Changes In Number Of Cigarettes Research Articles

The impact of perceived risk of COVID-19 from smoking on the change in number of cigarettes smoked

ABSTRACT Introduction Smoking increases the risk of severe illness and mortality from COVID-19. However, the impact of risk perception on smoking over time is unknown. Method Participants (n = 487) who reported having smoked daily or nondaily in February 2020 were recruited through Reddit and completed a cross-sectional survey. Linear regression models examined the impact of perception that smoking increases the risk of COVID-19 on changes in cigarettes per day (CPD). Results The greater perceived risk of smoking on COVID-19 predicted greater decreases in CPD from before the pandemic (December 2019 – February 2020) to March – May 2020, but no change was observed from March – May 2020 to June – August 2020. However, greater perceived risk predicted increases in CPD from June – August 2020 to November 2020 – January 2021. Participants with high levels of perceived risk (>75th percentile) were more likely to reduce their CPD in the beginning of the pandemic compared to those with low perceived risk (≤25th percentile), but more likely to increase their CPD between June – August 2020 to November 2020 – January 2021, even though perceived risk remained stable over time. Conclusion Perceived risk is associated with a reduction in CPD, but participants returned to their pre-COVID smoking behavior within less than a year.

Success rates of smoking cessation therapies to patients with mental illness by video consultants or by treatment in the community: A Randomized Controlled Trial

IntroductionSmoking is probably the one single factor with the highest impact on reducing the life expectancies of patients with mental illness. In Denmark, 38.8% of patients with persistent mental health problem are smoking. Patients may have problem in participating in ordinary smoking cession programs offered in the community, but they are concerned about the impact of tobacco use on their health and finances and are motivated to stop smoking.Videoconferencing addressing smoking cessation might be an alternative to ordinary consultation at the clinic because the patients can access the treatment at home.ObjectivesCompare rates of smoking cessation in two interventions.MethodsPatients diagnosed with schizophrenia, bipolar disorders or depression in 3 outpatient clinics are eligible for inclusion.Primary outcome is changes in number of cigarettes smoked pr. patients per day in at 6-month follow-up. Secondary outcome is abstinence from smoking at 6-month follow-up.This is a two-arm randomized controlled trial. 1. Daily video consultants at the start of smoking cessation and the months after. 2. Treatment as usual consistent of smoking cessation treatment in the community by weekly consultants.ResultsBy September 2021, we have included 64 patients. Among patients, receiving video 26% has stopped and 15% has stopped from treatment as usual.Many patients has reduced their smoking considerably. The patients in general express that they are satisfied with both interventions.ConclusionsSmoking cessation delivered by daily short video consultants seems to be the best and most effective way to help patients with serious mental illness to stop smoking.DisclosureNo significant relationships.

Association between tobacco use and symptomatology in individuals at ultra-high risk to develop a psychosis: A longitudinal study

BackgroundThe high prevalence rates and impact of tobacco smoking in individuals with a psychotic disorder have become an increasing interest. Little is known about tobacco smoking in individuals at ultra-high risk of psychosis (UHR). MethodsWe studied 345 UHR individuals of the high-risk study of the European network of national schizophrenia networks studying Gene-Environment Interactions (EU-GEI). Smoking status and the number of cigarettes per day were assessed at multiple moments using the CIDI. Symptom severity at each time point was assessed using CAARMS. Linear mixed-effects analyses were conducted to examine the multi-cross-sectional and prospective associations between (change in) smoking behaviour and symptomatology. FindingsAt baseline, 175 individuals (53%) smoked tobacco with an average of 12.4 (SD = 9.0) cigarettes per day. Smokers did not significantly differ in symptom severity from non-smokers on general, positive, negative, emotional, cognitive, behavioural, or motor symptoms across time. However, associations were found between the number of cigarettes and the severity of general psychopathology (estimate 0.349, SE 0.146, p = 0.017). Change in the number of cigarettes had no significant effect on change in general symptom severity (estimate 0.330, SE 0.285, p = 0.248). InterpretationSmoking prevalence in UHR individuals is high. Cigarette consumption was associated with higher levels of general symptoms. However, we observed no association between change in number of cigarettes and symptom severity. Given the fact that smoking is associated with poorer health and worse outcomes in people with psychosis, the clinical high-risk phase offers a window of opportunity for prevention and cessation interventions.

Efficacy of non-invasive brain stimulation interventions in reducing smoking frequency in patients with nicotine dependence: a systematic review and network meta-analysis of randomized controlled trials.

Nicotine is a highly addictive substance in tobacco products that dysregulates several neurotransmitters in the brain and impairs executive function. Non-invasive brain stimulation (NIBS) methods such as repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are promising treatments for nicotine dependence. We investigated the efficacy and acceptability of NIBS in managing smoking cessation through a systematic review and network meta-analysis (NMA). We conducted a systematic review to identify randomized controlled trials (RCTs) that investigated the efficacy of NIBS for smoking cessation. All pairwise meta-analyses and NMA procedures were conducted using random-effects and frequentist models. The co-primary outcomes were (1) the change in number of cigarettes smoked per day (change in frequency of smoking) in patients with nicotine dependence after NIBS and (2) acceptability (the dropout rate). The effect sizes for co-primary outcomes of change in frequency of smoking and acceptability were assessed according to standardized mean difference (SMD) and odds ratio, respectively. Twelve RCTs with 710 participants (mean age: 44.2years, 31.2% female) were included. Compared with the sham control, 10-Hz rTMS over the left dorsolateral prefrontal cortex (DLPFC) was associated with the largest changes in smoking frequency [SMD=-1.22, 95% confidence interval (95% CI)=-1.77 to -0.66]. The 2-mA bifrontal tDCS (SMD=-0.97, 95% CI=-1.32 to -0.62) and 10-Hz deep rTMS over the bilateral DLPFC with cue provocation (SMD=-0.77, 95% CI=-1.20 to -0.34) were associated with a significantly larger decrease in smoking frequency versus the sham. None of the investigated NIBSs was associated with dropout rates significantly different from those of the sham control groups. Prefrontal non-invasive brain stimulation interventions appear to reduce the number of cigarettes smoked with good acceptability.

Feasibility and Acceptability of a Smoking Cessation Program for Individuals Released From an Urban, Pretrial Jail

Tobacco use prevalence among individuals involved in the criminal-legal system is 125% higher than that of the general population and leads to high levels of smoking-related morbidity and mortality. To examine the acceptability, feasibility, and preliminary clinical outcomes of a smoking cessation intervention for individuals who are incarcerated. This pilot randomized clinical trial was conducted from January 2019 to May 2020. Participants were recruited in a pretrial county jail in a large Midwestern US city and were followed up after release. Participants were incarcerated, smoked daily before incarceration, desired to stay quit or reduce cigarette smoking upon release, and expected to be released to the community within 90 days of enrollment. Data analysis was performed from June to October 2020. Participants randomized to the counseling plus nicotine replacement therapy (NRT) group received 1 hour of smoking cessation counseling in jail, a supply of nicotine lozenges upon release, and up to 4 telephone counseling sessions after release. Those randomized to brief health education (BHE) received 30 minutes of general health education in jail. The primary clinical outcome was biologically verified 7-day point prevalence abstinence (PPA) at 3 weeks after release. Secondary clinical outcomes included 7-day PPA at 12 weeks, changes in number of cigarettes per day, and time to smoking lapse and relapse. A total of 46 participants (42 men [91%]; mean [SD] age, 38.2 [9.1] years) were enrolled and remained eligible at release; 23 were randomized to the counseling plus NRT group and 23 were randomized to the BHE group. Recruitment, enrollment, and retention of participants was feasible and acceptable. There were no significant differences in smoking abstinence between groups as determined by 7-day PPA at 3 weeks (adjusted 7-day PPA, 11.9% for counseling plus NRT vs 10.6% for BHE; odds ratio, 1.13; 95% CI, 0.14-9.07) and at 12 weeks (adjusted 7-day PPA, 11.1% for counseling plus NRT vs 14.3% for BHE; odds ratio, 0.75; 95% CI, 0.09-6.11). Cigarettes per day for the counseling plus NRT group decreased more compared with the BHE group at both 3 weeks (difference [SE], -4.58 [1.58] cigarettes per day; 95% CI, -7.67 to -1.48 cigarettes per day; P = .007) and 12 weeks (difference [SE], -3.26 [1.58] cigarettes per day; 95% CI, -5.20 to -0.20 cigarettes per day; P = .04) after release. Initiation of counseling plus NRT during incarceration and continuing after release is feasible and acceptable to participants and may be associated with reduced cigarette use after release. However, additional supports are needed to increase engagement in telephone counseling after release. A larger clinical trial is warranted to determine the effectiveness of counseling plus NRT. ClinicalTrials.gov Identifier: NCT03799315.

Tobacco smoking in pregnant women: fifty years of evolution in France

Abstract Background Smoking during pregnancy is a major modifiable risk factor for maternal and foetal morbidity. We aimed to describe 1/smoking trends in France between 1972 and 2016, 2/ the factors associated with smoking cessation and reduction during pregnancy in 2016. Methods French National Perinatal Surveys are routine surveys based on a representative sample of births (N = 11,733 in 2016). Data were collected in face-to-face interviews in postnatal wards and from the mother’s medical record. Smoking rates before pregnancy and during 3rd trimester were estimated for each study year and characteristics associated with smoking reduction (relative percent change in number of cigarettes smoked before and during pregnancy <50% or ≥ 50%) compared with smoking cessation were analysed using multinomial logistic regression. Results After significantly decreasing from 1995 onwards, smoking prevalence stagnates since 2010 both before pregnancy and in the 3rd trimester (30.1% and 16.2%, respectively in 2016). In 2016, 45.8% ceased smoking during pregnancy, 37.2% reduced by ≥ 50% their consumption and 16.9% reduced by < 50% or did not reduce at all. The more cigarettes women smoked before pregnancy, the greater this reduction was (p < 0,001). Moderate reduction (<50%) vs stopping was more frequent in multiparae compared to nulliparae (aOR=2,47 [IC95%:1,93-3,15]) and in women with low education (aOR(<High school vs university graduates)=7,20 [4,78-10,82]) and low income (aOR(<1500€per month/>3000€)=2,30 [1,51-3,50]). Conclusions Smoking rates were high before and during pregnancy in France in 2016. Socio-demographic factors should be considered when targeting women most at risk of continuing smoking during pregnancy. Key messages After significantly decreasing from 1995 onwards, smoking prevalence stagnates since 2010 both before pregnancy and in the 3rd trimester in France. Supporting female smokers of childbearing age in their attempts to quit and remain non-smokers even after pregnancy is crucial, especially in multiparae and women in poor social condition.

COach2Quit: A Pilot Randomized Controlled Trial of a Personal Carbon Monoxide Monitor for Smoking Cessation.

Mobile phone-based messaging support and biomarker feedback independently show evidence of increasing an individual's likelihood of quitting smoking. However, the combination of these two strategies to facilitate smoking cessation has not been adequately explored. We conducted a randomized controlled trial in Baltimore, Maryland, to assess the efficacy of COach2Quit, a smartphone application that provides exhaled carbon monoxide readings with message support. The primary outcome was self-reported and biochemically verified smoking cessation at 30-day follow-up. Secondary outcomes were reduction in smoking, motivation to quit, and engagement and satisfaction with COach2Quit. An intention-to-treat analysis was conducted. Adult smokers were randomized 1:1 to receive brief advice and COach2Quit (intervention, n = 50) or brief advice only (control, n = 52). Thirteen participants were lost to follow-up. At 30-day follow-up, one participant in each arm quit smoking. Median change in carbon monoxide levels (in parts per million (ppm)) (intervention: -3.0 [interquartile range (IQR) -12.0, 2.0]; control: -2.5 [IQR -9.0, 2.0]) and median change in number of cigarettes smoked per day (intervention: -5.5 [IQR -14.0, -1.0]; control: -6.0 [IQR -10.0, -2.0]) was similar between study arms. There was no significant difference in mean percent change in the Reasons for Quitting scale score (intervention: 6.3 [95% confidence interval = -2.2% to 14.8%]; control: -3.6 [95% confidence interval = -9.2% to 2.1%]). A majority (n = 32, 91%) of participants liked having COach2Quit to help them quit smoking. There were no significant differences in smoking cessation, smoking reduction, and motivation to quit between study arms. However, high satisfaction with the COach2Quit application indicates its feasibility and acceptability as a smoking cessation tool. Smoking is the leading preventable cause of morbidity and mortality in the United States. Although counseling and pharmacotherapy are efficacious for smoking cessation, they are not easily accessible or desirable to all smokers, highlighting the need for identifying other interventions. There is evidence for the efficacy of mobile phone-based messaging support for smoking cessation. However, there is limited research on the efficacy of biomarker feedback, much less interventions that combine these two approaches. This research contributes to filling this gap and identifying novel interventions to facilitate smoking cessation.

Posttraumatic stress symptoms and smoking among World Trade Center disaster responders: A longitudinal investigation

PurposeThe current longitudinal study examined posttraumatic stress disorder (PTSD) symptom severity in relation to smoking abstinence and reduction over time among responders to the World Trade Center (WTC) disaster. MethodParticipants were 763 police and 1881 non-traditional (e.g., construction workers) WTC responders who reported being smokers at an initial examination obtained between July 2002 and July 2011 at the WTC Health Program (WTC-HP). WTC responders were reassessed, on average, 2.5years later. ResultsFor police WTC responders, higher levels of WTC-related PTSD symptoms at the initial visit were associated with a decreased likelihood of smoking abstinence (OR=0.98, p=.002) and with decreased smoking reduction (β=−.06, p=.012) at the follow-up visit. WTC-related PTSD symptom severity was not related to likelihood of smoking abstinence or change in number of cigarettes smoked among non-traditional responders. Post hoc analyses suggested that for police, hyperarousal PTSD symptoms were predictive of decreased abstinence likelihood at the follow-up visit (OR=0.56, p=.006). DiscussionThe present findings suggest that PTSD symptoms may be differentially related to smoking behavior among police and non-traditional WTC responders in a naturalistic, longitudinal investigation. Future work may benefit from exploring further which aspects of PTSD (as compared to each other and to common variance) explain smoking maintenance.

Nicotine consumption and dependence: Genetic and environmental risk factors show indirect effects through nicotine craving

Aims: Although about 45% of women stop or reduce smoking during pregnancy, over half relapse to smoking after child birth. Though it is clear that there are individual differences in trajectories of smoking postpartum, the goal of this study was to identify predictors of these individual differences in relapse trajectories. Methods: Smoking (n=163) and demographically similar nonsmoking (n=80) pregnant women were recruited prenatally. Maternal smoking was assessed through a combination of selfreport, cotinine in saliva, and infant meconium at delivery. We used multilevel models to analyze changes in average number of cigarettes per day across four time points (preconception, 3rd trimester, 2 and 9 months postpartum). Results: On average, women nearly returned to their levels of preconception smoking (M=7.69, sd =8.33) by 9 months postpartum (M=4.58, sd =5.25). Time accounted for 55% of individual differences in smoking. Though themodel includedmaternal anger, race, marijuana and alcohol use as well as child’s gestational age, the only significant predictor of changes in smoking postpartum was partner smoking status. Relative to women with no partner, women with non-smoking partners had lower rates of change in smoking (B=−0.59, SE = .28, p= .035), but having a smoking partner was virtually the same as having no partner (B=0.09, SE = .38, p= .816). Average marijuana use predicted smoking at the 3rd trimester (B=0.59, SE = .21, p= .006), but did not predict change in smoking from 3rd trimester to 9 months postpartum. Conclusions:Our results suggest that timing of relapse prevention interventions for pregnant and postpartum smokers is crucial. With women nearly returning to preconception smoking levels by 9months postpartum, interventions should be targeted early in the postnatal period. In addition, having a non-smoking partner seems to be a protective factor against increases in smoking postpartum, so interventions should includepartners tomaximizeeffectiveness. Financial support: R01DA019632 (RDE).

Readiness to quit as a predictor for outcomes of smoking-reduction programme with transdermal nicotine patch or bupropion in a sample of 308 patients with schizophrenia.

Readiness to quit has been found to predict smoking-cessation outcomes in a general population. However, little is known about the relationship between the readiness to quit and smoking-reduction outcomes in patients with schizophrenia treated with pharmacological adjuvants. The aim of this study was to examine the association between readiness to quit and smoking-reduction outcomes in patients with schizophrenia. A total of 308 subjects using nicotine replacement therapy (NRT) (N = 242) or bupropion (N = 66) participated in an 8-week smoking-reduction programme. Participants were categorised into precontemplators (N = 127), contemplators (N = 76) and preparators (N = 105) to quit smoking based on the transtheoretical model. There was a significant difference in change in number of cigarettes (NOC) (p = 0.007) and Fagerstrom test for nicotine dependence (FTND) score (nicotine dependence level) (p = 0.029) across the stages of change. A linear regression model revealed trend of increasing reduction in NOC and FTND scores in different stages of change (NOC: B = -1.22, t = -2.81, p = 0.005; FTND: B = -0.43, t = -2.57, p = 0.011). However, the 7-day point prevalence of abstinence was 5.5% (18/308), but there was no significant association between stage of change and smoking cessation (p = 0.26), possibly due to a very small sample size of successful quitters. In summary, among a cohort of institutionalised chronic schizophrenia patients receiving 8-week NRT or bupropion, stage of change can predict smoking reduction and may serve as a useful indicator for patients' preparedness before a trial of smoking reduction.

Enhanced physician prompts in prenatal electronic medical records impact documentation on smoking cessation

ObjectiveSmoking cessation during pregnancy is a modifiable intervention that can improve maternal and neonatal outcomes. Encouraging smoking cessation is an assessed measure of the Meaningful Use incentives to ensure best practices with the increased use of the electronic medical record (EMR). Physician EMR prompts have been used shown to be successful with preventive care but there is a paucity of data evaluating prompts within obstetrics. The objective of this study is to determine the effectiveness of enhanced smoking cessation prompts in a prenatal EMR.MethodsA retrospective cohort study of an enhanced smoking cessation prompting system within our prenatal EMR was performed. Pregnant women who reported tobacco use at first prenatal visit were included. The number of times a smoking cessation method was offered and documented, the number of documented attempts at smoking cessation, and the final number of cigarettes smoked were compared pre and post the enhancement of the smoking cessation prompting system.Results95 patients were included (48 pre-enhancement; 47 post-enhancement). Post-enhancement, the documentation of smoking cessation method offered increased (0 vs. 1, p = 0.03) and documentation of smoking cessation attempts increased (1 vs. 2, p = 0.006). There was no change in the final number of cigarettes smoked (p = 0.9).ConclusionsEnhanced prompting systems increase documentation related to smoking cessation with no change in number of cigarettes smoked. In the era of Meaningful Use guidelines which focus on documentation in the EMR, continued research must be done to assure that software enhancements and improved documentation truly result in improved patient care.

A multi-route model of nicotine–cotinine pharmacokinetics, pharmacodynamics and brain nicotinic acetylcholine receptor binding in humans

The pharmacokinetics of nicotine, the pharmacologically active alkaloid in tobacco responsible for addiction, are well characterized in humans. We developed a physiologically based pharmacokinetic/pharmacodynamic model of nicotine pharmacokinetics, brain dosimetry and brain nicotinic acetylcholine receptor (nAChRs) occupancy. A Bayesian framework was applied to optimize model parameters against multiple human data sets. The resulting model was consistent with both calibration and test data sets, but in general underestimated variability. A pharmacodynamic model relating nicotine levels to increases in heart rate as a proxy for the pharmacological effects of nicotine accurately described the nicotine related changes in heart rate and the development and decay of tolerance to nicotine. The PBPK model was utilized to quantitatively capture the combined impact of variation in physiological and metabolic parameters, nicotine availability and smoking compensation on the change in number of cigarettes smoked and toxicant exposure in a population of 10,000 people presented with a reduced toxicant (50%), reduced nicotine (50%) cigarette Across the population, toxicant exposure is reduced in some but not all smokers. Reductions are not in proportion to reductions in toxicant yields, largely due to partial compensation in response to reduced nicotine yields. This framework can be used as a key element of a dosimetry-driven risk assessment strategy for cigarette smoke constituents.

Resistance training and predicted risk of coronary heart disease in sedentary males

The purpose of this study was to determine the impact of resistance training, designed to prevent the development of coronary heart disease (CHD) based on the Framingham Risk Assessment (FRA) score. Twenty-five healthy sedentary men with low CHD risk were assigned to participate in a 16-week (three days per week) resistance training programme (n = 13) or non-exercising control group (CG) (n = 12). Resistance training was performed using eight whole-body exercises for three sets of 15 repetitions at 60% of one-repetition maximum. Resistance training did not significantly (p > 0.05) reduce the number of cigarettes smoked daily (p > 0.133) or TC (p > 0.917), while significant improvements were found in SBP (p < 0.003), HDLC (p < 0.005) and FRA score (p < 0.021); thus improving absolute 10-year risks for CHD. The CG subjects were found to have had no significant changes in number of cigarettes smoked daily (p > 0.831), TC (p > 0.678), HDLC (p > 0.672) or FRA score (p > 0.504), but SBP increased significantly (p< 0.030). These data indicate that resistance training can effectively reduce the predicted risk of developing CHD, even in men with already low risk.

Changes in Tobacco Smoking Following Treatment for Cocaine Dependence

Incorporation of smoking cessation into cocaine treatment programs remains a challenge. A major concern is that cocaine abusers may tend to substitute one drug for the other. If this is true, successful treatment of cocaine abuse should lead to an increase in tobacco smoking. We compared tobacco smoking at admission, end of treatment and 9-month follow up for 168 crack cocaine dependent patients entering a 12-week outpatient treatment program for substance abuse. Smoking cessation was not a part of treatment. As expected cocaine patients improved with treatment and showed significant reduction in scores on the Addiction Severity Index (ASI). There were no significant changes in number of cigarettes smoked per day or scores on the Fagerstrom Test for Nicotine dependence (FTND) from baseline to end of treatment or follow-up. Also, there were no differences in the proportions of nonsmokers and smokers who changed their smoking habits over the treatment and follow up period. At follow up subjects who were abstinent as well as those using cocaine showed no changes in tobacco smoking. There is no evidence that reduction in crack cocaine smoking following treatment is accompanied by an increase in tobacco smoking. It appears that concerns over tobacco being substituted for cocaine may be unfounded in this population.

Effects of ammonium chloride on urinary pH and cigarette smoking behavior.

We determined the effects of acidification of urinary pH on cigarette smoking behavior to assess the postulated relationships between stress, urinary pH, and cigarette smoking. Urine was acidified by short-term administration of 12.5, 25, and 50 mg/kg ammonium chloride and long-term administration of 50 mg/kg ammonium chloride. Measurements of cigarette smoking behavior included the number of cigarettes smoked as well as automated measures of puff frequency and duration. Short- and long-term administration of ammonium chloride induced decreases in urinary pH but failed to induce any substantial changes in number of cigarettes smoked, puff frequency, or puff duration.