Search

BackgroundDual use of both e-cigarettes and cigarettes is popular among young adults and may lead to greater nicotine dependence and additive adverse health effects than single-product use. However, existing cessation programs target quitting either e-cigarettes or cigarettes, highlighting a need for interventions to help young adults quit both products (ie, dual tobacco cessation).ObjectiveThis formative study is part of a larger project to develop a smartphone intervention for dual tobacco cessation among young adults. This study aimed to (1) explore desires for and experiences with quitting both e-cigarettes and cigarettes and (2) identify needs and preferences for dual tobacco cessation intervention programming.MethodsSemistructured interviews were conducted to elicit the need for and experience with dual tobacco cessation among 14 young adults (18-29 years old) recruited through Instagram (Meta) advertisements in 2023. We conducted a thematic analysis to identify common themes related to quitting experiences and cessation needs.ResultsParticipants expressed a strong desire for dual tobacco cessation and had attempted to quit both tobacco products, mostly "cold turkey." The priority product for quitting first varied by the individual's perceived harm or level of consumption. Targets for dual tobacco cessation interventions included (1) highlighting the health effects of dual tobacco use compared with single product use, (2) providing cessation support to quit one prioritized product while cutting down the other product with the explicit goal to quit both, (3) emphasizing unique facilitators and barriers to quitting each product (eg, unpleasant smell of cigarettes facilitating smoking cessation and accessibility and flavors of e-cigarettes hindering vaping cessation), and (4) addressing co-use of tobacco with alcohol or cannabis. Participants wanted personalized interventions through smartphone apps that would tailor support to their tobacco use patterns and unique quitting goals and needs. They also suggested presenting intervention content in multimedia (eg, videos, graphic pictures, quizzes, and games) to increase engagement.ConclusionsThis study provides important insights into young adults' experiences, needs, and preferences for dual tobacco product cessation. We highlight important targets for future smartphone apps to deliver personalized and tailored support to meet the heterogeneous needs and preferences of young people who want to quit using both e-cigarettes and cigarettes.

Chronic use of nicotine is known to dysregulate metabolic signaling through altering circulating levels of feeding-related hormones, contributing to the onset of disorders like type 2 diabetes. However, little is known about the acute effects of nicotine on hormonal signaling. We previously identified an acute increase in food intake following acute nicotine, and we sought to determine whether this behavior was due to a change in hormone levels. We first identified that acute nicotine injection produces an increase in feeding behavior in dependent rats, but not nondependent rats. We confirmed that chronic nicotine use increases circulating levels of insulin, leptin, and ghrelin, and these correlate with rats' body weight and food intake. Acute nicotine injection in dependent animals decreased circulating GLP-1 and glucagon levels, and administration of glucagon prior to acute nicotine injection prevented the acute increase in feeding behavior. Thus, acute nicotine injection increases feeding behavior in dependent rats by decreasing glucagon signaling.

Purpose: To examine adolescents' perspectives regarding external and internal influences of the e-cigarette initiation process. Design: Semi-structured, in-depth qualitative interviews. Setting: California, remote videoconference. Participants: Adolescents ages 13-17 who currently or previously used e-cigarettes (n = 47). Method: Interviews occurred from May 2020-February 2021. Two researchers coded transcripts based on a codebook developed inductively. Coded excerpts were reviewed to identify encompassing themes related to adolescent e-cigarette initiation. Results: Adolescents were often near e-cigarette use by peers, family members, and others, creating ample opportunities to try e-cigarettes in response to curiosity, peer pressure, and desires to cope with stress or belong to a group. Adverse first experiences were common (eg, throat irritation, nausea), but many adolescents vaped again or continued to use regularly in attempts to cement friendships or alleviate symptoms of stress and anxiety. Specific characteristics of e-cigarette devices, including low-cost, concealability, and variety in designs and flavors facilitated initiation, continued use, and nicotine dependence. Conclusions: Adolescents progress to e-cigarette use via a multistage process, starting where social expectations and opportunity converge. While individual circumstances vary, many continue to vape as a perceived coping tool for emotional issues, to gain social belonging, or influenced by e-cigarette characteristics that contribute to ongoing use and dependence. Efforts to deter use should address the devices themselves and the social forces driving youth interest in them. [ABSTRACT FROM AUTHOR]

Background: 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]

Introduction Smoking cessation is a critical public health goal. This study examined the ability of e-cigarettes and very low nicotine cigarettes (VLNCs) to serve as cigarette substitutes and whether a substitution was supported by steady-state nicotine from a nicotine patch. Aims and Methods This mixed design experiment with study product (between-subjects) and patch (within-subjects) factors recruited adults smoking cigarettes daily and not motivated to quit (N  = 160). Participants were randomized to 4 weeks of: (1) VLNCs; (2) e-cigarettes; or (3) no product. During two switch weeks, one with an active nicotine patch and one with a placebo patch (in a double-blind and counterbalanced fashion), participants were told to not smoke their usual cigarettes. Results During the switch weeks, participants in the VLNC (M  = 2.88, SD = .65) and e-cigarette (M  = 3.20, SD = .63) groups smoked fewer of their own cigarettes per day than did no product group participants who continued to smoke their own cigarettes (M  = 5.48, SD = .63); the VLNC and e-cigarette groups did not differ. There was no main effect of patch on mean usual brand cigarettes smoked per day (P  = .09), nor was there a product × patch interaction (P  = .51). There was a product × age interaction (P  = .03); smokers aged 60–74 smoked more of their own cigarettes if they were randomized to no product group. Conclusions VLNCs and e-cigarettes appear to reduce usual brand cigarettes smoked per day to a similar degree, regardless of patch condition. Behavioral factors, in addition to nicotine dependence, play an important role in sustaining smoking behavior and need to be addressed in smoking cessation treatment. Implications This study found that behavioral substitutes for cigarettes, whether or not they delivered nicotine, reduced the number of usual brand cigarettes smoked. Specifically, both e-cigarettes delivering nicotine and VLNCs equally reduce usual brand cigarettes smoked among adults who smoke daily and do not want to quit. [ABSTRACT FROM AUTHOR]

Background: Remote work allows one to work free from workplace policy, but it may negatively affect health-related behaviors such as tobacco product use and alcohol drinking. Our study aimed to investigate the association of remote work with tobacco dependence and hazardous alcohol use. Methods: This nationwide Internet-based survey was conducted in Japan in February 2023. Using the data of 8,292 workers aged 18 – 64, frequency of remote work (0, < 1, ≥ 1 day per week), tobacco dependence based on the scores of the Tobacco Dependence Screener ≥ 5, hazardous alcohol use based on the scores of the Alcohol Use Disorders Identification Test ≥ 8 were assessed. Then, the associations of frequency of remote work with tobacco dependence and hazardous alcohol use were examined using a multivariable Poisson regression model. Results: The percentages of remote work 0, < 1, ≥ 1 day per week were 56.6%, 9.9%, and 33.5%, respectively, whereas those of tobacco dependency and hazardous alcohol use were 11.3% and 17.9%, respectively. Remote work < 1 day per week (adjusted prevalence ratio [aPR] 1.30, 95%CI 1.07 – 1.57), and ≥ 1 per week (aPR 1.29, 95%CI 1.13 – 1.47) were associated with tobacco dependence. Further, remote work < 1 day per week (aPR 1.43, 95%CI 1.25 – 1.65), and ≥ 1 per week (aPR 1.40, 95%CI 1.27 – 1.55) were associated with hazardous alcohol use. Conclusions: Remote workers showed higher prevalence of tobacco dependence and hazardous alcohol use. The health behavior of remote workers should be carefully monitored. [ABSTRACT FROM AUTHOR]

Background: Descriptions of long-term histories of alcohol dependence provide insight into the etiology, prevention and care. Objective: Report of empirical findings about the development into and remission from alcohol dependence. Method: Narrative literature review, analysis of findings from cohort studies in the general population. Results: Risk factors provide the opportunity to estimate increased probabilities of developing an alcohol dependence. Adolescents disclosed symptoms of alcohol dependence within 8 years after the first alcohol consumption. Alcohol dependence is related to a life expectancy 17.6 years fewer than in the general population. Data of a general population sample revealed a risk of early death 2.8 times higher than among people without mental disorders. The severity of alcohol dependence was shown to be a predictor of premature death. Nicotine dependence can add to the shortening of life in addition to alcohol dependence. Among the alcohol dependent residents in a general population sample, 90.2% did not have utilized detoxification treatment that included motivational treatment and 78.4% did not have utilized standard detoxification treatment in a psychiatric treatment facility. Remission without formal help has been proven. It is the main route of remission. Conclusion: To reduce unfavorable courses of alcohol dependence, prevention and treatment should be focused more on the needs in the general population. In psychiatric and other medical routine care, screening and an appropriate brief intervention should be carried out. [ABSTRACT FROM AUTHOR]

One of the fundamental questions in real‐time functional magnetic resonance imaging neurofeedback (rt‐fMRI NF) investigations is the definition of a suitable neural target for training. Previously, we applied a meta‐analytical approach to define a network‐level target for connectivity‐based rt‐fMRI NF in substance use disorders. The analysis yielded consistent connectivity alterations between the insula and anterior cingulate cortex (ACC) as well as the dorsal striatum and the ACC. In the current investigation, we addressed the feasibility of regulating this network and its functional relevance using connectivity‐based neurofeedback. In a double‐blind, sham‐controlled design, 60 nicotine users were randomly assigned to the experimental or sham control group for one NF training session. The preregistered primary outcome was defined as improved inhibitory control performance after regulation of the target network compared to sham control. Secondary outcomes were (1) neurofeedback‐specific changes in functional connectivity of the target network; (2) changes in smoking behavior and impulsivity measures; and (3) changes in resting‐state connectivity profiles. Our results indicated no differences in behavioral measures after receiving feedback from the target network compared to the sham feedback. Target network connectivity was increased during regulation blocks compared to rest blocks, however, the experimental and sham groups could regulate to a similar degree. Accordingly, the observed activation patterns may be related to the mental strategies used during regulation attempts irrespective of the group assignment. We discuss several crucial factors regarding the efficacy of a single‐session connectivity‐based neurofeedback for the target network. This includes high fluctuation in the connectivity values of the target network that may impact controllability of the signal. To our knowledge, this investigation is the first randomized, double‐blind controlled real‐time fMRI study in nicotine users. This raises the question of whether previously observed effects in nicotine users are specific to the neurofeedback signal or reflect more general self‐regulation attempts. [ABSTRACT FROM AUTHOR]

The present research explored the influence of nicotine dependence on anger, psychological distress, and quality of life among adult smokers aged >20 years. A cross-sectional research design was used in the present study, and the total sample included N =300 adult smokers. The data were collected using the purposive sampling technique. Pearson correlation analysis and linear regression analysis were performed to test the hypotheses. The correlation analysis revealed that nicotine dependence was positively related to anger and psychological distress and regression results revealed that nicotine dependence is a significant positive predictor of anger and psychological distress. The present study is useful in explaining the negative effects of nicotine dependence on mental health and raising awareness of nicotine-related problems on quality of life. [ABSTRACT FROM AUTHOR]

This paper investigates adult smoking in Pakistan by examining demographics, psychometrics, and socioeconomic disparities among smokers aged over 20 years. A cross-sectional design was employed with a sample of 300 adult smokers, using purposive sampling for data collection through self-report instruments: The Cigarette Dependence Scale, Novaco Anger Scale, Kessler Psychological Distress Scale, and WHO Quality of Life Scale. Key demographic factors, including area, socioeconomic status, family system, and marital status, were analyzed to identify trends in smoking behaviors. The study highlights psychological factors such as nicotine dependence and health-related quality of life. Additionally, it emphasizes disparities in tobacco use across income levels and regions, underscoring the need for targeted interventions to improve access to cessation resources and public health campaigns. [ABSTRACT FROM AUTHOR]

The purpose of this study was to provide useful information that could help female smokers quit smoking by exploring factors that could predict their empowerment to quit smoking. The participants were 337 Korean female smokers aged 20 years or older, whose average age was 35.70 years (SD = 9.19). The model predicting female smokers' empowerment to quit smoking was verified using stepwise regression analysis and a decision-tree data-mining method. The results revealed that nicotine dependence, stimulation smoking, smoking for relaxation and tension reduction, craving smoking, habitual smoking, and the recognition that premenstrual syndrome (PMS) interfered with smoking cessation were negatively correlated with the female smokers' empowerment to quit, whereas motivation to quit smoking was positively correlated therewith. Optimistic and present biases were positively correlated with perceived meaning of quit smoking. A stepwise regression analysis revealed that nicotine dependence accounted for the most variance of female smokers' empowerment to quit smoking. A decision-tree model predicting female smokers' empowerment to quit smoking included motivation to quit, amount of smoking per day, alcohol use, craving smoking, smoking for relaxation and tension reduction, and height. These findings provide useful information to assist in further research and to plan intervention for female smokers' smoking. [ABSTRACT FROM AUTHOR]

Introduction The high comorbidity between schizophrenia and cigarette smoking points to a possible shared heritable factor predisposing individuals with schizophrenia to nicotine addiction. The N -methyl- d -aspartate (NMDA) receptor has been highly implicated in both schizophrenia and nicotine addiction. Methods In the present study, we used mice with a null mutation on the serine racemase gene (srr), an established risk gene for schizophrenia, which encodes the enzyme to produce the NMDA receptor co-agonist d -serine, to model the pathology of schizophrenia and to determine whether NMDA receptor hypofunction reduced the ability of srr −/− mice to identify nicotine's subjective effects. Established nicotine discrimination procedures were used to train srr −/− and wild-type (WT) mice to discriminate 0.4 mg/kg nicotine under a 10-response fixed-ratio (FR10) schedule of food reinforcement. Results Results show that WT mice reliably acquired 0.4 mg/kg nicotine discrimination in about 54 training sessions, whereas srr −/− mice failed to acquire robust 0.4 mg/kg nicotine discrimination even after extended (>70) training sessions. These results show that NDMA receptor hypofunction in srr −/− mice decreased sensitivity to the interoceptive effects of nicotine. Conclusions Projected to humans, NMDA receptor hypofunction caused by mutations to the serine racemase gene in schizophrenia may reduce sensitivity to nicotine's subjective effects leading to increased nicotine consumption to produce the same effects as those unaffected by schizophrenia. Implications There is high comorbidity between schizophrenia and nicotine dependence as well as possible shared genetic risk factors between the two. The serine racemase knockout mouse (srr −/− ) with NMDA receptor hypofunction has been developed as a model for schizophrenia. We found that srr −/− mice were unable to acquire 0.4 mg/kg nicotine discrimination, while WT mice readily discriminated nicotine. These results show that decreased NMDA receptor function present in srr −/− mice and patients with schizophrenia may result in reduced sensitivity to nicotine's interoceptive effects, leading to increased nicotine consumption to produce the same subjective effects as those unaffected by schizophrenia. [ABSTRACT FROM AUTHOR]

Introduction Increased salience of drug-related cues over nondrug reinforcers can drive drug use and contribute to tobacco use disorder (TUD). An important scientific and clinical goal is to effectively measure this elevated drug-seeking behavior in TUD. However, most TUD assessments rely on self-reported cravings and cigarette consumption, not providing an objective measure of the impact of drug cues on biasing behavior toward drugs. The probabilistic image choice (PIC) task investigates the choice of viewing drug-related pictures as compared to other salient pictures (eg, pleasant and unpleasant). This study aimed to develop and validate the PIC task for TUD and evaluate the associations between behavioral choice and tobacco craving, daily cigarette consumption, quit attempts and motivation to quit, and nicotine dependence (the Fagerström score). Methods We recruited 468 smokers and 121 nonsmokers using the Prolific online platform. Participants performed the PIC task twice (at a 1-month interval) and completed other measures relevant to TUD. Results Compared to nonsmokers, tobacco smokers selected to view significantly more tobacco images and less pleasant (nondrug reinforcer) images, a profile that remained stable at retest. Individual differences in choice of tobacco as compared to pleasant images on the PIC task were associated with craving but not with the other tobacco dependence measures, suggesting that the task may serve as a behavioral proxy measure of drug "wanting" rather than of cumulative nicotine exposure or physical dependence. Conclusions These results suggest that the PIC task can be a valuable tool for objectively assessing craving-associated tobacco seeking in TUD. Implications Most of the current measures of TUD rely on self-reports of consumption, dependence, and craving, and do not take into consideration the role of drug-related cues in driving tobacco seeking. This study shows that the PIC task provides an objective, reliable proxy measure of tobacco image-seeking behavior in people who smoke cigarettes that is linked to craving (desire) for smoking but not to other measures of TUD. Therefore, the PIC task may be a useful complementary tool for the classification, diagnosis, and prognosis of TUD. [ABSTRACT FROM AUTHOR]

Background: The study aimed to assess the physiological dependence of tobacco use among patients visiting the tobacco cessation center (TCC) in the tertiary institute. Methods: A cross-sectional study design with simple random sampling was used. The information obtained from the subject was through interview recorded on a structured pro forma. The information included demographic details, dependence status based on tobacco use history and behavior, and the Fagerstrom test of nicotine dependence (FTND) for physiological dependence. Results: Of the total subjects in the study, 33.2%–37.5% subjects had either high or very high FTNDs score category. The mean FTND score was to be 6.8 ± 2.4. A high or very high FTND score was found for those tobacco users, who switch over to cheaper tobacco products on price rise, daily buyers, craving as reason for relapse, and those subjects who were in the precontemplation stage with a statistically significant difference. 31.3% did not agree that the price increase in tobacco products will decrease tobacco use for subjects starting the initiation of tobacco products in the morning 31–60 min after waking up. The amount of tobacco use was statistically significant for the pattern for purchase of tobacco products and stages of behavior. Conclusion: The physiological nicotine dependence in the study was of high level. Tolerance and withdrawal are important constructs in understanding physiological nicotine dependence using the FTNDs scale. Tolerance was associated with various stages of behavior and pattern of tobacco purchase in the study. Withdrawal was associated with various reasons of quitting tobacco use, stages of behavior, and some price influence on tobacco use. There was a gradual and less withdrawal in low physiological nicotine dependence in the study.

The purpose of the present study was to investigate the effects of neuromodulation techniques, including transcranial direct current stimulation, transcranial magnetic stimulation, and deep brain stimulation, on the treatments of nicotine dependence. Specifically, our objective was to assess the existing evidence by conducting an umbrella review of systematic reviews. The quality of the included studies was evaluated using the standardized tools designed to evaluate systematic reviews. The PubMed/MEDLINE database was queried for systematic reviews, and yielded 7 systematic reviews with a substantial sample size (N = 4,252), some of which included meta-analyses. A significant finding across these studies was the effectiveness of neuromodulation techniques to reduce nicotine cravings and consumption, through the evidence remains not yet conclusive. A significant efficacy of transcranial direct current stimulation and repetitive transcranial magnetic stimulation that targeted the dorsolateral prefrontal cortex was found, as well as the lateral prefrontal cortex and insula bilaterally, on smoking frequency and craving. Moreover, smoking behaviors may also be positively affected by the use of deep brain stimulation (DBS) targeting the nucleus accumbens. In conclusion, neuromodulation approaches hold promise as effective treatments for tobacco use disorder. Nonetheless, further research is required to comprehensively understand their effectiveness and to determine if combining them with other treatments can aid individuals to successfully quit smoking.

Abstract 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 Background India bears the highest global burden of oral cancer, despite having an operational tobacco cessation framework. Occupational groups like solid waste management personnel face significant health challenges due to prevalent tobacco use, leading to oral potentially malignant lesions and oral cancer. Enhanced tobacco control strategies are essential for these groups. Methods A pre-post interventional, community-based study enrolled 1200 municipal workers in Varanasi, India, from July 2022 to August 2023. 858 tobacco users underwent screening and were randomly assigned to one of three interventions: Very Brief Advice, Individual Behavioral Counseling, or Group Behavioral Therapy. Follow-up was conducted one year after the baseline interventions Effectiveness was measured by nicotine dependence reduction using the Fagerstrom Test for Nicotine Dependence (FTND) scores and cessation rates defined as at least 6-month abstinence. Appropriate statistical tests assessed the burden of tobacco use, oral potentially malignant lesions, and pre-post differences in FTND scores within and between groups. A p-value of

Abstract Cigarette smoking causes serious complications and diseases in a person’s life, such as Chronic Obstructive Pulmonary Disease (COPD) and some cancers, including lung cancer. On the other hand, studies have shown that smokers do not have a real understanding of the health hazards of smoking. This study was conducted to determine the perceived risk of lung cancer and COPD in current smokers. This cross-sectional study which was conducted between January-May 2023, recruited 380 current smokers by convenience sampling in community setting. The data were collected face to face using three questionnaires (1) the risk perception for lung cancer and COPD questionnaire, (2) the smoking stage of change questionnaire, and (3) the Fagerström test for nicotine dependence. We examined the relationship between the included variables and the smokers’ perceived risk of lung cancer and COPD by using multiple linear regression. We found that lower education (coefficient = 3.60, 95%CI [1.00, 6.19], P

Abstract 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.

Introduction: The increasing smoking population in Africa necessitates intensified tobacco cessation services. Assessing nicotine dependence with tools such as the heaviness of smoking index (HSI) aids in cessation efforts. This study evaluated the association between HSI and quit attempts and quit intentions among African cigarette smokers. Methods: Global Adult Tobacco Survey (GATS) data from eight African countries collected between 2011 and 2018 were analysed. The time to first smoke (TTFS) and number of cigarettes per day (CPD) were used to estimate the HSI score and dependence level. The association between HSI dependence level and quit attempts and quit intentions was evaluated using likelihood ratios (LR). Results: Among 2,399 daily cigarette users, 1,618 (67.5%) were exclusive cigarette users. The average and median CPDs were 8.27 ± 8.3 and 5 (IQR: 2–18), respectively, with Ethiopia having the highest mean CPD (11.6). In Ethiopia, 51.5% of exclusive and 42% of nonexclusive users had low dependence (HSI < 2), whereas 43.9% and 31.3% of other African countries had low dependence. The association between low dependence and quit attempts was significant only for exclusive cigarette smokers in Ethiopia, with LR of 1.45 (95% CI: 1.08–1.93). The association between low dependence and quit intentions was significant in Ethiopia for both exclusive (LR = 1.42) and nonexclusive (LR = 1.53) users. None of the LR estimates were > 10 or < 0.1. Conclusion: The association between low dependence (HSI < 2) and quit behaviour was limited in African settings, highlighting the complex interplay between usage patterns, dependence assessment, and quit behaviour. A contextual tool for assessing nicotine dependence tailored to African settings is warranted for effective smoking cessation. [ABSTRACT FROM AUTHOR]

In recent years, habits related to smoking have been changing. An increasing portion of light/occasional smokers tend to define themselves as non-smokers, leading to an incorrect perception of the risks that smoking even a few cigarettes can entail. In this study, we investigated the nicotine-induced cognitive distortion in young, higher-education students with low/moderate dependence (as indexed by the Fagerstrom questionnaire). The study involved 111 participants (62 female; mean age 24.43 ± 3.77) divided into smokers and non-smokers, who responded to specific questionnaires to evaluate their attachment style, emotion dysregulation, and state anxiety. Their response to smoking-related cues following emotional stimulation was experimentally evaluated, with participants being made to choose between care- or smoking-related images, following the presentation of threatening or neutral stimuli. The results show a cognitive bias in smokers, with participants choosing smoking-related stimuli significantly more often than non-smokers, with a slower reaction time, regardless of emotional cues. Emotion dysregulation and attachment style were also significantly correlated with response choice but not with response latency. Overall, our data indicate that there is no such thing as light use of nicotine and that smoking, even if not continuous, determines cognitive biases that lead to a vision of the environment as a function of substance seeking. [ABSTRACT FROM AUTHOR]

Background: India bears the highest global burden of oral cancer, despite having an operational tobacco cessation framework. Occupational groups like solid waste management personnel face significant health challenges due to prevalent tobacco use, leading to oral potentially malignant lesions and oral cancer. Enhanced tobacco control strategies are essential for these groups. Methods: A pre-post interventional, community-based study enrolled 1200 municipal workers in Varanasi, India, from July 2022 to August 2023. 858 tobacco users underwent screening and were randomly assigned to one of three interventions: Very Brief Advice, Individual Behavioral Counseling, or Group Behavioral Therapy. Follow-up was conducted one year after the baseline interventions Effectiveness was measured by nicotine dependence reduction using the Fagerstrom Test for Nicotine Dependence (FTND) scores and cessation rates defined as at least 6-month abstinence. Appropriate statistical tests assessed the burden of tobacco use, oral potentially malignant lesions, and pre-post differences in FTND scores within and between groups. A p-value of < 0.05 was considered statistically significant. Results: Municipal workers exhibited a high prevalence (71.5%) of smokeless tobacco (SLT) use. One-third (32.9%) of the participants screened positive for oral potentially malignant lesions and oral cancer. Leukoplakia was the most common lesion. Screened positivity correlated with significant nicotine dependence. Among 494 follow-up participants, 47.1% reported a significant reduction in nicotine dependence across all intervention groups. Quade's ANCOVA indicated significant differences in post-test FTND scores, with individual behavioral counselling showing the greatest reduction. However, no cessation was achieved in any group despite the significant decline in dependence. Conclusion: Solid waste management personnel in Varanasi show heightened SLT use and associated oral potentially malignant lesions. The persistent tobacco use in these high-risk occupational populations undermines government tobacco control efforts and highlights the need for robust policy and implementation strategies. The study demonstrated a significant reduction in nicotine dependence following interventions, though tobacco cessation was not achieved. More frequent interventions and addressing quitting barriers—such as cultural norms, lack of awareness, easy accessibility, and adverse working conditions—are crucial. Developing a tailored workplace model to tackle tobacco use in occupational settings may facilitate cessation. Clinical trial registration number: Trial registration Clinical Trials Registry India CTRI/2020/07/026479. Date of registration 10/07/2020. [ABSTRACT FROM AUTHOR]

Cigarette smoking causes serious complications and diseases in a person's life, such as Chronic Obstructive Pulmonary Disease (COPD) and some cancers, including lung cancer. On the other hand, studies have shown that smokers do not have a real understanding of the health hazards of smoking. This study was conducted to determine the perceived risk of lung cancer and COPD in current smokers. This cross-sectional study which was conducted between January-May 2023, recruited 380 current smokers by convenience sampling in community setting. The data were collected face to face using three questionnaires (1) the risk perception for lung cancer and COPD questionnaire, (2) the smoking stage of change questionnaire, and (3) the Fagerström test for nicotine dependence. We examined the relationship between the included variables and the smokers' perceived risk of lung cancer and COPD by using multiple linear regression. We found that lower education (coefficient = 3.60, 95%CI [1.00, 6.19], P < 0.0001) for elementary level and (coefficient = 2.81, 95% CI [0.36, 5.26], P < 0.05) for secondary level had greater lung cancer perceived risk. Besides, smoking age onset for 20 + years (coefficient=-1.36, 95%CI [-2.42, -3.17], P < 0.0001) lower than those who started before the age of 20 were associated with lower perceived risk for lung cancer. Regarding COPD, results indicated that lower education (coefficient = 4.54, 95% CI [1.87, 7.21], p < 0001) for elementary level (coefficient = 3.35, 95% CI [0.83, 5.87], p < 0.001) for secondary level and (coefficient = 3.03, 95% CI[-0.67, 4.25], P < 0.05) for high school dropout, and employment status (coefficient = 3.62, 95% CI[0.66, 6.59], p < 0.05) of employer and (coefficient = 3.23, 95% CI [0.14, 6.33], p < 0.05) for homemaker reported greater perceived risk. This study's results showed that participants' perceived risk was relatively low. It seems necessary to carry out interventions to inform about the harms of smoking and to enhance public awareness about the heightened risks of diseases such as lung cancer and COPD among cigarette smokers. [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]

This review article critically assesses the effectiveness and safety of the following alternative smoking cessation methods: electronic cigarettes, herbal supplements, acupuncture, compared with traditional approaches like nicotine replacement therapy, bupropion, and varenicline. Despite their increased popularity, most of these alternative methods are often lacking in robust scientific evidence and can pose serious health risks. It brought to the forefront case reports, studies revealing dangers, and high failure rates associated with these alternatives. Adhere to the time-tested, evidencebased traditional methods of smoking cessation. [ABSTRACT FROM AUTHOR]

Introduction: Tobacco kills half of its users and globally every year around 8 million deaths are attributable to tobacco use. All forms of tobacco are harmful and there is no safe level of exposure to tobacco but cigarette smoking is the most common and notorious since it kills not only its users but also the innocent passive bystanders. Objectives: The study was conducted to determine the prevalence of cigarette use, minimum length of cigarette (nicotine portion) to quench the craving, level of nicotine dependence along with their stage of change (in behaviour to quit tobacco use) and also to find out its determinants among males above 15 years residing in the urban field practicing area of a Public Health Institute. Materials and methods: A community based observational, crosssectional study was conducted in a slum of West Bengal. Data was collected as per a pre-designed and pre-tested schedule adapted from GATS India Questionnaire. Males above 15 years of age residing in the study area were interviewed during house-to-house visit. Results: A total of 352 study participants were interviewed. 38.4% of study participants consumes cigarettes on a regular basis. Study participants with a positive family history of tobacco use are 2.1 times (95% CI: 1.3, 3.4) more probable to use cigarettes. Half of the population are in stage of precontemplation and 43.7% of them are having high level of nicotine dependency. 66.7% of them do not need to consume the full length of a cigarette to quench their craving. Those with younger age of initiation (OR 5.35 95%CI:2.5,11.2) and consume full length of cigarette (OR 2.72, 95% CI: 1.3,5.7) are having more probability of high nicotine dependency than their counterparts. Odds of willingness to quit is significantly more among those who don't require full length of a cigarette even when adjusted with various covariates found significant in univariate regression. Conclusion: Length of the cigarettes (nicotine portion) may be reduced to at least half the size of present standard length to not only decrease the nicotine dependence but also to encourage quitting behaviour among the users. [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]

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. [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]

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]

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]

Copyright of Izmir Katip Celebi University Faculty of Health Sciences Journal / İzmir Katip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi is the property of Izmir Katip Celebi University, Faculty of Health Sciene Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: To enhance the treatment outcomes of tuberculosis (TB), it is crucial to understand the sleep quality of patients who use tobacco. This study seeks to measure the level of nicotine dependence in tuberculosis patients who use tobacco and its correlation to sleep quality. Additionally, it aims to examine the extent to which tobacco use affects the sleep quality of TB patients. Methods: A cross-sectional study was conducted at a TB centre in Patna, Bihar, India with n = 209 patients. The study used the Pittsburgh Sleep Quality Index questionnaire to measure sleep quality, and the Fagerström Test for Nicotine Dependence, as well as the Fagerström Test for Nicotine Dependence-Smokeless Tobacco questionnaires, to evaluate the level of nicotine dependence. Results: The study revealed that TB patients with tobacco use reported significantly worse sleep quality (86.1 %, 95 % CI: 80.6–91.1) compared to non-tobacco users (13.9 %, 95 % CI: 9.4–19.4). Additionally, the study identified a correlation between nicotine dependence (Smokers r = .550, p

Introduction Nicotine addiction poses a significant public health concern in Poland, exacerbated by smoking, e-cigarettes, and heated tobacco products. While tobacco companies claim their alternatives aid cessation, their vested interests warrant cautious scrutiny. This study examines tobacco harm reduction strategies. Aim of the Study This study examines IQOS tobacco heaters as a potential harm reduction alternative for smokers. Analyzing health data and regulatory findings, particularly from the FDA, it evaluates the effectiveness and public health impact of heated tobacco products within broader harm reduction strategies. Materials and Methods This study examined literature and data to assess IQOS and heated tobacco products' chemical and health risks. It analyzed findings to compare IQOS aerosol and cigarette smoke toxicant exposures, clarifying IQOS's nicotine profile and smoking cessation potential. Conclusion The findings indicate IQOS may reduce certain toxin exposures compared to cigarettes, but long-term health impacts are unclear. Further research is needed on IQOS's effects, including disease, addiction, and population-level consequences. Cautious regulation is warranted due to youth risks and ethical concerns surrounding nicotine alternatives.

Introduction Congenital clubfoot is a frequent malformation of the lower extremities. However, the causes of this pathology in children are still unclear. The identification of the factors associated with congenital clubfoot is a relevant problem, the solution of which will allow a prenatal prevention of clubfoot in newborns thus reducing the number of patients with this pathology. Purpose The search for possible risk factors leading to a violation of foot development in the fetus and their significance in the occurrence of congenital clubfoot in children. Materials and methods The study was of retrospective nature and was carried out in pairs “Mother-Newborn”. It included examination of 149 children. The first group (n = 97) was compiled by the “Mother Newborn” pairs, in which the child had a typical form of congenital clubfoot; the second group (n = 52) were pairs in which the baby was healthy. The data obtained were processed using tables 2×2 and logistics regression. Results According to the results of the study, it was found that the greatest sensitivity and specificity of congenital clubfoot was associated with the external factor of nicotine dependence in pregnant women (SE = 0.32; SP = 0.90) and the factor of hereditarily burdened congenital foot pathology in close relatives (SE = 0.16; SP = 0.98). An acute respiratory viral infection in the anamnesis, anemia in a pregnant woman or toxicosis did not show statistically significant causal connection with the occurrence of congenital clubfoot according to the analysis using the method of logistics regression (р > 0.05) and they should not be used as prognostic ones. Discussion The data obtained by us on the paramount significance of the two “risk” factors of the congenital clubfoot development (nicotine dependence in a pregnant woman and hereditarily burdened disorder of congenital foot pathology among close relatives) were reflected only in a few scientific sources. Conclusion The risk factors of the greatest sensitivity, specificity and causal relationship with the congenital clubfoot development were associated with the adverse effects of the external factor of nicotine dependence during pregnancy and burdened heredity associated with congenital foot pathology in close relatives (р < 0.05).

Abstract Background The related literature has primarily addressed cigarette smoking control. It seems that researchers have failed to explore the determinants of hookah smoking (HS) control. In an attempt to fill this gap, the present study explores experts’ views about aspects of HS control in Bandar Abbas, a city in the south of Iran. Methods The present qualitative study, conducted in 2022 and 2023, used a content analysis. To this aim, 30 experts in tobacco prevention and control were invited to participate in the research. Twenty seven accepted the invitation. In-depth, semi-structured, and face-to-face interviews were held with the experts. A purposive sampling was used and the data collection continued until data saturation. The interviews lasted between 18 and 65 min. MAXQDA 10.0 was used for data management and analysis. Results The expert interviewees had a mean age of 44.77 ± 6.57 years and a mean work experience of 18.6 ± 6.8 years. A total number of six main categories were extracted from the data, including usin influential figures to control HS, controlling HS by alternative activities, changing beliefs and attitudes toward HS, taking administrative and regulatory measures, and facilitating HS cessation. Conclusion This qualitative study explored the multifaceted ways people adopt to quit HS. Using influential figures to control hookah smoking, promoting alternative activities as a means of control, changing beliefs and attitudes, enforcing administrative regulations, and facilitating quit attempts all play an important role in tackling the prevalence of hookah smoking. These findings emphasize the importance of a comprehensive and multifaceted approach to integrate various interventions to effectively address hookah smoking behavior.

OBJECTIVE: To compare nicotine dependency and lung functions among cigarette and non-cigarette (e-cigarette & hookah) form of tobacco smokers. METHODS: This cross-sectional study was conducted from December 2023 and January 2024, at Aziz Fatimah Medical and Dental College, Faisalabad, Pakistan. The study included 100 male tobacco users aged 18 to 60 years, comprising 25 conventional cigarette smokers, 48 e-cigarette users, 25 hookah users, and 2 dual product users. Subjects with known lung diseases (asthma, COPD, tuberculosis), chest deformities affecting lung function, and smokers using nicotine patches or gum for smoking cessation were excluded. Nicotine dependence was assessed using the Fagerström test for nicotine dependence (FTND) and its adapted versions (eFTND) for hookah and e-cigarettes. Lung function parameters, were measured using a digital spirometer. RESULTS: Mean±SD FTND and eFTND scores for cigarette, e-cigarette, hookah, and dual users were 5.44±1.91, 6.25±2.20, 4.84±1.106 and 5.50± 0.707 respectively (p=0.027). FEV1 of cigarettes, e-cigarettes, hookah, and dual product users were 4.44± 2.69, 4.04±1.56, 3.28±2.21 and 4.72±0.763 respectively (p-value=0.84). FVC for the same groups were 5.86±3.33, 4.35±1.79, 3.7±2.58, and 5.05±0.53 (p=0.012) respectively. FEV1/FVC as followed: cigarettes, 79.44±14.88; e-cigarettes, 94.20±6.5; hookah, 87.39±13.8; dual products, 93.29±5.16 (p-value=0.000). PEF of cigarettes, e-cigarettes, hookah, and dual product users were 7.35±3.71, 8.18 ±2.52, 5.4±3.4, 8.45±0.19 respectively (p-value=0.001). CONCLUSION: This study reveals significant differences in nicotine dependency and lung function among tobacco-users. E-cigarette users have the highest nicotine dependence but less short-term lung impairment than hookah users. Targeted public health interventions, stricter advertising regulations, and multi-center studies on larger populations are recommended

Objectives: In hospitalized patients, cigarette smoking is linked to increased readmission rates, emergency department visits, and overall mortality. Smoking cessation reduces these risks, but many patients who smoke are unsuccessful in quitting. Nicotine replacement therapy (NRT) is an effective tool that assists patients who smoke with quitting. This study evaluates NRT prescriptions during and after hospitalization at a large health system for patients who smoke. Methods: A retrospective cohort study was conducted to determine the number of patients who were prescribed NRT during an inpatient admission and at time of discharge from a network of nine hospitals across South Carolina between January 1, 2019 and January 1, 2023. Results: This study included 20,757 patients identified as actively smoking with at least one hospitalization during the study period. Of the cohort, 34.9% were prescribed at least one prescription for NRT during their admission to the hospital. Of the patients identified, 12.6% were prescribed NRT upon discharge from the hospital. Conclusions: This study identified significantly low rates of NRT prescribed to smokers during hospitalization and at discharge. Although the management of chronic conditions is typically addressed in the outpatient setting, hospitalization may provide an opportunity for patients to initiate health behavior changes. The low rates of prescriptions for NRT present an opportunity to improve tobacco treatment during hospitalization and beyond. [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]

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]

Background: Nicotine dependence is one of the most significant barriers to smoking cessation. Therefore, measuring this dependence is crucial for effective smoking cessation interventions. The current study aimed to evaluate the degree of agreement between the Fagerström Test for Nicotine Dependence (FTND) and the Heaviness of Smoking Index (HSI) among Iranian smokers. Methods: We analyzed the data obtained from two previous studies among 580 daily smokers in Iran. Data were collected using the FTND scale. Cohen's kappa was utilized to assess the degree of agreement between HSI and FTND. Findings: The HSI showed significant agreement with FTND (Cohen's kappa = 0.72) in assessing nicotine dependence, with a sensitivity of 88.6% and a specificity of 90.3%. Conclusion: The HSI is a valid and reliable tool for measuring nicotine dependence, exhibiting significant agreement with FTND. As a result, the HSI can be considered an alternative to the FTND in both clinical and research settings, particularly for heavy smokers. [ABSTRACT FROM AUTHOR]

Conceptualizing tobacco dependence as a chronic relapsing condition suggests the need to use analytic strategies that reflect that premise. However, clinical trials for smoking cessation typically define the primary endpoint as a measure of abstinence at a single timepoint distal to the intervention, typically 3–12 months. This reinforces the concept of tobacco outcomes as a dichotomous state—one is, or is not, abstinent. Fortunately, there are several approaches available to handle longitudinal data that reflect the relapsing and remitting nature of tobacco use during treatment studies. In this paper, sponsored by the Society for Research on Nicotine and Tobacco's Treatment Research Network, we present an introductory overview of these techniques and their application in smoking cessation clinical trials. Topics discussed include models to examine abstinence outcomes (eg, trajectory models of abstinence, models for transitions in smoking behavior, models for time to event), models that examine reductions in tobacco use, and models to examine joint outcomes (eg, examining changes in the use of more than one tobacco product). Finally, we discuss three additional relevant topics (ie, heterogeneity of effects, handling missing data, and power and sample size) and provide summary information about the type of model that can be used based on the type of data collected and the focus of the study. We encourage investigators to familiarize themselves with these techniques and use them in the analysis of data from clinical trials of smoking cessation treatment. Implications Clinical trials of tobacco dependence treatment typically measure abstinence 3–12 months after participant enrollment. However, because smoking is a chronic relapsing condition, these measures of intervention success may not accurately reflect the common trajectories of tobacco abstinence and relapse. Several analytical techniques facilitate this type of outcome modeling. This paper is meant to be an introduction to these concepts and techniques to the global nicotine and tobacco research community including which techniques can be used for different research questions with visual summaries of which types of models can be used for different types of data and research questions. [ABSTRACT FROM AUTHOR]

Introduction With increasing tobacco product varieties, understanding tobacco use (TU) profiles and their associations with tobacco dependence (TD) has also become increasingly challenging. Aims and Methods We aimed to identify TU profiles and their associations with TD over time, and to identify subgroups with high risk of TD. We included 3463 adult recent tobacco users who had complete TU and TD data across waves 1–4 of the Population Assessment of Tobacco and Health (PATH) study. We used a composite index of TD and a summed TD score from an established 16-item TD measure. We applied a latent class analysis to identify TU profiles based on participants' usage of eight common tobacco product groups at each survey wave and to check the stability of the TU profiles over time. We then used generalized estimating equations regressions to evaluate the longitudinal TU–TD association, adjusting for potential confounders. Results We identified three distinct TU profiles that remained consistent across four survey waves: Dominant cigarette users (62%–68%), poly users with high propensity of using traditional cigarettes, e-cigarettes, and cigars (24%–31%), and dominant smokeless product users (7%–9%). Covariate-adjusted models showed that TD was significantly lower among the poly users and the dominant smokeless users, compared to that among the dominant cigarette users. Conclusions Both TU profiles and their associations with TD were stable over time at the population level. Poly users and smokeless product users were consistently associated with lower TD than cigarette-dominant users, suggesting the need for tailored tobacco cessation interventions for users with different TU profiles. Implications The finding of consistent TU profiles across four survey waves extends the current literature in capturing TU patterns in an evolving tobacco product landscape. The finding of the overall higher level of TD among the cigarette-dominant users compared to the other TU latent profiles (the Cig+eCig+Cigar dominant poly users and the dominant smokeless product users) can help identify high-risk groups for potential interventions. Our application of innovative statistical methods to high-quality longitudinal data from the PATH study helps improve the understanding of the dynamic TU–TD relationship over time. [ABSTRACT FROM AUTHOR]

Background and Aim: Despite decades of research on co-occurring smoking and depression, cessation rates remain consistently lower for depressed smokers than for smokers in the general population, highlighting the need for theory-driven models of smoking and depression. This paper provides a systematic review with a particular focus on psychological states that disproportionately motivate smoking in depression, and frame an incentive learning theory account of smoking-depression co-occurrence. The objective of the study was to estimate the sociodemographic correlates of tobacco consumption and its association with depression. Methodology: This is a cross sectional study. Over a period of one year around 120 depressed and tobacco dependent patients of age group 15 to 80 years were sampled from a tertiary care hospital in this study. Data on tobacco consumption and pattern was elicited from patients and household informants. Prevalence and sociodemographic profile of tobacco dependent depressed patients were used as outcome measures. Association between level of nicotine dependence and severity of depression was also assessed. Results: It was observed that such patients were more associated with the male gender (Females; N=5

Background: The related literature has primarily addressed cigarette smoking control. It seems that researchers have failed to explore the determinants of hookah smoking (HS) control. In an attempt to fill this gap, the present study explores experts' views about aspects of HS control in Bandar Abbas, a city in the south of Iran. Methods: The present qualitative study, conducted in 2022 and 2023, used a content analysis. To this aim, 30 experts in tobacco prevention and control were invited to participate in the research. Twenty seven accepted the invitation. In-depth, semi-structured, and face-to-face interviews were held with the experts. A purposive sampling was used and the data collection continued until data saturation. The interviews lasted between 18 and 65 min. MAXQDA 10.0 was used for data management and analysis. Results: The expert interviewees had a mean age of 44.77 ± 6.57 years and a mean work experience of 18.6 ± 6.8 years. A total number of six main categories were extracted from the data, including usin influential figures to control HS, controlling HS by alternative activities, changing beliefs and attitudes toward HS, taking administrative and regulatory measures, and facilitating HS cessation. Conclusion: This qualitative study explored the multifaceted ways people adopt to quit HS. Using influential figures to control hookah smoking, promoting alternative activities as a means of control, changing beliefs and attitudes, enforcing administrative regulations, and facilitating quit attempts all play an important role in tackling the prevalence of hookah smoking. These findings emphasize the importance of a comprehensive and multifaceted approach to integrate various interventions to effectively address hookah smoking behavior. [ABSTRACT FROM AUTHOR]