Browsing by Subject "Tobacco use"

Now showing 1 - 7 of 7
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    A selective review of smoking cessation interventions in the emergency department
    (Springer Nature, 2022) Pettit, Nicholas; Pope, Ian; Neuner, Bruno; Lash, Rebecca; Bernstein, Steven L.; Emergency Medicine, School of Medicine
    Background: Emergency department (ED) patients disproportionally smoke compared to the general population and frequently utilize the ED for routine, urgent, and emergent care. Thus, the ED is a target-rich environment for interventions aimed at increasing smoking cessation, especially among vulnerable populations. Promotion of smoking cessation in the ED has the potential to address health inequalities and reach patients that experience significant barriers to accessing preventive care and lifestyle modifications. Topics of review: This narrative review presents a concise summary of the major smoking cessation strategies studied in the ED setting for adults, children, and pregnant ED patients. Additionally, this review presents the strategies to increase the uptake of smoking cessation in the ED, as well as an international perspective of smoking cessation efforts in the ED. Past and ongoing efforts to improve smoking cessation among ED patients are discussed, and critical knowledge gaps and research opportunities are highlighted. Conclusion: Smoking cessation is both efficacious and feasible during an ED visit, with multiple options available to both adults, children, parents, and pregnant patients. Little standardization among cessation strategies among EDs has been demonstrated, despite the ED being uniquely positioned to address disparities in smoking cessation and contribute towards national smoking cessation goals. During most ED visits, any health care team member can address ongoing tobacco use, and smoking cessation can easily be related to the context of the patient’s presenting complaint. To be effective, health care systems and teams must recognize the ED as a suitable location to engage with patients regarding their knowledge and awareness of ongoing smoking use, and are well suited to provide and initiate effective smoking cessation treatments.
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    Are Cardiovascular Risk Factors Stronger Predictors of Incident Cardiovascular Disease in U.S. Adults With Versus Without a History of Clinical Depression?
    (Oxford University Press, 2018-12) Polanka, Brittanny M.; Berntson, Jessica; Vrany, Elizabeth A.; Stewart, Jesse C.; Psychology, School of Science
    Background Several mechanisms underlying the depression-to-cardiovascular disease (CVD) relationship have been proposed; however, few studies have examined whether depression promotes CVD through potentiating traditional cardiovascular risk factors. Purpose To test the combined influence of three cardiovascular risk factors and lifetime depressive disorder on incident CVD in a large, diverse, and nationally representative sample of U.S. adults. Methods Respondents were 26,840 adults without baseline CVD who participated in Waves 1 (2001–2002) and 2 (2004–2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. Lifetime depressive disorder, tobacco use, hypertension, and incident CVD were determined from structured interviews, and body mass index (BMI) was computed from self-reported height and weight. Results Logistic regression models predicting incident CVD (1,046 cases) revealed evidence of moderation, as the interactions between lifetime depressive disorder and current tobacco use (p = .002), hypertension (p < .001), and BMI (p = .031) were significant. The Former Tobacco Use × Lifetime Depressive Disorder interaction was not significant (p = .85). In models stratified by lifetime depressive disorder, current tobacco use (OR = 1.78, 95% CI = 1.36–2.32, p < .001 vs. OR = 1.41, 95% CI = 1.24–1.60, p < .001), hypertension (OR = 2.46, 95% CI = 1.98–3.07, p < .001 vs. OR = 1.39, 95% CI = 1.28–1.51, p < .001), and BMI (OR = 1.10, 95% CI = 1.01–1.20, p = .031 vs. OR = 1.03, 95% CI = 0.99–1.07, p = .16) were stronger predictors of incident CVD in adults with versus without a lifetime depressive disorder. Conclusions Our findings suggest that amplifying the atherogenic effects of traditional cardiovascular risk factors may be yet another candidate mechanism that helps to explain the excess CVD risk of people with depression.
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    Assessment of the dopamine system in addiction using positron emission tomography
    (2014) Albrecht, Daniel Strakis; Hutchins, Gary D.; Saykin, Andrew J.; Kareken, David A.; Yoder, Karmen K.; Grahame, Nicholas J.
    Drug addiction is a behavioral disorder characterized by impulsive behavior and continued intake of drug in the face of adverse consequences. Millions of people suffer the financial and social consequences of addiction, and yet many of the current therapies for addiction treatment have limited efficacy. Therefore, there is a critical need to characterize the neurobiological substrates of addiction in order to formulate better treatment options. In the first chapter, the striatal dopamine system is interrogated with [11C]raclopride PET to assess differences between chronic cannabis users and healthy controls. The results of this chapter indicate that chronic cannabis use is not associated with a reduction in striatal D2/D3 receptor availability, unlike many other drugs of abuse. Additionally, recent cannabis consumption in chronic users was negatively correlated with D2/D3 receptor availability. Chapter 2 describes a retrospective analysis in which striatal D2/D3 receptor availability is compared between three groups of alcohol-drinking and tobacco-smoking subjects: nontreatment-seeking alcoholic smokers, social-drinking smokers, and social-drinking non-smokers. Results showed that smokers had reduced D2/D3 receptor availability throughout the striatum, independent of drinking status. The results of the first two chapters suggest that some combustion product of marijuana and tobacco smoke may have an effect on striatal dopamine concentration. Furthermore, they serve to highlight the effectiveness of using baseline PET imaging to characterize dopamine dysfunction in addictions. The final chapter explores the use of [18F]fallypride PET in a proof-of-concept study to determine whether changes in cortical dopamine can be detected during a response inhibition task. We were able to detect several cortical regions of significant dopamine changes in response to the task, and the amount of change in three regions was significantly associated with task performance. Overall, the results of Chapter 3 validate the use of [18F]fallypride PET to detect cortical dopamine changes during a impulse control task. In summary, the results reported in the current document demonstrate the effectiveness of PET imaging as a tool for probing resting and activated dopamine systems in addiction. Future studies will expand on these results, and incorporate additional methods to further elucidate the neurobiology of addiction.
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    Perinatal smoking and its related factors
    (2018-07-12) Jones, Ashley; Shieh, Carol; Staten, Lisa; Carter-Harris, Lisa; Stiffler, Deborah; Macy, Jon
    The smoking rate of low-income pregnant women is almost 4 times the rate for higher-income women. A better understanding of smoking within the low-income population is needed. The purpose of this dissertation was to study smoking and related factors for pregnant and postpartum women living in poverty. The first component used Rodger’s evolutionary concept analysis method and uncovered three attributes, four antecedents, and three consequences for smoking cessation. The second (N = 1,554) and third (N = 71,944) components were a secondary data analysis of first-pregnancy Medicaid-eligible women enrolled in the Nurse-Family Partnership program from 2011-2016. The second component explored patterns of smoking and depression and their associations. Eight distinct patterns of smoking and depression were found. Smokers were more likely than nonsmokers to have depressive symptoms at the end of pregnancy (OR = 1.37 [1.04, 1.81] and 12 months post-delivery (OR = 1.93 [1.47, 2.51]. The third component investigated covariates present during early pregnancy and their relationships with smoking status and sought to find best fitting predictive models. Multivariable logistic regression showed cigarette use in the 3 months prior to pregnancy and at program intake were significant predictors for smoking status at the end of pregnancy and 12 months post-delivery. Interactive Matrix Language, Structured Query Language, and iterations of logistic regression identified 5 covariates (high school education, cigarette use prior to pregnancy, smoking status at pregnancy baseline, depression, and self-mastery) for the best fitting model at the end of pregnancy and three additional covariates (post-secondary education, marital status, and race) for the 12 months post-delivery model. The area under the receiver operator characteristic curve was 0.9681 for the end of pregnancy model and 0.9269 for 12 months post-delivery model, indicating excellent prediction ability of the models. Results can be integrated in smoking prevention education, screening, and cessation intervention programs.
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    Relationship of Negative Urgency to Cingulo-Insular and Cortico-Striatal Resting State Functional Connectivity in Tobacco Use
    (SpringerLink, 2020-10) Um, Miji; Hummer, Tom A.; Cyders, Melissa A.; Psychology, School of Science
    Negative urgency, defined as a tendency to act rashly under extreme negative emotion, is strongly associated with tobacco use. Despite the robust evidence linking negative urgency and tobacco use and accumulating evidence suggesting that localized, segregated brain regions such as the nucleus accumbens (NAcc), insula, and amygdala are related to negative urgency, resting state functional connectivity (rsFC) of negative urgency in tobacco use has not yet been examined. This study included 34 daily tobacco users and 62 non-users matched on age, gender, race/ethnicity, and lifetime psychiatric diagnosis from a publicly available neuroimaging dataset collected by the Nathan Kline Institute-Rockland Project. Using the bilateral NAcc, insula, and amygdala as seed regions, seed-based rsFC analyses were conducted on the whole brain. In the whole sample, negative urgency was positively correlated with rsFC between the left insula and right dorsal anterior cingulate cortex (dACC). Compared to non-users, tobacco users had a stronger rsFC strength between the right amygdala and right middle temporal gyrus. In tobacco users, negative urgency was negatively associated with rsFC between the left NAcc and right dACC and between the left NAcc and right dorsolateral prefrontal cortex; these relationships were positive in non-users. Identifying functional connectivity implicated in negative urgency and tobacco use is the crucial first step to design and test pharmacological and physiological interventions to reduce negative urgency related tobacco use.
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    Resting-state neural circuit correlates of negative urgency: a comparison between tobacco users and non-tobacco users
    (2017-06-28) Um, Miji; Cyders, Melissa A.
    Negative urgency, defined as a tendency to act rashly under extreme negative emotion, is strongly associated with tobacco use. Despite the robust cross-sectional and experimental evidence linking negative urgency and tobacco use, neural correlates of negative urgency in tobacco use have not been studied. The purpose of the current study was to 1) identify neural circuits that differ between tobacco users and non-tobacco users and 2) explore the relationship between resting-state seed-based functional connectivity (rsFC) and negative urgency, both in the overall group and between tobacco users and non-tobacco users. Using negative urgency-related brain regions as seed regions (voxel level p = .005, cluster-level a < .05), compared to non-tobacco users (n = 21; mean age = 36.57, 62% female, 76% white), tobacco users (n = 22; mean age = 37.50, 64% female, 77% white) had stronger rsFC strengths in the right amygdala – left medial orbitofrontal cortex/ventromedial prefrontal cortex circuit and the right nucleus accumbens – right temporoparietal junction circuit. Additionally, rsFC in the bilateral temporal pole – left supramarginal gyrus circuits was positively correlated with negative urgency (Left temporal pole: r = .55, p < .001; Right temporal pole: r = .51, p < .001). The current study extends previous neuroimaging findings, which have mainly focused on how negative urgency is related to brain responses in localized, segregated brain regions, by examining the network-level interactions between different brain regions. This study provides prime preliminary data for future neuroimaging studies of negative urgency by providing potential target networks that would aid the development of novel intervention strategies for negative urgency-based maladaptive behaviors.
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    The Impact of Donor Smoking on Primary Graft Dysfunction and Mortality after Lung Transplantation
    (American Thoracic Society, 2024) Diamond, Joshua M.; Cantu, Edward; Calfee, Carolyn S.; Anderson, Michaela R.; Clausen, Emily S.; Shashaty, Michael G. S.; Courtwright, Andrew M.; Kalman, Laurel; Oyster, Michelle; Crespo, Maria M.; Bermudez, Christian A.; Benvenuto, Luke; Palmer, Scott M.; Snyder, Laurie D.; Hartwig, Matthew G.; Todd, Jamie L.; Wille, Keith; Hage, Chadi; McDyer, John F.; Merlo, Christian A.; Shah, Pali D.; Orens, Jonathan B.; Dhillon, Gundeep S.; Weinacker, Ann B.; Lama, Vibha N.; Patel, Mrunal G.; Singer, Jonathan P.; Hsu, Jesse; Localio, A. Russell; Christie, Jason D.; Medicine, School of Medicine
    Rationale: Primary graft dysfunction (PGD) is the leading cause of early morbidity and mortality after lung transplantation. Prior studies implicated proxy-defined donor smoking as a risk factor for PGD and mortality. Objectives: We aimed to more accurately assess the impact of donor smoke exposure on PGD and mortality using quantitative smoke exposure biomarkers. Methods: We performed a multicenter prospective cohort study of lung transplant recipients enrolled in the Lung Transplant Outcomes Group cohort between 2012 and 2018. PGD was defined as grade 3 at 48 or 72 hours after lung reperfusion. Donor smoking was defined using accepted thresholds of urinary biomarkers of nicotine exposure (cotinine) and tobacco-specific nitrosamine (4-[methylnitrosamino]-1-[3-pyridyl]-1-butanol [NNAL]) in addition to clinical history. The donor smoking–PGD association was assessed using logistic regression, and survival analysis was performed using inverse probability of exposure weighting according to smoking category. Measurements and Main Results: Active donor smoking prevalence varied by definition, with 34–43% based on urinary cotinine, 28% by urinary NNAL, and 37% by clinical documentation. The standardized risk of PGD associated with active donor smoking was higher across all definitions, with an absolute risk increase of 11.5% (95% confidence interval [CI], 3.8% to 19.2%) by urinary cotinine, 5.7% (95% CI, −3.4% to 14.9%) by urinary NNAL, and 6.5% (95% CI, −2.8% to 15.8%) defined clinically. Donor smoking was not associated with differential post–lung transplant survival using any definition. Conclusions: Donor smoking associates with a modest increase in PGD risk but not with increased recipient mortality. Use of lungs from smokers is likely safe and may increase lung donor availability.