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Background: The tobacco epidemic is one of the biggest public health threats and the world's leading cause of preventable death which is responsible for killing 8 million people every year. Adolescents are the vulnerable age group and are at greater risk of any tobacco use including smokeless tobacco (SLT) and nicotine addiction. Tobacco use at a young age increases the risk of various non-communicable diseases (NCDs) such as respiratory illness, asthma, chronic obstructive respiratory disease (COPD), reduced pulmonary function, and cancers. This study aimed to determine the prevalence of smokeless tobacco and its associated factors among secondary school students of grades 11 and 12 in Rangeli Municipality, Nepal. Methodology: A cross-sectional study was conducted among 355 students from the selected secondary schools. A self-administered questionnaire was used to collect the data. Data was cleaned and then exported to IBM SPSS Statistics 20 for analysis. Participants' characteristics were described using frequencies, percentages, mean, and standard deviation. Multivariate logistic regression was conducted to determine the association between individual characteristics and prevalence of smokeless tobacco. All the tests were performed at a 95% Confidence Interval (CI) and a p-value less than 0.05. Results: The mean (±SD) age of the participants was 18.0±1.3 years. Most participants were female (61.1%). The majority of the participants were from grade 11 (58.3%), government schools (60%), and nuclear families (64.8%). This study found that 38.4% and 61.6% of the participants were SLT ever users and never users respectively. Among the ever users, 29.5% were current users and most tried (47.7%) at the age of 10–14 years. Most participants revealed that homes and public places were common sites for SLT use. Paan Masala and Gutkha were the most commonly preferrable SLTs. This study found that age (AOR = 1.5, CI: 1.2–2.2), sex (AOR = 2.6, CI:1.6–4.4), and school type (AOR = 1.8, CI:1.1–3.0) were significantly associated with the prevalence of SLT. Conclusion: This study found that the prevalence of current SLT users is higher than the national survey. This study concludes that males, young adolescents, and students from private schools are at greater risk of SLT use and are unaware of the consequences on their health. Concerned stakeholders must expand awareness and promote educational programs on the harmful use of tobacco targeting secondary school students. The government organizations, educational institutions, and private organizations jointly work to strengthen the implementation of tobacco cessation programs and tobacco control strategies. [ABSTRACT FROM AUTHOR]

Aim: Internet addiction is a mental health issue that can have detrimental effects on an individual's life. This study aims to estimate the prevalence of Internet Addiction and identify the risk factors associated with this behavioral addiction. Methods: This cross-sectional study was conducted in 6 universities in southern Morocco, involving 1,690 students who completed a self-administered questionnaire. The questionnaire collected socio-demographic data, and information on substance use, and included validated tools to assess Internet addiction (Young's IADQ), depressive symptoms (Patient Health Questionnaire. PHQ-9), and social phobia (Mini Neuropsychiatric International Interview. M.I.N.I). Results: The findings of our study indicate that the prevalence of Internet addiction was 30.60% (95% CI), depressive symptoms were present in 44.10% of participants, and the prevalence of social Phobia was 30.20%. A significant correlation was identified between early initiation of tobacco and Internet addiction (p = 0.05). The multivariate regression model revealed a possible association between cocaine use and Internet Addiction (OR = 5.67, IC 95%: 0.45 to 10.80) (p = 0.03), as well as a significant association between social phobia and a higher internet addiction score (OR = 3.45, IC 95%: 1.70–5.02) (p < 0.001). However, depressive symptoms were not significantly associated with internet addiction (p = 0.38). Conclusion: These results highlight the urgent need to address internet addiction in the coming years. Implementing Multidisciplinary prevention strategies, early diagnosis, and follow-up measures are essential to mitigate the physical, psychosocial, and academic impacts of this addiction on students. [ABSTRACT FROM AUTHOR]

Introduction: Substance-use disorders (SUDs) are a public health problem. The Global Adult Tobacco Survey (GATS) and National Family Health Survey (NFHS) provide evidence of high usage. Hence, the National Mental Health Survey (NMHS) WB data were analyzed to estimate the prevalence, pattern, disability burden, and service utilization of SUD. Methodology: The usual NMHS methodology was used. Four districts were selected, and thereafter, a multistage random sampling was done. The validated Bengali version of the Mini International Neuropsychiatric Interview (MINI) and other instruments like the Fagerstrom Test for Nicotine Dependence (FTND), disability, and health care utilization modules were used. Results: A total of 2,646 eligible members (age >18 years as per 2011 census) were interviewed. It was found that alcohol use as per MINI at least 3 drinks of alcohol within 3 hours on 3 or more occasions was 3.9%, and the weighted prevalence of alcohol-use disorder (AUD) and tobacco-use disorder (TUD) was 3.04% and 14%, respectively. The AUD and TUD prevalence was lower than the national prevalence, yet they were more prevalent in urban areas than in the national trend. The ratio of women to men suffering from AUD in WB (1:5) was one of the highest in the country (all India average 1:18). Also, the treatment gap of 89.2% was more than the national average. Discussion: SUDs are an important public health problem in the state of WB, which requires further research, particularly among women, comorbid psychiatric disorders, and in urban areas. [ABSTRACT FROM AUTHOR]

Introduction: Young people who use nicotine‐containing electronic cigarettes, or 'vapes', risk becoming addicted to these products. While several studies document dependency symptoms, few report in‐depth qualitative analyses of addiction. Methods: We explored experiences of self‐reported vaping addiction using in‐depth interviews with 22 young people aged 16–20 years who vaped and lived in Aotearoa New Zealand. Our semi‐structured interview guide probed participants' early experiences and how they progressed from experimentation to addiction and explored how addiction affected their perceptions and daily routines. We used an inductive reflexive thematic analysis approach to interpret the data. Results: Vaping's pervasiveness piqued participants' curiosity and encouraged trial. Most transitioned from experimentation to addiction within a couple of months; while a minority described a slower progression, nearly all felt irritable, angry or uncomfortable if they had to delay vaping. Intense cravings disrupted school and work routines and dictated how they spent their time. Many deeply regretted vaping and some suffered shame and embarrassment. These participants saw vaping as a threat to the well‐being of younger youth, which they tried to shield from addiction. Discussion and Conclusions: We go beyond earlier studies by probing the burden vaping comes to represent, offering new insights into young people's everyday experiences of vaping addiction. In addition to informing health promotion campaigns, our findings could inform policy directions. Understanding the speed with which addiction can occur, its impact on daily life, and the considerable regret many felt could help inform a more strategic and sorely needed approach to reducing youth vaping. [ABSTRACT FROM AUTHOR]

Background: Nicotine is largely responsible for the initiation and maintenance of tobacco dependence and contributes to a global health problem. Aims: This study characterizes nicotine oral consumption and preference in male and female mice of several Diversity Outbred (DO) founder strains: C57BL/6J, A/J, 129S1/SvImJ, PWK/PhJ, NOD/ShiLtJ, and CAST/EiJ. It assesses the impact of nicotine concentration on intake and preference, the potential interaction of strain with sex, and estimates the degree of heritable variation in nicotine consumption. Methods: Two-bottle choice oral self-administration paradigm was used to assess nicotine intake, nicotine preference, and total fluid intake in male and female mice of each strain in a concentration-response manner. A conditioned place preference (CPP) test was performed to evaluate the rewarding and aversive effects of nicotine in certain strains after systemic administration of the drug. Results: The highest nicotine-consuming strain was found to be 129S1/SvlmJ, and the lowest nicotine-consuming strain was A/J. Strain differences in nicotine intake were not due to differences in bitter and sweet tastes as shown in the saccharine and quinine two-bottle choice tests. A/J strain showed no significant CPP for nicotine while the 129S1/SvImJ strain showed a significant CPP for nicotine and a higher preference when compared to the C57BL/6J strain. Heritability estimates of nicotine intake were sex dependent and concentration dependent. Conclusions: Data support that nicotine consumption patterns are heritable with an influence of genotype in a voluntary oral self-administration paradigm. Results pave the way for future studies with the highly recombinant DO mice that might lead to the identification of novel genetic loci and genes influencing nicotine consumption. [ABSTRACT FROM AUTHOR]

Continuous nicotine exposure during adolescence can have profound implications on the development and well-being of individuals in this critical stage of life. As the prevalence of nicotine use among adolescents continues to be a significant public health concern, understanding the impact of this addictive substance on young minds and bodies is crucial. We explored the various dimensions of nicotine exposure in adolescents, from its effects on brain development and cognitive function to the social, emotional, and educational consequences. By looking into the complexities of adolescent nicotine addiction, we can better comprehend the challenges faced by this vulnerable population and develop potential strategies for prevention and intervention. [ABSTRACT FROM AUTHOR]

The well-documented detrimental effects of tobacco on children and adolescents make it imperative to prevent tobacco use in young populations, which is a critical public health objective. Youth are particularly susceptible to nicotine's addictive properties, and they are more susceptible to developing an addiction to tobacco products if they begin using them at a young age, according to research. The reduction of tobacco use among young people can be achieved by implementing evidence-based strategies, including increasing the minimum legal age for purchasing tobacco products, increasing taxation on these products, restricting marketing aimed at youth, and facilitating comprehensive school-based prevention programs, etc. Furthermore, prevention initiatives may be further bolstered by initiatives to encourage smoke-free environments and offer access to smoking cessation resources. In order to effectively prevent tobacco use in young populations and promote healthier outcomes for future generations, it is necessary to target various levels of intervention and involve multiple sectors, including healthcare professionals, educators, policymakers, and community leaders. [ABSTRACT FROM AUTHOR]

E-cigarettes have gained notable popularity among youth in recent years, posing a serious societal issue that has elicited much concern from public health professionals and legislators. The increase in e-cigarette consumption among adolescents can be ascribed to assertive marketing strategies employed by corporations that focus on appealing to young consumers through flavored offerings and aesthetically pleasing designs. This rise is concerning because of the possible long-term health ramifications linked to vaping, such as nicotine addiction and exposure to hazardous chemicals found in numerous e-cigarette formulations. The normalization of e-cigarette usage in social contexts may result in heightened peer pressure and the endorsement of detrimental conduct. To properly address this issue, government agencies must enforce stronger rules on e-cigarette sales and marketing directed at minors, while schools and community organizations should educate youth about the risks of vaping. [ABSTRACT FROM AUTHOR]

AbstractBackground: The prevalence and dependence of e-cigarettes have increased among young adult college students in recent years. Though several independent risk factors for e-cigarette use and dependence have been identified, research employing theory-informed models to predict e-cigarette use and dependence is limited. Objectives: Using Self Determination Theory (SDT), e-cigarette use and dependence may be understood as stemming from need frustration that impairs autonomy, competence, and relatedness, which increases vulnerability for negative health outcomes, including e-cigarette use. Further, need frustration may relate to more e-cigarette use and dependence via higher ruminative thinking, which is known to relate to both need frustration and tobacco use. Method: This study tested this path model (i.e., SDT need frustration components [autonomy, relatedness, competency]→rumination facets [problem-focused thoughts, counterfactual thinking, repetitive thinking, anticipatory thoughts]→e-cigarette use frequency and dependence outcomes) among 1001 college students (75.3% female; 60.4% White, non-Hispanic; 52% first-year students) who endorsed past-month e-cigarette use. Results: Within our path model, we found significant indirect effects via problem-focused thoughts on e-cigarette use frequency and e-cigarette dependence. Specifically, higher scores on SDT autonomy, competence, and relatedness frustration were associated with greater problem-focused thoughts, which was associated with higher e-cigarette use frequency and e-cigarette dependence scores. Conclusions/Importance: Results highlight the importance of distinguishing between the unique facets of rumination in understanding relations with e-cigarette use. Further intervention research targeting need frustration and ruminative thinking (particularly problem-focused thoughts) among college student e-cigarette-dependent users is needed. [ABSTRACT FROM AUTHOR]

Electronic cigarette use among adolescents is a growing concern, not only due to the high incidence of co‐use with other substances, such as alcohol, but also due to the fact brain is still maturing during this period. Combined exposure to alcohol and nicotine leads to plastic adaptation of crucial circuits in the brain, which can contribute to the development of addiction. It is well established that nicotine exposure can facilitate alcohol binge drinking, and vice‐versa, in a sex‐, age‐ and exposure‐dependent manner. Nonetheless, the central mechanisms underlying the synergistic relationship between these two substances and the emergence of differential behavioural traits dependent on these factors remain underexplored. Preclinical studies continue to provide valuable insights into such mechanisms. Here, we discuss recent preclinical findings that report behavioural changes characteristic of addiction following nicotine consumption, primarily in models of vaping and alcohol use; and insights into the neural mechanisms impacted by intake of these two substances, with a focus on the adolescent brain. [ABSTRACT FROM AUTHOR]

Background: Nicotine dependence is associated with glutamatergic neurotransmission in the caudate and putamen (CPu) of the forebrain which includes alterations in the structure of dendritic spines at glutamate synapses. These changes after nicotine exposure can lead to the development of habitual behaviors such as smoking. The present study investigated the hypothesis that cofilin, an actin-binding protein that is linked to the GluN2B subunits of N-methyl-D-aspartate (NMDA) receptors regulates the morphology of dendritic spines in the neurons of the CPu after repeated exposure to nicotine. Results: Adult male rats received subcutaneous injections of nicotine (0.3 mg/kg/day) or vehicle for seven consecutive days. DiI staining was conducted to observe changes in dendritic spine morphology. Repeated subcutaneous injections of nicotine decreased the phosphorylation of cofilin while increasing the formation of thin spines and filopodia in the dendrites of medium spiny neurons (MSN) in the CPu of rats. Bilateral intra-CPu infusion of the cofilin inhibitor, cytochalasin D (12.5 µg/µL/side), restored the thin spines and filopodia from mushroom types after repeated exposure to nicotine. Similar results were obtained from the bilateral intra-CPu infusion of the selective GluN2B subunit antagonist, Ro 25-6981 (4 µM/µL/side). Bilateral intra-CPu infusion of cytochalasin D that interferes with the actin-cofilin interaction attenuated the repeated nicotine-induced increase in locomotor sensitization in rats. Conclusions: These findings suggest that active cofilin alters the structure of spine heads from mushroom to thin spine/filopodia by potentiating actin turnover, contributing to behavioral sensitization after nicotine exposure. [ABSTRACT FROM AUTHOR]

Background: The modifiable risk factor exerting the most substantial influence on the development and disease course of multiple sclerosis (MS) is cigarette smoking. Furthermore, smoking is associated with a higher risk of suffering from one or more comorbidities and potentially contributes to polypharmacy. We aimed to use personality tests to explore health-promoting and harmful patient characteristics. Objective: To investigate two important factors influencing the course of MS – the degree of smoking dependence and the status of polypharmacy – in association with personality traits. Design: This is a bicentric, cross-sectional study. Methods: We collected sociodemographic, clinical and medical data from patients with MS (n = 375) at two German neurological clinics. The participants were asked to complete the NEO Five-Factor Inventory (NEO-FFI) and the Temperament and Character Inventory-Revised (TCI-R). Relationships between variables were examined using correlation analyses, and differences between groups were examined using linear models. Current smokers with MS were also asked to complete the Fagerström questionnaire to categorize them into patients with mild, moderate and severe smoking dependence. Results: In our sample, 67.5% were women, and the mean age was 48.1 years. The patients had a median Expanded Disability Status Scale of 3.0 at a median disease duration of 10 years. Patients with MS with severe smoking dependence had on average a significantly higher neuroticism score in the NEO-FFI compared to those with mild or moderate smoking dependence. Patients with MS and polypharmacy had significantly higher neuroticism scores than those without. In the extraversion scale of the NEO-FFI, patients with MS and polypharmacy had significantly lower scores on average. Significant differences were also found when analysing the TCI-R in patients with MS and heavy smoking dependence, with higher scores for harm avoidance (HA) and lower scores for reward dependence, self-directedness (S-D) and cooperativeness (CO) in various subscales. Polypharmacy in patients with MS was associated with higher scores for HA and self-transcendence. Furthermore, patients with polypharmacy showed lower values than patients without polypharmacy in individual subscales of the dimensions of persistence, S-D and CO. Conclusion: Using the NEO-FFI, we were able to show that neuroticism is a detrimental trait and extraversion a protective trait in patients with MS in relation to nicotine dependence and polypharmacy. In addition, the evaluation of the TCI-R showed that high HA as well as low S-D and CO scores were more common in patients with MS and nicotine dependence or polypharmacy. With this knowledge, the risk of polypharmacy and smoking can be understood in the context of personality characteristics and targeted treatment and counselling can be provided. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Discussion and Conclusions Most patients receiving opioid agonist treatment (OAT) smoke tobacco. Approved cessation interventions are less effective in this group than the wider population. We investigated how people on OAT experience nicotine vaping to quit smoking.Patients on OAT randomised to the vaping arm of a smoking cessation trial were invited to participate in structured interviews incorporating broad pre‐determined themes. A qualitative descriptive approach employing template analysis was used. Four authors coded transcripts, discussed discrepancies, modified the template using both inductive and deductive approaches. Authors made explicit their starting orientations and independent authors sought disconfirmatory data in a subsequent round of analysis.Four women and eight men (median age 44 years) participated, including four who identified as Aboriginal. Participants reported vaping as cheaper, more acceptable and less stigmatising than smoking but expressed concerns about ongoing accessibility due to the Australian prescription access model. Some found it technically challenging at first, but not more so than standard nicotine replacement therapies. Participants gave accounts of craving and withdrawal experiences, including supplementary use of nicotine patches, and compulsions to vape frequently and intensely, potentially indicating need for higher nicotine dosage. Participants generally reported that vaping helped them quit smoking, though some worried about swapping nicotine addictions. Others were glad to be using a lower‐risk alternative.This group reported varied experiences of nicotine vaping but were mainly optimistic that it could help them and others quit smoking. This was despite initial nicotine cravings and concerns about remaining addicted long‐term. [ABSTRACT FROM AUTHOR]

Early life adversity (ELA) is associated with earlier initiation and maintenance of tobacco smoking and with a greater risk of subsequent relapse. There is growing evidence that appetite hormones, including peptide YY (PYY), which modulates craving and satiety responses, play a role in stress and addiction processes. This study employed a quasi‐experimental design to examine the association between ELA and circulating PYY stress responses in smokers and nonsmokers (N = 152, ages 19–73 years) to examine the effects of nicotine addiction. Smokers initiated a quit attempt as part of the study and were classified as either abstinent smokers or relapsed smokers based on their nicotine use during the follow‐up period. PYY levels were measured at five timepoints during three lab sessions and compared between nonsmokers and the two smoking groups (abstainers, relapsers): while smokers were using nicotine ad libitum, 24 h after smokers initiated a quit attempt, and 4 weeks after smokers initiated a quit attempt. Multivariate analyses showed the main effects of time on PYY, which decreased over time within each session. The main effects of ELA during the first (ad libitum smoking) and second (24‐h post‐cessation for smokers) sessions indicated that experiencing ELA was associated with lower PYY. No systematic effect of nicotine addiction or relapse was observed in this study. These findings suggest that adults with higher ELA may experience lower PYY. Additional research is needed to further explore the role of PYY in stress and addiction processes. [ABSTRACT FROM AUTHOR]

Rationale: Nicotine dependence is highly comorbid with opioid use disorders (OUDs). The use of nicotine-containing products increases the propensity to misuse prescription opioids and addressing both nicotine and opioid use simultaneously is more efficacious for treatment of OUDs than treating opioid use alone. Objectives: Given this extreme comorbidity, further elucidation of the effects of nicotine as a factor in promoting vulnerability to development of OUDs is needed. Here, we sought to further explore the effects of nicotine administration on operant self-administration of remifentanil (RMF), a fast-acting synthetic µ-opioid receptor agonist, using a heterogenous seeking–taking chain schedule of reinforcement in unpunished and punished conditions. Methods: Male and female rats received nicotine (0.4 mg/kg) or saline prior to operant self-administration sessions. These sessions consisted of pressing a 'seeking' lever to gain access to a 'taking' lever that could be pressed for delivery of 3.2 µg/kg RMF. After acquisition, continued drug seeking/taking was punished through contingent delivery of foot-shock. Results: Nicotine, relative to saline, increased RMF consumption. Furthermore, nicotine treatment resulted in significantly higher seeking responses and cycles completed, and this effect became more pronounced during punished sessions as nicotine-treated rats suppressed RMF seeking significantly less than controls. Nicotine treatment functionally reduced the efficacy of foot-shock punishment as a deterrent of opioid-seeking. Conclusions: Nicotine administration enhanced both appetitive and consummatory responding for RMF and engendered a punishment-insensitive phenotype for RMF that was less impacted by contingent administration of foot-shock punishment. These findings provide further support for the hypothesis that nicotine augments vulnerability for addiction-like behaviors for opioids. [ABSTRACT FROM AUTHOR]

Background Increasingly, people smoke cigarettes outdoors and avoid exposing bystanders to harm. People may not have the same motivation to vape outdoors since e-cigarettes, unlike cigarettes, do not create side stream emissions and exhaled aerosol contains fewer toxicants than secondhand smoke. This study aims to estimate the prevalence and correlates of vaping and smoking indoors among adults in England. Aims and Methods Data came from the Health Survey for England 2019, a cross-sectional household survey. Adults who vape or smoke (N  = 1530) were asked whether they had vaped or smoked indoors inside the home, car, or other places within the past 7 days. Logistic regression was used to estimate prevalence and key correlates of indoor use, including age, sex, presence of adults/children in home, housing tenure, and nicotine dependence. Results People who exclusively vaped were much more likely to use their product indoors than those who exclusively smoked (87.0% vs. 52.0%; odds ratio [OR] = 6.16, 95% confidence interval [CI] = 4.09 to 9.28). Similarly, people who dual used had higher odds of vaping than smoking indoors (62.1% vs. 44.3%; OR = 3.76, 95% CI = 2.06 to 6.84). The preference for vaping over smoking indoors was found across different locations, including at home and in cars. Those who were older, highly dependent on nicotine, and lived alone were most prone to use any product indoors. While housing tenure was not strongly associated with vaping indoors, those living in social housing were much more likely to smoke indoors than homeowners. Conclusions Adults in England are much more likely to vape than smoke indoors. Age, nicotine dependence, and living alone are strongly associated with both behaviors. Implications Our results show that people have a strong preference for vaping over smoking indoors, including in the home. Given the high prevalence of vaping indoors, policy makers, landlords, and businesses must weigh up the ethics, benefits, and harms of extending smoke-free laws to include e-cigarettes. [ABSTRACT FROM AUTHOR]

Background: Most smokers attempting to quit will quickly relapse to tobacco use even when treated with the most efficacious smoking cessation agents currently available. This highlights the need to develop effective new smoking cessation medications. Evidence suggests that positive allosteric modulators (PAM) and other enhancers of nicotinic acetylcholine receptor (nAChR) signaling could have therapeutic utility as smoking cessation agents. Methods: 3-[3-(3-pyridyl)-1,2,4-oxadiazol-5-yl]benzonitrile (NS9283) was used as a starting point for medical chemistry efforts to develop novel small molecule enhancers of a4ß2* nAChR stoichiometries containing a low-affinity agonist binding site at the interface of a4/a4 and a4/a5 subunits. Results: The NS9283 derivative SR9883 enhanced the effect of nicotine on a4ß2* nAChR stoichiometries containing low-affinity agonist binding sites, with EC50 values from 0.2-0.4 µM. SR9883 had no effect on a3ß2* or a3ß4* nAChRs. SR9883 was bioavailable after intravenous (1 mg kg-1) and oral (10-20 mg kg-1) administration and penetrated into the brain. When administered alone, SR9883 (5-10 mg kg-1) had no effect on locomotor activity or intracranial selfstimulation (ICSS) thresholds in mice. When co-administered with nicotine, SR9883 enhanced locomotor suppression and elevations of ICSS thresholds induced by nicotine. SR9883 (5 and 10 mg kg-1) decreased responding for intravenous nicotine infusions (0.03 mg kg-1 per infusion) but had no effect on responding for food rewards in rats. Conclusions: These data suggest that SR9883 is useful for investigating behavioral processes regulated by certain a4ß2* nAChR stoichiometries. SR9883 and related compounds with favorable drug-like physiochemical and pharmacological properties hold promise as novel treatments of tobacco use disorder. [ABSTRACT FROM AUTHOR]

Background: Previous research has investigated the association between attachment styles and smoking behaviors, indicating a positive association of insecure attachment styles with nicotine dependence. However, these links were mostly explored in adolescent and student samples. Moreover, the explanatory mechanisms and the variables influencing the strength of this relationship remained understudied. In this context, the present study aims to: (1) examine the associations between attachment anxiety, avoidance, and nicotine dependence; (2) investigate the mediating role of emotion dysregulation and metacognitions about smoking; and (3) test the moderating roles of psychological capital and type of tobacco product used by the participants. Method: This cross-sectional study was conducted on a convenience sample of 447 participants who reported smoking. The age range of participants was 18 to 64 (M = 26.76; 59.7% women). All participants have completed five questionnaires measuring nicotine dependence, adult attachment, emotion dysregulation, metacognitions about smoking, and psychological capital. They also reported the type of tobacco product commonly used: classic cigarettes, e-cigarettes, or heated tobacco products. Results: Our findings show that the direct link between insecure attachment and nicotine dependence is rather inconsistent. However, it was mediated by the metacognitions about smoking. Psychological capital can act as a protective factor against the effects of attachment on nicotine dependence, especially for those using alternative tobacco products alongside classic cigarettes. Conclusions: The findings highlight the possibility of developing better-tailored interventions and treatments to discourage smoking and increase smoking cessation. These should focus on eliminating the dysfunctional beliefs related to the metacognitions about smoking and on improving the levels of psychological capital. In addition, targeting attachment insecurities in early adolescence can also function as a mean to prevent smoking. [ABSTRACT FROM AUTHOR]

ObjectiveMethodResultsConclusionsThis pre-registered analysis aimed to examine the moderating role of nicotine-use motives on the association between minority stress and nicotine use and craving among sexual minority youth.Data stem from a 30-day ecological momentary assessment study conducted among 83 sexual minority youth ages 15–19 years old (M age = 17.96, SD = 1.10; 56.63% cisgender women; 73.5% non-Hispanic White). Participants were instructed to complete at least four assessments per day on wireless devices. Two types of multilevel models were estimated: models predicting day-level nicotine use and models predicting momentary nicotine use craving.Experiencing minority stressors was not associated with day-level nicotine use, but it was associated with greater momentary nicotine craving. Nicotine use-motives did not moderate the association between minority stress and nicotine use. In contrast, stress-reduction motives, assessed as a person-level trait, moderated the association between minority stress and nicotine craving, such that nicotine craving after experiencing a minority stressor was consistently higher relative to when minority stress had not been reported. Sensitivity analyses that examined associations between minority stress and nicotine use on a given day, regardless of temporal order, showed that minority stress was associated with higher odds of nicotine use on that day.Experiencing minority stressors did not predict day-level nicotine use but does contribute to greater momentary nicotine craving, informing minority stress theory. Consistency of the minority stress and nicotine craving relation, largely regardless of trait-level motives, highlights the potential context dependence of nicotine craving among sexual minority youth.Preregistration: This study was preregistered at osf.io/w5sz9. [ABSTRACT FROM AUTHOR]

Background: Although the negative impact of smoking and health-related quality of life (HRQoL) on depression has been confirmed in various studies, There has been little exploration of how HRQoL mediates the relationship between smoking and depression. The purpose of the current study was to examine the relationship between smoking and depression in the Chinese current smokers with nicotine dependence and the mediating role of HRQoL. Methods: A cross-sectional study named "Psychology and Behavior Investigation of Chinese Residents" was conducted from July 10 to September 15, 2021 in China. Nicotine dependence, HRQoL and depression were measured by Fagerstrom Test for Nicotine Dependence (FTND), the European Five Dimensional Five Level Health scale (EQ-5D-5L) and the 9-item Patient Health Questionnaire (PHQ-9) respectively. Information on age, gender, place of residence, household registration, education level, marital status, employment status, average family monthly income, drinking frequency, living status, BMI, multiple chronic conditions were also collected. Pearson's correlation test and logistic regression analysis were conducted to explore the association between nicotine dependence, HRQoL and depression and a mediation analysis was applied to explore the mediating effect of the HRQoL on this relationship. Results: A total of 1,381 current smokers were included in the study. The participants showed a moderate level of nicotine dependence with a mean of 1.36(SD=1.50), a relatively high level of HRQoL scores (Mean=0.94, SD=0.13), and a depression score with a mean of 6.48(SD=6.09). Approximately 22.74% (314/1,381) of the participants were considered to indicate depression. In the univariable regression model, it was found that nicotine dependence was positively associated with depression (OR:1.094, 95%CI: 1.008-1.187), while HRQoL was negatively associated with depression (OR:0.011, 95%CI: 0.004-0.033). In the multivariable regression model, HRQoL was still notably associated with depression (OR:0.008, 95%CI: 0.002-0.027), however, the positive association was not observed between nicotine dependence and depression. The Pearson's correlation test demonstrated that nicotine dependence was negatively correlated with HRQoL(rs= -0.147, P<0.001) and HRQoL was negatively correlated with depression(rs= -0.275, P<0.001). In contrast, nicotine dependence was positively correlated with depression(rs= 0.136, P<0.001). Mediation analysis found that HRQoL moderated the relationship between nicotine dependence and depression with a mediating effect of 26.49%. Conclusions: The findings support that nicotine dependence is positively associated with depression and HRQoL is negatively associated with depression in current smokers. HRQoL mediated the relationship between nicotine dependence and depression. The well-established imperative interventions aimed at promoting smoking cessation and improving quality of life may benefit for alleviation of depression in current smokers. [ABSTRACT FROM AUTHOR]

Background: Young adults face unique vulnerabilities during major life disruptions like the COVID-19 pandemic. The pandemic contributed to increases in mental health challenges and substance use among young adults. This study explores the experiences of young adults who increased their cannabis use during the pandemic. Methods: Participants were recruited from the Nicotine Dependence in Teens (NDIT) study, and qualitative data were collected through semi-structured interviews conducted via Zoom. A total of 25 participants (ages 33–34) reporting increased cannabis use during the pandemic were included. Thematic analysis and gender-based analysis was employed to extract key themes. Results: Five themes emerged: (1) No disruption in cannabis use; (2) Cannabis use to manage declines in mental health; (3) Cannabis use to break up pandemic boredom; (4) Cannabis use as an expression of freedom; (5) Cannabis use as "another way to chill out." Conclusions: This research provides valuable perspectives on how major life disruptions, like the COVID-19 pandemic, influence cannabis use among young adults. The findings offer guidance for public health initiatives and highlight avenues for further investigation. [ABSTRACT FROM AUTHOR]

There is uncertainty regarding whether the degree of nicotine dependence directly impacts the increase or decrease of attentional biases towards smoking-related cues. Their relationship remains unclear. Therefore, we compared the attentional bias among smokers with varying levels of dependence. We conducted the study with 114 smokers, utilizing a Modified Stroop Paradigm and Dot Probe Tasks to assess attentional biases toward both smoking-related and neutral cues. The objective was to compare attention bias levels among individuals with varying degrees of dependence. At various levels of nicotine dependence -whether mild, moderate, or severe- individuals demonstrated a consistent attentional bias towards smoking-related cues, suggesting no significant distinction between these groups. The results of the study show that there was no discernable correlation between attentional bias concerning smoking-related stimuli and the level of nicotine dependency. The results are discussed together with the existing studies. [ABSTRACT FROM AUTHOR]

INTRODUCTION Nicotine pouches are a new type of nicotine-containing product that have been marketed in many countries worldwide, generating growing acceptance among consumers. The aim of this study was to assess factors associated with public awareness and use of nicotine pouches among adults in Poland. METHODS A cross-sectional survey was conducted with a nationally representative sample of 1080 adults in Poland (February 2024). Awareness of nicotine pouches, history of use, current (past 30-day) use of nicotine pouches, as well as perception of harm was assessed using a purpose-designed questionnaire. RESULTS Awareness of nicotine pouches was reported by 24% of the sample, while 9.2% reported ever having used a nicotine pouch product, and 4.3% using a nicotine pouch in the past 30 days. Among all respondents, 60.7% perceived nicotine pouches as harmful as combustible cigarettes, 28.2% perceived nicotine pouches as less harmful, and 11% as more harmful than combustible cigarettes. In multivariable logistic regression model, women (adjusted odds ratio, AOR=1.40; 95% CI: 1.03-1.91; p<0.05), individuals aged <60 years (p<0.05), current tobacco smokers (AOR=2.59; 95% CI: 1.75-3.82; p<0.001), former tobacco smokers (AOR=1.53; 95% CI: 1.01-2.32; p<0.05) and ever users of e-cigarette or heated tobacco (AOR=2.90; 95% CI: 2.07-4.05; p<0.001) were more likely to declare that had ever heard of nicotine pouches. Moreover, individuals aged <60 years (p<0.05), occupationally active individuals (AOR=1.82; 95% CI: 1.01-3.31; p<0.05), current tobacco smokers (AOR=2.71; 95% CI: 1.48-4.97; p<0.01), and ever users of e-cigarette or heated tobacco (AOR=5.29; 95% CI: 2.96-9.44; p<0.001) were more likely to declare ever use of nicotine pouches. CONCLUSIONS This study provides the first national data on public awareness and use (ever and current) of nicotine pouches in Poland. Young adults, current smokers, and ever e-cigarette and heated tobacco users are at higher risk of ever use of nicotine pouches, so policy interventions are needed to protect young people from nicotine pouch marketing and nicotine initiation. [ABSTRACT FROM AUTHOR]

Introduction: Understanding the readiness to quit smoking is essential to deliver the best quit-smoking services in Malaysia. Objective: This study was conducted to determine the relationship between biopsychosocial and spiritual factors and the readiness to quit smoking among Malaysian adults. Materials and methods: A cross-sectional study using convenience sampling was used in this study. A total of 389 smokers aged 18 years old and above who registered at jomquit.com website participated in this study voluntarily. Questionnaires such as the stages of change readiness and treatment eagerness scale for smoking cessation (SOCRATES-S), Fagerstrom test for nicotine dependence (FTND), depression anxiety stress scale (DASS), the multidimensional scale of perceived social support (MSPSS), and a modified version of functional assessment of chronic illness therapy - spiritual well-being for non-illness (FACITSP-Non-Illness) were used in this study. Results: The results of this study found that nicotine dependence, stress, anxiety, depression, and social support (family, friends, and significant other) have significant relationships with the early stage of readiness to quit smoking (domains of recognition and ambivalence (p<0.05). Anxiety, social support (family, friends and significant other), and spiritual well-being had a significant relationship with the end stage of the readiness to quit smoking (domain of taking action, p<0.05). Conclusion: This study conclusively showed that nicotine dependence, stress, anxiety, depression, social support, and spiritual well-being might potentially play crucial roles in the initial stages of readiness to quit smoking and the final stage of taking action towards quitting. Therefore, emphasising the significance of including these variables in programmes aimed at helping people quit smoking is noteworthy. [ABSTRACT FROM AUTHOR]

Research on individual differences in brain structural features of internet gaming disorder (IGD) and established addictions such as tobacco use disorder (TUD) is currently limited. This study utilized normative modeling to analyze the cortical thickness (CT) development patterns of male patients with IGD and TUD, aiming to provide further insights into whether IGD qualifies as an addiction. Surface-based brain morphometry (SBM) was used to calculate CT from T1-weighted magnetic resonance imaging data of 804 male participants (665 healthy individuals, 68 IGD and 71 TUD). Gaussian process regression was employed to generate normative models of CT development. Deviation maps were produced to depict deviations of IGD and TUD participants from the typical developmental patterns. Both addiction groups exhibited widespread cortical thinning, particularly in regions such as the bilateral temporal pole and medial orbitofrontal cortex. The TUD group demonstrated a higher degree of individualization and limited spatial overlap compared to the IGD group. Opposite trends in CT changes were observed between the two groups in the bilateral pericalcarine cortex and pars triangularis. These findings regarding the similarities and differences between IGD and TUD provide support for the idea that IGD shares common features with substance-related addictions and contribute to a deeper understanding of the neural mechanisms underlying IGD. [ABSTRACT FROM AUTHOR]

Alcohol consumption is an important risk factor for illness, disability, and mortality. Alcohol withdrawal symptoms have a significant health concern for individuals with alcohol dependence. This study aims to investigate the prevalence of withdrawal symptoms and liver function test abnormalities in this population and also to identify the factors associated with the severity of withdrawal symptoms. This cross-sectional study was conducted at a tertiary care facility involving 100 patients seeking treatment for alcohol dependence. Data collection included structured interviews and assessments using standardized scales and biochemical tests. Descriptive statistics, t-tests, and chi-square tests were employed to analyse the data. Individuals exhibiting mild/moderate alcohol withdrawal symptoms in this study displayed several distinctive features. They were more likely to have attained at least a high school education, their average alcohol consumption was notably lower, Importantly, their blood parameters, including RBC count, platelet count, total bilirubin levels, and liver enzyme levels (AST and ALT), generally exhibited fewer deviations from normal ranges. Family history of alcohol dependence and nicotine dependence was common among the participants. This research highlights the need for a holistic approach to address alcohol dependence, taking into consideration sociodemographic factors, clinical markers, and the diverse nature of this condition. The findings provide important insights for healthcare professionals to identify individuals at higher risk and guide treatment decisions. [ABSTRACT FROM AUTHOR]

Background: It is a truth universally acknowledged that the diagnosis of cancer is a huge stress for both individuals and families. While many psychosocial variables have been shown to influence the mental well-being, these factors are so complicated and interlinked with each other, that their integrated effect on oral cancer patients, who constitute a large morbid group of patients, is yet to be recognized. Aims and Objectives: The present research work aims to find more about the prevalence of stress, anxiety, and depression among patients with cancers of the oral cavity and work out on some key potentially predictive factors associated with anxiety and depressive symptoms. Materials and Methods: A cross-sectional observational study was carried out for patients of oral cancer, attending the radiation oncology out-patient department (OPD) at Medical college, Kolkata, between April 2022 and March 2023, a 1-year period. A total of 89 patients with oral cancer were interviewed with questionnaires on demographic variables, depression anxiety stress scale 21, and National Comprehensive Cancer Network Distress Thermometer. Chi-square tests and Spearman Correlation tests were conducted where appropriate to explore relationships between different variables. Results: The prevalence of stress symptoms, anxiety symptoms, and depressive symptoms was 44% (39/89), 60% (53/89), and 84% (75/89), respectively, among the patients interviewed. Addiction history of the patients was an important association found in this study. Conclusion: The prevalence of stress and depressive symptoms was high among the oral cancer patients attending the Radiation Oncology OPD at our institution as well as levels of anxiety. Certain social variables such as relationship with spouse, children, and other family members had a profound effect on the mental well-being of the patients. Furthermore, certain factors such as addiction to tobacco and its different forms reduced the coping up capability of the patients. [ABSTRACT FROM AUTHOR]

Rationale: People with tobacco addiction have deficits in cognition, in particular deficits in attention. It is not clear however, whether deficits are a cause or a consequence, or both, of chronic nicotine use. Here we set out a series of experiments in rats to address this question and, more specifically, to assess the effects of exposure to and withdrawal from chronic nicotine self-administration on attentional performance. Methods: Animals were trained in a 5-choice serial reaction time task to probe individual attentional performance and, then, were given access to a fixed versus increasing dose of intravenous nicotine for self-administration, a differential dose procedure known to induce two between-session patterns of nicotine intake: a stable versus escalation pattern. Attentional performance was measured daily before, during and also 24-h after chronic access to the differential dose procedure of nicotine self-administration. Conclusions: We found that pre-existing individual variation in attentional performance predicts individual vulnerability to develop escalation of nicotine intake. Moreover, while chronic nicotine self-administration increases attention, withdrawal from nicotine intake escalation induces attentional deficits, a withdrawal effect that is dose-dependently reversed by acute nicotine. Together, these results suggest that pre-existing individual variation in attentional performance predicts individual vulnerability to develop escalation of nicotine intake, and that part of the motivation for using nicotine during escalation might be to alleviate withdrawal-induced attentional deficits. [ABSTRACT FROM AUTHOR]

Background and Objectives: There is little information on changes in the process and outcomes of intensive tobacco dependence treatment during the COVID-19 pandemic. The following characteristics were evaluated: interest in treatment, the number of face-to-face or telephone follow-ups, the duration of pharmacotherapy use, and the success rate. The aim of our study was to compare the number of patients who entered tobacco dependence treatment programmes and evaluate the one-year success rate in patients three years before and three years after the COVID-19 pandemic. Materials and Methods: A single-site retrospective cohort study using data from patients treated at the Centre for Tobacco Dependence in Prague, Czech Republic, between 2017 and 2022 (n = 2039) was performed. The one-year abstinence rate was validated by measuring carbon monoxide in exhaled air (6 ppm cut-off). Patients were divided into two groups: the group for which treatment was initiated in 2017–2019 (i.e., before the COVID-19 pandemic, BC; n= 1221) and the group for which treatment was initiated in 2020–2022 (i.e., during the COVID-19 pandemic, DC; n = 818). Results: No significant differences in the success rate of tobacco dependence treatment were found between the two groups (BC group, 40.5% (494/1221) vs. DC group, 42.2% (345/818)) (χ2 (1, N = 2.039) = 0.6, p = 0.440). Furthermore, differences were not found in sex, education level, age at first cigarette, the duration of pharmacotherapy use, or the number of in-person visits. In contrast, there was an increase in the number of telephone contacts between the groups (18.7% (SD = 17.5%) vs. 32.9% (SD = 18.2%), p < 0.001). Conclusions: The number of patients who started treatment during the COVID-19 pandemic decreased by one-third compared to that during the 3-year period before the pandemic. The overall treatment success rate did not change significantly even with the increase in the number of telephone visits with the therapist. [ABSTRACT FROM AUTHOR]

Context Tobacco addiction is an important public health problem. Among several theories of addiction proposed, PRIME theory of motivation is found to be a comprehensive one to synthesise prevention strategies. Aims This case study was conducted on the basis of PRIME theory to explain smokeless tobacco (SLT) addiction patterns among slum dwelling female residents of Cuttack district, Odisha. Settings and Design Cuttack district of Odisha state and Qualitative synthesis. Methods and Material Qualitative semistructured face-to-face interviews and framework analysis techniques were employed. The study was conducted over a period of 2 months between February 2020 and March 2020. Face-to-face interviews of 26 participants of Dasha Sahi slum using a semistructured questionnaire assessing responses based on five main themes including P, Plans; R, Responses; I, Impulses And Inhibitory Forces; M, Motives; and E, Evaluations of the said theory. Statistical Analysis Used Verbatim transcripts were analysed using thematic framework analysis. Results A majority of the participants were multiple SLT product users, and they did not have an immediate plan to quit. Most of the participants showed strong emotional attachment with these products and considered them the only source of pleasure (want) in a life full of miseries. The words “Tobacco” and “Nicotine” were medical jargons for them. Though they were aware of the harmful effects, they had a positive evaluative belief about its use because of cognitive dissonance. Most of them were habitual users living in an environment full of physical and social cues. Conclusions This case study is well in line with the PRIME theory in explaining the addictive behaviour; a comprehensive multi-strategic approach was formulated for inculcating quitting behaviour among this disadvantaged section of the population as suggested by the proposer of this theory.

Introduction Nicotine pouches are a new type of nicotine-containing product that have been marketed in many countries worldwide, generating growing acceptance among consumers. The aim of this study was to assess factors associated with public awareness and use of nicotine pouches among adults in Poland. Methods A cross-sectional survey was conducted with a nationally representative sample of 1080 adults in Poland (February 2024). Awareness of nicotine pouches, history of use, current (past 30-day) use of nicotine pouches, as well as perception of harm was assessed using a purpose-designed questionnaire. Results Awareness of nicotine pouches was reported by 24% of the sample, while 9.2% reported ever having used a nicotine pouch product, and 4.3% using a nicotine pouch in the past 30 days. Among all respondents, 60.7% perceived nicotine pouches as harmful as combustible cigarettes, 28.2% perceived nicotine pouches as less harmful, and 11% as more harmful than combustible cigarettes. In multivariable logistic regression model, women (adjusted odds ratio, AOR=1.40; 95% CI: 1.03–1.91; p

Objectives: Substance use disorders (SUDs) represent a significant global health concern, demanding the development of effective pharmacological treatments. To address this, an investigation was conducted to examine the anti-addictive properties of two compounds, (S)-T1 and (S)-T2, which specifically target the α3β4 nicotinic acetylcholine receptor (nAChR). Methods: The effects of (S)-T1 and (S)-T2 on nicotine-induced conditioned place preference (CPP), locomotor activity and dopamine levels in particular brain regions associated to addiction were investigated and compared in male C57BL/6N mice. Results: The results demonstrate that neither (S)-T1 nor (S)-T2 induced place conditioning or conditioned place aversion (CPA), suggesting the absence of rewarding or aversive effects. Both compounds significantly attenuated nicotine-induced CPP, with (S)-T1 exhibiting a dose-dependent effect. Furthermore, the co-administration of (S)-T2 (10 mg/kg) with nicotine markedly reduced locomotor activity compared to nicotine treatment alone. Additionally, dopamine analysis revealed that nicotine increased dopamine levels in the nucleus accumbens (NAc) and dorsal striatum, whereas the co-administration of (S)-T1 (1, 3, and 10 mg/kg) and (S)-T2 (10 mg/kg) significantly decreased dopamine levels in these brain regions. No significant effects were observed in the prefrontal cortex (PFC). Conclusions: These findings suggest that (S)-T1 and (S)-T2 hold promise for treating nicotine addiction by attenuating nicotine-induced CPP and modulating dopamine release in key reward-related brain regions. Further research is needed to gain insights into the underlying mechanisms behind their anti-addictive effects and substantiate their potential for treating nicotine addiction. [ABSTRACT FROM AUTHOR]

Aim: The use of tobacco is responsible for many preventable diseases and deaths worldwide. Digital interventions have greatly improved patient health and clinical care and have proven to be effective for quitting smoking in the general population due to their flexibility and potential for personalization. However, there is limited evidence on the effectiveness of digital interventions for smoking cessation in Asian countries. Methods: Three major databases - Web of Science (WOS), Scopus, and PubMed - for relevant studies published between 1 January 2010 and 12 February 2023 were searched for studies evaluating the effectiveness of digital intervention for smoking cessation in Asian countries. Results: A total of 25 studies of varying designs were eligible for this study collectively involving a total of n=22,005 participants from 9 countries. Among different digital tools for smoking cessation, the highest abstinence rate (70%) was reported with cognitive behavioural theory (CBT)-based smoking cessation intervention via Facebook followed by smartphone app (60%), WhatsApp (59.9%), and Pharmacist counselling with Quit US smartphone app (58.4%). However, WhatsApp was preferred over Facebook intervention due to lower rates of relapse. WeChat was responsible for 15.6% and 41.8% 7-day point prevalence abstinence. For telephone/text messaging abstinence rate ranged from 8-44.3% and quit rates from 6.3% to 16.8%. Whereas, no significant impact of media/multimedia messages and web-based learning on smoking cessation was observed in this study. Conclusion: Based on the study findings the use of digital tools can be considered an alternative and cost-effective smoking cessation intervention as compared to traditional smoking cessation interventions. [ABSTRACT FROM AUTHOR]

Non-Invasive Brain Stimulation (NIBS) techniques seem to be effective in treating tobacco use disorder. We aimed to analyze what kinds of protocols are used to treat nicotine addiction in term of cessation and/or reduction and to evaluate the long-term effects of NIBS techniques.We searched PubMed, Scopus, and Web of Science for papers published, with combinations of the following search terms: “Non-invasive brain stimulation OR TMS OR transcranial magnetic stimulation OR tDCS OR transcranial direct current stimulation OR transcranial electrical stimulation OR TES AND Nicotine addiction”.We conducted a preliminary search, which revealed papers on the topic. Articles were included in the review according to the following inclusion criteria: English language, publication in peer reviewed journals, articles about studies performed on non-invasive brain stimulations techniques, and RCT studies. Studies involving clinical populations with organic or psychiatric diseases were excluded. We found 280 articles. Of these, at the first screening and conducted by title and abstract, 63 studies were excluded after duplicates were removed (118). After the second screening conducted by full-text examination, 45 articles were excluded. Ten studies met the inclusion criteria and were included in the review.The clinical benefits of NIBS, including the fast onset and minor side effects, showed that this kind of treatment could be helpful in patients with a long history of smoking in terms of cessation and abstinence rates.

Introduction Disposable e-cigarettes are the predominant type of vaping product used by adolescents and pose a significant public health concern. Identifying factors contributing to this growing trend is essential to curbing the vaping epidemic among youths. This study aims to investigate the growing prevalence and correlates of disposable e-cigarette use among US students. Material and Methods Data from 48437 US middle and high school students from the 2021 and 2022 National Youth Tobacco Survey (NYTS) were analyzed using logistic and ordinal regression models to evaluate disposable e-cigarette use and frequency of use (low, medium, and high) with demographic and psychosocial factors. Weighted prevalence of current e-cigarette use with 95% CIs by device types in 2021 and 2022, were calculated. Odds ratios (ORs) of correlations of disposable e-cigarette use and frequency of use with demographic and psychosocial factors were analyzed. Results Disposable e-cigarette use increased from 3.9% (95% CI: 3.3–4.7) in 2021 to 5.1% (95% CI: 4.2–6.1) in 2022, and was associated with being female (OR=1.57; 95% CI: 1.29–1.91 vs male), high schoolers (OR=5.14; 95% CI: 3.96– 6.67 vs middle schoolers), having low harm perceptions of e-cigarettes (OR=7.75; 95% CI: 5.58–10.75 vs lot of harm), and high exposure to marketing (OR=1.57; 95% CI: 1.05–2.35 vs low exposure). Identifying as LGBTQ (OR=1.41; 95% CI: 1.00–2.00 vs straight), having low academic performance (OR=2.16; 95% CI: 1.15–4.07, D vs A grades), and having psychological distress (OR=2.01; 95% CI: 1.64–2.47, severe vs none) were also linked to increased frequency of use. Conclusions This study underscores increasing disposable e-cigarette use among US students, noting existing disparities. It identifies high-risk adolescent subgroups vulnerable to disposable e-cigarette use. These findings emphasize the urgency of targeted prevention and stricter regulations on disposable e-cigarettes to combat nicotine addiction among youths.

Abstract Objective Describe the screening, referral, and treatment delivery associated with an opt-out tobacco treatment program (TTP) implemented in six hospitals varying in size, rurality and patient populations. Methods Between March 6, 2021 and December 17, 2021, adult patients (≥ 18 years) admitted to six hospitals affiliated with the Medical University of South Carolina were screened for smoking status. The hospitals ranged in size from 82 to 715 beds. Those currently smoking were automatically referred to one of two tobacco treatment options: 1) Enhanced care (EC) where patients could receive a bedside consult by a trained tobacco treatment specialist plus an automated post-discharge follow-up call designed to connect those smoking to the South Carolina Quitline (SCQL); or 2) Basic care (BC) consisting of the post-discharge follow-up call only. An attempt was made to survey patients at 6-weeks after hospitalization to assess smoking status. Results Smoking prevalence ranged from 14 to 49% across the six hospitals; 6,000 patients were referred to the TTP.The delivery of the bedside consult varied across the hospitals with the lowest in the Charleston hospitals which had the highest caseload of referred patients per specialist. Among patients who received a consult visit during their hospitalization, 50% accepted the consult, 8% opted out, 3% claimed not to be current smokers, and 38% were unavailable at the time of the consult visit. Most of those enrolled in the TTP were long-term daily smokers.Forty-three percent of patients eligible for the automated post-discharge follow-up call answered the call, of those, 61% reported smoking in the past seven days, and of those, 34% accepted the referral to theSCQL. Among the 986 of patients surveyed at 6-weeks after hospitalization quit rates ranged from 20%-30% based on duration of reported cessation and were similar between hospitals and for patients assigned to EC versus BC intervention groups. Conclusion Findings demonstrate the broad reach of an opt-out TTP. Elements of treatment delivery can be improved by addressing patient-to-staffing ratios, improving systems to prescribe stop smoking medications for patients at discharge and linking patients to stop smoking services after hospital discharge.

Although previous studies have shown that repetitive transcranial magnetic stimulation (rTMS) can ameliorate addictive behaviors and cravings, the underlying neural mechanisms remain unclear. This study aimed to investigate the effect of high‐frequency rTMS with the left dorsolateral prefrontal cortex (L‐DLPFC) as a target region on smoking addiction in nicotine‐dependent individuals by detecting the change of spontaneous brain activity in the reward circuitry. We recruited 17 nicotine‐dependence participants, who completed 10 sessions of 10 Hz rTMS over a 2‐week period and underwent evaluation of several dependence‐related scales, and resting‐state fMRI scan before and after the treatment. Functional connectivity (FC) analysis was conducted with reward‐related brain regions as seeds, including ventral tegmental area, bilateral nucleus accumbens (NAc), bilateral DLPFC, and bilateral amygdala. We found that, after the treatment, individuals showed reduced nicotine dependence, alleviated tobacco withdrawal symptoms, and diminished smoking cravings. The right NAc showed increased FC with right fusiform gyrus, inferior temporal gyrus (ITG), calcarine fissure and surrounding cortex, superior occipital gyrus (SOG), lingual gyrus, and bilateral cuneus. No significant FC changes were observed in other seed regions. Moreover, the changes in FC between the right NAc and the right ITG as well as SOG before and after rTMS were negatively correlated with changes in smoking scale scores. Our findings suggest that high‐frequency L‐DLPFC‐rTMS reduces nicotine dependence and improves tobacco withdrawal symptoms, and the dysfunctional connectivity in reward circuitry may be the underlying neural mechanism for nicotine addiction and its therapeutic target. [ABSTRACT FROM AUTHOR]

Background: Albeit smoking cessation has unequivocal health benefits, attempts to quit are not unanimous, even in patient populations at high risk for smoking-related diseases cessation. Allelic variations of enzymes involved in dopamine metabolism are being considered as candidates for nicotine addiction. We set out to assess whether rs4680 G/A and rs2235186 G/A polymorphisms of COMT and MAO-A, respectively are associated with the ability to quit smoking in chronic inflammatory pulmonary disease patients. Methods: Patients managed for chronic inflammatory pulmonary disease by the Department of Pulmonology (University of Debrecen, Hungary), with a current or past smoking habit were included in the current analysis. The study was designed in line with the STROBE statement for cross-sectional studies and was approved by the National Center for Public Health, Hungary. Genomic DNA was extracted from peripheral blood specimens. SNPs were genotyped using TaqMan SNP genotyping assays. Results: rs4680 COMT polymorphism showed significant effect for successful smoking cessation in patients with pulmonary disease. Accordingly, A/A subjects had lower odds for successful smoking cessation (odds ratio 0.37; 95% confidence interval 0.20–0.69, p = 0.002 (additive model). On the other hand, patients homozygous for the minor allele (A) at rs2235186 of MAO-A showed a non-significant trend toward increased odds for successful smoking cessation. Conclusions: The presence of the minor allele for rs4680 COMT was shown to decrease the odds for successful smoking cessation, a finding that may be interpreted in view of the altered balance between tonic and phasic dopamine release. [ABSTRACT FROM AUTHOR]

One of the first steps in tobacco addiction treatment is gaining insight into whether the individual has a problem with nicotine use and realizing the need for cessation treatment. This study is a methodological study describing the cultural adaptation of the Nicotine Use Awareness and Insight Scale and evaluating its Turkish validity and reliability. Linguistic validation was carefully performed through forward and backward translation. The study group consisted of 368 individuals who were confirmed to be tobaccodependent by scoring four or higher on the The Fagerström Test for Nicotine Dependence. A strong positive correlation was found between Nicotine Use Awareness and Insight Scale and Stages of Change Readiness and Treatment Eagerness Scale scores, used for equivalent criterion (predictive) validity. Cronbach's α coefficient was 0.85. Exploratory factor analysis showed that the scale explained 52.7% of the total variance with a single-factor structure. Nicotine Use Awareness and Insight Scale, a reliable and valid scale for Turkish people, can be utilized in studies aimed at raising awareness and raising consciousness among addicted individuals. [ABSTRACT FROM AUTHOR]

This study aimed to detect the mediating role of mindfulness in the relationship between psychological dependence on smoking and perceived stress levels. Fagerström Test for Nicotine Dependence, Mindful Attention Awareness Scale, Psychological Dependence to Smoking Scale, and Perceived Stress Level Scale were applied. To evaluate the indirect effects, regression analysis and the Sobel Z test were used. Of the 68 female (45%) and 83 male (55%) participants, Fagerström Test for Nicotine Dependence score (5.75 ± 2.51) was higher in past experiences of quitting for less than 1 month vs. longer quitting periods (p = .02). The mindfulness level was found to be negatively correlated with the Fagerström Test for Nicotine Dependence score (p = .216; r = -.101), perceived stress score (p < .001; r = -.296), and psychological dependence scores (p = .001; r = -.271). Regression analysis revealed that the perceived stress and mindfulness levels were predictors on psychological dependence (B = 0.204; t = 2.548; p = .012, and B = -0.236; t = -3.525; p = .005, respectively). The results of the Sobel test evaluating the mediator role of mindfulness in the relationship between perceived stress and psychological dependence were significant (Z value = 2.337, p = .019). These results highlight the role of mindfulness in smokers toward reducing associated perceived stress with psychological dependence. [ABSTRACT FROM AUTHOR]

This study aimed to determine the prevalence and factors affecting the use of electronic cigarettes among university students. This cross-sectional study included 987 participants. The prevalence of electronic cigarette use among students was 5.4%, and the prevalence of trying electronic cigarettes at least once was 26.3%. Nicotine dependence levels of students who smoked electronic cigarettes were significantly high. Everyday electronic cigarette smokers commonly perceive traditional cigarettes to be more harmful. The rates of electronic cigarette use were significantly higher in males, those with high household income, those with a family history of traditional or electronic cigarette smoking, those who had smoked traditional cigarettes at least once in their lives, and those who were everyday cigarette smokers. Male sex and family history of electronic cigarette use were direct and effective predictors of everyday electronic cigarette use. The risk of everyday electronic cigarette use increased 7.91 times in the presence of electronic or traditional cigarette smokers in the family and 4.66 times in the presence of e-cigarette users in the family. The rates of electronic cigarette use and attempted electronic cigarette use were found to be high among university students. Awareness training and increased inspections and sanctions on the places where electronic cigarettes were purchased might prevent the growth of this problem. [ABSTRACT FROM AUTHOR]

Background & Methods: The aim of the study is to assess the medicolegal aspects of female victims examined under immoral trafficking prevention act. Blood samples were taken for testing HIV, VDRL and Hepatitis-B. X-ray were taken for the purpose of age estimation. If in cases where any medical condition other than STD was detected, victim females were counselled and offered treatment or referred to the appropriate medical professional for further management of their condition. Results: Maximum (97%) of the female victims didn't show any sign and symptoms of sexually transmitted disease while 3% showed the sign and symptoms of sexually transmitted disease. In our study we found maximum cases in range of 01-05 years duration i.e. 60%. In our study we found maximum cases of addiction in Tobacco 32% & 44% found no addiction. Conclusion: Awareness programmes related to various health hazards of prostitution should be carried out targeting vulnerable population especially sexually transmitted diseases should be carried. Proper screening tests regarding sexually transmitted diseases should be carried on regularly in red light areas and treatment to be given. Deaddiction counselling should be done as addiction to tobacco and alcohol in long term is hazardous to health. [ABSTRACT FROM AUTHOR]

Introduction: One of the most important prognostic factors in non-small cell lung cancer (NSCLC), a condition with a high mortality rate, is the presence of mediastinal lymph node metastases alongside distant metastases. The aim of this study was to evaluate the prognostic value of selected parameters of N2 stage NSCLC with a special focus on lymph node ratio (LNR). Material: The study included 163 patients (61 women and 102 men) operated on due to NSCLC, postoperatively diagnosed as stage N2. The age of the patients ranged from 38 to 82 years (mean age: 62.4 years). The effects of the following factors on clinical data and survival rate were assessed: N1 stage, total number of all metastatic nodes, LNR and LNR N2 ratios, and the presence of skip, single- or multistation metastases. Results: Univariate analysis showed patient survival to be correlated with LNR and LNR N2 ratios, single/multistation metastases, and the number of nodes involved in metastasis. A multivariate model based on patient clinical data found nicotine dependence (p = 0.013), LNR > 0.26 (p = 0.004), and Charlson Comorbidity Index (CCI) value > 3 (p = 0.014) to be independent adverse prognostic factors in this group. Conclusions: LNR ratio is a significant cancer disease-derived independent prognostic factor for patients with postoperative N2 stage NSCLC. In addition, smoking and comorbidities also appear to have prognostic value. [ABSTRACT FROM AUTHOR]

Tobacco smoking has been highlighted as a major health challenge in modern societies. Despite not causing death directly, smoking has been associated with several health issues, such as cardiovascular diseases, respiratory disorders, and several cancer types. Moreover, exposure to nicotine during pregnancy has been associated with adverse neurological disorders in babies. Nicotine Replacement Therapy (NRT) is the most common strategy employed for smoking cessation, but despite its widespread use, NRT presents with low success and adherence rates. This is attributed partially to the rate of nicotine metabolism by cytochrome P450 2A6 (CYP2A6) in each individual. Nicotine addiction is correlated with the high rate of its metabolism, and thus, novel strategies need to be implemented in NRT protocols. Naturally derived products are a cost-efficient and rich source for potential inhibitors, with the main advantages being their abundance and ease of isolation. This systematic review aims to summarize the natural products that have been identified as CYP2A6 inhibitors, validated through in vitro and/or in vivo assays, and could be implemented as nicotine metabolism inhibitors. The scope is to present the different compounds and highlight their possible implementation in NRT strategies. Additionally, this information would provide valuable insight regarding CYP2A6 inhibitors, that can be utilized in drug development via the use of in silico methodologies and machine-learning models to identify new potential lead compounds for optimization and implementation in NRT regimes. [ABSTRACT FROM AUTHOR]

Introduction Digital cessation support appeals to pregnant smokers. In two pooled RCTs, MiQuit, a pregnancy-specific tailored text messaging intervention, did not show effectiveness for validated prolonged abstinence. However, secondary outcomes and potential moderators and mediators have not been investigated. We aimed to determine, using pooled RCT data: (1) MiQuit effectiveness on a range of smoking outcomes; (2) whether baseline tobacco dependence or quit motivation moderate effectiveness; (3) whether hypothesized mechanisms of action (quitting determination, self-efficacy, baby harm beliefs, lapse prevention strategies) mediate effectiveness. Methods Pooled data analysis from two procedurally identical RCTs comparing MiQuit (N  = 704) to usual care (N  = 705). Participants were smokers, <25 weeks pregnant, recruited from 40 English antenatal clinics. Outcomes included self-reported 7-day abstinence at 4 weeks post-baseline and late pregnancy, and prolonged abstinence. Late pregnancy outcomes were also biochemically validated. We used hierarchical regression and structural equation modeling. Results MiQuit increased self-reported, 7-day abstinence at 4 weeks (OR = 1.73 [95% CI 1.10–2.74]) and was borderline significant at late pregnancy (OR = 1.34 [0.99–1.82]) but not for prolonged or validated outcomes. Effectiveness was not moderated by baseline dependence (heaviness of smoking "low" vs. "moderate–high") or motivation (planning to quit ≤30 days [high] vs. >30 days [low]), but effects on self-reported outcomes were larger for the high motivation sub-group. MiQuit had a small effect on mean lapse prevention strategies (MiQuit 8.6 [SE 0.17], UC 8.1 [SE 0.17]; P  = .030) but not other mechanisms. Conclusions MiQuit increased short-term but not prolonged or validated abstinence and may be most effective for those motivated to quit sooner. Implications Digital cessation support appeals to pregnant smokers. MiQuit, a tailored, theory-guided text messaging program for quitting smoking in pregnancy, has not shown effectiveness for validated prolonged abstinence in two previous RCTs but its impact on other smoking outcomes and potential mechanisms of action are unknown. When pooling trial data, MiQuit increased self-reported short-term abstinence, including making a quit attempt and abstinence at 4-week follow-up, but not late pregnancy, sustained, or validated abstinence. MiQuit appeared effective at late pregnancy for participants with high quitting motivation, but its mechanisms of action remain uncertain. Additional support components are likely required to enhance effectiveness. [ABSTRACT FROM AUTHOR]

Introduction The Fagerström test for cigarette dependence (FTCD) and Brief Wisconsin index of smoking dependence motives (WISDM) are widely used measures of smoking dependence. The FTCD was previously found to have 1-factor and 2-factor structures and Brief WISDM has been found to have an 11-factor and 11-factor hierarchical structure. As such, the current study sought to further investigate the psychometric properties of the FTCD and Brief WISDM with a novel criminal-legal system-involved sample using both a factor-analytic and an item response theory (IRT) approach. Aims and Methods Data from 517 criminal-legal system-involved adults (ie, 18 years of age or older) who smoke from Alabama, USA were analyzed. Confirmatory factor analyses (CFA) were conducted on 1-factor and 2-factor structures of the FTCD and 1-factor, 11-factor, and 11-factor hierarchical structures of the Brief WISDM. IRT analyses investigating item discrimination and threshold parameters were also conducted on the brief WISDM. Results The CFA showed poor fit for a single-factor structure and mixed results for two 2-factor results for the FTCD. CFA also showed poor fit for a single-factor and mixed results for the 11-factor model. Initial IRT investigations using the 11-factor model showed strong item discrimination, but non-ordered threshold parameters. Conclusions Two-factor structures for the FTCD and the 11-factor model for the Brief WISDM were partially supported in a criminal-legal population, suggesting continued support for the multidimensional structure of the measures. Additionally, exploratory IRT analyses suggested good discrimination across the use spectrum for the Brief WISDM. Implications The Fagerström Test of Cigarette Dependence (FTCD) and Brief Wisconsin index of smoking dependence motives (WISDM) are two widely used measures of nicotine dependence, though previous research has shown mixed results for their internal consistency and factor structure. The current study used a unique sample of criminal-legal-involved participants who generally have moderate to high levels of nicotine dependence. The current study found that the FTCD displayed poor internal consistency, a poor fit for a single-factor model, but mixed support for two two-factor models. The Brief-WISDM was found to have strong internal consistency, a poor fit for a single-factor model, but mixed fit for an 11-factor model and good item discrimination. [ABSTRACT FROM AUTHOR]

Introduction Increasing electronic cigarette use among youth has led to a need for a novel intensity measure of e-cigarette use and its association with nicotine addiction variables. Aims and Methods Using a cross-sectional study of the 2018–2019 PATH Wave 5 Youth survey, a new intensity metric of e-cigarette use, the average number of puffs per month as a function of frequency (days of use per month), number of uses per day and number of puffs per use, was developed for adolescent e-cigarette users. Using logistic regression, standard addiction measures were tested for association with higher quartile (Q) of e-cigarette intensity: Q 1 (1–5 puffs), Q 2 (6–50 puffs), Q 3 (51–528 puffs), and Q 4 (529 + puffs). Results Among 1051 current youth e-cigarette users, cravings were associated with greater intensity of use (Q 2: aOR = 1.90, 95% CI: 0.94–3.87; Q 3: aOR = 6.91, 95% CI: 3.25–14.69; and Q4: aOR = 21.48, 95% CI: 10.03–45.97). Craving associations exceeded the corresponding aORs for the identical regression using the frequency of use. Higher intensity was significantly associated with being an older adolescent (aOR = 1.85), best friend use (aOR: 3.35), not thinking about quitting (aOR: 2.51), and lower perceived addiction (aOR: 1.95). Conclusions This study found that an intensity metric (puffs per month) was strongly associated with cravings, best friend use, harm perception, and lack of intention to quit. This metric provides a more accurate picture of the intensity of youth e-cigarette use than other commonly used measures and may be important for understanding the current and future impact of the youth e-cigarette epidemic. Implications Adolescent addiction to e-cigarettes affects learning, memory, and attention. However, it is unknown whether the intensity of use, puffs per month, differs from frequency, days of use per month, and in relation to addiction measures. This study provides evidence that high-intensity use characterized by puffs per month has a stronger association with cravings compared to frequency, which suggests puffs per month may be a better measure of nicotine exposure. This new intensity metric may give insights into youth e-cigarette use patterns, addiction, and appropriate treatment of intense but intermittent users. [ABSTRACT FROM AUTHOR]

Smoking is one of the main causes of death in the world. Cigarette use is related with various components of metabolic syndrome (e.g., insulin resistance, raised blood pressure, dyslipidemia, oxidative stress, inflammation state) and psychiatric disorders. This study was conducted to determine the effect of crocin (Cro) supplementation on nicotine dependence, anxiety, depression, and metabolic indices in smokers. A total of 50 smokers were selected and randomly categorized into two groups (crocin and placebo). The intervention group received crocin (30 mg per day; n = 25) and placebo (containing Avicel; n = 25) once a day. The primary (nicotine dependence, depression, and anxiety inventory) and secondary (metabolic indices) outcomes were assessed at the start of the intervention and after the 3 months. Multiple linear regression models were used to assess the treatment effects on the outcomes adjusting for confounding variables. The primary outcome results such as nicotine dependence, depression, and anxiety inventory did not have a significant difference among the intervention groups (P > 0.05). Also in the secondary outcomes, fasting plasma glucose (FPG), insulin, and homeostasis model of assessment-insulin resistance (HOMA-IR) levels did indicate a significant difference by Cro intervention (β − 3.27 mg/dL; 95% CI, − 5.23, − 1.31; P = 0.002; β − 0.76 μIU/mL; 95% CI, − 1.38, − 0.15; P = 0.01; β − 0.18; 95% CI, − 0.29, − 0.07; P = 0.002), respectively. There were also significant reductions in serum levels of high-sensitivity C-reactive protein (hs-CRP) (β − 0.72 mg/L; 95% CI, − 1.37, − 0.07; P = 0.03), compared with the placebo. Cro intake may have favorable effects on the level of FPG, insulin, HOMA-IR, and hs-CRP in smokers. However, due to the small sample size and limited scientific reports on smokers, further studies are necessary. ClinicalTrial.gov Identifier: IRCT20170420033551N11 [ABSTRACT FROM AUTHOR]

AbstractBackgroundObjectiveMethodsResultsConclusionTobacco use is one of the leading causes of preventable mortality and morbidity. Although Cyprus is considered a developed country, the tobacco prevalence and related issues have not been explored sufficiently in the general population of North Cyprus.The objective of this study is to determine the rate of tobacco product consumption and related factors among the visitors of a community health center and a university hospital in Northern Cyprus.The study was designed as a cross-sectional study The data were collected using a questionnaire developed in compliance with WHO guidelines. The data were analyzed using IBM-SPSS18.0 with p < 0.05 evaluated as significant.Out of a total of 635 individuals approached, 615 provided responses. The participation rate was 96%. The frequency of male smokers was 47.2%, while the frequency of female smokers was 34.0%, with a total smoking rate of 40.7%, much higher than world averages. The survey identified friendship influence as the primary reason for starting tobacco use, accounting for 42%, followed by being stressed at 34.6%. Male gender, being single, having no children, Turkish nationality were predictors of smoking, while financial status was not. The participants indicated a high frequency regarding exposure to passive smoke (51.1%). More than half of the respondents thought tobacco control in Northern Cyprus is not satisfactory.More research needs to be done to determine the exact overall prevalence of tobacco consumption in the population, which was found high in this study. Moreover, implementation of comprehensive tobacco control strategies is essential to control the prevalent tobacco dependence. [ABSTRACT FROM AUTHOR]