregnancy and need for smoking cessation efforts throughout pregnancy to help women stay smoke free during postpartum.
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Wang SD, Loftus P, Pang RD, Kirkpatrick MG. Impact of self-efficacy on daily intention to not smoke. Addict Behav 2021; 118:106877. [PMID: 33714032 DOI: 10.1016/j.addbeh.2021.106877] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 02/07/2021] [Accepted: 02/09/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND To improve cessation interventions, it is necessary to understand the factors associated with daily motivation to not smoke. One hypothesized factor is self-efficacy; however, there has been a lack of evidence investigating self-efficacy as a dynamic construct. METHODS This study examined the influence of baseline and daily self-efficacy on setting daily abstinence plans in pre-quit smokers and successful plans. Participants (N = 76) completed measures of self-efficacy at baseline, and each evening during 28 days of ecological momentary assessment. RESULTS Baseline self-efficacy was not correlated with mean daily rating of self-efficacy or variance in ratings. GLMM found that participants who had higher baseline self-efficacy than others were more likely to set an abstinence plan while participants who had a higher rating of self-efficacy on the previous night than others were more likely to set a plan on any given morning. Participants were less likely to set an abstinence plan if they had smoked on the previous day but were more likely if they had set an abstinence plan on the previous day. Participants were less likely to have a successful plan not to smoke if they smoked on the previous day. CONCLUSIONS The current data indicates that both baseline rating and day-to-day fluctuations in SE influence daily abstinence plan in pre-quit smokers. Future intervention research could examine the use of methods designed to increase and maintain a person's daily self-efficacy and how this can be leveraged to encourage these smokers to attempt long-term cessation.
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Doglikuu BID, Abubakari A, Yaseri M, Shakibazadeh E, Djazayery A, Mirzaei K. Association of household socioeconomic status, neighborhood support system and adherence to dietary recommendation among persons with T2DM, a facility-based cross-sectional study in Ghana. BMC Public Health 2021; 21:911. [PMID: 33985462 PMCID: PMC8117492 DOI: 10.1186/s12889-021-10963-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 04/30/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Dietary recommendation help persons with diabetes adopt to healthy eating habits to achieve optimal glycemic control. Socioeconomic-status and neighborhood support system can influence adherence to dietary recommendation. The purpose of our study is to assess the association of household-socioeconomic status and neighborhood-support system with adherence to dietary recommendation among persons with type 2 diabetes mellitus (T2DM). METHODS Facility-based cross-sectional-survey was conducted in Brong Ahafo region, Ghana. Six hospitals were randomly selected and 530 individuals with T2DM consecutively recruited from the selected hospitals for the study. Structured-questionnaires were used to collect socio-demographic variables. Adherence to dietary-recommendation was the outcome-variable, and was assessed using perceived dietary-adherence questionnaire. RESULTS Age (years) (P-value = 0.005), Physical-Activity level (P-value = 0.024) Receive-moderate Social-Support (P-value = 0.004) and High-Socioeconomic status (P-value = 0.046) were significantly correlated with adherence to dietary-recommendation. Age (years) regression coefficient (β) -0.089, 95%CI (- 0.12, - 0.001), Being married β0.103, 95%CI (0.002, 0.02), moderate and low-social support system β 0.309, 95%CI (0.17, 0.38) and β-0.192, 95%CI (- 0.26, - 0.06) respectively, and high-socioeconomic status β 0.197, 95%CI (0.06, 0.25) were significantly associated with adherence to dietary-recommendation. CONCLUSION Social-support system and socioeconomic-status could be associated with adherence to dietary-recommendation. Therefore, health workers should consider patients' social support system and socioeconomic status as modifiable factors for optimum adherence.
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Affiliation(s)
- Be-Ikuu Dominic Doglikuu
- International Campus, Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
- Ministry of Health, Nursing and Midwifery Training College, Twifo Praso, Central Region, Ghana
| | - Abdulai Abubakari
- Department of Nutritional Sciences, School of Allied Health Sciences, University of Development Studies (UDS), Tamale, Ghana
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Shakibazadeh
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Abolghassem Djazayery
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
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Rudasingwa G, Kim Y, Lee C, Lee J, Kim S, Kim S. Comparison of Nicotine Dependence and Biomarker Levels among Traditional Cigarette, Heat-Not-Burn Cigarette, and Liquid E-Cigarette Users: Results from the Think Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4777. [PMID: 33947137 PMCID: PMC8124521 DOI: 10.3390/ijerph18094777] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/12/2021] [Accepted: 04/22/2021] [Indexed: 11/21/2022]
Abstract
This study aimed to compare Korean smokers' smoking-related biomarker levels by tobacco product type, including heat-not-burn cigarettes (HNBC), liquid e-cigarettes (EC), and traditional cigarettes (TC). Nicotine dependence levels were evaluated in Korean adult study participants including TC-, EC-, HNBC-only users and nonsmokers (n = 1586) from March 2019 to July 2019 in Seoul and Cheonan/Asan South Korea using the Fagerström Test Score. Additionally, urine samples (n = 832) were collected for the measurement of urinary nicotine, cotinine, OH-cotinine, NNAL(4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol), CYMA(N-acetyl-S-(2-cyanoehtyl)-L-cysteine), or CEMA (2-cyanoethylmercapturic acid) using LC-MS/MS. The median(interquartile range) nicotine dependence level was not different among the three types of smokers, being 3.0 (2.0-5.0) for TC- (n = 726), 3.0 (1.0-4.0) for EC- (n = 316), and 3.0 (2.0-4.0) for HNBC- (n = 377) only users. HNBC-only users presented similar biomarker levels compared to TC-only users, except for NNAL (HNBC: 14.5 (4.0-58.8) pg/mL, TC: 32.0 (4.0-69.6) pg/mL; p = 0.0106) and CEMA (HNBC: 60.4 (10.0-232.0) ng/mL, TC: 166.1 (25.3-532.1) ng/mL; p = 0.0007). TC and HNBC users showed increased urinary cotinine levels as early as the time after the first smoke of the day. EC users' biomarker levels were possibly lower than TC or HNBC users' but higher than those of non-smokers.
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Affiliation(s)
- Guillaume Rudasingwa
- Integrated Research Center of Risk Assessment, Soonchunhyang University, Soonchunhyang-Ro 22, Asan 31538, Korea;
| | - Yeonjin Kim
- Department of ICT Environmental Health System, Graduate School, Soonchunhyang University, Soonchunhyang-Ro 22, Asan 31538, Korea;
| | - Cheolmin Lee
- Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul 06236, Korea;
| | - Jeomkyu Lee
- Division of Respiratory and Allergy Disease Research, Department of Chronic Disease Convergence Research, National Institute of Health (NIH), Korea Disease Control and Prevention Agency (KDCA), Osong 28159, Korea; (J.L.); (S.K.)
| | - Seunghyun Kim
- Division of Respiratory and Allergy Disease Research, Department of Chronic Disease Convergence Research, National Institute of Health (NIH), Korea Disease Control and Prevention Agency (KDCA), Osong 28159, Korea; (J.L.); (S.K.)
| | - Sungroul Kim
- Integrated Research Center of Risk Assessment, Soonchunhyang University, Soonchunhyang-Ro 22, Asan 31538, Korea;
- Department of ICT Environmental Health System, Graduate School, Soonchunhyang University, Soonchunhyang-Ro 22, Asan 31538, Korea;
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Masuda AMM, Trevisan IB, Gouveia TDS, Tacao GY, Ramos EMC, Ramos D. Acute Effect of Resistance Exercise on Mucociliary Clearance in Active Smokers. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2021. [DOI: 10.36660/ijcs.20200006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Scarinci IC, Ribeiro M, Gibson E, Hansen B, Kienen N. Assessing Tobacco Cessation Needs Among Persons Living With HIV in Brazil: Results From a Qualitative Interview Study. J Assoc Nurses AIDS Care 2021; 32:e3-e13. [PMID: 32482949 DOI: 10.1097/jnc.0000000000000181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
ABSTRACT With regard to tobacco cessation, persons living with HIV (PLWH) are an underserved population, given the high prevalence of use and lack of evidence-based cessation programs tailored to this population. This study examined barriers and facilitators to tobacco use and cessation among PLWH in southern Brazil. We interviewed a total of 36 PLWH: 26 current smokers, of whom eight had a previous diagnosis of pulmonary TB, and 10 former smokers. Motivations for smoking included anxiety relief, social influence, and habitual behaviors. Motivations to quit included bad smell/taste and consequences/symptoms. Barriers to cessation included cost of pharmacological aids, distance to treatment, and reluctance to seek tobacco cessation services at the public primary care clinics due to confidentiality concerns. Participants favored individual or group interventions, no-cost pharmacologic aids, and assured confidentiality. There are specific contextual factors associated with tobacco cessation among PLWH in Brazil, which have important clinical, research, and policy implications.
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Affiliation(s)
- Isabel C Scarinci
- Isabel C. Scarinci, PhD, MPH, is a Professor, Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. Marcos Ribeiro, MD, is an Associate Professor, Department of Medicine, Universidade Estadual de Londrina, Londrina, Paraná, Brazil. Elena Gibson, MD, MPH, was a medical student at the University of Alabama at Birmingham at the time of the study, Birmingham, Alabama, USA. Barbara Hansen, PhD, is a Research Scientist, Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. Nadia Kienen, PhD, is an Associate Professor, Department of Psychology, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
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Pattern of Tobacco Smoking Among Egyptian Patients With Bipolar Disorder. ADDICTIVE DISORDERS & THEIR TREATMENT 2021. [DOI: 10.1097/adt.0000000000000248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Determining Optimal Cutoffs for Exhaled Carbon Monoxide and Salivary Cotinine to Identify Smokers among Korean Americans in a Smoking Cessation Clinical Trial. J Smok Cessat 2021; 2021:6678237. [PMID: 34306232 PMCID: PMC8279201 DOI: 10.1155/2021/6678237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 01/11/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction It is critical to accurately identify individuals who continue to smoke even after treatment, as this may prompt the use of more intensive and effective treatment strategies to help them attain complete abstinence. Aims This study examined optimal cutoffs for exhaled carbon monoxide (CO) and salivary cotinine to identify smokers among Korean Americans in a smoking cessation clinical trial. Methods CO and cotinine were measured three to four times over 12 months from the quit day. Statistical analysis was conducted using Receiver Operating Characteristic (ROC) curves. Results A CO cutoff of 5 parts per million provided robust sensitivity (80.8-98.3%) and perfect specificity (100%), and a salivary cotinine cutoff of level 2 (30-100 ng/ml) provided the best sensitivity (91.2-95.6%) and perfect specificity (100%). Using these cutoffs, the agreement between self-reports and the two biomarkers ranged from 88.6% to 97.7%. The areas under ROC curves (AUCs) of exhaled CO ranged from 0.90 to 0.99, all of which were significant (all p values < 0.001), and the AUCs of salivary cotinine ranged from 0.96 to 0.98 (all p values < 0.001). Conclusion Exhaled CO and salivary cotinine are complementary, and they should be used together to verify smoking abstinence for smokers in a clinical trial.
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Gárate KMS, Cotrim JDM, Brasil MAA, Castro GFBDA. Influence of Depression and Use of Alcohol and / or Tobacco by Parents in the Oral Health of Children with Disabilities. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Tindle HA, Freiberg MS, Gnatienko N, Blokhina E, Cheng DM, Yaroslavtseva T, Bendiks S, Winter M, Krupitsky E, Samet JH. Design of a randomized controlled trial of smoking cessation medications for alcohol reduction among HIV-positive heavy drinkers and daily smokers in St. Petersburg, Russia. Contemp Clin Trials Commun 2020; 19:100625. [PMID: 33659761 PMCID: PMC7889999 DOI: 10.1016/j.conctc.2020.100625] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 07/08/2020] [Accepted: 07/13/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND HIV, heavy drinking, and smoking are all pro-inflammatory and increase risk for coronary heart disease (CHD). Interventions that reduce alcohol use, smoking, or both in HIV-positive people could lower inflammation, CHD and death risk. Varenicline and cytisine are proven therapies for smoking cessation and may also reduce alcohol consumption. The comparative efficacy of varenicline and cytisine to reduce alcohol consumption has not been tested, nor has their comparative effectiveness been reported for smoking. OBJECTIVE This paper describes the protocol of the Studying Partial agonists for Ethanol and Tobacco Elimination in Russians with HIV (St PETER HIV), a four-arm parallel-group randomized controlled trial comparing effects of varenicline, cytisine, and nicotine replacement therapy (NRT). METHODS The study is recruiting four hundred HIV-positive heavy drinking smokers interested in cutting down on alcohol and/or tobacco in St. Petersburg, Russia. Participants are randomly assigned to receive either active varenicline + NRT placebo, varenicline placebo + active NRT, active cytisine + NRT placebo, cytisine placebo + active NRT. All participants receive evidence-based counseling for alcohol and tobacco use, one active medication, and one placebo. Outcomes are: 1) % heavy drinking days in the past month (primary study outcome at three months) and alcohol craving; 2) cigarettes per day (primary smoking outcome at 3 months) and 7-day point prevalence abstinence and; 3) inflammation, CHD risk, and mortality risk. CONCLUSION St PETER HIV addresses the paucity of randomized controlled trial data to guide treatment of alcohol consumption and smoking in HIV-positive heavy drinking smokers.
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Affiliation(s)
- Hilary A. Tindle
- Vanderbilt Center for Tobacco, Addiction and Lifestyle (ViTAL), Vanderbilt University Medical Center, Division of General Internal Medicine & Public Health and Vanderbilt Ingram Cancer Center, 2525 West End, Suite 450, Nashville, TN, 37203, United States
- Veterans Health Administration-Tennessee Valley Healthcare System Geriatric Research Education Clinical Center (GRECC), Nashville, TN, United States
| | - Matthew S. Freiberg
- Veterans Health Administration-Tennessee Valley Healthcare System Geriatric Research Education Clinical Center (GRECC), Nashville, TN, United States
- Vanderbilt Center for Clinical Cardiovascular Trials Evaluation (V-C3REATE), Vanderbilt University Medical Center, Division of Cardiovascular Medicine, 2525 West End, Suite 300-A, Nashville, TN, 37203, United States
| | - Natalia Gnatienko
- Department of Medicine, Section of General Internal Medicine, Boston Medical Center, Clinical Addiction Research and Education (CARE) Unit, 801 Massachusetts Avenue, 2nd Floor, Boston, MA, 02118, United States
| | - Elena Blokhina
- Pavlov University, Lev Tolstoy St. 6-8, St. Petersburg, 197022, Russian Federation
| | - Debbie M. Cheng
- Department of Biostatistics, Boston University School of Public Health, 801 Massachusetts Avenue, 3rd Floor, Boston, MA, 02118, United States
| | | | - Sally Bendiks
- Department of Medicine, Section of General Internal Medicine, Boston Medical Center, Clinical Addiction Research and Education (CARE) Unit, 801 Massachusetts Avenue, 2nd Floor, Boston, MA, 02118, United States
| | - Michael Winter
- Biostatistics and Epidemiology Data Analytics Center (BEDAC), Boston University School of Public Health, 85 East Newton Street, 9th Floor, Boston, MA 02118, United States Pasteur Research Institute of Epidemiology and Microbiology, Russian Federation, Mira St. 14, St. Petersburg, 197101, Russian Federation
| | - Evgeny Krupitsky
- Pavlov University, Lev Tolstoy St. 6-8, St. Petersburg, 197022, Russian Federation
- Bekhterev National Medical Research Center for Psychiatry and Neurology, Bekhtereva St., 3, St. Petersburg, 192019, Russian Federation
| | - Jeffrey H. Samet
- Department of Medicine, Section of General Internal Medicine, Boston University School of Medicine/Boston Medical Center, Clinical Addiction Research and Education (CARE) Unit, 801 Massachusetts Avenue, 2nd Floor, Boston, MA, 02118, United States
- Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, 2nd Floor, Boston, MA, 02118, United States
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Khobragade B, Sharma V, Deshpande SN. A study on tobacco use in women with major mental illnesses- schizophrenia, bipolar disorder and recurrent depression. Psychiatry Res 2020; 290:113121. [PMID: 32505927 DOI: 10.1016/j.psychres.2020.113121] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/21/2020] [Accepted: 05/22/2020] [Indexed: 11/29/2022]
Abstract
About 14.2% of women in the general Indian population and 4.8% in Delhi use tobacco but its use among women with Major Mental Illness (MMI) in developing countries has not been adequately studied. We assessed tobacco use in women with MMI in a tertiary care psychiatry outpatient department through a cross-sectional, observational study, with sample size of at least n= 77 each for schizophrenia-SZ, bipolar disorder-BD and Recurrent Depressive Disorder-RDD. Fagerstrom Test for Nicotine Dependence (FTND) both for smoke and smokeless tobacco were applied along with a subset of questions from Global Adult Tobacco Survey 2016. After diagnosis and referral by the treating psychiatrist and written informed consent, in our total sample of 321 women participants, lifetime use of tobacco was reported by 14.64%. Of all those who had ever used tobacco, 12.14% used it currently as well. As for diagnosis, those with BD (16.25%) used tobacco most frequently followed by SZ (14.18%) and RDD (6%). The FTND score was higher for schizophrenia indicating greater dependence. Tobacco use among women with MMI was thrice as common as women in general population of Delhi State, with smoke and smokeless tobacco use being equally prevalent, a grave cause for concern and intervention.
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Affiliation(s)
- Bhupendra Khobragade
- Dept. of Psychiatry, De-addiction Services & Resource Center for Tobacco Control, Centre of Excellence in Mental Health, ABVIMS Dr. Ram Manohar Lohia Hospital, Bangabandhu Sheikh Mujib Road, New Delhi, India 110001
| | - Vikas Sharma
- Dept. of Psychiatry, De-addiction Services & Resource Center for Tobacco Control, Centre of Excellence in Mental Health, ABVIMS Dr. Ram Manohar Lohia Hospital, Bangabandhu Sheikh Mujib Road, New Delhi, India 110001
| | - Smita N Deshpande
- Dept. of Psychiatry, De-addiction Services & Resource Center for Tobacco Control, Centre of Excellence in Mental Health, ABVIMS Dr. Ram Manohar Lohia Hospital, Bangabandhu Sheikh Mujib Road, New Delhi, India 110001.
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Trevisan IB, Vanderlei LCM, David RM, Santos CP, Ramos EMC, Ramos D. Influência de uma sessão de exercício aeróbico submáximo e máximo sobre o transporte mucociliar e função autonômica em tabagistas. FISIOTERAPIA E PESQUISA 2020. [DOI: 10.1590/1809-2950/20003627032020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO O objetivo do estudo foi avaliar e correlacionar o comportamento da depuração mucociliar e do sistema nervoso autônomo de fumantes após sessões de exercício aeróbico submáximo e máximo. Foram avaliados 25 fumantes e 15 não fumantes, entre 30 e 50 anos. Ambos os grupos foram submetidos ao teste do tempo de trânsito de sacarina (TTS) e variabilidade da frequência cardíaca (VFC) antes e após uma sessão de exercício submáximo (teste de caminhada de seis minutos) e máximo (teste de exercício cardiopulmonar). Teste t pareado ou Wilcoxon foi utilizado para análise intragrupos e o teste t não pareado ou Mann-Whitney para a análise intergrupos. A correlação foi realizada utilizando os coeficientes de Pearson ou Spearman (p <0,05). Houve redução significativa do TTS após exercícios submáximo e máximo em ambos os grupos. Após o exercício submáximo, ambos grupos apresentaram redução significativa do intervalo RR e aumento da FC em comparação ao repouso, no grupo de não fumantes houve reduções significativas nos índices RMSSD, HFms² e SD1. Após o exercício máximo, ambos grupos apresentaram reduções significativas no SDNN, RMSSD, intervalo RR, LF e HF, em ms² e un, SD1 e SD2, além do aumento da FC, LFun e da razão LF/HF. Houve correlação positiva entre TTS e LFms² (r = 0,520, p = 0,008) após o exercício máximo para o grupo de fumantes. Conclui-se que independentemente da intensidade do exercício aeróbio, houve um aumento na depuração mucociliar em fumantes, mas essa alteração parece ser influenciada pelo sistema nervoso autônomo apenas frente o exercício máximo.
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Affiliation(s)
| | | | | | | | | | - Dionei Ramos
- Universidade Estadual Paulista Júlio de Mesquita Filho, Brasil
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Gouveia TDS, Trevisan IB, Santos CP, Silva BSDA, Ramos EMC, Proença M, Ramos D. Smoking history: relationships with inflammatory markers, metabolic markers, body composition, muscle strength, and cardiopulmonary capacity in current smokers. ACTA ACUST UNITED AC 2020; 46:e20180353. [PMID: 32556029 PMCID: PMC7572273 DOI: 10.36416/1806-3756/e20180353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 10/09/2019] [Indexed: 12/02/2022]
Abstract
Objective: To determine the relationships that smoking history has with inflammatory markers, metabolic markers, body composition, muscle strength, and cardiopulmonary capacity in current smokers. Methods: This was a cross-sectional study involving 65 smokers (age range: 18-60 years). On three non-consecutive days, each participant was evaluated in terms of smoking history, pre-existing comorbidities, lung function (by spirometry), peripheral muscle strength (by dynamometry), body composition (by bioelectrical impedance analysis), levels of metabolic/inflammatory markers, and maximum cardiopulmonary capacity (by treadmill exercise test). We evaluated the relationships that smoking history has with inflammatory markers, metabolic markers, body composition, muscle strength, and cardiopulmonary capacity, using logarithmic transformation of the data and calculating Pearson’s correlation coefficient and for partial correlations adjusted for age, gender, body mass index (BMI), and comorbidities. To identify the influence of smoking history on pre-existing comorbidities, we used a logistic regression model adjusted for age, BMI, and duration of smoking. Results: Smoking history correlated significantly, albeit weakly, with triglyceride level (r = 0.317; p = 0.005), monocyte count (r = 0.308; p = 0.013), and waist circumference (r = 0.299; p = 0.017). However, those correlations did not retain their significance in the adjusted analysis. In the logistic regression model, smoking more than 20 cigarettes/day correlated significantly with the presence of metabolic diseases (OR = 0.31; 95% CI: 1.009-1.701; p = 0.043). Conclusions: In this sample of smokers, smoking history correlated positively with the triglyceride level, the monocyte count, and waist circumference. The prevalence of metabolic disease was highest in those who smoked more than 20 cigarettes/day.
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Affiliation(s)
| | | | | | | | | | - Mahara Proença
- . Universidade Estadual do Norte do Paraná, Jacarezinho (PR) Brasil
| | - Dionei Ramos
- . Universidade Estadual Paulista, Presidente Prudente (SP) Brasil
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Perceived Stress Mediates the Association between Deployment Sexual Trauma and Nicotine Dependence in Women Veterans. Womens Health Issues 2020; 30:214-220. [PMID: 32317136 DOI: 10.1016/j.whi.2020.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 03/11/2020] [Accepted: 03/12/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Rates of smoking and related health consequences are higher for women veterans as compared with their civilian counterparts, and trauma is a known risk factor associated with smoking. Military sexual trauma is prevalent among women veterans and associated with deleterious health outcomes, including tobacco use. However, research has not examined variables that may explain this association. The purpose of the present study was to examine the association between deployment sexual trauma (DST; military sexual trauma that occurs during deployment) and nicotine dependence, and whether perceived stress is a potential explanatory variable (i.e., mediator) in this relationship. METHODS Cross-sectional associations and Hayes mediation models were examined using baseline interview data from the Survey of Experiences of Returning Veterans sample (352 recently returned women veterans). RESULTS DST was associated with postdeployment nicotine dependence and greater perceived stress. Further, perceived stress was a significant mediator between DST and binary nicotine dependence (indirect effect [standard error] of DST on nicotine dependence through perceived stress, 0.04 [0.01]; 95% confidence interval, 0.01-0.07; odds ratio, 1.04; p < .01) when controlling for education. CONCLUSIONS Findings suggest that perceived stress may be a clinical target for decreasing nicotine dependence among women veterans who have experienced DST.
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Kelly ME, Guillot CR, Quinn EN, Lucke HR, Bello MS, Pang RD, Leventhal AM. Anxiety sensitivity in relation to cigarette smoking and other substance use in African American smokers. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2020; 34:669-679. [PMID: 32162964 DOI: 10.1037/adb0000573] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Anxiety sensitivity (AS)-fearfulness of anxiety symptoms-has been implicated in the etiology of emotional disorders (e.g., depressive and anxiety disorders) and linked to cigarette smoking and other substance use (SU). However, studies examining AS in relation to SU primarily have been conducted with racially/ethnically heterogeneous or mostly European American samples. Hence, this cross-sectional study involving secondary analysis of baseline data focused on investigating associations of AS with cigarette smoking and other SU in a sample of 630 non-treatment-seeking African American smokers (37.3% female; M age = 49.6 years; M cigarettes smoked per day = 15.4). After screening out individuals with non-nicotine substance dependence, participants reported their demographics, AS, dysphoria symptoms (i.e., depression and anxiety symptoms), and SU. In regression analyses controlling for dysphoria symptoms, age, education level, income level, and years of regular smoking, AS was positively associated with tobacco withdrawal severity (β = .12, p = .007), overall smoking motives (β = .17, p < .001), alcohol use problems (β = .12, p = .005), and other (non-nicotine, nonalcohol) SU problems (β = .16, p < .001). Though lacking the passage of time between assessments needed to provide strong evidence of mediation, unplanned analyses further revealed indirect associations of AS with several SU variables through dysphoria symptoms. Current findings are consistent with those found in prior samples and suggest that AS is similarly related to SU in African Americans, who may benefit from interventions that have been helpful in improving AS, dysphoria symptoms, and SU in other groups. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | | | | | | | - Mariel S Bello
- Department of Psychology, University of Southern California
| | - Raina D Pang
- Department of Preventive Medicine, University of Southern California Keck School of Medicine
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Ben Barnes J, Presseau C, Jordan AH, Kline NK, Young-McCaughan S, Keane TM, Peterson AL, Litz BT. Common Data Elements in the Assessment of Military-Related PTSD Research Applied in the Consortium to Alleviate PTSD. Mil Med 2020; 184:e218-e226. [PMID: 30252077 DOI: 10.1093/milmed/usy226] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 07/24/2018] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION Driven by the need to share data, sufficiently power studies, and allow for cross-study comparisons of medical and psychiatric diseases, the President's National Research Action Plan issued in 2013 called for the use of state-of-the-art common data elements (CDEs) for research studies. CDEs are variables measured across independent studies that facilitate methodologically sound data aggregation and study replication. Researchers in the field of military-related post-traumatic stress disorder (PTSD) have suggested applicable CDEs; however, to date, these recommendations have been conceptual and not field-tested. The Consortium to Alleviate PTSD (CAP) - an interdisciplinary and multi-institutional, military-related PTSD research consortium funded by the Departments of Defense and Veterans Affairs - generated and applied CDEs that can be used to combine data from disparate studies to improve the methodological and statistical capabilities of study findings. We provide a description and rationale for the CAP CDEs and details about administration with two main goals: (1) to encourage military-related PTSD researchers to use these measures in future studies and (2) to facilitate comparison, replication, and data aggregation. MATERIALS AND METHODS The CAP compiled mandated (core) and optional CDEs based on the following criteria: (1) construct applicability to military-related PTSD; (2) precedence (use) in prior, related research; (3) published and strong psychometric evidence; (4) no cost (public domain); and (5) brevity, to limit participant burden. We provided descriptive statistics and internal consistency reliabilities for mandated measures from an initial cohort of around 400 participants enrolled in CAP studies. RESULTS Mandated CDEs in the CAP were found to have very good internal consistency reliability. CONCLUSION Although further research is needed to determine the incremental validity of these CDEs, preliminary analyses indicated that each mandated measure has very good internal consistency reliability. Investigators designing military-related PTSD research should consider using these field-tested CDEs to facilitate future data aggregation. Feedback based on empirical evidence or practical concerns to improve these CDEs is welcome.
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Affiliation(s)
- J Ben Barnes
- Massachusetts Veterans Epidemiology Research and Information Center, MAVERIC, VA Boston Healthcare System, 150 S. Huntington Avenue, Boston, MA
| | - Candice Presseau
- Massachusetts Veterans Epidemiology Research and Information Center, MAVERIC, VA Boston Healthcare System, 150 S. Huntington Avenue, Boston, MA
| | - Alexander H Jordan
- Massachusetts Veterans Epidemiology Research and Information Center, MAVERIC, VA Boston Healthcare System, 150 S. Huntington Avenue, Boston, MA.,Department of Psychiatry, Boston University School of Medicine, 72 East Concord Street, Boston, MA
| | - Nora K Kline
- Massachusetts Veterans Epidemiology Research and Information Center, MAVERIC, VA Boston Healthcare System, 150 S. Huntington Avenue, Boston, MA
| | - Stacey Young-McCaughan
- Department of Psychiatry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX
| | - Terence M Keane
- Department of Psychiatry, Boston University School of Medicine, 72 East Concord Street, Boston, MA.,Behavioral Science Division, National Center for PTSD, VA Boston Healthcare System, 150 South Huntington Ave, Boston, MA
| | - Alan L Peterson
- Department of Psychiatry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX.,Research and Development Service, South Texas Veterans Health Care System, 7400 Merton Minter, San Antonio, TX.,Department of Psychology, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX
| | - Brett T Litz
- Massachusetts Veterans Epidemiology Research and Information Center, MAVERIC, VA Boston Healthcare System, 150 S. Huntington Avenue, Boston, MA.,Department of Psychiatry, Boston University School of Medicine, 72 East Concord Street, Boston, MA.,Department of Psychological and Brain Sciences, Boston University, 64 Cummington Mall, Boston, MA
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Gnatienko N, Lioznov D, Raj A, Blokhina E, Rosen S, Cheng DM, Lunze K, Bendiks S, Truong V, Bushara N, Toussova O, Quinn E, Krupitsky E, Samet JH. Design of a randomized controlled trial to Link Infectious and Narcology Care (LINC-II) in St. Petersburg, Russia. Addict Sci Clin Pract 2020; 15:1. [PMID: 31931884 PMCID: PMC6958793 DOI: 10.1186/s13722-020-0179-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 01/04/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND If Russia is to achieve the UNAIDS 90-90-90 HIV targets, better approaches to engage, effectively treat, and retain patients in care are needed. This paper describes the protocol of a randomized controlled trial (RCT) testing the effectiveness of LINC-II, a strength-based case management program for HIV-positive people who inject drugs (PWID) to increase rates of HIV viral suppression, ART initiation, and opioid abstinence. METHODS This RCT will enroll and randomize 240 participants, recruited from a narcology (addiction care) hospital in St. Petersburg, Russia. Participants are randomized to the intervention or control arms. Those in the intervention arm receive: (1) strengths-based HIV case management supporting coordinated care; (2) rapid ART initiation; and (3) pharmacotherapy for opioid use disorder. We will evaluate the intervention's effectiveness compared to standard of care on the following outcomes: (1) undetectable HIV viral load at 12 months (primary); (2) initiation of ART within 28 days of randomization; (3) change in CD4 count from baseline to 12 months; (4) retention in HIV care (i.e., ≥ 1 visit to medical care in 2 consecutive 6 month periods); (5) undetectable HIV viral load at 6 months; and (6) past 30-day opioid abstinence (at 6 and at 12 months). DISCUSSION This RCT will assess the LINC-II intervention in an urban Russian setting. If effective, it will offer a new approach for increasing the uptake of both HIV and opioid use disorder treatment and coordination of these modalities in standard Eastern European clinical settings. Trial registration This study was registered with ClinicalTrials.gov through the National Institutes of Health, NCT03290391. Registered 19 September 2017, https://clinicaltrials.gov/ct2/show/NCT03290391.
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Affiliation(s)
- Natalia Gnatienko
- Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118 USA
| | - Dmitry Lioznov
- Pavlov University, L’va Tolstogo St. 6-8, St. Petersburg, 197022 Russian Federation
- Research Institute of Influenza, 15/17, Prof. Popov Street, St. Petersburg, 197376 Russian Federation
| | - Anita Raj
- Center On Gender Equity and Health, Department of Medicine, University of California San Diego, La Jolla, CA 92093 USA
- Department of Education Studies, Division of Social Sciences, University of California San Diego, La Jolla, CA 92093 USA
| | - Elena Blokhina
- Pavlov University, L’va Tolstogo St. 6-8, St. Petersburg, 197022 Russian Federation
| | - Sydney Rosen
- Department of Global Health, Boston University School of Public Health, 801 Massachusetts Avenue, 3rd Floor, Boston, MA 02118 USA
- Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Debbie M. Cheng
- Department of Biostatistics, Boston University School of Public Health, 801 Massachusetts Avenue, 3rd Floor, Boston, MA 02118 USA
| | - Karsten Lunze
- Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine/Boston Medical Center, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118 USA
| | - Sally Bendiks
- Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118 USA
| | - Ve Truong
- Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118 USA
| | - Natalia Bushara
- Pavlov University, L’va Tolstogo St. 6-8, St. Petersburg, 197022 Russian Federation
| | - Olga Toussova
- Pavlov University, L’va Tolstogo St. 6-8, St. Petersburg, 197022 Russian Federation
| | - Emily Quinn
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, 85 East Newton Street, M921, Boston, MA 02118 USA
| | - Evgeny Krupitsky
- Pavlov University, L’va Tolstogo St. 6-8, St. Petersburg, 197022 Russian Federation
- St. Petersburg Bekhterev Research Psychoneurological Institute, Bekhtereva St., 3, St. Petersburg, 192019 Russian Federation
| | - Jeffrey H. Samet
- Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine/Boston Medical Center, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118 USA
- Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118 USA
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Paraskevopoulou M, van Rooij D, Schene AH, Scheres AP, Buitelaar JK, Schellekens AFA. Effects of Substance Misuse and Family History of Substance Use Disorder on Delay Discounting in Adolescents and Young Adults with Attention-Deficit/Hyperactivity Disorder. Eur Addict Res 2020; 26:295-305. [PMID: 32659779 PMCID: PMC7513619 DOI: 10.1159/000509147] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 05/20/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) and substance use disorder (SUD) often co-occur. Both disorders are characterized by impulsive choice. However, little is known about the effects of substance misuse (SM) and family history of SUD (FH) on impulsive choice in ADHD-SUD comorbidity. Impulsive choice is also linked to callous-unemotional (CU) traits, which are suggested to play a role in ADHD-SUD comorbidity. Our aim was to examine the effects of (1) FH and (2) SM on impulsive choice, while exploring the role of CU traits. METHODS Impulsive choice was assessed with the delay discounting (DD) task. We compared task performance across (1) ADHD patients and controls with or without FH of SUD (ADHD FH+: n = 86; ADHD FH-: n = 63; control FH+: n = 49; control FH-: n = 72; mean age of the whole sample [n = 270]: 16.39, SD: 3.43) and (2) family history-matched ADHD groups with and without SM and controls (ADHD + SM: n = 62; ADHD-only: n = 62; controls: n = 62; mean age of the whole sample [n = 186]: 18.01, SD: 2.71). Effects of CU traits were explored by adding this as a covariate in all analyses. RESULTS (1) There was no main effect of FH on DD. (2) We found increased DD in ADHD + SM compared to ADHD-only and no difference between ADHD-only and controls. Finally, increased DD was associated with increased callous traits only in ADHD FH+ and control FH+. CONCLUSIONS In adolescents and young adults with ADHD, high impulsive choice might only be present in those with comorbid SM and in an FH+ subgroup with high callous traits. This suggests that impulsive choice in ADHD might result from (1) effects of SM and (2) a combined effect of SUD vulnerability and high callousness. Future studies should investigate efficacy of early interventions, targeting CU traits.
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Affiliation(s)
- Maria Paraskevopoulou
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands,Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands,*Maria Paraskevopoulou, Departments of Psychiatry & Cognitive Neuroscience, Radboud University Medical Center & Donders Institute for Brain, Cognition and Behaviour, Kapittelweg 29, NL–6525 Nijmegen (The Netherlands),
| | - Daan van Rooij
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Aart H. Schene
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands,Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Anouk P.J. Scheres
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Jan K. Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands,Karakter Child and Adolescent Psychiatry, Nijmegen, The Netherlands
| | - Arnt F. A. Schellekens
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands,Nijmegen Institute for Scientist Practitioners in Addiction, Nijmegen, The Netherlands
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Olando Y, Kuria M, Mathai M, Huffman MD. Efficacy of a group tobacco cessation behavioral intervention among tobacco users with concomitant mental illness in Kenya: protocol for a controlled clinical trial. BMC Public Health 2019; 19:1700. [PMID: 31852536 PMCID: PMC6921564 DOI: 10.1186/s12889-019-8040-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 12/04/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The rate of tobacco use among people with mental illness is nearly twice that of the general population. Psychotropic medications for tobacco cessation are relatively expensive for most Kenyans. Behavioral counseling and group therapy are effective lower cost strategies to promote tobacco cessation, yet have not been studied in Kenya among individuals with concomitant mental illness. METHODS/DESIGN One hundred tobacco users with mental illness who were part of an outpatient mental health program in Nairobi, Kenya were recruited and allocated into intervention and control groups of the study (50 users in intervention group and 50 users in control group). Participants allocated to the intervention group were invited to participate in 1 of 5 tobacco cessation groups. The intervention group received the 5As (Ask, Advise, Assess, Assist and Arrange) and tobacco cessation group behavioral intervention, which included strategies to manage cravings and withdrawal, stress and anxiety, and coping with depression due to withdrawal; assertiveness training and anger management; reasons to quit, benefits of quitting and different ways of quitting. Individuals allocated to the control group received usual care. The primary outcome was tobacco cessation at 24 weeks, measured through cotinine strips. Secondary outcomes included number of quit attempts and health-related quality of life. DISCUSSION This study will provide evidence to evaluate the efficacy and safety of a tobacco cessation group behavioral intervention among individuals with mental illness in Kenya, and to inform national and regional practice and policy. TRIAL REGISTRATION Trial registration number: NCT04013724. Name of registry: ClinicalTrials.gov. URL of registry: https://register.clinicaltrials.gov Date of registration: 9 July 2019 (retrospectively registered). Date of enrolment of the first participant to the trial: 5th September 2017. Protocol version: 2.0.
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Affiliation(s)
| | | | | | - Mark D Huffman
- Northwestern University Feinberg School of Medicine, Chicago, USA.,The George Institute for Global Health, UNSW, Sydney, Australia
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Cochran G, Smid MC, Krans EE, Bryan MA, Gordon AJ, Lundahl B, Silipigni J, Haaland B, Tarter R. A pilot multisite study of patient navigation for pregnant women with opioid use disorder. Contemp Clin Trials 2019; 87:105888. [PMID: 31731006 PMCID: PMC7201898 DOI: 10.1016/j.cct.2019.105888] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 11/06/2019] [Accepted: 11/09/2019] [Indexed: 11/17/2022]
Abstract
The opioid crisis continues to affect pregnant and postpartum women the United States, with the number of pregnant women diagnosed with opioid use disorder (OUD) quadrupling over the last decade. The associated increase in morbidity and mortality among mother and baby warrants prompt, targeted intervention efforts that improve engagement, linkage of care, and treatment retention. Patient navigation (PN) is a chronic care intervention that can directly address this need by helping women identify medical, behavioral, and psychosocial care goals. Moreover, PN can assist women in preparing for, engaging in, and maintaining patient participation in necessary services. Specifically, PN includes strengths-based case management, 1-1 clinical support, motivational interviewing, and addiction-relapse prevention programming. The objective of this article is to present the study protocol of a pilot multisite randomized clinical trial, entitled: Optimizing Pregnancy and Treatment Interventions for Moms 2.0 (OPTI-Mom 2.0; NCT03833245). In this study, we build upon a proof-of-concept study, employing evidence-informed frameworks for protocol and intervention expansion in order to construct a PN intervention tailored for pregnant women with OUD in central Utah and southwestern Pennsylvania. Our protocol provides an initial framework of a potentially impactful intervention and may guide development of future programs. Importantly, this study further establishes the evidence-base-with potential to ameliorate serious adverse opioid-related outcomes and improve health for women and their children.
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Affiliation(s)
- Gerald Cochran
- Program for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States; Informatics, Decision-Enhancement, and Analytic Sciences Center, VA Salt Lake City Health Care System, Salt Lake City, UT, United States.
| | - Marcela C Smid
- Department of Maternal Fetal Medicine, University of Utah School of Medicine, 30 N 1900 E, Salt Lake City, UT, United States
| | - Elizabeth E Krans
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Magee-Womens Research Institute, 300 Halket Street, Pittsburgh, PA, United States
| | - M Aryana Bryan
- Program for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States; University of Utah College of Social Work, 395 S 1500 E #111, Salt Lake City, UT, United States
| | - Adam J Gordon
- Program for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States; Informatics, Decision-Enhancement, and Analytic Sciences Center, VA Salt Lake City Health Care System, Salt Lake City, UT, United States
| | - Brad Lundahl
- University of Utah College of Social Work, 395 S 1500 E #111, Salt Lake City, UT, United States
| | - John Silipigni
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Magee-Womens Research Institute, 300 Halket Street, Pittsburgh, PA, United States
| | - Benjamin Haaland
- Department of Population Health Sciences, University of Utah School of Medicine 30 N 1900 E, Salt Lake City, UT, United States
| | - Ralph Tarter
- University of Pittsburgh School of Pharmacy, 3501 Terrace St, Pittsburgh, PA, United States
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Mushtaq N, Huque R, Beebe LA, Shah S, Siddiqi K. Evaluation of tobacco dependence measures in South Asian smokeless tobacco users. Drug Alcohol Depend 2019; 203:66-71. [PMID: 31404851 DOI: 10.1016/j.drugalcdep.2019.05.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 05/12/2019] [Accepted: 05/14/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Despite the high prevalence of smokeless tobacco (ST) use in South Asia, ST dependence in this population has not been studied. Therefore, it is of interest to explore if ST dependence measures developed and validated in the western countries are of similar relevance to ST users who are culturally different and use distinct ST products. The aim of this study is to assess ST dependence among its users in Bangladesh by employing ST dependence scales based on three different approaches to measure tobacco dependence. METHODS Data collected from a community-based sample of exclusive ST users living in Dhaka, Bangladesh (n = 200) were used for this study. Three ST dependence measures, Tobacco Dependence Screener (TDS), Fagerström Test for Nicotine Dependence for ST users (FTND-ST), and Oklahoma Scale for Smokeless Tobacco Dependence (OSSTD), were translated in Bangla and administered to the study participants. Saliva samples were collected for cotinine measurement. Reliability and concurrent and construct validity of FTND-ST and OSSTD were examined. RESULTS Median cotinine concentration of the study participants was 440.2 (min = 2.9, max = 1874) ng/ml and 47% of them had TDS-based dependence diagnosis. Women had higher mean OSSTD, FTND-ST, and TDS scores as compared to men (p < 0.001). OSSTD demonstrated better reliability (α = 0.93) than FTND-ST, and TDS (α = 0.64 and 0.86, respectively). Concurrent validity of FTND-ST as evaluated by TDS, OSSTD, and cotinine concentration was affirmative. CONCLUSION The FTND-ST is a valid and reliable tool to measure physical dependence among ST users in Bangladesh. The study was unable to replicate the structure of OSSTD.
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Affiliation(s)
- Nasir Mushtaq
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, 4502 East 41st Street, SAC 1G06, Tulsa, OK 74135, United States.
| | - Rumana Huque
- Department of Economics, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Laura A Beebe
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, United States
| | - Sarwat Shah
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, United Kingdom
| | - Kamran Siddiqi
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, United Kingdom
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Ruglass LM, Root JC, Dambreville N, Shevorykin A, Haque N, Sun V, Sheffer CE, Melara RD. Smoking policies in the home have less influence on cigarettes per day and nicotine dependence level among African American than White smokers: A cross-sectional analysis. J Natl Med Assoc 2019; 111:606-615. [PMID: 31375277 DOI: 10.1016/j.jnma.2019.07.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 04/30/2019] [Accepted: 07/09/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND African American smokers suffer disproportionately from tobacco-related disease caused, in part, by lower rates of smoking cessation. We examined whether smoke-free home policies and delay discounting were differentially associated with cigarettes smoked per day (CPD) and nicotine dependence (ND) among African Americans and Whites. METHODS Secondary data analysis was conducted using data from 65 African American (n = 40) and White (n = 25) smokers who completed measures of CPD, ND, tobacco craving, stress, depression, home smoking policy, and delay discounting. RESULTS A significant interaction was found between race and home smoking policy on CPD (B = -11.21, p = 0.002) and ND (B = -3.42, p = 0.004). Smoke-free policies in the home were associated with fewer CPD and lower ND levels among Whites, but not among African Americans. Whites who allowed smoking in their homes had significantly greater mean CPD and higher mean ND than their counterparts who did not allow smoking in the home. Among African American smokers, there were no differences in CPD and ND among those who allowed smoking in their home versus those who did not. CONCLUSIONS The findings extend the scientific literature by suggesting that a malleable environmental factor (home smoking policy) commonly associated with cessation among Whites does not have the same influence on cessation among African American.
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Affiliation(s)
- Lesia M Ruglass
- Department of Psychology, The City College of New York, CUNY, USA.
| | - James C Root
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, USA
| | - Naomi Dambreville
- Department of Psychology, The City College of New York and the Graduate Center, CUNY, USA
| | - Alina Shevorykin
- Department of Psychology and Mental Health Counseling, Pace University, USA
| | - Noshin Haque
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, USA
| | - Vicki Sun
- Sophie Davis School of Biomedical Education, CUNY School of Medicine, USA
| | | | - Robert D Melara
- Department of Psychology, The City College of New York, CUNY, USA
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Is There an Association Between the Degree of Nicotine Dependence and the Motivation to Stop Smoking? Arch Bronconeumol 2018; 55:139-145. [PMID: 30316531 DOI: 10.1016/j.arbres.2018.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 07/27/2018] [Accepted: 08/20/2018] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To evaluate the association between degrees of nicotine dependence measured by the Fagerström test (FTCD) and different tests of motivation to stop smoking. MATERIAL AND METHODS Observational study, multicenter conducted in smoking clinics in daily clinical practice. Demographics, smoking status, FTCD scores, and motivation test results were collected: Richmond test (TR), Henri Mondor Paris motivation test (HMP), Khimji-Watts test (KW), and the visual analog scale of motivation to stop smoking. The statistical analysis was descriptive, and correlation and analysis tests and regression models were used. RESULTS A total of 314 subjects were included [162 women (51.59%)]. Males smoked an average of 3.3 cigarettes/day more than women (95% CI: 0.9-5.6 cigarettes/day, p=0.006) and their cumulative consumption was 7.8 pack-years higher than in women (95% CI: 2.1 to 13.5 pack-years). We found no association between FTCD and the motivation tests to stop smoking used in this study. CONCLUSIONS We found no association between the degree of dependence and the motivation to quit smoking measured by the aforementioned instruments.
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Gnatienko N, Freiberg MS, Blokhina E, Yaroslavtseva T, Bridden C, Cheng DM, Chaisson CE, Lioznov D, Bendiks S, Koerbel G, Coleman SM, Krupitsky E, Samet JH. Design of a randomized controlled trial of zinc supplementation to improve markers of mortality and HIV disease progression in HIV-positive drinkers in St. Petersburg, Russia. HIV CLINICAL TRIALS 2018; 19:101-111. [PMID: 29663871 DOI: 10.1080/15284336.2018.1459344] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background Russia continues to have an uncontrolled HIV epidemic and its per capita alcohol consumption is among the highest in the world. Alcohol use among HIV-positive individuals is common and is associated with worse clinical outcomes. Alcohol use and HIV each lead to microbial translocation, which in turn results in inflammation. Zinc supplementation holds potential for lowering levels of biomarkers of inflammation, possibly as a consequence of its impact on intestinal permeability. This paper describes the protocol of a double-blinded randomized placebo-controlled trial of zinc supplementation in St. Petersburg, Russia. Methods Participants (n = 254) were recruited between October 2013 and June 2015 from HIV and addiction clinical care sites, and non-clinical sites in St. Petersburg, Russia. Participants were randomly assigned, to receive either zinc (15 mg for men; 12 mg for women) or placebo, daily for 18 months. The following outcomes were assessed at 6, 12, and 18 months: (1) mortality risk (primary outcome at 18 months); (2) HIV disease progression; (3) cardiovascular risk; and (4) microbial translocation and inflammation. Adherence was assessed using direct (riboflavin) and indirect (pill count, self-report) measures. Conclusion Given the limited effectiveness of current interventions to reduce alcohol use, zinc supplementation merits testing as a simple, low-cost intervention to mitigate the consequences of alcohol use in HIV-positive persons despite ongoing drinking.
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Affiliation(s)
- Natalia Gnatienko
- a Department of Medicine, Section of General Internal Medicine , Boston Medical Center, Clinical Addiction Research and Education (CARE) Unit , Boston , MA , USA
| | - Matthew S Freiberg
- b Vanderbilt Center for Clinical Cardiovascular Trials Evaluation (V-C3REATE) , Vanderbilt University Medical Center , Nashville , TN , USA
| | - Elena Blokhina
- c First Pavlov State Medical University of St. Petersburg , St. Petersburg , Russian Federation
| | - Tatiana Yaroslavtseva
- c First Pavlov State Medical University of St. Petersburg , St. Petersburg , Russian Federation
| | - Carly Bridden
- a Department of Medicine, Section of General Internal Medicine , Boston Medical Center, Clinical Addiction Research and Education (CARE) Unit , Boston , MA , USA
| | - Debbie M Cheng
- d Department of Biostatistics , Boston University School of Public Health , Boston , MA , USA
| | - Christine E Chaisson
- e Data Coordinating Center , Boston University School of Public Health , Boston , MA , USA
| | - Dmitry Lioznov
- c First Pavlov State Medical University of St. Petersburg , St. Petersburg , Russian Federation.,f Research Institute of Influenza , St. Petersburg , Russian Federation
| | - Sally Bendiks
- a Department of Medicine, Section of General Internal Medicine , Boston Medical Center, Clinical Addiction Research and Education (CARE) Unit , Boston , MA , USA
| | - Glory Koerbel
- g Department of Medicine, Division of General Internal Medicine , University of Pittsburgh , Pittsburgh , PA , USA
| | - Sharon M Coleman
- e Data Coordinating Center , Boston University School of Public Health , Boston , MA , USA
| | - Evgeny Krupitsky
- c First Pavlov State Medical University of St. Petersburg , St. Petersburg , Russian Federation.,h St. Petersburg Bekhterev Research Psychoneurological Institute , St. Petersburg , Russian Federation
| | - Jeffrey H Samet
- i Department of Medicine, Section of General Internal Medicine, School of Medicine/Boston Medical Center, Clinical Addiction Research and Education (CARE) Unit , Boston University , Boston , MA , USA.,j Department of Community Health Sciences , Boston University School of Public Health , Boston , MA , USA
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Mushtaq N, Beebe LA. Psychometric Properties of Fagerström Test for Nicotine Dependence for Smokeless Tobacco Users (FTND-ST). Nicotine Tob Res 2018; 19:1095-1101. [PMID: 28387864 DOI: 10.1093/ntr/ntx076] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 04/03/2017] [Indexed: 11/12/2022]
Abstract
Introduction Fagerström Test for Nicotine Dependence (FTND) is the most commonly used measure of dependence among tobacco users. Psychometric properties of FTND have been validated among cigarette smokers, but the reliability and validity of its variant for smokeless tobacco (ST) users (FTND-ST) is not well documented. The objective of the present study is to evaluate reliability, construct validity, and structure model of FTND-ST. Methods Data from 95 exclusive ST users living in Oklahoma were used for this study. Participants completed a self-administered mail survey including FTND-ST and other questionnaires. Measures of internal consistency, Cronbach's coefficient α and item-total correlation were estimated to evaluate reliability of the FTND-ST. To ascertain the factor structure of the scale, confirmatory factor analysis was performed. We examined concurrent and construct validity with correlation and regression analysis. Salivary cotinine concentration was used as a criterion variable. Results The FTND-ST demonstrated good reliability with acceptable Cronbach's coefficient (α = 0.72) and significant item-total correlations. Study findings showed that FTND-ST had positive significant association with salivary cotinine concentration (r = 0.61, p <.0001) and Tobacco Dependence Screener (r = 0.44, p < .0001). Results of factor analysis support a unidimensional factor structure of FTND-ST. Conclusions The FTND-ST demonstrated good psychometric properties. The unidimensional structure of the scale indicates that it measures single clearly defined aspect of dependence, physical dependence. Given its good reliability and demonstrated construct validity, FTND-ST is a useful measure of dependence among ST users. Implications Because of the paucity of ST dependence research, there are limited studies evaluating ST dependence measures. Although the FTND was exclusively developed for cigarette smoking, it has been adapted for ST users in the form of FTND-ST. This is the first study to examine reliability, concurrent and construct validity, and structure model of FTND-ST among regular ST users. Findings suggest that the FTND-ST measures physical aspect of dependence. Good psychometric properties of FTND-ST and its orientation as a continuous scale indicate that FTND-ST is a useful measure of dependence among ST users.
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Affiliation(s)
- Nasir Mushtaq
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Tulsa, OK
| | - Laura A Beebe
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK
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Lasser KE, Lunze K, Cheng DM, Blokhina E, Walley AY, Tindle HA, Quinn E, Gnatienko N, Krupitsky E, Samet JH. Depression and smoking characteristics among HIV-positive smokers in Russia: A cross-sectional study. PLoS One 2018; 13:e0189207. [PMID: 29408935 PMCID: PMC5800551 DOI: 10.1371/journal.pone.0189207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 11/21/2017] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Globally, persons with HIV infection, depression and substance use disorders have a higher smoking prevalence and smoke more heavily than other populations. These associations have not been explored among Russian smokers with HIV infection and substance use disorders. The purpose of this study was to examine the relationship between the presence of depressive symptoms and smoking outcomes in an HIV-positive cohort of Russian smokers with a history of substance use disorders (alcohol and/or drug use disorders). METHODS We performed a cross-sectional secondary data analysis of a cohort of HIV-positive regular smokers with a history of substance use disorders recruited in St. Petersburg, Russia in 2012-2015. The primary outcome was heavy smoking, defined as smoking > 20 cigarettes per day. Nicotine dependence (moderate-very high) was a secondary outcome. The main independent variable was a high level of depressive symptoms in the past 7 days (defined as CES-D > = 24). We used multivariable logistic regression to examine associations between depressive symptoms and the outcomes, controlling for age, sex, education, income, running out of money for housing/food, injection drug use, and alcohol use measured by the AUDIT. RESULTS Among 309 regular smokers, 79 participants (25.6%) had high levels of depressive symptoms, and 65 participants (21.0%) were heavy smokers. High levels of depressive symptoms were not significantly associated with heavy smoking (adjusted odds ratio [aOR] 1.50, 95% CI 0.78-2.89) or with moderate-very high levels of nicotine dependence (aOR 1.35, 95% CI 0.75-2.41). CONCLUSIONS This study did not detect an association between depressive symptoms and smoking outcomes among HIV-positive regular smokers in Russia.
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Affiliation(s)
- Karen E. Lasser
- Department of Medicine, Section of General Internal Medicine, Boston University Schools of Medicine and Public Health/Boston Medical Center, Boston, Massachusetts, United States of America
| | - Karsten Lunze
- Department of Medicine, Section of General Internal Medicine, Clinical Addiction Research and Education Unit, Boston University School of Medicine/Boston Medical Center, Boston, Massachusetts, United States of America
| | - Debbie M. Cheng
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Elena Blokhina
- First St. Petersburg Pavlov State Medical University, St. Petersburg, Russian Federation
| | - Alexander Y. Walley
- Department of Medicine, Section of General Internal Medicine, Clinical Addiction Research and Education Unit, Boston University School of Medicine/Boston Medical Center, Boston, Massachusetts, United States of America
| | - Hilary A. Tindle
- The Vanderbilt Center for Tobacco, Addiction, and Lifestyle, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Emily Quinn
- Data Coordinating Center, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Natalia Gnatienko
- Department of Medicine, Section of General Internal Medicine, Clinical Addiction and Research Education Unit, Boston Medical Center, Boston, Massachusetts, United States of America
| | - Evgeny Krupitsky
- First St. Petersburg Pavlov State Medical University, St. Petersburg, Russian Federation
- St. Petersburg Bekhterev Research Psychoneurological Institute, St. Petersburg, Russian Federation
| | - Jeffrey H. Samet
- Department of Medicine, Section of General Internal Medicine, Clinical Addiction Research and Education Unit, Boston University School of Medicine/Boston Medical Center, Boston, Massachusetts, United States of America
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts, United States of America
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Wang HR, Cho H, Kim DJ. Prevalence and correlates of comorbid depression in a nonclinical online sample with DSM-5 internet gaming disorder. J Affect Disord 2018; 226:1-5. [PMID: 28938229 DOI: 10.1016/j.jad.2017.08.005] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 07/10/2017] [Accepted: 08/09/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND We investigated the prevalence and correlates of comorbid depression among patients with internet gaming disorder using the Internet Gaming Disorder scale (IGD-9) and the Patient Health Questionnaire-9 (PHQ-9) among nonclinical online survey respondents. METHODS Korean adolescents and adults from 14 to 39 years of age were selected. We compared internet gaming use patterns and sociodemographic and clinical variables between patients with internet gaming disorder who had depression and those without depression. RESULTS In 2016, 7200 people participated in an online survey. Respondents with internet gaming disorder that was comorbid with depression were older, more often female, had greater Internet Addiction Test total scores, Alcohol Use Disorder Identification Test total scores, Generalized Anxiety Disorder Scale-7 total scores, Fagerstrom Test for Nicotine Dependence total scores, and higher Dickman Dysfunctional Impulsivity Instrument dysfunctional subscale scores than those without depression. The binary logistic regression analysis revealed that female gender, problematic alcohol use, anxiety, and a past history of psychiatric counseling or treatment due to internet gaming use were significant predictors for comorbid depression among participants with internet gaming disorder. CONCLUSION Depression was a common comorbidity of internet gaming disorder. Internet gaming disorder with comorbid depression was related to more serious psychiatric phenomenology and a greater psychiatric burden.
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Affiliation(s)
- Hee Ryung Wang
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyun Cho
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dai-Jin Kim
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Kulkarni PS, Parkar SR, Kate N, Ninawe K, Limbachiya R. Role of personality in tobacco smoking behavior in corporate sector: A cross-sectional study. Ind Psychiatry J 2018; 27:103-109. [PMID: 30416300 PMCID: PMC6198598 DOI: 10.4103/ipj.ipj_46_16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND India's corporate sector has grown steadily over the past decade, and it is providing a lot of work opportunities to Indian youth. Around 20% of employees in the corporate sector in India smoke cigarettes. In general, addictive behaviors including smoking are associated with certain personality dimensions. Hence, we conducted a study with the aims to assess the level of nicotine dependence in tobacco smokers (working in corporate sector), study their personality profile, and association of their personality traits with continuing smoking behavior. MATERIALS AND METHODS The study proposal along with its intended aims and objectives was cleared by the Institutional Ethical Review Board. It was a cross-sectional study. We used FTND for level of nicotine dependence and NEO FFI 3 for personality profile along with a structured proforma. RESULTS Most of the clients were of very low to low level of nicotine dependence. As high as 40% of the clients did not even attempt to quit smoking, most common reason for attempt at quitting was health concerns. Major causes of relapse were friends, people at workplace, and nature of work. Clients were high on neuroticism, average on extraversion and openness, and low on agreeableness and conscientiousness. Neuroticism was significantly associated with the level of nicotine dependence. Extraversion and openness were associated with health concerns, while agreeableness and conscientiousness were associated with social factors as a reason to quit. Extraversion and agreeableness were associated with occupational factors and social factors as reasons to relapse. CONCLUSION Understanding one's personality would be helpful to identify health-enhancing (which help to attempt at quitting) and health-destructive (which were responsible for relapse) behaviors. This can further help in framing interventions that particularly target these personality traits and behaviors.
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Affiliation(s)
| | - Shubhangi R Parkar
- Department of Psychiatry, Seth GSMC and KEMH, Mumbai, Maharashtra, India
| | - Natasha Kate
- Department of Psychiatry, Seth GSMC and KEMH, Mumbai, Maharashtra, India
| | - Kaneenica Ninawe
- Department of Psychiatry, Seth GSMC and KEMH, Mumbai, Maharashtra, India
| | - Rimple Limbachiya
- Department of Psychiatry, Seth GSMC and KEMH, Mumbai, Maharashtra, India
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Diehl A, Pillon SC, Santos MAD, Laranjeira R. Abortion and sex-related conditions in substance-dependent Brazilian patients. CAD SAUDE PUBLICA 2017; 33:e00143416. [PMID: 29166482 DOI: 10.1590/0102-311x00143416] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 02/06/2017] [Indexed: 01/27/2023] Open
Abstract
Abortion is a very sensitive issue with relevance to public health; however few clinical or population-based studies have examined induced abortion among drug users. The study aims to evaluate the prevalence of induced abortion and sex-related conditions in an inpatient drug user sample. A cross-sectional design study was conducted in an inpatient addiction treatment unit in São Paulo, Brazil, with a sample of 616 patients, aged 18-75. Sociodemographic data, sexual behavior, and dependence severity were evaluated in relation to induced abortion. Approximately 27% of patients reported having a history of abortion (themselves in the case of women or partners in the case of men). The mean age was 34.6±10.9 years old, 34.9% diagnosed with severe alcohol dependence, 33% were diagnosed with severe levels of dependence on other drugs, 69.6% were diagnosed cocaine users (inhaled and smoked), and alcohol was the drug of choice for 30.4%. Chances of having a history of abortion is greater for women than for men with a odds ratio (OR = 2.9; 95%CI: 1.75-4.76), (OR = 1.7; 95%CI: 1.09-2.75) of no condom use; (OR = 2.0; 95%CI: 1.35-3.23) of history of STI and (OR = 3.2; 95%CI: 1.29-5.73) use of morning-after pill. Drug- and alcohol-dependent patients have high-risk behaviours of sporadic use or no-condom use which contribute to unplanned pregnancy and induced abortion, making this vulnerable population a group which deserves special attention in sexual health prevention programmes and health promotion efforts for the reduction of induced abortion.
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Affiliation(s)
- Alessandra Diehl
- Unidade de Pesquisa em Álcool e Drogas, Universidade Federal de São Paulo, São Paulo, Brasil
| | - Sandra Cristina Pillon
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | - Manoel Antonio Dos Santos
- Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brasil
| | - Ronaldo Laranjeira
- Unidade de Pesquisa em Álcool e Drogas, Universidade Federal de São Paulo, São Paulo, Brasil
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