Tobacco Use Characteristics Research Articles

A scientometric study of tobacco and alcohol use as risk factors for oral cavity health

Background/purposeTobacco and alcohol are the well-known carcinogenic agents of oral cavity health. The purpose of this study was to investigate the scientometric characteristics of alcohol and tobacco use and oral health. Materials and methodsThe papers on alcohol and tobacco use and oral cavity were published since 1885 and 1895, respectively. All the eligible papers were retrieved on March 20, 2023 from the Scopus database. ResultsThere are 2529 and 1545 papers on tobacco smoking and alcohol drinking and oral cavity in the Scopus database, respectively. Based on the frequency of keywords in all included papers, both smoking and drinking are involved in mouth neoplasms, oral cancer, leukoplakia, and periodontal diseases. In the papers on tobacco and alcohol use and oral cavity, the same research keywords confirm tobacco and alcohol use associate with oral cancer risk possibly through influencing genetics and gene and protein expression. For the distinctive keywords, nicotine, smoking cessation, and electronic cigarette are unique keywords of tobacco use. Acetaldehyde, alcohol dehydrogenase, and alcohol metabolism are unique ones of alcohol use. ConclusionThis study for the first time reports the scientometric characteristics of tobacco and alcohol use and oral health, which might aid healthcare authorities to promote tobacco and alcohol control measures focused on the necessities of their population.

Characteristics of tobacco use among secondary school students: a cross-sectional study in a school in Valencia, Spain.

Cigarette smoking is a significant public health problem, and it is essential to work actively with young people to limit the incorporation of this addiction. This study aimed to identify characteristics associated with tobacco use in adolescents in a real setting. Epidemiologic, cross-sectional study including secondary school students aged 12-17 years in the 1st, 2nd, and 3rd grades of "Joan Fuster High School" in the city of Sueca, Valencia (Spain). An anonymous, self-administered questionnaire was used to collect data on demographics, cigarette smoking history, alcohol consumption, nicotine dependence, and exposure to parental cigarette smoking. The final sample of individuals surveyed included 306 students (50.6% females) with a median age of 13 years. The prevalence of cigarette smoking was 11.8% (13.5% in females and 9.9% in males). The mean age of cigarette smoking onset was 12.7 ± 1.6 years. Ninety-three students (30.4%) were repeaters, and 114 (37.3%) reported alcohol consumption. Significant factors associated with tobacco use were being a repeater (odds ratio [OR] 4.19, 95% confidence interval [CI] 1.75-10.55, p = 0.002), alcohol consumption (OR 4.06, 95% CI 1.75-10.15, p = 0.002) and parental cigarette smoking (OR 3.76, 95% CI 1.52-10.74, p = 0.007). An operational profile of features associated with tobacco consumption was identified in the presence of parental cigarette smoking, alcohol consumption, and poor academic performance. Consideration of these factors could be useful in the operational design of cigarette smoking cessation interventions for young people in a context where there is a great need for better prevention and control of cigarette smoking.

Dental Caries Risk in the U.S. Air Force: 2009 to 2017.

The Air Force uses dental caries risk assessments (CRA) to determine which active duty Air Force (ADAF) members are at high caries risk (HCR) and will benefit from additional preventive and restorative dental care. The purpose of this study is to describe the caries risk of ADAF from 2009 to 2017 and determine how demographic, military, and tobacco-use characteristics affect caries risk. Data from ~300,000 ADAF annual dental examinations from 2009 to 2017 were used. The outcome variable investigated was dental caries risk (high, moderate, or low). Independent variables analyzed were: age, sex, race, education, marital status, military rank, service years, flying status, and tobacco use. Descriptive and multivariable analyses were performed to explore associations between potential risk indicators and caries risk outcomes. From 2009 to 2013, there was a steady decline in ADAF that were diagnosed as low caries risk (LCR), from 80.3% to 67.7%. Since 2013, the prevalence of ADAF that are LCR has remained unchanged at about two-thirds of the force. The proportion of the ADAF that are moderate caries risk (MCR) increased from 15.7% in 2009 to 25.3% in 2013 and remained unchanged affecting about a quarter of the force since then. The proportion that was diagnosed as HCR increased from 3.9% in 2009 to 7.1% in 2013 and declined slightly in 2017 (6.0%). After controlling for other covariates, younger age (<20years old: odds ratio [OR], 4.4; 95% confidence interval [CI], 3.3-5.8), less time in service (≤4years: OR, 2.1; 95% CI, 1.7-2.6), junior rank (E-1-E-4: OR, 1.6; 95% CI, 1.3-1.8), less education (high-school graduate: OR, 2.3; 95% CI, 2.0-2.6), using tobacco (Smoker: OR, 1.6; 95% CI, 1.5-1.7), being a nonflyer (OR, 1.2; 95% CI, 1.1-1.3), being male (OR, 1.1; 95% CI, 1.1-1.2), or being black (OR, 1.2; 95% CI, 1.1-1.2) were each associated with being HCR. Among the cohort of Airmen who were LCR at baseline, the majority (75.9%) remained at low risk, but for nearly a quarter (24.1%), their risk of caries increased over 9years. Among those who were originally MCR in 2009, 61.5% improved to LCR, whereas 4.6% progressed to HCR; among those identified as high risk for caries in 2009, a substantial majority (89.1%) improved over 9years, but 10.9% remained unchanged. The prevalence of HCR and MCR service members increased from 2009 to 2013 but has remained consistent since 2013. Overall caries risk in the Air Force is lower compared to previously published findings from 2001 to 2004. This suggests that CRA and prevention programs have been effective at helping to reduce caries prevalence among Airmen. Smoking prevalence among ADAF has also declined substantially over the past 16years which may contribute to overall caries risk reductions. Using a CRA approach may be an effective tool for helping to identify and develop strategies to manage dental caries risk in patients.

Basic Behavioural Characteristics of Tobacco Use in Patirnts Who Plan Quitting

Aim/Background. Most smokers try to stop smoking without professional&#x0D; support and soon begin to smoke again. In our country, the number of admissions&#x0D; to smoking cessation outpatient clinics are gradually increasing due to the&#x0D; anti-smoking campaigns and increasing smoking-related diseases. The aim of the&#x0D; present study was to investigate the basic behavioural characteristics of&#x0D; tobacco use in patients who plan to quitting. Methods.Patients who&#x0D; applied to Outpatient Clinics of Family Medicine Department of Adnan Menderes&#x0D; University Hospital between September 1st, 2017 and August 31st,&#x0D; 2018 with the aim of smoking cessation were included in this prospective&#x0D; descriptive study.Data collection was done through the follow-up protocol form of smoking&#x0D; cessation outpatient clinic. Data analysis was done by using SPSS 18.0 program.&#x0D; Besides comparative statistical methods, t test and Mann Whitney-U test were&#x0D; used for quantitative variables, and chi-square test was used for categorical&#x0D; variables. Results.The mean age of 146 patients who were mostly male was 41.8 years. The most common reason for quitting&#x0D; smoking was fear of being ill or the present disease (69.9%). The mean age of&#x0D; starting to smoke was 16.4 years and the smoking-load was 28.6 packs/year. The&#x0D; age of starting smoking was similar in males and females however males had&#x0D; smoked more heavily(smoking load was 212 package/year and 32.9 package year in&#x0D; females and males, respectively, p=0.08).Approximately one third of smokers&#x0D; were nicotine-dependent at very high levels and started to smoke with social&#x0D; impact (59.6%). Stress was the most common factor of desire to smoke (60.3%).&#x0D; Approximately 74% of the cigarette addicts were at the stage of preparing to&#x0D; quit smoking and the most common medical treatment used was nicotine replacement&#x0D; treatment (69.9%). Conclusions.Smokers who want to quit smoking generally start smoking due to social&#x0D; impact at an early age and use cigarettes as a tool of coping with stress and&#x0D; want to quit smoking due to diseases or fear to be ill. It is important to focus&#x0D; on the basic characteristics of the patients’ smoking behaviour in smoking&#x0D; cessation process.Amaç. Sigara içenlerin çoğu sigara&#x0D; bırakmayı yardımsız olarak denemekte ve kısa süre sonra tekrar sigara içmeye&#x0D; başlamaktadır. Ülkemizde sigara karşıtı kampanyalar ve sigara kullanımına bağlı&#x0D; giderek artan hastalıklar nedeniyle sigara kullanan kişilerin sigara bırakma&#x0D; polikliniklerine başvuru sayısı günden güne artmaktadır. Çalışmamızın amacı,&#x0D; tütün kullanımını bırakmayı düşünen hastaların tütün kullanımına ilişkin temel&#x0D; davranış özelliklerinin araştırılmasıydı. Yöntem.İleriye dönük tanımlayıcı&#x0D; tipteki araştırmaya Adnan Menderes Üniversitesi (ADÜ) Aile Hekimliği&#x0D; Polikliniğine 1 Eylül 2017 - 31 Ağustos 2018 tarihleri arasında sigara&#x0D; kullanımını bırakmak için başvuran sigara içicileri katıldı. Veri toplama tütün&#x0D; kullanımını bırakma polikliniği izlem protokolü formu,veri analizi ise SPSS&#x0D; 18.0 programı ile yapıldı. Tanımlayıcı istatistiksel yöntemlerin yanı sıra&#x0D; niceliksel değişkenler için t testi ve Mann Whitney-U testi, kategorik&#x0D; değişkenler için ki-kare testi kullanıldı. Bulgular. Çoğu erkek olan 146&#x0D; katılımcının yaş ortalaması 41,8 idi. En çok ifade edilen sigarayı bırakma&#x0D; nedeni hastalık ya da hasta olma korkusuydu (%69,9). Başvuranların sigaraya&#x0D; başlama yaşı ortalama 16,4 ve toplam sigara içme yükü 28,6 paket/yıldı. Kadın&#x0D; ve erkeklerin sigaraya başlama yaşı benzerdi ancak erkekler daha yoğun şekilde&#x0D; sigara içmişti (kadınlarda sigara içme yükü ortalama 21,2 paket/yıl, erkeklerde&#x0D; 32,9 paket/yıl, p=0,008). Yaklaşık üçte biri çok yüksek düzeyde nikotin&#x0D; bağımlısı olan içicilerin %59,6’sı sosyal etki ile sigaraya başlamıştı. Sigara&#x0D; içme isteğini en çok stres artırmaktaydı (%60,3). Yüzde 74’ü sigara bırakmaya&#x0D; hazırlanma evresinde gelen sigara bağımlılarına en çok verilen tıbbi tedavi&#x0D; %69,9 ile nikotin replasman tedavisi idi.Sonuç. Sigarayı bırakmak isteyen&#x0D; içiciler sigara içmeye daha çok sosyal etki ile ve erken yaşta başlamakta, en&#x0D; çok stresle başa çıkma aracı olarak sigara kullanmakta ve hastalık ya da&#x0D; hastalık korkusuyla sigarayı bırakmak istemektedir. Sigara bırakma danışmanlığı sürecinde hastaların bu&#x0D; temel sigara içme davranış özelliklerine de odaklanmalıdır.

Determinants of Smoking Status in a Sample of Outpatients Afferent to a Tertiary Referral Hospital.

The identification of determinants of attempts to quit smoking and quitting smoking success is crucial for effective smoking prevention and/or cessation programs. Thus, here we have conducted a survey to determine the sociodemographic characteristics of tobacco use and the potential determinants of quitting smoking among a population of 140 subjects—101 smokers and 39 ex-smokers—referred to our clinic for respiratory diseases. Subject characteristics included demographic data, employment and education status, respiratory disease family history, smoking habits, life habits, diet, alcohol intake, and physical activity. In comparison with former smokers, active smokers were younger, lived with at least one smoking family member, and were more frequently exposed to passive smoke. They also displayed a higher coffee consumption, a higher frequency of in-between-meal snacks, and a lower chronic obstructive pulmonary disease (COPD) prevalence. In comparison with subjects who had never attempted to quit smoking, individuals who had attempted to quit smoking were younger, had a lower pack-year median, consumed a higher amount of coffee and alcohol, and conducted regular physical activity. Determinants of successful smoking cessation were older age, lower passive smoking exposure and daily coffee intake, and COPD diagnosis. Overall, our findings underscore the importance of health education in fostering successful smoking cessation in respiratory disease patients.

Smoking related outcomes before and after implementation of tobacco-free grounds in residential substance use disorder treatment programs

BackgroundThis study examined the impact of a tobacco-free grounds (TFG) policy and the California $2.00/pack tobacco tax increase on tobacco use among individuals in residential substance use disorder (SUD) treatment. MethodsWe conducted three cross-sectional surveys of clients enrolled in three residential SUD treatment programs. Wave 1 (Pre-TFG) included 190 clients, wave 2 (post-TFG and pre-tax increase) included 200 clients, and wave 3 (post-tax increase) included 201 clients. Demographic and tobacco-use characteristics were first compared between waves using bivariate comparisons. Regression models were used to compare each outcome with survey wave as the predictor, while adjusting for demographic characteristics and nesting of participants within programs. ResultsOdds of clients being current smokers was lower (AOR = 0.43, 95%CI = 0.30,0.60) after implementation of TFG compared to baseline. Adjusted mean ratio (AMR) for cigarettes per day was lower post-TFG compared to baseline (AMR = 0.70, CI = 0.59, 0.83). There were no differences, across waves, in tobacco-related knowledge, attitudes, or services received by program clients, or use of nicotine replacement therapy. Increased cigarette taxation was not associated with reductions in client smoking. ConclusionImplementation of a TFG policy was associated with a lower prevalence of client smoking among individuals in residential SUD treatment. Increased state cigarette excise taxes were not associated with a further reduction in client smoking in the presence of TFG policies, though this may have been confounded by relaxing of the TFG policy. SUD treatment programs should promote TFG policies and increase tobacco cessation services for clients.

Problematic alcohol and tobacco use among healthcare professionals

O objetivo deste estudo foi descrever a prevalência e características do uso problemático de álcool e tabaco entre profissionais de saúde atuantes na Estratégia de Saúde da Família. Foi realizado um estudo transversal com profissionais de saúde do Alto Uruguai Catarinense, Santa Catarina, Brasil. As variáveis dependentes foram o uso problemático de álcool e o uso de tabaco e as variáveis independentes foram as características sociodemográficas, socioeconômicas e condições de saúde. Observou-se que 6,2% apresentavam uso problemático de álcool e 8,5% usavam tabaco. Torna-se essencial que os serviços de saúde estruturem políticas e ações específicas o desenvolvimento de estratégias de prevenção e tratamento específicos para este grupo de profissionais, aumentando a qualidade dos serviços prestados aos usuários neste nível de atenção

Recomendación de abandono del tabaquismo en una muestra de adultos de la ciudad de Rosario

Introduction: Smoking is the leading cause of preventable death worldwide; nevertheless, many physicians do not advice to quit smoking.Objectives: The goal of this cross-sectional study was to evaluate the characteristics of tobacco use and the frequency of smoking cessation recommendation in adults in the city of Rosario between July and December 2010.Methods: A closed survey was performed to adults attending the seven districts of the city of Rosario for reasons not related to health care, using a prearranged questionnaire based on non-probability convenience sampling.Results: A total of 1,217 volunteers were surveyed; 57% were women and 11% worked in health care sectors. Mean age was 48 years; 28% were current smokers and 24% were former smokers. The median number of attempts to quit smoking was lower in former smokers (1 vs. 3 times; p < 0.0001). Of those who received advice to quit smoking, 72.5% attempted to do so during the preceding year, while 57% of those not receiving advice tried to quit smoking (p = 0.003). A multiple correspondence factor analysis with subsequent classification showed that current smokers who did not attempt cessation started smoking later in life and smoked fewer cigarettes per day.Conclusions: The quality of the recommendation for smoking cessation and the self-perception of the risk associated with this addiction are aspects that are not systematically taken into account when this topic is raised. We consider that the present study emphasizes the importance of theses aspects, which should undergo further evaluation in the future for a better approach to the complexity of achieving tobacco cessation

Factores relacionados con el inicio en el consumo de tabaco en alumnos de Enseñanza Secundaria Obligatoria

Objective: To study the prevalence of smoking in students of Secondary Education at IES "The Valley" and the factors that lead to the first use of snuff.Methods: Cross-sectional study on a sample of 123 students obtained through convenience sampling. The information was collected by a self-administered questionnaire that included variables of age, sex, family socioeconomic status, characteristics of tobacco use among adolescents, knowledge about snuff and parental attitudes.Results: The prevalence of snuff stood at 42%, of which 48% are regular smokers. Are confirmed as risks factors for the initial use of snuff the existence of smoking sibilings and a good friend who does too. Other variables such as the absence of a parent, parental smoking, educational level and parental occupation, physical activity and attendance at festivals could not be defined as risk factors due to insufficient sample size.Conclusions: The prevalence of smokers was similar to that obtained in other studies with similar characteristics. Smoking prevention should focus on the family and the adolescent environment.

Familial Aggregation of Tobacco Use Behaviors Among Amish Men

Tobacco use is a complex behavior. The Old Order Amish community offers unique advantages for the study of tobacco use because of homogenous ancestral background, sociocultural similarity, sex-specific social norms regarding tobacco use, and large family size. Tobacco use in the Old Order Amish community is almost exclusively confined to males.We examined characteristics of tobacco use and familial aggregation among 1,216 Amish males from cross-sectional prospectively collected data. Outcomes examined included ever using tobacco regularly, current use, quantity of use, duration of use, and frequency of use.Sixteen percent of Amish men were current tobacco users, with the majority reporting cigar use only. Higher rates of tobacco use were found among sons of fathers who smoked compared with sons of fathers who did not smoke (46% vs. 22%, p < .001) as well as among brothers of index cases who smoked compared with brothers of index cases who did not smoke (61% vs. 29%, p < .001). After controlling for shared household effects and age, heritability accounted for 66% of the variance in ever smoking regularly (p = .045).The familial patterns of tobacco use observed among Amish men highlight the important role of family in propagating tobacco use and support the usefulness of this population for future genetic studies of nicotine addiction.

The many faces of tobacco use among women.

Smoking is still considered to be mainly a male problem. However, it is estimated that there are approximately 250 million women worldwide who smoke cigarettes and millions more women who use smokeless tobacco products. This article addresses the many facets of tobacco use among women. The aim of the paper is to increase recognition among clinicians and researchers of the specific characteristics of female tobacco use. Together with providing epidemiological data on the distribution of tobacco use among women and data from population-based analyses on sociocultural factors that influence it, the article presents tobacco use during pregnancy as a particularly important public health problem. Further, the article points out sex-related differences (ie, physiological, psychological, or behavioral) between male and female tobacco use. A special focus is on the important role of ovarian hormones. Adverse effects of tobacco use to women and their children as well as tobacco-related morbidities and comorbidities are presented, and women’s greater susceptibility to tobacco constituents as compared to men is stressed. Awareness of these differences can contribute to improvement of the effectiveness of smoking cessation programs addressed both to the specific female population and to an individual smoking woman.

Second-hand smoke exposure levels and tobacco consumption patterns among a lesbian, gay, bisexual and transgender community in Ireland

To estimate and identify characteristics of tobacco use, including use of roll-your-own (RYO) cigarettes and second-hand smoke (SHS) exposure, among a self-identified lesbian, gay, bisexual and transgender (LGBT) community in Ireland. Web-based self-administered questionnaire survey using a cross-sectional study design. A convenience sample of 661 self-identified LGBT respondents was recruited through a well-advertised web-based survey tool method between March and May 2012. Prevalence rates were adjusted for age, sexual orientation, social class and nationality. Multivariable logistic regression was performed to characterize tobacco use profile and SHS exposure levels for estimating adjusted odds ratios (AOR) with 95% confidence intervals (CI). Of the 661 respondents, 45.3% (95% CI 44.9-45.7) reported current use of tobacco and 15.6% reported current use of RYO cigarettes (results were significantly higher for lesbians in both categories). In addition, 40.3% (95% CI 39.9-40.6) of respondents reported SHS exposure at home (significantly higher in gays), and 50.1% (95% CI 49.3-50.8) reported SHS exposure in cars (significantly higher in lesbians); these two groups were not mutually exclusive. The oldest individuals and non-Irish nationals were more than twice as likely to report SHS exposure in cars compared with the youngest individuals and Irish nationals, and the least-educated individuals were more than twice as likely to report current use of RYO cigarettes compared with the most-educated individuals (AOR 2.26; 95% CI 1.06-4.79). Non-tobacco users were less likely to report SHS exposure at home compared with current tobacco users (AOR 0.31; 95% CI 0.21-0.46). Despite inherent methodological limitations associated with identification of such a study sample, the adjusted rates indicate that tobacco use is very high among the LGBT community in Ireland compared with the general Irish population (smoking rate 29%). High levels of SHS exposure at home and in cars further underscore the significance of smoke-free private vehicle and 100% smoke-free home policies. A targeted tobacco control strategy should be explored for this vulnerable population.

The Pap smear screening as an occasion for smoking cessation and physical activity counselling: baseline characteristics of women involved in the SPRINT randomized controlled trial

BackgroundGender-specific smoking cessation strategies have rarely been developed. Evidence of effectiveness of physical activity (PA) promotion and intervention in adjunct to smoking cessation programs is not strong. SPRINT study is a randomized controlled trial (RCT) designed to evaluate a counselling intervention on smoking cessation and PA delivered to women attending the Italian National Health System Cervical Cancer Screening Program. This paper presents study design and baseline characteristics of the study population.Methods/DesignAmong women undergoing the Pap examination in three study centres (Florence, Turin, Mantua), participants were randomized to the smoking cessation counselling [S], the smoking cessation + PA counselling [S + PA], or the control [C] groups. The program under evaluation is a standard brief counselling on smoking cessation combined with a brief counselling on increasing PA, and was delivered in 2010. A questionnaire, administered before, after 6 months and 1 year from the intervention, was used to track behavioural changes in tobacco use and PA, and to record cessation rates in participants.DiscussionOut of the 5,657 women undergoing the Pap examination, 1,100 participants (55% of smokers) were randomized in 1 of the 3 study groups (363 in the S, 366 in the S + PA and 371 in the C groups). The three arms did not differ on any demographic, PA, or tobacco-use characteristics. Recruited smokers were older, less educated than non-participant women, more motivated to quit (33% vs.9% in the Preparation stage, p < 0.001), smoked more cigarettes per day (12 vs.9, p < 0.001), and were more likely to have already done 1 or more quit attempts (64% vs.50%, p < 0.001). The approach of SPRINT study appeared suitable to enrol less educated women who usually smoke more and have more difficulties to quit.Trial registration numberISRCTN: ISRCTN52660565

Effectiveness of a stepped primary care smoking cessation intervention: cluster randomized clinical trial (ISTAPS study)

To evaluate the effectiveness in primary care of a stepped smoking cessation intervention based on the transtheoretical model of change. Cluster randomized trial; unit of randomization: basic care unit (family physician and nurse who care for the same group of patients); and intention-to-treat analysis. All interested basic care units (n = 176) that worked in 82 primary care centres belonging to the Spanish Preventive Services and Health Promotion Research Network in 13 regions of Spain. A total of 2,827 smokers (aged 14-85 years) who consulted a primary care centre for any reason, provided written informed consent and had valid interviews. The outcome variable was the 1-year continuous abstinence rate at the 2-year follow-up. The main variable was the study group (intervention/control). Intervention involved 6-month implementation of recommendations from a Clinical Practice Guideline which included brief motivational interviews for smokers at the precontemplation-contemplation stage, brief intervention for smokers in preparation-action who do not want help, intensive intervention with pharmacotherapy for smokers in preparation-action who want help and reinforcing intervention in the maintenance stage. Control group involved usual care. Among others, characteristics of tobacco use and motivation to quit variables were also collected. The 1-year continuous abstinence rate at the 2-year follow-up was 8.1% in the intervention group and 5.8% in the control group (P = 0.014). In the multivariate logistic regression, the odds of quitting of the intervention versus control group was 1.50 (95% confidence interval = 1.05-2.14). A stepped smoking cessation intervention based on the transtheoretical model significantly increased smoking abstinence at a 2-year follow-up among smokers visiting primary care centres.

Consumo de drogas en menores residentes en un área urbana pequeña

The use of potentially addictive substances may be influenced by the young person's place of residence. To determine the frequency and characteristics of tobacco, alcohol and cannabis use in secondary school pupils in a small urban area during the academic year 2008-09. Cross-sectional survey. Socio-demographic data related to tobacco, alcohol and cannabis use were gathered by means of a confidential self-administered questionnaire. The survey was responded to by 88% of the pupils (393). Prevalence of tobacco use was 48%, 16% of whom smoked every day. Forty four percent of third grade pupils and fifty two per cent of forth-graders, did consume alcohol on the week ends. Thirty-five percent said that they had been drunk on at least one occasion, while 30% of the pupils had tried cannabis, and 50% of third-graders. Among those who had used cannabis, 23% had done so in the previous month. At onset of cannabis use was 13 years. Almost 80% of those surveyed said they had not paid for the first drugs they used. The use of legal and illegal drugs for those in our sample begins between the ages of 12 and 14 years, representing slightly higher frequencies than those found in big cities. Despite the illegality of the sale of tobacco and alcohol to minors, Spanish teenagers continue to obtain them. It is essential for primary care professionals, educators and families to be aware of the importance of early detection of the use of psychoactive substances. The prevention of drug addiction is more effective the sooner the potential risk is detected.

Sensitivity and specificity of a self-administered questionnaire of tobacco use; including the Fagerström test

Background Preventing tobacco consumption and promoting cessation among health professionals are of great significance as their habits can influence their patients’ attitudes. Knowledge of the prevalence and characteristics of tobacco use in a specific population is important for the design of efficient strategies for preventing people from acquiring the habit and persuading them to stop. Self-administered questionnaires are a very common method for determining tobacco use, but assessment is needed of their validity for specific groups, such as occasional smokers or students of health sciences. Objectives The aim of this study was to determine the sensitivity and specificity of a self-administered questionnaire for determining tobacco use among a population of young female students of health sciences. As a gold standard, we used a measure of the concentration of cotinine in saliva with different cut-off points. We also analysed the influence on sensitivity and specificity of the questionnaire of nicotine dependence and exposure to secondary smoke. Design This is an internal validity study (sensitivity and specificity) of a self-administered questionnaire. Settings The study was carried out in the School of Health Sciences of the University of León, at its centres in León and Ponferrada. Participants Data were collected on 432 of a total of 480 women aged under 25 who were studying Health Sciences at the University of León in 2007. Methods The self-administered questionnaire included data concerning demography, education, tobacco habits and exposure to environmental smoke. Saliva cotinine concentration was determined with an EIA kit. Results The questionnaire used showed high values of sensitivity and specificity (85.3% and 95.3%) and a very good correlation (Kappa = 81.0%) with cotinine values of 10 ng/ml or higher. Discrepancies in the test results for those who declared themselves to be smokers only occurred in women with a low nicotine dependency. Among those who did not declare themselves smokers, those exposed to second-hand smoke were 7 times more frequently classified erroneously as smokers than those who had not been exposed. Conclusion The self-administered questionnaire used showed a very good internal validity and a good correlation with cotinine levels of 10 ng/mg, and therefore seems to be a good instrument for measuring tobacco use in this population. The availability of information on passive smoking and nicotine dependence is essential for the correct interpretation of the discrepancies.

Stage-Tailored Tobacco Cessation Treatment in Inpatient Psychiatry

Stage-Tailored Tobacco Cessation Treatment in Inpatient Psychiatry

Stage-Tailored Tobacco Cessation Treatment in Inpatient Psychiatry

Individuals with mental illness and co-occurring addictive disorders account for 44% of the cigarettes sold in the United States (JAMA 284:2606–2610, 2000). Smokers with mental illness face serious tobacco-related consequences, including increased morbidity and mortality, isolation, stigma, and financial hardship. Tobacco use also increases the metabolism of some antipsychotic and antidepressant medications, with the potential for subtherapeutic treatment and higher rates of rehospitalization. Nearly half of U.S. state psychiatric hospitals now ban tobacco use on their premises. The American Psychiatric Association identifies psychiatric hospitalizations as an ideal opportunity to treat tobacco dependence. Yet little research has examined tobacco cessation treatments in inpatient psychiatry. If tobacco dependence is left unaddressed, most psychiatric patients return to smoking immediately after discharge (American Journal of Addictions 15:15–22, 2006). Multi-component interventions are needed that address the motivational, behavioral, and physiological aspects of nicotine dependence for smokers with co-occurring psychiatric disorders. We briefly describe an innovative tobacco treatment intervention initiated during psychiatric hospitalization. The intervention combines a computer-delivered expert system intervention and manual based on the transtheoretical model, an individual counseling session, and nicotine replacement therapy (NRT). The model identifies five stages of change: precontemplation (no immediate intention to stop smoking), contemplation (intending to quit in the next six months), preparation (considering quitting in the next month with a quit attempt in the past year), action (quit smoking for less than six months), and maintenance (smoke-free for at least six months). The 20-minute computer intervention generates individualized feedback at a sixth-grade reading level to guide participants through the stages of quitting smoking and to direct them to relevant sections of the manual. In a 30-minute session with the participant, study counselors review the printed feedback and manual, identify and support goals concerning tobacco use, and discuss proper use of NRT. Nine hospitalized psychiatric patients representing a range of psychiatric, demographic, and tobacco-use characteristics intensively evaluated the intervention components. Despite having fairly limited computer experience, all agreed or strongly agreed that the program was easy to understand and gave sound advice, and all recommended the computer program to others. Most participants required assistance with program navigation, suggesting the need for more user-friendly capabilities, such as a touch screen and audio. All participants read part of the manual, and most read beyond their stage-of-change chapter. Participants rated the manual highly for its organization and helpful strategies, describing it as “realistic” and “easy to understand … good for any person to read.” Participants also rated the counseling session highly, citing the openness of the dialogue, the focus on their needs and interests, and the lack of pressure to quit: “She didn’t push any points … she just presented the material. She was open, nonjudgmental. … She let me come to my own conclusions that I want to quit.” Most participants used NRT, identified several benefits, and expressed interest in continuing NRT after hospitalization. Side effects also were noted. Of concern, most participants stated that clinical staff did not instruct them in proper use of NRT. This small and intensive evaluation suggests that the intervention provides a viable and acceptable strategy for initiating tobacco treatment in the inpatient psychiatric setting. In a randomized clinical trial, we are evaluating efficacy of the intervention relative to usual care. With a 79% recruitment rate, we enrolled 224 participants. After the brief hospital stay, intervention participants received ten weeks of NRT and two additional computer contacts, and their outpatient providers were informed of their cessation goals. Follow-up continues for 18 months. Psychiatric hospitals are making important strides in banning tobacco use. Bans, however, are only part of a much larger strategy needed to overcome the high rates of tobacco use in populations with mental illness. If cessation services are not offered, patients may misperceive smoking bans as punitive and themselves as unworthy of receiving intervention on this deadly addiction. When smoking was allowed on psychiatric units, an average of 15 minutes was spent per nursing shift managing patients’ cigarette use. Ideally, a portion of the time saved with a no-smoking policy could be shifted to delivery of cessation services. The findings present an innovative, acceptable, multicomponent intervention for initiating tobacco treatment in inpatient psychiatry.

Smoking and alcohol drinking among medical students at the Pontificia Universidad Católica de Chile

Tobacco and alcohol consumption are public health problems, generally starting in adolescence. Medical students are not an exception. To determine the characteristics of tobacco and alcohol use among medical students at the Pontificia Universidad Católica de Chile and their association with gender, career level and mental health. A questionnaire to evaluate substance use was applied along with Goldberg Health Questionnaire (GHQ-12), as a mental health risk predictor, to all medical students in November 2005. The survey was completed by 569 of 775 students (74%). Current smokers were 23- 7%, with the lowest figure, 13-5% in sixth year, and the highest, 40.5% in seventh year (p <0.01). Thirty one percent of students with an score of five and over in the GHQ-12 were smokers, compared to 19% among those with a lower score. Daily smokers were 40%o of the current smokers. Seventy four percent of students consumed alcohol during the last month. No association with sex or GHQ-12 was observed. The lowest alcohol consumption rate was observed in second year, and the highest in sixth year (66%o and 89-2%o, respectively, p <0.01). Fifty three percent of men and 26%o of women drank three or more drinks in any given day (p <0.01). Sixty three percent of men and 81% of women never drank more than five drinks in one day, during the last month (p <0.01). Our medical students smoke less than Chilean youth but more than medical students of countries such as the USA. They drink less than Anglo-Saxon medical students but more than Chilean youth. Male consumption is greater than that of women. Smoking and alcohol drinking are mutually associated.

Consumo de tabaco y alcohol entre los estudiantes de medicina de la Pontificia Universidad Católica de Chile

Tobacco and alcohol consumption are public health problems, generally starting in adolescence. Medical students are not an exception.To determine the characteristics of tobacco and alcohol use among medical students at the Pontificia Universidad Católica de Chile and their association with gender, career level and mental health.A questionnaire to evaluate substance use was applied along with Goldberg Health Questionnaire (GHQ-12), as a mental health risk predictor, to all medical students in November 2005.The survey was completed by 569 of 775 students (74%). Current smokers were 23- 7%, with the lowest figure, 13-5% in sixth year, and the highest, 40.5% in seventh year (p <0.01). Thirty one percent of students with an score of five and over in the GHQ-12 were smokers, compared to 19% among those with a lower score. Daily smokers were 40%o of the current smokers. Seventy four percent of students consumed alcohol during the last month. No association with sex or GHQ-12 was observed. The lowest alcohol consumption rate was observed in second year, and the highest in sixth year (66%o and 89-2%o, respectively, p <0.01). Fifty three percent of men and 26%o of women drank three or more drinks in any given day (p <0.01). Sixty three percent of men and 81% of women never drank more than five drinks in one day, during the last month (p <0.01).Our medical students smoke less than Chilean youth but more than medical students of countries such as the USA. They drink less than Anglo-Saxon medical students but more than Chilean youth. Male consumption is greater than that of women. Smoking and alcohol drinking are mutually associated.