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Uslu NZ, Karaman I, Oral A, Torun SD, Kalamanoglu Balci M. Correlates of Smoking, Work Stress, and Mindful Awareness among Private Hospital Workers in Istanbul. Subst Use Misuse 2024; 59:743-751. [PMID: 38321759 DOI: 10.1080/10826084.2024.2302129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
Background: The recent increase in workload and stress experienced by healthcare workers (HCW) is a significant global concern. Mindfulness enables one to be aware of emotions, thoughts, and present moment experiences. Objectives: The primary objective of this research is to investigate the correlates between smoking, occupational stress, and mindful awareness levels, among HCWs within the private healthcare sector. This study was conducted at a tertiary-level university-affiliated hospital in Istanbul between January - February 2023. 208 HCW participated, yielding a response rate of 20%. The participants were requested to complete a 61-item questionnaire consisting of demographics, General Work Stress Scale(GWS), Mindful Attention Awareness Scale (MAAS) and Test to Assess the Psychological Dependence on Smoking (TAPDS). Results: Smokers had significantly higher levels of mean GWS scores than nonsmokers. The mean MAAS scores of smokers were the lowest in the group with the highest scores of psychological dependence; it was highest in the group with the lowest scores. A negative correlation was found between general work stress and mindful awareness levels and between psychological dependence on smoking and mindfulness levels. HCWs aged 45 and older had significantly lower general stress than others. Conclusion: This study showed that the general work stress levels of smoker HCWs were higher than those of nonsmokers. Mindful awareness level was the lowest in the group, with the highest scores in psychological dependence on smoking. There was a negative correlation between psychological dependence on smoking and both work stress and mindful awareness levels. This study demonstrated that high work stress and low mindful awareness levels are not only related to each other but also to high psychological dependence on smoking.
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Affiliation(s)
- Nazlı Zeynep Uslu
- Department of Pulmonary Medicine, Bahcesehir University Faculty of Medicine, Istanbul, Turkey
| | - Irem Karaman
- Bahcesehir University School of Medicine, Istanbul, Turkey
| | - Asli Oral
- Bahcesehir University School of Medicine, Istanbul, Turkey
| | - Sebahat Dilek Torun
- Department of Public Health, Bahcesehir University Faculty of Medicine, Istanbul, Turkey
| | - Merih Kalamanoglu Balci
- Department of Pulmonary Medicine, Bahcesehir University Faculty of Medicine, Istanbul, Turkey
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2
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Mazza M, Kotzalidis GD, Marano G, De Berardis D, Martinotti G, Romagnoli E, Biondi-Zoccai G, Abbate A, Sani G. Lorcaserin: Worthy of Further Insights? Results from Recent Research. CNS Neurol Disord Drug Targets 2024; 23:278-283. [PMID: 37005521 DOI: 10.2174/1871527322666230330124137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 02/20/2023] [Accepted: 02/20/2023] [Indexed: 04/04/2023]
Abstract
Lorcaserin is a 3-benzazepine that binds 5-HT2C serotonin receptors in the hypothalamus, where it mediates lack of hunger and/or satiety, and in the ventral tegmental area, the site of origin of the mesolimbic and mesocortical dopaminergic projections, which mediate pleasure and reward. The drug has been first developed for the treatment of obesity, where it has shown efficacy, and subsequently trialed to counter substance use (mostly cocaine, cannabis, opioids, and nicotine) and craving, but showed inconsistent effects. Since 2020, the US Food and Drug Administration obtained that the drug was voluntarily withdrawn from the US market on the grounds that its long-term use was found to be associated with a greater incidence of some types of cancer. Provided it can show to be free from cancerogenic effects, ongoing research suggests that lorcaserin may have therapeutic potential for a variety of disorders and conditions beyond obesity. Since 5-HT2C receptors are involved in many diversified physiological functions (mood, feeding, reproductive behavior, neuronal processes related to impulsiveness, and modulating reward-related mechanisms) this drug has the potential to treat different central nervous system conditions, such as depression and schizophrenia.
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Affiliation(s)
- Marianna Mazza
- Department of Geriatrics, Institute of Psychiatry and Psychology, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Department of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Georgios D Kotzalidis
- Department of Geriatrics, Institute of Psychiatry and Psychology, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Department of Neurosciences, Mental Health, and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy
| | - Giuseppe Marano
- Department of Geriatrics, Institute of Psychiatry and Psychology, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Department of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | | | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, 66100 Chieti, Italy
- Department of Pharmacy, Pharmacology, Clinical Science, University of Hertfordshire, AL 10 9AB Herts, UK
| | - Enrico Romagnoli
- Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Giuseppe Biondi-Zoccai
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy
- Mediterranea Cardiocentro, 80122 Napoli, Italy
| | - Antonio Abbate
- Berne Cardiovascular Research Center, University of Virginia, 22908 Charlottesville, Virginia, USA
| | - Gabriele Sani
- Department of Geriatrics, Institute of Psychiatry and Psychology, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Department of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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3
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Solanki V, Mallik S, Khan S, Desai V, Pergolizzi J. Utility of Cupping Therapy in Substance Use Disorder: A Novel Approach or a Bizarre Treatment? Cureus 2023; 15:e47445. [PMID: 38021923 PMCID: PMC10660246 DOI: 10.7759/cureus.47445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 10/21/2023] [Indexed: 12/01/2023] Open
Abstract
Substance use disorder is a psychiatric problem not bound by age, sex, ethnicity, sexual preference, geography, socio-economic status, educational level, or political and religious ideologies. While robust pharmacotherapy and psychotherapy treatments are available for de-addiction and managing withdrawal symptoms, patients from rural areas and lower socio-economic classes often prefer alternative medicine. Cupping therapy is one such ancient practice used mainly for organic physical conditions. A patient addicted to alprazolam, codeine, and tobacco presented to our psychiatry outpatient department for de-addiction and management of his withdrawal symptoms. He came to seek professional help after a trial of cupping therapy by an alternative medicine practitioner, which did not improve his condition. His withdrawal symptoms subsided after standard treatment. As found in this case, cupping therapy is not beneficial in treating substance use disorder or managing withdrawal symptoms. Awareness of the utility and consequences of cupping therapy and other alternative therapies is required to promote rational scientific treatments. Substantial reforms in health promotion and health education are required to educate the general population regarding the most effective treatments available, and the risks of iatrogenesis associated with traditional cures that are not evidentially backed.
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Affiliation(s)
- Viren Solanki
- Psychiatry, Gujarat Medical Education and Research Society (GMERS) Medical College and Hospital, Valsad, IND
| | | | - Shahin Khan
- Medicine, Government Medical College, Baroda, Vadodara, IND
| | - Vedant Desai
- Medicine, Gujarat Medical Education and Research Society (GMERS) Medical College and Hospital, Valsad, IND
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Harmelech T, Hanlon CA, Tendler A. Transcranial Magnetic Stimulation as a Tool to Promote Smoking Cessation and Decrease Drug and Alcohol Use. Brain Sci 2023; 13:1072. [PMID: 37509004 PMCID: PMC10377606 DOI: 10.3390/brainsci13071072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/30/2023] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive, drug-free, neural-circuit-based therapeutic tool that was recently cleared by the United States Food and Drug Associate for the treatment of smoking cessation. TMS has been investigated as a tool to reduce consumption and craving for many other substance use disorders (SUDs). This review starts with a discussion of neural networks involved in the addiction process. It then provides a framework for the therapeutic efficacy of TMS describing the role of executive control circuits, default mode, and salience circuits as putative targets for neuromodulation (via targeting the DLPFC, MPFC, cingulate, and insula bilaterally). A series of the largest studies of TMS in SUDs are listed and discussed in the context of this framework. Our review concludes with an assessment of the current state of knowledge regarding the use of rTMS as a therapeutic tool in reducing drug, alcohol, and nicotine use and identifies gaps in the literature that need to be addressed in future studies. Namely, while the presumed mechanism through which TMS exerts its effects is by modulating the functional connectivity circuits involved in executive control and salience of drug-related cues, it is also possible that TMS has direct effects on subcortical dopamine, a hypothesis that could be explored in greater detail with PET imaging.
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Affiliation(s)
| | - Colleen A Hanlon
- BrainsWay Ltd., Winston-Salem, NC 27106, USA
- Wake Forest School of Medicine, Winston-Salem, NC 27106, USA
| | - Aron Tendler
- BrainsWay Ltd., Winston-Salem, NC 27106, USA
- Department of Life Sciences, Ben Gurion University of the Negev, Beer-Sheva 84105, Israel
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Kalhan S, Chen LPE, Garrido MI, Hester R. People with tobacco use disorder exhibit more prefrontal activity during preparatory control but reduced anterior cingulate activity during reactive control. Addict Biol 2022; 27:e13159. [PMID: 35229950 PMCID: PMC9285037 DOI: 10.1111/adb.13159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 01/17/2022] [Accepted: 01/27/2022] [Indexed: 11/30/2022]
Abstract
Reduced inhibitory control and a hypersensitivity to reward are key deficits in drug dependents; however, they tend to be studied in isolation. Here, we seek to understand the neural processes underlying control over reward and how this is different in people with a tobacco use disorder (pTUD). A novel variant of the monetary incentive delay task was performed by pTUD (n = 20) and non-smokers (n = 20), where we added a stop-signal component such that participants had to inhibit prepotent responses to earn a larger monetary reward. Brain activity was recorded using functional magnetic resonance imaging (fMRI). We estimated stop signal reaction times (SSRTs), an indicator of impulsivity, and correlated these with brain activity. Inhibitory accuracy scores did not differ between the control group and pTUD. However, pTUD had slower SSRTs, suggesting that they may find it harder to inhibit responses. Brain data revealed that pTUD had greater preparatory control activity in the middle frontal gyrus and inferior frontal gyrus prior to successful inhibitions over reward. In contrast, non-smokers had greater reactive control associated with more activity in the anterior cingulate cortex during these successful inhibitions. SSRT-brain activity correlations revealed that pTUD engaged more control-related prefrontal brain regions when SSRTs are slower. Overall, while the inhibition accuracy scores were similar between groups, differential neural processes and strategies were used to successfully inhibit a prepotent response. The findings suggest that increasing preparatory control in pTUD may be one possible treatment target in order to increase inhibitory control over reward.
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Affiliation(s)
- Shivam Kalhan
- School of Psychological Sciences University of Melbourne Melbourne Victoria Australia
| | - Li Peng Evelyn Chen
- School of Psychological Sciences University of Melbourne Melbourne Victoria Australia
| | - Marta I. Garrido
- School of Psychological Sciences University of Melbourne Melbourne Victoria Australia
- Australian Research Council Centre of Excellence for Integrative Brain Function Clayton Victoria Australia
| | - Robert Hester
- School of Psychological Sciences University of Melbourne Melbourne Victoria Australia
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Abstract
Substance use disorders (SUDs) are an extremely challenging category of disorders because of the high rate of relapse, lower life expectancy, important rate of psychiatric and somatic co-morbidity, lack of patients' insight during most of the disease duration, healthcare costs, etc. One of the reasons to consider these disorders very difficult for physicians and the healthcare system is the lack of adequate pharmacological agents with long-term proven efficacy. So far, there are no Food and Drug Administration (FDA) or European Medicines Agency (EMA)-approved treatments for most of the SUDs, except for alcohol use disorder, nicotine use disorder, and opioid use disorder. Immunotherapy has been considered a possible solution to SUDs because it may selectively target a certain drug of abuse, it may have a long-lasting effect (several weeks or months), and it ensures an adequate therapeutic adherence. The objective of this paper was to establish the current stage of research in the field of SUDs vaccines, based on a brief literature review. Vaccines for cocaine and nicotine dependence have reached phase III trials, while other researchers are focusing on passive immunization therapy for methamphetamine use disorder. New generations of vaccines are currently explored, and they are based on superior technologies compared to the first generation of immune therapy (e.g., viral transfer genes, more immunogenic adjuvants, or higher specificity haptens). Therefore, finding immune therapies for substance use disorders SUDs remains a matter of interest, and this approach may be useful for the management of an extremely dangerous and versatile psychiatric pathology.
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Affiliation(s)
- Octavian Vasiliu
- Department of Psychiatry, Dr. Carol Davila University Emergency Central Military Hospital, Bucharest, Romania
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Haugg A, Manoliu A, Sladky R, Hulka LM, Kirschner M, Brühl AB, Seifritz E, Quednow BB, Herdener M, Scharnowski F. Disentangling craving- and valence-related brain responses to smoking cues in individuals with nicotine use disorder. Addict Biol 2022; 27:e13083. [PMID: 34363643 PMCID: PMC9285426 DOI: 10.1111/adb.13083] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/17/2021] [Accepted: 07/21/2021] [Indexed: 11/30/2022]
Abstract
Tobacco smoking is one of the leading causes of preventable death and disease worldwide. Most smokers want to quit, but relapse rates are high. To improve current smoking cessation treatments, a better understanding of the underlying mechanisms of nicotine dependence and related craving behaviour is needed. Studies on cue‐driven cigarette craving have been a particularly useful tool for investigating the neural mechanisms of drug craving. Here, functional neuroimaging studies in humans have identified a core network of craving‐related brain responses to smoking cues that comprises of amygdala, anterior cingulate cortex, orbitofrontal cortex, posterior cingulate cortex and ventral striatum. However, most functional Magnetic Resonance Imaging (fMRI) cue‐reactivity studies do not adjust their stimuli for emotional valence, a factor assumed to confound craving‐related brain responses to smoking cues. Here, we investigated the influence of emotional valence on key addiction brain areas by disentangling craving‐ and valence‐related brain responses with parametric modulators in 32 smokers. For one of the suggested key regions for addiction, the amygdala, we observed significantly stronger brain responses to the valence aspect of the presented images than to the craving aspect. Our results emphasize the need for carefully selecting stimulus material for cue‐reactivity paradigms, in particular with respect to emotional valence. Further, they can help designing future research on teasing apart the diverse psychological dimensions that comprise nicotine dependence and, therefore, can lead to a more precise mapping of craving‐associated brain areas, an important step towards more tailored smoking cessation treatments.
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Affiliation(s)
- Amelie Haugg
- Psychiatric University Hospital Zurich Zurich Switzerland
- Faculty of Psychology University of Vienna Vienna Austria
| | - Andrei Manoliu
- Psychiatric University Hospital Zurich Zurich Switzerland
- McLean Hospital Belmont Massachusetts USA
- Harvard Medical School Harvard University Boston Massachusetts USA
| | - Ronald Sladky
- Faculty of Psychology University of Vienna Vienna Austria
| | - Lea M. Hulka
- Psychiatric University Hospital Zurich Zurich Switzerland
| | - Matthias Kirschner
- Psychiatric University Hospital Zurich Zurich Switzerland
- Montreal Neurological Institute McGill University Montreal Canada
| | | | - Erich Seifritz
- Psychiatric University Hospital Zurich Zurich Switzerland
| | | | | | - Frank Scharnowski
- Psychiatric University Hospital Zurich Zurich Switzerland
- Faculty of Psychology University of Vienna Vienna Austria
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Adams ZW, Kwon E, Aalsma MC, Zapolski TCB, Dir A, Hulvershorn LA. Treatment of Adolescent e-Cigarette Use: Limitations of Existing Nicotine Use Disorder Treatment and Future Directions for e-Cigarette Use Cessation. J Am Acad Child Adolesc Psychiatry 2021; 60:14-16. [PMID: 33353661 PMCID: PMC7977626 DOI: 10.1016/j.jaac.2020.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 07/02/2020] [Accepted: 07/17/2020] [Indexed: 10/22/2022]
Abstract
Electronic cigarette use ("vaping") has surged in the United States since the mid-2010s. From 2011 to 2018, current e-cigarette use among high school students escalated from 1.5% to 20.8% (∼3.05 million youths),1 countering downward trends in combustible nicotine product use (21.8% in 2011 to 13.9% in 2018).1 Although preventing the initial uptake of vaping is crucial, for the millions of adolescents who have taken up this behavior-many of whom express interest in quitting (eg, 44.5% of current, adolescent non-light e-cigarette users in one US national representative sample)2-it is critically important to help them quit vaping so as to curtail future substance use disorders and other health consequences. Here, we discuss several challenges around adolescent vaping treatment, and highlight research areas in urgent need of attention.
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Affiliation(s)
- Zachary W. Adams
- Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Elizabeth Kwon
- Indiana University School of Medicine, Indianapolis, Indiana, USA
| | | | | | - Allyson Dir
- Indiana University School of Medicine, Indianapolis, Indiana, USA
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Woodcock EA, Stanley JA, Diwadkar VA, Khatib D, Greenwald MK. A neurobiological correlate of stress-induced nicotine-seeking behavior among cigarette smokers. Addict Biol 2020; 25:e12819. [PMID: 31418989 DOI: 10.1111/adb.12819] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 07/11/2019] [Accepted: 07/14/2019] [Indexed: 02/06/2023]
Abstract
Stress is known to influence smoking relapse. Experimental studies indicate that acute stress increases nicotine-seeking behavior, yet neurobiological mechanisms remain poorly understood. Herein, we investigated disrupted excitatory neural activity in the dorsolateral prefrontal cortex (dlPFC) as a mechanism of stress-induced nicotine-seeking behavior. Non-treatment-seeking cigarette smokers were screened for psychiatric, medical, and neuroimaging contraindications. Using a double-blind, placebo-controlled, randomized crossover design, participants (N = 21) completed two oral-dosing sessions: stress (yohimbine 54 mg + hydrocortisone 10 mg) vs placebo (lactose 54 mg + lactose 10 mg). During each experimental session, working memory proficiency, dlPFC excitatory neural activity, nicotine-seeking behavior, and subjective effects were measured. dlPFC excitatory neural activity was quantified via glutamate modulation during working memory performance using functional proton magnetic resonance spectroscopy. Nicotine-seeking behavior was assayed using a cigarette puffs vs money choice progressive ratio task. Results indicated that yohimbine + hydrocortisone evoked a sustained physiological stress response (elevated heart rate, blood pressure, saliva cortisol, and saliva α-amylase levels; ps < .05). Relative to placebo levels, acute stress increased nicotine-seeking behavior (ps < .05), disrupted dlPFC glutamate modulation (p = .025), and impaired dlPFC function (working memory proficiency; ps < .05). The stress-induced increase in nicotine-seeking behavior was linearly related to the stress-induced disruption of dlPFC glutamate modulation (R2 = 0.24-0.37; ps < .05). These findings suggest that disrupted dlPFC excitatory neural activity is a neurobiological correlate of acute stress-induced nicotine-seeking behavior. These findings further emphasize the central role of the dlPFC in regulating drug-seeking behavior. Future studies are needed to evaluate interventions to improve dlPFC resilience to acute stress effects, including neurostimulation, working memory training, and "anti-stress" medications.
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Affiliation(s)
- Eric A. Woodcock
- Department of Psychiatry Yale University School of Medicine New Haven Connecticut USA
- Department of Psychiatry and Behavioral Neurosciences Wayne State University School of Medicine Detroit Michigan USA
| | - Jeffrey A. Stanley
- Department of Psychiatry and Behavioral Neurosciences Wayne State University School of Medicine Detroit Michigan USA
| | - Vaibhav A. Diwadkar
- Department of Psychiatry and Behavioral Neurosciences Wayne State University School of Medicine Detroit Michigan USA
| | - Dalal Khatib
- Department of Psychiatry and Behavioral Neurosciences Wayne State University School of Medicine Detroit Michigan USA
| | - Mark K. Greenwald
- Department of Psychiatry and Behavioral Neurosciences Wayne State University School of Medicine Detroit Michigan USA
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Wilcox CE, Claus ED, Calhoun VD, Rachakonda S, Littlewood RA, Mickey J, Arenella PB, Goodreau N, Hutchison KE. Default mode network deactivation to smoking cue relative to food cue predicts treatment outcome in nicotine use disorder. Addict Biol 2018; 23:412-424. [PMID: 28231626 DOI: 10.1111/adb.12498] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Revised: 12/16/2016] [Accepted: 02/02/2017] [Indexed: 11/28/2022]
Abstract
Identifying predictors of treatment outcome for nicotine use disorders (NUDs) may help improve efficacy of established treatments, like varenicline. Brain reactivity to drug stimuli predicts relapse risk in nicotine and other substance use disorders in some studies. Activity in the default mode network (DMN) is affected by drug cues and other palatable cues, but its clinical significance is unclear. In this study, 143 individuals with NUD (male n = 91, ages 18-55 years) received a functional magnetic resonance imaging scan during a visual cue task during which they were presented with a series of smoking-related or food-related video clips prior to randomization to treatment with varenicline (n = 80) or placebo. Group independent components analysis was utilized to isolate the DMN, and temporal sorting was used to calculate the difference between the DMN blood-oxygen-level dependent signal during smoke cues and that during food cues for each individual. Food cues were associated with greater deactivation compared with smoke cues in the DMN. In correcting for baseline smoking and other clinical variables, which have been shown to be related to treatment outcome in previous work, a less positive Smoke - Food difference score predicted greater smoking at 6 and 12 weeks when both treatment groups were combined (P = 0.005, β = -0.766). An exploratory analysis of executive control and salience networks demonstrated that a more positive Smoke - Food difference score for executive control network predicted a more robust response to varenicline relative to placebo. These findings provide further support to theories that brain reactivity to palatable cues, and in particular in DMN, may have a direct clinical relevance in NUD.
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Affiliation(s)
- Claire E. Wilcox
- Department of Psychiatry; University of New Mexico; Albuquerque NM USA
| | - Eric D. Claus
- Mind Research Network and Lovelace Biomedical and Environmental Research Institute; Albuquerque NM USA
| | - Vince D. Calhoun
- Mind Research Network and Lovelace Biomedical and Environmental Research Institute; Albuquerque NM USA
| | - Srinivas Rachakonda
- Mind Research Network and Lovelace Biomedical and Environmental Research Institute; Albuquerque NM USA
| | - Rae A. Littlewood
- Mind Research Network and Lovelace Biomedical and Environmental Research Institute; Albuquerque NM USA
| | - Jessica Mickey
- Mind Research Network and Lovelace Biomedical and Environmental Research Institute; Albuquerque NM USA
| | | | - Natalie Goodreau
- Mind Research Network and Lovelace Biomedical and Environmental Research Institute; Albuquerque NM USA
| | - Kent E. Hutchison
- Mind Research Network and Lovelace Biomedical and Environmental Research Institute; Albuquerque NM USA
- Department of Psychology; University of Colorado Boulder; Boulder CO USA
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Heffner JL, Mull KE. Smartphone Ownership Among US Adult Cigarette Smokers: 2014 Health Information National Trends Survey (HINTS) Data. J Med Internet Res 2017; 19:e305. [PMID: 28860108 PMCID: PMC5599728 DOI: 10.2196/jmir.7953] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 06/28/2017] [Accepted: 07/14/2017] [Indexed: 01/04/2023] Open
Abstract
Background Despite increasing interest in smartphone apps as a platform for delivery of tobacco cessation interventions, no previous studies have evaluated the prevalence and characteristics of smokers who can access smartphone-delivered interventions. Objective To guide treatment development in this new platform and to evaluate disparities in access to smartphone-delivered interventions, we examined associations of smartphone ownership with demographics, tobacco use and thoughts about quitting, other health behaviors, physical and mental health, health care access, and Internet and technology utilization using a nationally representative sample of US adult smokers. Methods Data were from the National Cancer Institute’s 2014 Health Information National Trends Survey 4 (HINTS 4), Cycle 4. This mailed survey targeted noninstitutionalized individuals aged 18 years or older using two-stage stratified random sampling. For this analysis, we restricted the sample to current smokers with complete data on smartphone ownership (n=479). Results Nearly two-thirds (weighted percent=63.8%, 248/479) of smokers reported owning a smartphone. Those who were younger (P<.001), employed (P=.002), never married (P=.002), and had higher education (P=.002) and income (P<.001) had the highest rates of ownership. Smartphone owners did not differ from nonowners on frequency of smoking, recent quit attempts, or future plans to quit smoking, although they reported greater belief in the benefits of quitting (P=.04). Despite being equally likely to be overweight or obese, smartphone owners reported greater fruit and vegetable consumption (P=.03) and were more likely to report past-year efforts to increase exercise (P=.001) and to lose weight (P=.02). No differences in health care access and utilization were found. Smartphone owners reported better physical and mental health in several domains and higher access to and utilization of technology and the Internet, including for health reasons. Conclusions Smartphone ownership among smokers mirrors many trends in the general population, including the overall rate of ownership and the association with younger age and higher socioeconomic status. Apps for smoking cessation could potentially capitalize on smartphone owners’ efforts at multiple health behavior changes and interest in communicating with health care providers via technology. These data also highlight the importance of accessible treatment options for smokers without smartphones in order to reach smokers with the highest physical and mental health burden and prevent worsening of tobacco-related health disparities as interventions move to digital platforms.
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Affiliation(s)
- Jaimee L Heffner
- Fred Hutchinson Cancer Research Center, Division of Public Health Sciences, Seattle, WA, United States
| | - Kristin E Mull
- Fred Hutchinson Cancer Research Center, Division of Public Health Sciences, Seattle, WA, United States
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Bullock K, Cservenka A, Ray LA. Severity of alcohol dependence is negatively related to hypothalamic and prefrontal cortical gray matter density in heavy drinking smokers. Am J Drug Alcohol Abuse 2016; 43:281-290. [PMID: 27996310 DOI: 10.1080/00952990.2016.1257632] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND While research has examined brain structure in individuals who use alcohol or nicotine, heavy drinking smokers comprise a unique subpopulation of substance users for whom less is known about the relationship between alcohol or nicotine use and structural brain abnormalities. OBJECTIVES The present study examined gray matter morphometry in a sample of 39 heavy drinking smokers (24 males, 15 females) in relation to alcohol and nicotine dependence and quantity of use. METHODS Traditional voxel-based morphometry techniques were employed for preprocessing of imaging data. One multiple regression analysis for alcohol and nicotine dependence severity and another for alcohol and nicotine quantity of use were conducted, while controlling for age, gender, and total intracranial volume (ICV). RESULTS Alcohol dependence severity was significantly negatively associated with gray matter density in the hypothalamus (p < 0.001, uncorrected) and the right superior frontal gyrus (p < 0.001, uncorrected), while controlling for nicotine dependence severity, age, gender, and ICV. There were no significant relationships observed with respect to nicotine dependence severity, the quantity of alcohol use, or the quantity of nicotine use variables and gray matter density. CONCLUSIONS These findings suggest that within heavy drinking smokers, alcohol dependence severity is significantly related to alterations in brain structure, while this effect is not seen for the quantity of alcohol or nicotine use, or severity of nicotine dependence. The current findings help clarify the contribution of alcohol and nicotine effects on brain structure, which could aid in understanding their neurocognitive consequences in heavy drinking smokers.
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Affiliation(s)
- Kyle Bullock
- a Department of Psychology , University of California , Los Angeles , CA , USA
| | - Anita Cservenka
- b School of Psychological Science , Oregon State University , Corvallis , OR , USA
| | - Lara A Ray
- a Department of Psychology , University of California , Los Angeles , CA , USA.,c Department of Psychiatry and Biobehavioral Sciences , University of California , Los Angeles , CA , USA.,d Brain Research Institute , University of California , Los Angeles , CA , USA
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Abstract
Addiction to tobacco-derived nicotine remains highly prevalent in the United States, with 18% using daily, and 53% of those with serious mental illness using daily. While smokers with serious mental illness have been excluded from most large nicotine-dependence treatment studies, a growing evidence base is available to guide clinicians in assisting their patients with psychiatric illness to quit smoking. The aim of this review is to present the evidence on safety and efficacy of smoking cessation interventions for those with serious mental illness. Smokers with schizophrenia spectrum disorders should receive varenicline or bupropion with or without nicotine replacement therapy in combination with behavioral treatment. Although more research is needed, preliminary evidence suggests that varenicline in combination with behavioral support is efficacious and well tolerated for smoking cessation for those with bipolar disorder and major depressive disorder. Controlled trials have found no evidence that in patients with serious mental illness, the use of pharmacotherapeutic cessation aids worsens psychiatric symptoms or increases the rate of psychiatric adverse events. Converging evidence indicates that a majority of smokers with serious mental illness want to quit smoking and that available pharmacotherapeutic cessation aids combined with behavioral support are both effective for, and well tolerated by, these smokers.
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Affiliation(s)
- A. Eden Evins
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital,Harvard Medical School
| | - Corinne Cather
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital,Harvard Medical School
| | - Alexandra Laffer
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital
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