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Meeuwsen EG, de Kleijn MJJ, de Boer EM, Koçak AF, Chavannes NH, Meijer E. "Boy, what are we all doing? We are crazy, really crazy": a qualitative study of psychosocial processes around an atypical one-time smoking cessation course. BMC Psychol 2023; 11:405. [PMID: 37986099 PMCID: PMC10662623 DOI: 10.1186/s40359-023-01448-0] [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: 06/06/2023] [Accepted: 11/14/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Smoking prevalence is still high, which requires effective interventions that help many people who smoke at once in addition to time-consuming individual interventions. 'I Quit' is a large-scale smoking cessation course in The Netherlands. This qualitative study explored I Quit participants' experiences during and after the course, and perceptions of whether and how the course may have altered their smoking behavior. METHODS We performed individual semi-structured interviews with course participants (N = 21) who had either quit successfully, attempted to quit but relapsed, or had continued to smoke after 'I Quit'. Shortly after qualitative data collection was completed, Foundation I Quit was accused in the media of a number of misbehaviors. Although unplanned, this provided a unique opportunity to explore participants' views on alleged fraud in a second round of interviews (N = 16). Data were collected from 2016 to 2018. RESULTS Qualitative findings showed two psychosocial processes that may explain smoking cessation after course attendance. First, the confrontation with a large group of people who smoke, of whom some had already developed smoking-related complaints, triggered identity processes both towards and away from quitting smoking. Unorthodox methods used in the course appeared to trigger identity processes. Second, social support after the course from participants' own social network facilitated maintenance of successful quitting. The study also found that interview participants' opinions on I Quit did not change much after allegations of fraud in the media. CONCLUSIONS Findings suggest that a one-time course might initiate psychosocial processes that could help certain smokers to gain motivation to quit, requiring a minimum of resources. Identity processes triggered by the course seem tricky as people have different ways of dealing with identity threat, some of which can be counterproductive and even result in more difficulty quitting. More research is needed to examine who can benefit from a one-time course, and who needs more support in order to quit successfully.
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Affiliation(s)
- E G Meeuwsen
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, Postzone V0-P, PO Box 9600, Leiden, RC, 2300, The Netherlands
| | - M J J de Kleijn
- Independent 'Health for all' consultancy PinK-FOX, Tienhoven, The Netherlands
| | - E M de Boer
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, Postzone V0-P, PO Box 9600, Leiden, RC, 2300, The Netherlands
| | - A F Koçak
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, Postzone V0-P, PO Box 9600, Leiden, RC, 2300, The Netherlands
| | - N H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, Postzone V0-P, PO Box 9600, Leiden, RC, 2300, The Netherlands
- National eHealth Living Lab, Leiden, The Netherlands
| | - E Meijer
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, Postzone V0-P, PO Box 9600, Leiden, RC, 2300, The Netherlands.
- National eHealth Living Lab, Leiden, The Netherlands.
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Zettergren A, Sompa S, Palmberg L, Ljungman P, Pershagen G, Andersson N, Lindh C, Georgelis A, Kull I, Melen E, Ekström S, Bergstrom A. Assessing tobacco use in Swedish young adults from self-report and urinary cotinine: a validation study using the BAMSE birth cohort. BMJ Open 2023; 13:e072582. [PMID: 37438074 PMCID: PMC10347476 DOI: 10.1136/bmjopen-2023-072582] [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] [Received: 02/09/2023] [Accepted: 06/26/2023] [Indexed: 07/14/2023] Open
Abstract
OBJECTIVES Studies on health effects of tobacco often rely on self-reported exposure data, which is subjective and can lead to misclassification. The aim of this study was to describe the prevalence of cigarette smoking, snus and e-cigarette use, as well as to validate self-reported tobacco use among young adults in Sweden. METHOD Participants of a population-based Swedish cohort (n=3052), aged 22-25 years, assessed their tobacco use in a web questionnaire. Urinary cotinine was analysed in a subsample of the study population (n=998). The agreement between self-reported tobacco use and urinary cotinine was assessed using Cohen's Kappa coefficient (κ) at a cut-off level of 50 ng/mL. RESULTS Patterns of tobacco use differed between men and women. Among men, 20.0% reported daily snus use, 5.8% daily cigarette smoking and 5.6% any e-cigarette use. In contrast, 3.2% of the women reported daily snus use, 9.0% daily cigarette smoking and 2.4% any e-cigarette use. Among the tobacco use categories, daily snus users had the highest levels of cotinine. Of reported non-tobacco users, 3.5% had cotinine levels above the cut-off, compared with 68.0% among both occasional cigarette smokers and snus users, 67.5% among all e-cigarette users and 94.7% and 97.8% among daily cigarette smokers and snus users, respectively. Agreement between self-reported tobacco use and urinary cotinine was classified as strong for daily use of cigarettes (κ=0.824) and snus (κ=0.861), while moderate to weak for occasional smoking (κ=0.618), occasional snus use (κ=0.573) and any e-cigarette use (κ=0.576). CONCLUSIONS We found high validity of self-reported tobacco use in our study population, particularly for daily tobacco use. Further, we found that daily snus users were exposed to high levels of cotinine. Together with previous findings, our results indicate good validity of self-reported tobacco use among young adults.
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Affiliation(s)
- Anna Zettergren
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Shanzina Sompa
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Lena Palmberg
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Cardiology, Danderyd University Hospital, Stockholm, Sweden
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Niklas Andersson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Christian Lindh
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Antonios Georgelis
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Inger Kull
- Sachs' Children and Youth Hospital, Södersjukhuset AB, Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Erik Melen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Sachs' Children and Youth Hospital, Södersjukhuset AB, Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Sandra Ekström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Anna Bergstrom
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
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Tatekawa S, Shimamoto S, Miyata Y, Yoshino Y, Hirata T, Tamari K, Seo Y, Isohashi F, Yamamoto Y, Uno A, Inohara H, Ogawa K. Monitoring expiratory carbon monoxide to study the effect of complete smoking cessation on definitive radiation therapy for early stage glottic carcinoma. Acta Oncol 2021; 60:582-588. [PMID: 33406970 DOI: 10.1080/0284186x.2020.1865563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Previous studies reported that cigarette smoking during radiation therapy was associated with unfavorable outcomes in various cancers using medical interviewing or monitoring of cotinine. Here, we evaluated the effect of smoking cessation on definitive radiation therapy for early stage glottic carcinoma by monitoring expiratory carbon monoxide (CO). MATERIAL AND METHODS We enrolled 103 patients with early glottic carcinoma (T1N0/T2N0 = 79/24) who underwent conventional radiotherapy between 2005 and 2016. The median age was 70 years. Pathologically, all patients had squamous cell carcinoma. Since 2009, we confirmed smoking cessation before radiation therapy by medical interviews. Since 2014, we measured expiratory CO to strictly monitor smoking cessation. The patients were divided according to diagnosis years: 'no cessation' (2005-2008), 'incomplete cessation' (2009-2013), and 'complete cessation' (2014-2016). We retrospectively analyzed the local recurrence rate and disease-free survival (DFS). RESULTS The median follow-up period was 60.1 months (range, 1.9-110.0 months). The 2-year local recurrence rate in the 'complete cessation' group was 5.3% and tended to be lower than that in the 'incomplete cessation' group (13.7%) and 'no cessation' group (21.2%). Multivariate analysis revealed that 'no cessation' was a risk factor for DFS (hazard ratio [HR] = 4.25) and local recurrence rate (HR = 16.5, p < .05) compared to 'complete cessation.' DISCUSSION We confirmed that the 'complete cessation' group had better prognosis than the 'no cessation' group by monitoring expiratory CO during radiation therapy for early stage glottic carcinoma. Moreover, monitoring expiratory CO was easier and more suitable than conventional methods for evaluating smoking cessation because it provided real-time measurements.
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Affiliation(s)
- Shotaro Tatekawa
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Radiation Oncology, Osaka General Medical Center, Osaka, Japan
| | | | - Yoshiaki Miyata
- Department of Radiation Oncology, Saito Yukoukai Hospital, Osaka, Japan
| | - Yutaro Yoshino
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takero Hirata
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Keisuke Tamari
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yuji Seo
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Fumiaki Isohashi
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yoshifumi Yamamoto
- Department of Otorhinolaryngology-Head and Neck surgery, Osaka General Medical Center, Osaka, Japan
| | - Atsuhiko Uno
- Department of Otorhinolaryngology-Head and Neck surgery, Osaka General Medical Center, Osaka, Japan
| | - Hidenori Inohara
- Department of Otorhinolaryngology-Head and Neck surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kazuhiko Ogawa
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
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The Influence of Smoking Status on Exhaled Breath Profiles in Asthma and COPD Patients. Molecules 2021; 26:molecules26051357. [PMID: 33806279 PMCID: PMC7961431 DOI: 10.3390/molecules26051357] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/20/2021] [Accepted: 02/26/2021] [Indexed: 01/18/2023] Open
Abstract
Breath analysis using eNose technology can be used to discriminate between asthma and COPD patients, but it remains unclear whether results are influenced by smoking status. We aim to study whether eNose can discriminate between ever- vs. never-smokers and smoking <24 vs. >24 h before the exhaled breath, and if smoking can be considered a confounder that influences eNose results. We performed a cross-sectional analysis in adults with asthma or chronic obstructive pulmonary disease (COPD), and healthy controls. Ever-smokers were defined as patients with current or past smoking habits. eNose measurements were performed by using the SpiroNose. The principal component (PC) described the eNose signals, and linear discriminant analysis determined if PCs classified ever-smokers vs. never-smokers and smoking <24 vs. >24 h. The area under the receiver–operator characteristic curve (AUC) assessed the accuracy of the models. We selected 593 ever-smokers (167 smoked <24 h before measurement) and 303 never-smokers and measured the exhaled breath profiles of discriminated ever- and never-smokers (AUC: 0.74; 95% CI: 0.66–0.81), and no cigarette consumption <24h (AUC 0.54, 95% CI: 0.43–0.65). In healthy controls, the eNose did not discriminate between ever or never-smokers (AUC 0.54; 95% CI: 0.49–0.60) and recent cigarette consumption (AUC 0.60; 95% CI: 0.50–0.69). The eNose could distinguish between ever and never-smokers in asthma and COPD patients, but not recent smokers. Recent smoking is not a confounding factor of eNose breath profiles.
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Carson-Chahhoud KV, Smith BJ, Peters MJ, Brinn MP, Ameer F, Singh K, Fitridge R, Koblar SA, Jannes J, Veale AJ, Goldsworthy S, Hnin K, Esterman AJ. Two-year efficacy of varenicline tartrate and counselling for inpatient smoking cessation (STOP study): A randomized controlled clinical trial. PLoS One 2020; 15:e0231095. [PMID: 32348306 PMCID: PMC7190140 DOI: 10.1371/journal.pone.0231095] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 03/15/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Varenicline tartrate is superior for smoking cessation to other tobacco cessation therapies by 52 weeks, in the outpatient setting. We aimed to evaluate the long-term (104 week) efficacy following a standard course of inpatient-initiated varenicline tartrate plus Quitline-counselling compared to Quitline-counselling alone. METHODS Adult patients (n = 392, 20-75 years) admitted with a smoking-related illnesses to one of three hospitals, were randomised to receive either 12-weeks of varenicline tartrate (titrated from 0.5mg daily to 1mg twice-daily) plus Quitline-counselling, (n = 196) or Quitline-counselling alone, (n = 196), with continuous abstinence from smoking assessed at 104 weeks. RESULTS A total of 1959 potential participants were screened for eligibility between August 2008 and December 2011. The proportion of participants who remained continuously abstinent (intention-to-treat) at 104 weeks were significantly greater in the varenicline tartrate plus counselling arm (29.2% n = 56) compared to counselling alone (18.8% n = 36; p = 0.02; odds ratio 1.78; 95%CI 1.10 to 2.86, p = 0.02). Twenty-two deaths occurred during the 104 week study (n = 10 for varenicline tartrate plus counselling and n = 12 for Quitline-counselling alone). All of these participants had known or developed underlying co-morbidities. CONCLUSIONS This is the first study to examine the efficacy and safety of varenicline tartrate over 104 weeks within any setting. Varenicline tartrate plus Quitline-counselling was found to be an effective opportunistic treatment when initiated for inpatient smokers who had been admitted with tobacco-related disease.
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Affiliation(s)
- Kristin V. Carson-Chahhoud
- Australian Centre for Precision Health, School of Health Sciences, The University of South Australia, Adelaide, South Australia, Australia
- School of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Brian J. Smith
- School of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Matthew J. Peters
- Thoracic Medicine, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
| | - Malcolm P. Brinn
- Australian Centre for Precision Health, School of Health Sciences, The University of South Australia, Adelaide, South Australia, Australia
| | - Faisal Ameer
- Respiratory Medicine, Ipswich Hospital, Ipswich, Queensland, Australia
| | - Kuljit Singh
- School of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
- Cardiology Department, Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Robert Fitridge
- Division of Surgery, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
| | - Simon A. Koblar
- Stroke Research Programme, University of Adelaide, Adelaide, South Australia, Australia
| | - Jim Jannes
- Stroke Research Programme, University of Adelaide, Adelaide, South Australia, Australia
- Stroke Unit, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
| | - Antony J. Veale
- Respiratory Medicine Department, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
| | - Sharon Goldsworthy
- Pharmacy Department, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
| | - Khin Hnin
- Department of Respiratory and Sleep Medicine, Flinders Medical Centre, Adelaide, South Australia, Australia
| | - Adrian J. Esterman
- School of Nursing and Midwifery, The University of South Australia, Adelaide, South Australia, Australia
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Tejera-Vaquerizo A, Descalzo-Gallego MA, Traves V, Requena C, Bolumar I, Pla A, Nagore E. No association between smoking and sentinel lymph node metastasis and survival in cutaneous melanoma. J Eur Acad Dermatol Venereol 2019; 33:2283-2290. [PMID: 31283036 DOI: 10.1111/jdv.15789] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 06/21/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND There is little evidence that smoking is associated with metastasis in patients with cutaneous melanoma. OBJECTIVE Using a propensity score matching analysis, we assessed whether smoking was associated with a higher rate of sentinel lymph node (SLN) metastasis and worse survival in these patients. METHODS Retrospective cohort study at a referral hospital for melanoma. We studied 762 patients with known smoking status from the melanoma database of the Instituto Valenciano de Oncología who underwent SLN biopsy between 1 January 2000 and 31 December 2016. The patients were matched by smoking status. The matching procedure was implemented using three logistic regression models featuring never vs. former smokers, never vs. current smokers and former vs. current smokers. The study outcomes were disease-free survival (DFS), melanoma-specific survival (MSS), overall survival (OS) and SLN status. RESULTS The following groups were formed based on the propensity matching scores: 114 pairs of smokers vs. never smokers, 113 pairs of smokers vs. former smokers and 174 pairs of never smokers vs. former smokers. Smoking status was not associated with SLN metastasis or with DFS, MSS or OS in any of the three groups. CONCLUSION Smoking does not influence SLN metastasis or survival in patients with cutaneous melanoma.
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Affiliation(s)
- A Tejera-Vaquerizo
- Servicio de Dermatología, Instituto Dermatológico GlobalDerm, Palma del Río (Córdoba), Spain
| | | | - V Traves
- Servicio de Anatomía Patológica, Instituto Valenciano de Oncología, Valencia, Spain
| | - C Requena
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, Spain
| | - I Bolumar
- Servicio de Cirugía, Instituto Valencia de Oncología, Valencia, Spain
| | - A Pla
- Servicio de Otorrinolaringología, Instituto Valenciano de Oncología, Valencia, Spain
| | - E Nagore
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, Spain
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Hirvonen E, Stepanov M, Kilpeläinen M, Lindqvist A, Laitinen T. Consistency and reliability of smoking-related variables: longitudinal study design in asthma and COPD. Eur Clin Respir J 2019; 6:1591842. [PMID: 31007878 PMCID: PMC6461091 DOI: 10.1080/20018525.2019.1591842] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 02/27/2019] [Indexed: 10/27/2022] Open
Abstract
Introduction: Smoking has a significant impact on the development and progression of asthma and chronic obstructive pulmonary disease (COPD). Self-reported questionnaires and structured interviews are usually the only way to study patients' smoking history. In this study, we aim to examine the consistency of the responses of asthma and COPD patients to repeated standardised questions on their smoking habits over the period of 10 years. Methods: The study population consisted of 1329 asthma and 959 COPD patients, who enrolled in the study during years 2005-2007. A follow-up questionnaire was mailed to the participants 1, 2, 4, 6, 8, and 10 years after the recruitment. Results: Among the participants who returned three or more questionnaires (N = 1454), 78.5 % of the patients reported unchanged smoking status (never smoker, ex-smoker or current smoker) across the time. In 4.5% of the answers, the reported smoking statuses were considered unreliable/conflicting (first never smoker and, later, smoker or ex-smoker). The remainder of the patients changed their status from current smoker to ex-smoker and vice versa at least once, most likely due to struggling with quitting. COPD patients were more frequently heavy ex- or current smokers compared to the asthma group. The intraclass coefficient correlations between self-reported starting (0.85) and stopping (0.94) years as well as the consumption of cigarettes (0.74) over time showed good reliability among both asthma and COPD patients. Conclusion: Self-reported smoking data among elderly asthma and COPD patients over a 10-year follow-up is reliable. Pack years can be considered a rough estimate for their comprehensive consumption of tobacco products over time. We also observed that the questionnaire we used was not designed for dynamic changes in smoking which are rather common among heavy smokers especially when the follow-up time is several years, as in our study.
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Affiliation(s)
- Eveliina Hirvonen
- Department of Pulmonary Diseases and Clinical Allergology, Turku University Hospital, Turku, Finland.,Department of Pulmonary Diseases, University of Turku, Turku, Finland
| | - Mikhael Stepanov
- Centre for Clinical Informatics, Turku University Hospital, Turku, Finland
| | - Maritta Kilpeläinen
- Department of Pulmonary Diseases and Clinical Allergology, Turku University Hospital, Turku, Finland
| | - Ari Lindqvist
- Clinical Research Unit for Pulmonary Diseases, Helsinki University and Helsinki University Hospital, Helsinki, Finland
| | - Tarja Laitinen
- Department of Pulmonary Diseases and Clinical Allergology, Turku University Hospital, Turku, Finland.,Department of Pulmonary Diseases, University of Turku, Turku, Finland
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Andersen AM, Ryan PT, Gibbons FX, Simons RL, Long JD, Philibert RA. A Droplet Digital PCR Assay for Smoking Predicts All-Cause Mortality. J Insur Med 2019; 47:220-229. [PMID: 30702368 PMCID: PMC7518325 DOI: 10.17849/insm-47-4-1-10.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVES -Determine whether an epigenetic assay for smoking predicts all-cause mortality in adults participating in a longitudinal study of Iowa adoptees. BACKGROUND -Improved biomarkers for smoking are needed given its large public health impact and significant limitations of both self-report and current biomarkers, such as cotinine in detecting smoking. In the past 5 years, multiple epigenome-wide association studies of smoking have identified loci suitable for translation as epigenetic biomarkers for smoking, in particular the CpG cg05575921. Digital polymerase chain reaction methods hold promise for the development of this and other epigenetic biomarkers. METHODS -Participants in the Iowa Adoption Studies were interviewed regarding their smoking habits. DNA was prepared from whole blood and bisulfite-converted for methylation analysis and digital droplet polymerase chain reaction assay of methylation at cg05575921 was performed. National Death Index records were requested for 584 study participants, resulting in 24 complete matches, 210 partial matches and 350 non-matching records. Complete matches were coded as deceased while the remainder were coded as alive (ie, censored). In total, methylation data and vital status information were available for a total of N = 193 subjects, including 15 deceased and 178 non-deceased. Cox regression was used to examine the ability of cg05575921 methylation as a continuous value to predict the timing of mortality with and without the inclusion of age, sex, race, BMI, marital status, educational status, socioeconomic status, cardiovascular risk factors, and a history of cancer as covariates. RESULTS -Methylation at cg05575921 predicted the hazard of mortality as the sole predictor and after accounting for major demographic and clinical risk factors. The fitted model showed the hazard ratio increased by 3.5% for every 1% decrease in methylation. CONCLUSIONS -Decreased methylation at cg05575921, an emerging epigenetic biomarker for smoking, was associated with early mortality in a longitudinal study of adults after accounting for the impact of major demographic and clinical risk factors for all-cause mortality. This approach may be useful in clinical research or actuarial assessments.
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Affiliation(s)
- Allan M. Andersen
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA 52242
| | - Philip T. Ryan
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA 52242
| | - Fredrick X. Gibbons
- Department of Psychological Sciences, University of Connecticut, Storrs, CT 06269
| | - Ronald L. Simons
- Department of Sociology, University of Georgia, Athens, GA 30602
| | - Jeffrey D. Long
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA 52242
- Department of Biostatistics, University of Iowa, Iowa City, IA USA 52242
| | - Robert A. Philibert
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA 52242
- Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA 52242
- Behavioral Diagnostics, Coralville IA 52241
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Obeidat M, Zhou G, Li X, Hansel NN, Rafaels N, Mathias R, Ruczinski I, Beaty TH, Barnes KC, Paré PD, Sin DD. The genetics of smoking in individuals with chronic obstructive pulmonary disease. Respir Res 2018; 19:59. [PMID: 29631575 PMCID: PMC5892035 DOI: 10.1186/s12931-018-0762-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 03/27/2018] [Indexed: 11/10/2022] Open
Abstract
Background Smoking is the principal modifiable environmental risk factor for chronic obstructive pulmonary disease (COPD) which affects 300 million people and is the 3rd leading cause of death worldwide. Most of the genetic studies of smoking have relied on self-reported smoking status which is vulnerable to reporting and recall bias. Using data from the Lung Health Study (LHS), we sought to identify genetic variants associated with quantitative smoking and cessation in individuals with mild to moderate COPD. Methods The LHS is a longitudinal multicenter study of mild-to-moderate COPD subjects who were all smokers at recruitment. We performed genome-wide association studies (GWASs) for salivary cotinine (n = 4024), exhaled carbon monoxide (eCO) (n = 2854), cigarettes per day (CPD) (n = 2706) and smoking cessation at year 5 follow-up (n = 717 quitters and 2175 smokers). The GWAS analyses were adjusted for age, gender, and genetic principal components. Results For cotinine levels, SNPs near UGT2B10 gene achieved genome-wide significance (i.e. P < 5 × 10− 8) with top SNP rs10023464, P = 1.27 × 10− 11. For eCO levels, one significant SNP was identified which mapped to the CHRNA3 gene (rs12914385, P = 2.38 × 10− 8). A borderline region mapping to KCNMA1 gene was associated with smoking cessation (rs207675, P = 5.95 × 10− 8). Of the identified loci, only the CHRNA3/5 locus showed significant associations with lung function but only in heavy smokers. No regions met genome-wide significance for CPD. Conclusion The study demonstrates that using objective measures of smoking such as eCO and/or salivary cotinine can more precisely capture the genetic contribution to multiple aspects of smoking behaviour. The KCNMA1 gene association with smoking cessation may represent a potential therapeutic target and warrants further studies. Trial registration The Lung Health Study ClinicalTrials.gov Identifier: NCT00000568. Date of registration: October 28, 1999. Electronic supplementary material The online version of this article (10.1186/s12931-018-0762-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ma'en Obeidat
- The University of British Columbia Center for Heart Lung Innovation, St Paul's Hospital, Vancouver, BC, Canada.
| | - Guohai Zhou
- The University of British Columbia Center for Heart Lung Innovation, St Paul's Hospital, Vancouver, BC, Canada
| | - Xuan Li
- The University of British Columbia Center for Heart Lung Innovation, St Paul's Hospital, Vancouver, BC, Canada
| | - Nadia N Hansel
- Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Nicholas Rafaels
- Division of Biomedical Informatics and Personalized Medicine, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA
| | - Rasika Mathias
- Division of Genetic Epidemiology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Ingo Ruczinski
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Terri H Beaty
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Kathleen C Barnes
- Division of Biomedical Informatics and Personalized Medicine, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA
| | - Peter D Paré
- The University of British Columbia Center for Heart Lung Innovation, St Paul's Hospital, Vancouver, BC, Canada.,Respiratory Division, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Don D Sin
- The University of British Columbia Center for Heart Lung Innovation, St Paul's Hospital, Vancouver, BC, Canada.,Respiratory Division, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
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10
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Outcomes for a Public Hospital Tobacco Cessation Program: The Cook County Health and Hospitals System Experience. J Community Health 2018; 41:1130-1139. [PMID: 27393143 DOI: 10.1007/s10900-016-0215-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The objective of this study is to determine the rate and predictors of sustained smoking cessation for a cohort of smokers exposed to a guideline-based health education program delivered during routine clinical care at an urban public hospital. This is a retrospective analysis of 755 public hospital system patients who had at least two health educator contacts embedded in routine clinical care, with the latter contact 12-18 months after the baseline. The education occurred during visits to primary care, specialty clinics, urgent/episodic care, or during hospitalization. The assessment of smoking status is determined by the health educators as part of their routine assessment and recorded in the program's database. The primary outcomes are self-reported 12-month sustained smoking cessation at the 12-18 month contact and predictors of cessation. The cohort is predominantly minority smokers (African American 69 % and Latino 15 %) and uninsured (70 %) or on Medicaid (13 %). The sustained cessation rate was 9.3 %. Latino ethnicity, smoking 1-9 cigarettes/day at baseline, reporting smoke-free home, and additional educator contact in the year after the baseline were independent predictors of sustained cessation in the multivariate analysis. Smokers with multiple risks for poor cessation outcomes exposed to a guideline-based program of health education during routine healthcare encounters had sustained smoking cessation rates that compare favorably with published National Health Interview Study population cessation rates. An additional educator contact after the baseline was a predictor of cessation. The findings support development of cessation programs in which health educators are integrated into clinical care settings.
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11
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Validation of Self-reported Smoking with Urinary Cotinine Levels and Influence of Second-hand Smoke among Conscripts. Sci Rep 2017; 7:15462. [PMID: 29133917 PMCID: PMC5684204 DOI: 10.1038/s41598-017-15526-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 10/30/2017] [Indexed: 01/31/2023] Open
Abstract
Accurate identification of smoking behaviour is crucial to monitor the smoking rate. This study used urinary cotinine (UC) as a biomarker to verify the effectiveness of self-reported smoking behaviour among conscripts during recruit training. The influence of second-hand smoke (SHS) on the UC concentration was also analysed. A cross-sectional study was conducted from July 2014 to December 2014. The participants comprised a total of 621 military service and basic military training conscripts. A self-administered questionnaire survey and a urine test were performed to verify the participants’ smoking behaviour. The UC concentration of 100 ng/mL was adopted as the baseline to identify smokers. A high level of consistency was observed between the conscripts’ self-reported results and the results validated by the UC concentrations (the overall kappa coefficient was 0.918). Moreover, the overall sensitivity and specificity were 92.9% and 98.1%, respectively. The sensitivity for the military service conscripts was significantly lower than that for the basic military training conscripts (86.1% vs. 97.5%, P-value = 0.002). For the self-reported nonsmokers among the military service conscripts, SHS exposure was related to their UC concentrations. The method of self-reporting through a questionnaire survey can serve as a tool to assess conscripts’ smoking behaviour.
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12
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Cha S, Ganz O, Cohn AM, Ehlke SJ, Graham AL. Feasibility of biochemical verification in a web-based smoking cessation study. Addict Behav 2017; 73:204-208. [PMID: 28551588 DOI: 10.1016/j.addbeh.2017.05.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 05/03/2017] [Accepted: 05/19/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIMS Cogent arguments have been made against the need for biochemical verification in population-based studies with low-demand characteristics. Despite this fact, studies involving digital interventions (low-demand) are often required in peer review to report biochemically verified abstinence. To address this discrepancy, we examined the feasibility and costs of biochemical verification in a web-based study conducted with a national sample. METHODS Participants were 600U.S. adult current smokers who registered on a web-based smoking cessation program and completed surveys at baseline and 3months. Saliva sampling kits were sent to participants who reported 7-day abstinence at 3months, and analyzed for cotinine. RESULTS The response rate at 3-months was 41.2% (n=247): 93 participants reported 7-day abstinence (38%) and were mailed a saliva kit (71% returned). The discordance rate was 36.4%. Participants with discordant responses were more likely to report 3-month use of nicotine replacement therapy or e-cigarettes than those with concordant responses (79.2% vs. 45.2%, p=0.007). The total cost of saliva sampling was $8280 ($125/sample). CONCLUSIONS Biochemical verification was both time- and cost-intensive, and yielded a relatively small number of samples due to low response rates and use of other nicotine products during the follow-up period. There was a high rate of discordance of self-reported abstinence and saliva testing. Costs for data collection may be prohibitive for studies with large sample sizes or limited budgets. Our findings echo previous statements that biochemical verification is not necessary in population-based studies, and add evidence specific to technology-based studies.
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13
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Andersen AM, Philibert RA, Gibbons FX, Simons RL, Long J. Accuracy and utility of an epigenetic biomarker for smoking in populations with varying rates of false self-report. Am J Med Genet B Neuropsychiatr Genet 2017; 174:641-650. [PMID: 28816414 PMCID: PMC5653254 DOI: 10.1002/ajmg.b.32555] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 05/05/2017] [Indexed: 01/08/2023]
Abstract
Better biomarkers to detect smoking are needed given the tremendous public health burden caused by smoking. Current biomarkers to detect smoking have significant limitations, notably a short half-life for detection and lack of sensitivity for light smokers. These limitations may be particularly problematic in populations with less accurate self-reporting. Prior epigenome-wide association studies indicate that methylation status at cg05575921, a CpG residue located in the aryl hydrocarbon receptor repressor (AHRR) gene, may be a robust indicator of smoking status in individuals with as little as half of a pack-year of smoking. In this study, we show that a novel droplet digital PCR assay for measuring methylation at cg05575921 can reliably detect smoking status, as confirmed by serum cotinine, in populations with different demographic characteristics, smoking histories, and rates of false-negative self-report of smoking behavior. Using logistic regression models, we show that obtaining maximum accuracy in predicting smoking status depends on appropriately weighting self-report and cg05575921 methylation according to the characteristics of the sample being tested. Furthermore, models using only cg05575921 methylation to predict smoking perform nearly as well as those also including self-report across populations. In conclusion, cg05575921 has significant potential as a clinical biomarker to detect smoking in populations with varying rates of accuracy in self-report of smoking behavior.
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Affiliation(s)
- Allan M. Andersen
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA 52242,To whom correspondence should be addressed: Department of Psychiatry, Rm 2-219 MEB, 500 Newton Road, Iowa City, IA, 52242, USA; phone 319-353-4537
| | - Robert A. Philibert
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA 52242,Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA 52242,Behavioral Diagnostics, Coralville IA 52241
| | - Fredrick X. Gibbons
- Department of Psychological Sciences, University of Connecticut, Storrs, CT 06269
| | - Ronald L. Simons
- Department of Sociology, University of Georgia, Athens, GA 30602
| | - Jeffrey Long
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA 52242,Department of Biostatistics, University of Iowa, Iowa City, IA USA 52242
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14
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Jones MS, Jones PC, Stern SL, Elashoff D, Hoon DSB, Thompson J, Mozzillo N, Nieweg OE, Noyes D, Hoekstra HJ, Zager JS, Roses DF, Testori A, Coventry BJ, Smithers MB, Andtbacka R, Agnese D, Schultz E, Hsueh EC, Kelley M, Schneebaum S, Jacobs L, Bowles T, Kashani-Sabet M, Johnson D, Faries MB. The Impact of Smoking on Sentinel Node Metastasis of Primary Cutaneous Melanoma. Ann Surg Oncol 2017; 24:2089-2094. [PMID: 28224364 PMCID: PMC5553293 DOI: 10.1245/s10434-017-5775-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Indexed: 01/06/2023]
Abstract
BACKGROUND Although a well-established causative relationship exists between smoking and several epithelial cancers, the association of smoking with metastatic progression in melanoma is not well studied. We hypothesized that smokers would be at increased risk for melanoma metastasis as assessed by sentinel lymph node (SLN) biopsy. METHODS Data from the first international Multicenter Selective Lymphadenectomy Trial (MSLT-I) and the screening-phase of the second trial (MSLT-II) were analyzed to determine the association of smoking with clinicopathologic variables and SLN metastasis. RESULTS Current smoking was strongly associated with SLN metastasis (p = 0.004), even after adjusting for other predictors of metastasis. Among 4231 patients (1025 in MSLT-I and 3206 in MSLT-II), current or former smoking was also independently associated with ulceration (p < 0.001 and p < 0.001, respectively). Compared with current smoking, never smoking was independently associated with decreased Breslow thickness in multivariate analysis (p = 0.002) and with a 0.25 mm predicted decrease in thickness. CONCLUSION The direct correlation between current smoking and SLN metastasis of primary cutaneous melanoma was independent of its correlation with tumor thickness and ulceration. Smoking cessation should be strongly encouraged among patients with or at risk for melanoma.
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Affiliation(s)
- Maris S Jones
- Division of Surgical Oncology, John Wayne Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA
| | - Peter C Jones
- Division of Surgical Oncology, John Wayne Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA
- Department of Molecular Oncology, John Wayne Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA
| | - Stacey L Stern
- Department of Biostatistics, John Wayne Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA
| | | | - Dave S B Hoon
- Department of Molecular Oncology, John Wayne Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA
| | - John Thompson
- Melanoma Institute Australia, Sydney, NSW, Australia
| | | | - Omgo E Nieweg
- Melanoma Institute Australia, Sydney, NSW, Australia
| | - Dirk Noyes
- IHC Cancer Services, Intermountain Medical Center, Salt Lake City, UT, USA
| | | | | | | | | | - Brendon J Coventry
- Royal Adelaide Hospital Discipline of Surgery, Royal Adelaide HospitalUniversity of Adelaide, Adelaide, SA, Australia
| | - Mark B Smithers
- Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | | | | | - Erwin Schultz
- Nuremberg General Hospital - Paracelsus Medical University, Nuremberg, Germany
| | | | | | | | - Lisa Jacobs
- Johns Hopkins Medical Institute, Baltimore, USA
| | - Tawnya Bowles
- IHC Cancer Services, Intermountain Medical Center, Salt Lake City, UT, USA
| | | | | | - Mark B Faries
- Department of Melanoma Research, John Wayne Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA.
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15
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Hitsman B, Baker AL, King A. POINT: Are Advanced Practice Professionals More Likely to Achieve Better Tobacco Cessation Results than Physicians? Yes. Chest 2017; 152:466-469. [PMID: 28414030 DOI: 10.1016/j.chest.2017.03.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 03/13/2017] [Indexed: 11/16/2022] Open
Affiliation(s)
- Brian Hitsman
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
| | - Amanda L Baker
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Andrea King
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL
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16
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Self-Reporting of Smoking Cessation in Cardiac Patients: How Reliable Is It and Is Reliability Associated With Patient Characteristics? J Addict Med 2016; 9:308-16. [PMID: 26083956 DOI: 10.1097/adm.0000000000000137] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The objectives of this study were to determine the accuracy of smoking cessation self-reports by cardiac patients who participated in a smoking cessation program, and to determine which patient characteristics are associated with an inaccurate self-report during a follow-up interview 12 months after the start of the program. METHODS Smoking cessation self-reports (point prevalence abstinence) were validated against salivary cotinine levels. Using χ analyses, patients who reported accurately being a nonsmoker were compared with those who reported inaccurately being a nonsmoker (biochemically verified as smokers) on factors the literature has indicated to be associated with inaccurate self-report in smoking. Potential predictors of inaccurate self-report of smoking (P ≤ 0.20 in univariate analyses) were subsequently tested in a multivariate logistic regression analysis. RESULTS Of the 95 patients tested, almost 25% inaccurately reported having quit smoking at a cutoff of 10-ng/mL cotinine in saliva. The data show more underreporting of smoking among patients who received a face-to-face counseling intervention and among patients with an intermediate education level. There was significantly less underreporting among patients characterized as having a Type D personality. CONCLUSIONS These findings suggest that underreporting of smoking status in cardiac patients who participate in a smoking cessation program is high, especially in those who receive intensive face-to-face counseling. Having a Type D personality seems to be a protective factor, whereas having an intermediate level of education is a risk factor for inaccurate reporting. Biochemical validation in high-risk populations is highly needed, ideally accompanied by alternative forms of verification. Optimal validation testing in smoking cessation studies of cardiac patients is difficult because of high refusal rates, no-show, and organizational difficulties.
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Philibert R, Hollenbeck N, Andersen E, McElroy S, Wilson S, Vercande K, Beach SRH, Osborn T, Gerrard M, Gibbons FX, Wang K. Reversion of AHRR Demethylation Is a Quantitative Biomarker of Smoking Cessation. Front Psychiatry 2016; 7:55. [PMID: 27092088 PMCID: PMC4822186 DOI: 10.3389/fpsyt.2016.00055] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 03/24/2016] [Indexed: 12/29/2022] Open
Abstract
Smoking is the largest preventable cause of morbidity and mortality in the world. Although there are effective pharmacologic and behavioral treatments for smoking cessation, our inability to objectively quantify smokers' progress in decreasing smoking has been a barrier to both clinical and research efforts. In prior work, we and others have shown that DNA methylation at cg05575921, a CpG residue in the aryl hydrocarbon receptor repressor (AHRR), can be used to determine smoking status and infer cigarette consumption history. In this study, we serially assessed self-report and existing objective markers of cigarette consumption in 35 subjects undergoing smoking cessation therapy, then quantified DNA methylation at cg05575921 at study entry and three subsequent time points. Five subjects who reported serum cotinine and exhaled carbon monoxide verified smoking abstinence for the 3 months prior to study exit averaged a 5.9% increase in DNA methylation at cg05575921 (p < 0.004) over the 6-month study. Although the other 30 subjects did not achieve smoking cessation at the 6-month time point, their self-reported reduction of cigarette consumption (mean = 6 cigarettes/day) was associated with a 2.8% increase DNA methylation at cg05575921 (p < 0.05). Finally, a survey of subjects as they exited the study demonstrated strong support for the clinical use of epigenetic biomarkers. We conclude that AHRR methylation status is a quantifiable biomarker for progress in smoking cessation that could have substantial impact on both smoking cessation treatment and research.
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Affiliation(s)
- Robert Philibert
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA; Behavioral Diagnostics, Iowa City, IA, USA
| | - Nancy Hollenbeck
- Department of Psychiatry, University of Iowa , Iowa City, IA , USA
| | | | - Shyheme McElroy
- Department of Psychiatry, University of Iowa , Iowa City, IA , USA
| | - Scott Wilson
- Department of Internal Medicine, University of Iowa , Iowa City, IA , USA
| | - Kyra Vercande
- Department of Psychiatry, University of Iowa , Iowa City, IA , USA
| | - Steven R H Beach
- Department of Psychology, Center for Family Research, University of Georgia , Athens, GA , USA
| | | | - Meg Gerrard
- Department of Psychology, University of Connecticut , Storrs, CT , USA
| | | | - Kai Wang
- Department of Biostatistics, College of Public Health, University of Iowa , Iowa City, IA , USA
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18
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Validation of Non-Smoking Status by Spouse Following a Cessation Intervention. J Smok Cessat 2015; 12:38-42. [PMID: 28239426 DOI: 10.1017/jsc.2015.11] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Following cessation interventions, self-reported smoking abstinence with biochemical verification is the "gold standard" for defining outcomes. Because obtaining biochemical verification is challenging in community studies, we compared self-reported cessation among smokers completing treatment to the smoking status reported by each participant's spouse or proxy. METHOD Participants were smokers who had reported quitting 12 months after a cessation intervention. Participants had either attended a smoking cessation clinic or they were patients seen by physicians who had recently participated in a cessation-training program. Proxies living with these participants were interviewed by telephone to ask about their partner's smoking status. We compared the participants' responses to those from their spouses. RESULTS At 12 months, 346 of 1423 baseline smokers had quit; 161/346 reported non-smokers were called and 140 proxies were interviewed. The participants averaged 51 years of age, 69% were women. At baseline, the mean number of cigarettes smoked per day was 20.1 (SD = 9.9) and the average number of quit attempts was 2.4 (SD = 1.2). Cessation methods used were medical advice (21%) and/or pharmacotherapy (79%). Of the 140 spouses interviewed, only 10 (7.1%) reported that their partners were currently smoking. CONCLUSIONS Proxy-reported data on smoking status could be used to validate self-report.
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19
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Hardinge M, Annandale J, Bourne S, Cooper B, Evans A, Freeman D, Green A, Hippolyte S, Knowles V, MacNee W, McDonnell L, Pye K, Suntharalingam J, Vora V, Wilkinson T. British Thoracic Society guidelines for home oxygen use in adults: accredited by NICE. Thorax 2015; 70 Suppl 1:i1-43. [DOI: 10.1136/thoraxjnl-2015-206865] [Citation(s) in RCA: 170] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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20
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A pilot randomized controlled trial of smoking cessation in an outpatient respirology clinic. Can Respir J 2015; 22:91-6. [PMID: 25647168 DOI: 10.1155/2015/871204] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To assess the feasibility and potential effectiveness of a modified version of the Ottawa Model for Smoking Cessation in an outpatient respirology clinic. METHODS Adult tobacco smokers attending the respirology clinic and willing to choose a quit date within one month of enrollment were randomly assigned to receive standard care or the intervention. Standard care participants received smoking cessation advice, a brochure and a prescription for smoking cessation medication if requested. Intervention participants received a $110 voucher to purchase smoking cessation pharmacotherapy and were registered to an automated calling system. Answers to automated calls determined which participants required nurse telephone counselling. Feasibility indicators included recruitment and retention rates, and intervention adherence. The effectiveness indicator was self-reported smoking status at 26 to 52 weeks. RESULTS Forty-nine (54.4%) of 90 eligible smokers were randomly assigned to the intervention (n=23) or control (n=26) group. Self-reported smoking status at 26 to 52 weeks was available for 32 (65.3%) participants. The quit rate for intervention participants was 18.2% compared with 7.7% for controls (OR2.36 [95% CI 0.39 to 14.15]). CONCLUSION It would be feasible to evaluate this intervention in a larger trial. Alternatives to face-to-face follow-up at the clinic are recommended.
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Brügger OE, Frei M, Sendi P, Reichart PA, Ramseier CA, Bornstein MM. Assessment of smoking behaviour in a dental setting: a 1-year follow-up study using self-reported questionnaire data and exhaled carbon monoxide levels. Clin Oral Investig 2013; 18:909-15. [DOI: 10.1007/s00784-013-1036-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Accepted: 07/02/2013] [Indexed: 11/29/2022]
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