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China is a large country with substantial urban-rural disparity. With the increasing concerns related to the rapid growth of the older adult population and problems related to smoking and alcohol consumption, this study aims to examine the potential urban-rural disparity associated with nicotine or alcohol dependence among Chinese older adults. We used three waves of the Chinese Longitudinal Healthy Longevity Survey and included older adults who were 65 years old or above (CLHLS; n = 18,207). The Heckman two-step selection procedure was applied to reduce potential selection bias. The first and the second steps of the Heckman two-step selection procedure all included multivariable logistic regressions. In the final study sample, approximately 8.1% and 4.0% of older adults reported nicotine and alcohol dependence, respectively. In the first step of the Heckman selection procedure, urban residents were less likely to become current smokers and alcohol users than rural residents (all p <.05). However, urban-rural disparity was not associated with either nicotine or alcohol dependence (all p >.05). We did not observe the urban-rural disparity in nicotine and alcohol dependence among Chinese older adults. Chinese policymakers should continue to strengthen national policy to combat smoking and alcohol consumption, especially older adults. [ABSTRACT FROM AUTHOR]

INTRODUCTION Multi-morbidity is a public health priority as it is associated with an increased risk of mortality and a substantial healthcare burden. Smoking is considered a predisposing factor for multi-morbidity, but evidence for an association between multi-morbidity and nicotine dependence is insufficient. This study aimed to explore the association between smoking status, nicotine dependence, and multi-morbidity in China. METHODS We recruited 11031 Chinese citizens from 31 provinces in 2021 using a multistage stratified cluster sampling strategy to ensure the study population represented national population characteristics. The association between smoking status and multi-morbidity was analyzed using binary logistic regression and multinomial logit regression models. We then analyzed the associations between four kinds of smoking status (age at smoking initiation, cigarette consumption per day, smoking when ill in bed, and inability to control smoking in public places), nicotine dependence, and multi-morbidity among participants who were current smokers. RESULTS Compared with non-smokers, the odds of multi-morbidity were higher among ex-smokers (adjusted odd ratio, AOR=1.40, 95% CI: 1.07-1.85). The risk of multi-morbidity was greater in participants who were underweight/overweight/ obese (AOR=1.90; 95% CI: 1.60-2.26) compared with those who were normal weight. and also greater for drinkers (AOR=1.34; 95% CI: 1.09-1.63) than nondrinkers. Compared with children who began smoking at the age of <15 years, participants aged >18 years had a lower likelihood of multi-morbidity (AOR=0.52; 95% CI: 0.32-0.83). People who consumed ≥31 cigarettes per day (AOR=3.77; 95% CI: 1.47-9.68) and those who smoked when ill in bed (AOR=1.70; 95% CI: 1.10-2.64) were more likely to have multi-morbidity. CONCLUSIONS Our findings show that smoking behavior, including initiation age, frequency of daily smoking, and still smoking during illness or in public, is a critical risk factor for multi-morbidity, especially when combined with alcohol consumption, physical inactivity, and abnormal weight (underweight, overweight, or obese). This highlights the crucial effect of smoking cessation in the prevention and control of multi-morbidity, especially in patients with three or more diseases. Implementing smoking and lifestyle interventions to promote health would both benefit adults and prevent the next generation from initiating habits that increase the risk of multi-morbidity. [ABSTRACT FROM AUTHOR]

INTRODUCTION This study aimed to investigate the impact of smoking on physical activity level, emotional status, and cardiopulmonary endurance in healthy young Chinese college students in order to develop future nicotine dependence management solutions. METHODS This survey-based study was conducted in college students aged 19-26 years who were currently smoking. Cardio-respiratory endurance was assessed by estimating VO2max. Participants were given a questionnaire containing five factors from the Cigarette Dependence Scale-5 (CDS-5), also assessed were variables for physical activity level, using the Global Physical Activity Questionnaire (GPAQ), and emotional status. The sports training behavior was assessed using the Coaching Behavior Scale for Sport (CBS-S). RESULTS A total of 400 participants were randomly selected and included in the study. All of them were current smokers. The highest percentage of participants had a score of 4 on the CDS-5 (n=93, 23.2%), scored 3-5 on each module of sports training, and experienced negative emotions, particularly depression (n=172; 43.0%) and anger (n=162; 40.5%). VO2max levels were significantly lower in participants with high nicotine dependence (CDS-5 score 4-5), and they correlated negatively with CDS-5 scores (r= -0.883, p<0.001). Nicotine dependence scores were negatively correlated with physical activity levels (r= -0.830, p<0.001), and high nicotine dependence scores were independently related to low physical activity (adjusted odds ratio, AOR=14.66; 95% CI: 4.98- 43.19, p<0.001). CONCLUSIONS Tobacco smoking has a negative impact on emotional status. It also reduces cardiopulmonary endurance by reducing VO2max levels and negatively affects physical activity. Accordingly, it is critical to implement effective tobacco prevention programs for college students, such as a smoking warning system and physical exercise training, as well as to educate them on how to quit smoking. [ABSTRACT FROM AUTHOR]

Motivation, encompassing positive reinforcement, negative reinforcement, and compulsion, significantly influences addictive behavior. Yet, there is little research available on these motivational dimensions and their connection to addictive behavior. This study addressed these gaps by investigating motivation in internet addiction (IA) and nicotine dependence (ND). Cross-sectional data from 472 nicotine users (NUs) and 1004 internet users (IUS) were examined using the Chinese version of the Habit, Reward, and Fear Scale. The Glasso network method was used to estimate the networks, and four interrelated centrality measures were calculated. IUs exhibited significantly lower total addiction motivation scores, as well as lower reward and fear dimensions, compared to NUs. In the Severity-Motivation Network, reward and fear motivations had the highest centrality. The habitual motivation of NUs demonstrated the highest closeness and betweenness centrality, showing a strong positive correlation with the degree of ND. The fear motivation of IUs exhibited a strong positive correlation with the degree of IA. In the symptom-motivation network, reward and habit nodes displayed higher centrality in NUs, whereas reward and fear nodes were most central for IUs. The findings indicate that reward, fear, and habit motivations are key factors in explaining behaviors associated with nicotine use and internet use. The unique positions of habitual motivation in ND and fear motivation in IA provide new perspectives for understanding addictive behaviors. These should be considered key motivational targets for clinicians to address. • The paper uses network analysis to explore addictive motivations, offering insights into the core mechanisms of addiction. • The paper emphasizes the distinct roles of habitual motivation in nicotine dependence and fear motivation in internet addiction, suggesting targeted treatments. • The study uses a relatively large sample size, which increases the robustness and generalizability of the results. [ABSTRACT FROM AUTHOR]

INTRODUCTION Cigarette and tobacco use is a leading cause of chronic obstructive pulmonary disease, lung cancer, and other malignant tumors. In China, people prefer to engage in mental activities (gambling, overtime work, playing video games, or other mental activities) on the weekends or during spare time, especially in the evening before they prepare for bed. In China, smokers frequently consume tea while smoking. The relationship between smokers who consume tea, engage in mental activities after dinner, or both (drinking tea and engaging in cognitive activities after dinner together), and daily cigarette smoking or nicotine addiction must be clarified. METHODS A total of 438 smokers were included in the study. Age, gender, body mass index (BMI), smoking habits, Fagerström test for nicotine dependence scores, and behaviors, were recorded. The study excluded smokers with a Fagerström score <1 or with a mental disorder diagnosis. The smokers were divided into four groups based on their behaviors: those who did not drink tea, did not engage in mental activities after dinner, those who drank tea only, those who engaged in mental activities only, and those who engaged in both. RESULTS Only drinking tea or doing mental activities after dinner cannot increase cigarettes per day (22.20 ± 10.143 vs 23.49 ± 11.966, p=0.362; 22.20 ± 10.143 vs 22.66 ± 1.192, p=0.750) or FTND scores [6.0 (4.0; 7.0) vs 6.0 (4.0; 7.75), p=0.941; 6.0 (4.0; 7.0) vs 6.0 (4.25; 7.75), p=0.980]. People who drink tea and engage in mental activities after dinner smoke more (22.20 ± 10.143 vs 30.75 ± 17.264, p<0.0001) and have higher nicotine dependence levels [6.0 (4.0; 7.0) vs 7.0 (5.0; 8.0), p=0.015]. CONCLUSIONS The consumption of tea or a mental activity after dinner is not associated with daily smoking or nicotine dependence. There is an association between the combined behaviors (tea drinking and mental activity after dinner) and the daily consumption of cigarettes, and the degree of nicotine dependence. [ABSTRACT FROM AUTHOR]

The exact relationship between nicotine metabolism and dependence is not fully understood but is known to be influenced at a molecular level by genetic factors. A sample comprising 274 Chinese adult male smokers was categorized into groups based on their metabolic rates, namely fast, intermediate, and slow metabolizers. We then measured their smoking topography, evaluated their nicotine dependence, and assessed the rewarding effects. Based on these findings, we proposed the hypothesis that the rate of nicotine metabolism could influence the level of dopamine release which in turn had repercussions on the pleasurable and rewarding effects. To test this hypothesis, male mice were selected with different nicotine metabolic rates that closely resembled in the smoker group. We evaluated their nicotine dependence and rewarding effects through conditioned place preference and withdrawal symptom tests, supplemented with dopamine release measurements. In both animal and human, the slow metabolism group (SMG) required less nicotine to maintain a comparable level of dependence than the fast metabolism group (FMG). The SMG could achieve similar rewarding effects to FMG despite consuming less nicotine. Comparable dopamine levels released were therefore critical in setting the nicotine acquisition behavior in this animal model and also for the smokers tested. Our findings suggested that even within the same ethnicity of established smokers (Chinese Han), differences in nicotine metabolism were an important parameter to modulate the degree of nicotine dependence., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Tobacco use is one of the most important risk factors for health, and China is the largest producer and consumer of tobacco in the world. Monitoring and controlling the tobacco epidemic is an important issue. However, the motivation underlying smoking behavior is complex and specific to the individual. The Habit, Reward and Fear Scale (HRFS) is a feasible tool to evaluate this complex motivation. Objectives: To validate the psychometric properties of the HRFS Chinese version (HRFS‐C) and to assess the relationship between motivation and smoking behavior. Method: We recruited 967 participants through social media and assessed their smoking behavior with three instruments: the Fagerstrom Test for Nicotine Dependence‐Chinese version (FTND‐C), the Questionnaire on Smoking Urges‐Brief Scale‐Chinese version (QSU‐brief‐C), and the HRFS‐C. Ultimately, we retained 700 valid data points. Cronbach's α and split‐half tests were used to evaluate the reliability. Confirmatory factor analysis, Pearson's r and an analysis of variance (ANOVA) were used to evaluate the validity. In addition, linear regression was used to explore the relationship among the three instruments. The HRFS‐C showed good homogeneity (α = 0.965), concurrent validity, and discriminant validity. A significant linear relationship was observed among the FTND‐C, QSU‐brief‐C, and HRFS‐C (p <.001). Conclusion: The motivation measured by the HRFS‐C can significantly predict nicotine dependence and craving in the smoking population. The HRFS‐C can be used to carry out targeted interventions for addicted patients (e.g., motivational enhancement therapy). [ABSTRACT FROM AUTHOR]

The association between nicotine dependence and intentions to quit smoking is well established. However, the underlying mechanisms and psychosocial factors that moderate this relationship have not been adequately delineated. Reinforcement theory, social learning theory, the theory of planned behavior, and the focus theory of normative conduct suggest that perceived behavioral control (PBC) over smoking cessation is a central mechanism that underlies the relationship between nicotine dependence and quitting intentions. Purpose/Objectives: The present study tested a moderated mediation model to examine the roles of PBC over smoking cessation and social norms, in the relationship between nicotine dependence and quit intentions among male regular smokers. Methods: Self-report measures of nicotine dependence, PBC over smoking cessation, descriptive and injunctive quitting norms, and intentions to quit smoking were administered to 204 Chinese male regular smokers. Results: Nicotine dependence was negatively related to quit intentions, and this relationship was mediated by PBC over smoking cessation. Further, the relationship between nicotine dependence and PBC was moderated by descriptive rather than injunctive quitting norms. The negative effects of nicotine dependence on PBC over smoking cessation were not significant among male regular smokers who reported strong descriptive quitting norms. Conclusions/Importance: Poor PBC over smoking cessation underlies the negative effects of nicotine dependence, and descriptive quitting norms act as a buffer against the adverse effects of nicotine dependence on PBC over smoking cessation. These findings have implications for smoking cessation interventions for male regular smokers. [ABSTRACT FROM AUTHOR]

Objective: More effective tobacco prevention and cessation programs require in-depth understanding of the mechanism by which multiple factors interact with each other to affect smoking behaviors. Stress has long been recognized as a risk factor for smoking. However, the underlying mediation and moderation mechanisms are far from clear. The purpose of this study was to examine the role of negative emotions in mediating the link between stress and smoking and whether this indirect link was modified by resilience. Methods: Survey data were collected using audio computer-assisted self-interview (ACASI) from a large random sample of urban residents (n = 1249, mean age = 35.1, 45.3% male) in Wuhan, China. Perceived stress, negative emotions (anxiety, depression), resilience were measured with reliable instruments also validated in China. Self-reported smoking was validated with exhaled carbon monoxide. Results: Mediation analysis indicated that two negative emotions fully mediated the link between stress and intensity of smoking (assessed by number of cigarettes smoked per day, effect =.082 for anxiety and.083 for depression) and nicotine dependence (assessed by DSM-IV standard, effect =.134 for anxiety and.207 for depression). Moderated mediation analysis demonstrated that the mediation effects of negative emotions were negatively associated with resilience. Conclusions: Results suggest resilience interacts with stress and negative emotions to affect the risk of tobacco use and nicotine dependence among Chinese adults. Further research with longitudinal data is needed to verify the findings of this study and to estimate the effect size of resilience in tobacco intervention and cessation programs. [ABSTRACT FROM AUTHOR]

Background: This study examines how nicotine dependence is distributed across socioeconomic gradients in rural Yunnan province, which has the most ethnic minorities in one province in southwest China.Methods: A cross-sectional survey was conducted in four rural areas of Yunnan province among 17,158 consenting individuals aged ≥18 years in 2011. Information on demographic characteristics and smoking habits was obtained using a standard questionnaire. The Fagerstrom Test for Nicotine Dependence (FTND) was applied to assess nicotine dependence. Multilevel logistic regression was used to model the variation in prevalence of nicotine dependence.Results: In the study population, the overall prevalence of current smokers and nicotine dependence was 32.4 % and 31.6 %, respectively. Females were much less likely to have nicotine addiction than males: odds ratio (OR) of 0.01 (95 % CI: 0.008 - 0.012). Higher annual household income was associated with a greater risk of nicotine dependence (OR 1.09, 95 % CI: 1.01 - 1.17). Adults who grew tobacco were more likely to have nicotine addiction (OR 1.22, 95 % CI 1.07 - 1.41). Individual educational level was inversely associated with the probability of nicotine dependence (OR 0.63, 95 % CI 0.55 - 0.72), lower community educational level was also associated with an increased risk of nicotine dependence (OR 0.94, 95 % CI 0.92 - 0.98).Conclusions: Nicotine dependence showed significant variations across different indicators of both contextual and individual socioeconomic status in rural southwest China. Future interventions on tobacco cessation should give increased attention to men, tobacco farmers, less educated or poorer persons, and lower educational level communities. [ABSTRACT FROM AUTHOR]

Objective: The current study aimed to assess the level of nicotine dependence and its influencing factors among daily smokers in Zhejiang, China., Setting: The 2020 Global Adult Tobacco Survey was conducted in Zhejiang, China., Participants: 1244 daily smokers aged ≥15 years., Measures: Respondents were asked questions regarding their age, sex, residence, education level, occupation, household income, age of starting daily smoking and nicotine dependence., Results: The findings revealed that 17.4% of daily smokers were highly dependent on nicotine, and the mean Fagerström Test for Nicotine Dependence score of daily smokers was (3.1±2.4). Age, educational level, occupation and age of starting daily smoking had significant effects on high nicotine dependence, whereas residence, sex and yearly household income were not significant factors. Compared with the age group ≥60 years, the proportion of respondents with a higher nicotine dependence level was lower in the age group of 15-39 years (OR=0.45). Daily smokers with a higher education level had a lower nicotine dependence level than those with a lower education level: primary or less (OR=3.07) and secondary (OR=2.62). Government institution staff (OR=4.02), unemployed persons (OR=3.08) and industrial workers (OR=2.46) had significantly higher nicotine dependence levels than did workers in the other occupation categories. People who started daily smoking at ≤18 years of age had a higher nicotine dependence level (OR=2.25) than those who started later., Conclusions: This study elucidated that nearly one-fifth of daily smokers in Zhejiang, China, have high nicotine dependence levels. Improved health information on tobacco smoking is needed to encourage daily smokers to quit smoking, particularly among young males, unemployed persons and those with lower education levels., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

To investigate the association of CYP2A6 genetic polymorphisms with smoking-related phenotypes in Chinese smokers. Case-only genetic association study. Southern China. A total of 1328 Han Chinese smokers who participated in a community-based chronic disease screening project in Guangzhou and Zhuhai from 2006 to 2007. All participants answered a structured questionnaire about socio-demographic status and smoking behaviors and informative alleles were genotyped for the cytochrome P450 2A6 ( CYP2A6) gene ( CYP2A6* 4,* 5,* 7,* 9 and * 10). The frequencies of CYP2A6* 4, * 5, * 7, * 9 and * 10 alleles were 8.5, 1.2, 6.3, 13.5 and 2.4%, which corresponded to 48.9, 15.4, 24.2 and 11.5% of participants being classified as normal, intermediate, slow and poor metabolizers, respectively. Multivariate analyses in male smokers demonstrated that compared with normal metabolizers, poor metabolizers reported smoking fewer cigarettes per day [adjusted odds ratio (OR) = 0.49; 95% confidence interval (CI): 0.32-0.76], started smoking regularly later in life (adjusted OR = 1.55; 95% CI: 1.06-2.26) and, among former smokers, reported smoking for a shorter duration prior to quitting (adjusted OR = 0.33; 95% CI: 0.12-0.94). However, poor metabolizers were less likely to quit smoking and remain abstinent than normal metabolizers (adjusted OR = 0.54; 95% CI: 0.34-0.86). Reduced metabolism function of cytochrome P450 2A6 in smokers appears to be associated with fewer cigarettes smoked, later initiation of smoking regularly, shorter smoking duration and lower likelihood of smoking cessation. [ABSTRACT FROM AUTHOR]

Abstract: To explore the characteristics of nicotine dependence among Chinese opiate addicts, a survey was conducted among 357 opiate addicts in Drug Detoxification and Rehabilitation Center from 4 different provinces by using a self-designed questionnaire and Fagerström Test for Nicotine Dependence (FTND). Among the 357 opiate addicts, 355 (99.4%) had the history of cigarette smoking and the mean cigarette smoked per day were 19.1, 34.9, 21.5 and 21.5 sticks during the time of before drug taking, addiction phase, abstinence period and after abstinence respectively. Among 347 smokers with FTND score, 67.2% were severe nicotine dependence (FTND score ≥7.0). The lower education degree, injection, poly-drug use and 3 or more relapse were dependently associated with the severe nicotine dependence, and the adjusted odds ratio (OR) were 3.8 (1.5–10.0), 2.3 (1.3–4.0), 3.7 (2.1–6.5) and 1.9 (1.1–3.4) respectively. This study exhibited high rate of cigarette smoking in Chinese opiate addicts and the majority had severe nicotine dependence and suggested that a comprehensive intervention of cigarette smoking should be paid attention to during substance abuse treatment in China. [Copyright &y& Elsevier]

Background: The Obsessive Compulsive Drug Use Scale (OCDUS) measures the overall craving level within a period from a multidimensional perspective. However, no studies have addressed the validity of the new OCDUS factor structure, presented in 2016, in China. Additionally, there is lack of evidence on the interaction among risk factors for relapse. We aimed to assess the psychometric properties of the scores of the Chinese version of the OCDUS in patients with heroin dependence receiving methadone maintenance treatment (MMT). Further, we aimed to assess the correlations of the OCDUS scores with withdrawal symptoms, depression, anxiety, and nicotine dependence. Methods: We enrolled 113 adults (age 32–64 years) and administered them with the OCDUS, Subjective Opioid Withdrawal Scale (SOWS), Beck Depression Inventory-II (BDI-II), State-Trait Anxiety Inventory (STAI), and Fagerstrom Test for Nicotine Dependence (FTND). Results: Exploratory factor analysis identified a 3-dimensional component that included "Frequency of craving," "Inference of heroin," and "Control of heroin." These factors showed acceptable internal consistency, adequate item-total correlations, and significant item-subscale correlations. There was no correlation between the OCUDS scores and age, education, duration of receiving MMT, and MMT dosages. However, there was a significant correlation between the OCDUS total scores and the SOWS, STAI, BDI-II, and FTND scores. The scores of all the subscales were associated with the SOWS scores; further, the scores of the first two subscales were associated with BDI-II scores while only the scores of the first subscale were associated with the FTND scores. Conclusions: Our findings support the reliability and structure validity of the OCDUS scores. Heroin craving, withdrawal symptoms, negative emotions, and nicotine dependence, which are considered as risk factors for heroin relapse, might interact with each other. There is a need for further studies on the underlying mechanism of these clinical phenomena. [ABSTRACT FROM AUTHOR]

Background: Hardcore smoking behaviours and test of hardening are seldom reported from low-and-middle-income countries (LMICs). We report country-wise changes in smoking behaviors between two sequential surveys and explored ecologically the relationship between MPOWER scores and smoking behaviors including hardcore smoking., Methods: We analysed sequential Global Adult Tobacco Survey (GATS) data done at least at five years interval in 10 countries namely India, Bangladesh, China, Mexico, Philippines, Russia, Turkey, Ukraine, Uruguay, and Vietnam. We estimated weighted prevalence rates of smoking behaviors namely current smoking (both daily and non-daily), prevalence of hardcore smoking (HCS) among current smokers (HCSs%) and entire surveyed population (HCSp%), quit ratios (QR), and the number of cigarettes smoked per day (CPD). We calculated absolute and relative (%) change in rates between two surveys in each country. Using aggregate data, we correlated relative change in current smoking prevalence with relative change in HCSs% and HCSp% as well as explored the relationship of MPOWER score with relative change in smoking behaviors using Spearman' rank correlation test., Results: Overall daily smoking has declined in all ten countries lead by a 23% decline in Russia. In India, Bangladesh, and Philippines HCSs% decreased as the smoking rate decreased while HCSs% increased in Turkey (66%), Vietnam (33%) and Ukraine (15%). In most countries, CPD ranged from 15 to 20 sticks except in Mexico (7.8), and India (10.4) where CPD declined by 18 and 22% respectively. MPOWER scores were moderately correlated with HCSs% in both sexes (r = 0.644, p = 0.044) and HCSp% (r = 0.632, p = 0.05) and among women only HCSs% (r = 0.804, p = 0.005) was significantly correlated with MPOWER score., Conclusion: With declining smoking prevalence, HCS had also decreased and quit rates improved. Ecologically, a positive linear relationship between changes in smoking and HCS is a possible evidence against 'hardening'. Continued monitoring of the changes in quitting and hardcore smoking behaviours is required to plan cessation services.

Damage to the insular cortex has been shown to disrupt smoking behavior. However, whether smoking cessation outcomes are associated with abnormal functions of insula and its subregions remains unclear. In this study, we investigated the relationship between insular functions (interregional functional connectivity and regional activity) and treatment outcomes of cigarette smoking. Thirty treatment-seeking smokers were recruited into the treatment study and underwent magnetic resonance imaging (MRI) scans immediately before and after the treatment. Sixteen participants remained abstinent from smoking (quitters), while 14 relapsed to smoking (relapers). Changes in resting-state functional connectivity and fractional amplitude of low frequency fluctuation (fALFF) across groups and visits were assessed using repeated measures ANCOVA. Significant interaction effects were detected: 1) between the left anterior insula and left precuneus; and 2) between the right anterior insula and left precuneus and medial frontal gyrus. Post-hoc region-of-interest analyses in brain areas showing interaction effects indicated significantly increased functional connectivity after treatment compared with before treatment in quitters but opposite longitudinal changes in relapsers. However, no significant effects in fALFF were observed. These novel findings suggest that increased interregional functional connectivity of the anterior insula is associated with improved smoking cessation outcome: individuals with increased functional connectivity of the anterior insula during the treatment would more likely quit smoking successfully. These insular circuits may serve as therapeutic targets for more efficacious treatment of nicotine addiction.

Background: Patients with lung cancer continue to smoke owing to complex factors. Failure to quit smoking (defined as nicotine dependence) is significantly associated with genetic status. This study aimed to investigate the relationship between polymorphisms in nicotine dependence genes and smoking status after the diagnosis of lung cancer., Patients and Methods: A total of 240 patients with lung cancer were included from July 2017 to March 2018. According to the actual smoking condition after lung cancer diagnosis, eligible patients were divided into 3 groups: the never-smoking group, the failure to quit smoking group, and the successful smoking cessation group. Fagerstrom Test for Nicotine Dependence scores were used to evaluate the smoking status of each group. Three nicotine-dependent genes with 6 loci were detected., Results: Among the 240 patients, 86 were never-smokers, 51 failed to quit smoking, and 104 successfully quit smoking. The initial age of smoking in the failure to quit smoking group was significantly younger than those in the successful smoking cessation group (P = .001). There was a significant difference in the GG and AG and AA genotype distributions of CHRNA3 (rs578776) among the 3 groups (P = .003). There was also a significant difference in the distribution of CHRNA4 (rs2229959) genotypes among the 3 groups (P = .003). However, there was no significant difference in the genotype distribution of CHRNA5 (rs588765) among the 3 groups (P = .277)., Conclusions: Gene polymorphisms of CHRNA3 (rs578776) and CHRNA4 (rs1044396 and rs2229959) were associated with the success of smoking cessation after the diagnosis of lung cancer, which should be considered in the management of smoking cessation after patients are diagnosed with lung cancer., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Objectives: This study examines ethnic disparities in prevalence and patterns of smoking and nicotine dependence in rural southwest China., Design: This was a cross-sectional design., Setting: This study was conducted in rural Yunnan Province of China., Participants: 7027 consenting individuals aged ≥35 years among Han majority and four ethnic minority groups (Na Xi, Li Shu, Dai and Jing Po) participated in this study. Information about participants' demographic characteristics as well as smoking habits and an assessment of nicotine dependence with the Fagerstrom Test for Nicotine Dependence (FTND) was obtained using a standard questionnaire., Results: Males had significantly higher prevalence of current smoking than females (64.8% and 44.4%, p<0.01). Among current smokers, the prevalence of nicotine dependence was significantly higher in males compared with females (19.9% and 7.1%, p<0.01). Jing Po men and women had the highest prevalence of current smokers (72.2% vs 23.1%, p<0.01), whereas the highest prevalence of nicotine dependence was found in male Dai current smokers and female Li Shu current smokers (44.8% vs 32.5%, p<0.01). Filtered cigarettes were the most popular form of tobacco used across all five ethnic groups. Over 75% of tobacco users initiated smoking and regularly smoked during adolescence, and those of minority ethnicity smoked regularly at a younger age than those of Han descent (p<0.05). Individuals in all five ethnic groups with higher levels of education had a lower probability of current smoking status (p<0.05), whereas a negative association of level of education with nicotine dependence was only observed in current smokers in the Han majority and Dai ethnic minority groups. Among Han majority current smokers, higher annual household income was associated with a higher risk of nicotine dependence (p<0.05)., Conclusion: Future interventions to control tobacco use should be tailored to address ethnicity and socioeconomic factors., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Previous studies have showed association between smoking and central fat distribution. However, the impact of smoking on whole body fat distribution, particularly peripheral fat distribution remains unclear., Methods: Nicotine dependence was assessed in a total of 1264 male adults aged 18-80 years using the Fagerström Test for Nicotine Dependence (FTND). Smoking status was categorised as non-smokers, former and current smokers with very low, low/moderate, or high FTND scores. Body fat distribution was determined using the dual energy X-ray absorptiometry and anthropometric measurements. Multivariable linear regression models were applied to examine the adjusted associations between body fat distribution and smoking in all participants, and its association with FTND scores in the current smokers., Results: Greater waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), trunk fat percentage (%TF), android fat percentage (%AF) and android-to-gynoid fat mass ratio (AOI); but lower legs fat percentage (%LegF), limb fat percentage (%LimbF) and gynoid fat percentage (%GF) were found in current smokers with high FTND scores compared with non-smokers. In current smokers aged 60 years or older, FTND scores had positive associations with WC, WHR, WHtR, %TF, %AF and AOI, and negative associations with %LegF, %LimbF and %GF., Conclusions: Nicotine dependence was positively associated with central fat distribution and negatively associated with peripheral fat distribution in Chinese male adults, particularly in those older or heavy smokers, and these associations were independent from body mass index, which might be due to long exposure to smoking., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Indices of mood, mood regulation expectancies and everyday executive functioning were examined in adult current smokers and never-smokers of both genders in Australia (N = 97), where anti-smoking campaigns have dramatically reduced smoking prevalence and acceptability, and in China (N = 222), where smoking prevalence and public acceptance of smoking remain high. Dependent measures included the Depression Anxiety Stress Scales (DASS-21), the Negative Mood Regulation (NMR) expectancies scale, the Frontal Systems Behavior Scale (FrSBe), the Fagerström Test for Nicotine Dependence (FTND) and the Alcohol Use Disorders Identification Test (AUDIT). Multivariate analyses of covariance (MANCOVAs) controlling for demographic and recruitment related variables revealed highly significant differences between current smokers and never-smokers in both countries such that smokers indicated worse moods and poorer functioning than never-smokers on all dependent measures. Chinese smokers scored significantly worse on all dependent measures than Australian smokers whereas Chinese and Australian never-smokers did not differ on any of the same measures. Although nicotine dependence level as measured by FTND was significantly higher in Chinese than Australian smokers and was significantly correlated with all other dependent measures, inclusion of FTND scores as another covariate in MANCOVA did not eliminate the highly significant differences between Chinese and Australian smokers. Results are interpreted in light of the relative ease of taking up and continuing smoking in China compared to Australia today., (© 2013 Elsevier Ltd. All rights reserved.)