Fagerstrom Score Research Articles

Fagerstrom score predicts smoking status six months after hospitalization for acute myocardial infraction:a prospective study

Abstract Backround Cardiovascular patients who quit smoking reduce their risk for future disease and mortality by 1/3 after 2 years. Despite this, more than half of all cardiac patients continue to smoke after being discharged from the hospital. Fagerstrom score is a validated marker of nicotine addiction in smokers. Purpose The aim of this study is to investigate the predictive value of the Fargestrom score (F.Sc) as a smoking cessation tool in patients with acute myocardial infarction (AMI) at 3 and 6 months after discharge. Methods We investigated a) the predictive value of F.Sc for the smoking status in patients early after AMI and b) the effectiveness of medically assisted smoking cessation programs in the prevention of relapsing to smoking post discharge. In 103 smokers (58±12 years,79.6% males) we assessed F.Sc during hospitalization for AMI. Patients filled a questionnaire during a face-to-face interview were followed-up at 3 and 6 months. The questionnaire was divided into the following sections: demographics, habits related to smoking, knowledge of smoking risks to health and methods to quit smoking. We recorded the type of MI, number and type of diseased coronary vessels, peak cardiac enzymes levels, left ventricular ejection fraction by echocardiography, intervention during hospitalization, previous medical history. The hospital anxiety and depression scale (HADS) were used to assess the patient’s mental health condition. For the evaluation of nicotine addiction, we use F.Sc. Results 59 people were hospitalized for STEMI and 44 for NSTEMI. The peak levels of high-sensitivity (hs)-troponin T during hospitalization were 3843.2 [991.3–9338.8] ng/mL. 100 AMI patients underwent PCI and 3 received thrombolysis. All patients were smoking conventional cigarettes before admission for AMI. 29 (28.2%) οf participants had a previous diagnosis of CAD, 55 (53.4%) had hypertension, 49 (47.6%) had hyperlipidemia. The mean HADS-D value was 7.4 ± 1.6, and only 20/103 (19.41%) participants had HADS-D score equal or greater than 10. 28 patients (27.2%) did not quit smoking throughout the 6 months of follow-up (F.Sc: 8.1±1.6), 39 patients (37.8%) ceased smoking at 3 months but relapsed to smoking at 6 months (score:6.8±2.1) and only 34 (33%) had ceased smoking for 6 consecutive months (F.Sc:5.2±2 P<0.05 for all comparisons between subgroups). Out of 73 patients that abstained from smoking the first 3 months post-AMI, those who participated in a smoking cessation program displayed lower rate of relapsing to smoking compared with those who opted to cease smoking without any support(33.3% vs 61.8% p=0.012). Conclusion Fagerstrom score was found to be a valid quantitative predictor of smoking cessation in the period of 6-months follow-up AMI. Patients who participated in a smoking cessation program displayed lower relapse rates suggesting the effectiveness of these programs for smoking cessation in AMI patients.F.Sc and different smoking behaviorsAssociation of F.Sc with smoking status

Adherence to Annual Lung Cancer Screening in a Centralized Academic Program

BackgroundAdherence to lung cancer screening (LCS) protocols is critical for achieving mortality reductions. However, adherence rates, particularly for recommended annual screening among patients with low-risk findings, are often sub-optimal. We evaluated annual LCS adherence for patients with low-risk findings participating in a centralized screening program at a tertiary academic center. Patients and MethodsWe conducted a retrospective, observational cohort study of a centralized lung cancer screening program launched in July 2018. We performed electronic medical review of 337 patients who underwent low-dose CT (LDCT) screening before February 1, 2021 (to ensure ≥ 15 months follow up) and had a low-risk Lung-RADS score of 1 or 2. Captured data included patient characteristics (smoking history, Fagerstrom score, environmental exposures, lung cancer risk score), LDCT imaging dates, and Lung-RADS results. The primary outcome measure was adherence to annual screening. We used multivariable logistic regression models to identify factors associated with adherence. ResultsOverall, 337 patients had an initial Lung-RADS result of 1 (n = 189) or 2 (n = 148). Among this cohort, 139 (73.5%) of Lung-RADS 1 and 111 (75.0%) of Lung-RADS 2 patients completed the annual repeat LDCT within 15 months, respectively. The only patient characteristic associated with adherence was having Medicaid coverage; compared to having private insurance, Medicaid patients were less adherent (adjusted OR = 0.37, 95% CI = 0.15-0.92). No other patient characteristic was associated with adherence. ConclusionOur centralized screening program achieved a high initial annual adherence rate. Although LCS has first-dollar insurance coverage, other socioeconomic concerns may present barriers to annual screening for Medicaid recipients.

Evaluation of Nicotine Dependence Among Smokeless Tobacco Users Using the Fagerstrom Nicotine Dependence Scale for Smokeless Tobacco.

The primary aim is to assess the nicotine dependence in a group of smokeless tobacco by using a six-questionFagerstrom Test for Nicotine Dependence for Smokeless Tobacco (FTND-ST) and to assess the nicotine dependence among three groups, namely Group - 1, who were exclusively pan masala, gutka chewers, Group - 2, who were exclusively Hans users, and Group - 3, who were exclusively betel quid with smokeless tobacco chewers. Only those who use smokeless tobacco in the age groups between 21 to 70 years were randomly selected. The total sample size is 100 patients. The age groups were divided into 21-28, 29-35, 36-42, 43-49, 50-56, 57-63, and 64-70. Informed consent was obtained from the participants of the study. The Hans chewers are predominantly females. Pan masala and gutka chewers are predominantly males. Smokeless tobacco chewers like pan masalawere found to have high mean nicotine dependence Fagerstrom score than Hans and betel quid with smokeless tobacco chewers.

Impact of health education and cognitive behavioural therapy intervention during tobacco cessation session for smokers: A comparative study in Eastern India.

Background: Tobacco use remains the leading cause of death worldwide. Smoking cessation is the only way to fight the most feared disease in the world. Current evidence-based treatment approaches to smoking cessation include several behavioural treatments and health education-such as cognitive behavioural therapy, and individual and group counseling which tobacco cessation can help control global causes of preventable death. Health professionals play an important role in combating the tobacco epidemic. Materials and methods: All the current smokers who had participated in this study submitted their self-reported case record forms. Baseline data was collected, tobacco history was obtained, the Fagerstrom nicotine dependency questionnaire was administrated and for the quitter, a standardized cotinine test was used. The total number of participants enrolled in this study is 240, but only 190 participants completed the entire program study. Tobacco users who met the inclusion criteria were randomly assigned to three intervention groups: the health education (HE) group, the cognitive behavioural therapy group (CBT), and the combination of health education with the cognitive behavioural therapy (HE+CBT) group. All the participants were visited five times within the six-month duration. Pearson's Chi-square test, paired and unpaired t-tests, Fagerstrom score scale, and Fisher's exact test were used to test the effectiveness of all interventions among the groups. SPSS 22.0, IBM, USA, was used for the analysis of all statistical events. Results: Both groups showed no difference in attempts to quit and had no statistical significance. The reduction in Fagerstrom's score was greater in the HE+CBT group than in the individual CBT and HE groups. Among all the groups, the HE+CBT group shows more effectiveness in cessation therapy than those in the individual groups, which improves the possibility of smoking cessation. Conclusion: In term of tobacco habit reduction, the combination of HE and CBT is more effective than individual therapy for smokers. Further, it can be studied that which kind of barriers are faced by the health professionals during the practice of HE and CBT intervention in their tobacco cessation practices in order to making the sessions clinically effective and educationally more impactful, as well as the heavy tobacco users are can be given immediate attention and prior opportunity for the treatment.

Theta-Burst Stimulation over the pre-Supplementary Motor Area in Schizophrenia and comorbid substance use disorder: Preliminary clinical data

Schizophrenia (SZ) is a debilitating disorder, which tremendously impacts the psychological, social, and financial aspects of a patient’s life. Frequently, SZ patients present with poor insight, which can even worsen the symptomatology. Antipsychotic medications frequently result in suboptimal outcomes, especially the ones concerning negative and cognitive symptoms. Accordingly, new therapeutic options are warranted. Transcranial Magnetic Stimulation (TMS) has been adopted in SZ with promising results. Continuous Theta burst stimulation (cTBS) is a particular brief and effective form of TMS. It has been successfully applied in patients with poor cognitive control (e.g., gambling disorder patients) targeting the pre-Supplementary Motor Area (pre-SMA). Given that poor cognitive control has been regarded as a core deficit in SZ, 11 patients with SZ were included in this study and treated with cTBS for a total of 10 sessions during a two-week period. Patients were divided into two groups: patients with a diagnosis of SZ in comorbidity with Substance Use Disorder (SZ + SUD) vs SZ. Patients were evaluated before and after treatment, assessing executive functions, awareness, and nicotine craving. Within-group comparisons showed a significant reduction in the Scale to assess Unawareness in Mental Disorders (SUMD) scores (p < 0.05) and in the test of Fagerstrom (to assess nicotine dependence) scores (p < 0.001) before and after treatment in the SZ + SUD group. These results showed the efficacy of cTBS for craving reduction as well as in improving awareness of the illness and of treatment. This can be considered a remarkable result since better insight has been previously associated with an improved quality of life in SZ.

Éducation thérapeutique chez les patients coronariens : impact sur le sevrage tabagique

Aim of the studyTo describe the results of a therapeutic education program (cessation rate and success factors) among smoking coronary patients followed in the smoking cessation clinic at Sahloul University Hospital in Sousse during the period from 2015 to 2020. Patients and methodsA descriptive cross-sectional study was conducted among smokers with coronary artery disease who presented to the smoking cessation clinic at Sahloul University Hospital during the period from 2015 to 2020. The data collection was done by reviewing the records of smokers. We defined cessation as complete and continuous abstinence at 1 week, at 3 months, at 6 months and at 12 months and more. The study of cessation success factors involved subjects whose cessation was maintained for 1 year or more. ResultsAmong 93 patients with coronary artery disease, the prevalences of smoking cessation rates were 54.8% (n = 51), 44.1% (n = 41), 35.5% (n = 33), 31.2% (n = 29), and 24.7% (n = 23) at 1 week, 1 month, 3 months, 6 months, and 12 months respectively.In univariate analysis, the number of visits greater than or equal to three (p = 0.000) and nicotine treatment (p = 0.018) were significantly associated with successful smoking cessation at 12 months. In multivariate analysis, being non-active (p = 0.028) with a Fagerstrom score <7 (p = 0.040) and three or more visits (p = 0.005) were the independent factors associated with successful smoking cessation at 12 months. ConclusionThe evaluation of the smoking cessation axis of therapeutic education of the coronary patient with tobacco addiction at the Sahloul University Hospital, allowed us to note that the cessation rate is comparable or even higher than that of other studies. However, the rate of maintenance of this cessation at 1 year and more proved to be low despite the strong motivation of the consultants. This observation allows us to better orientate the areas of improvement in the management of our consultants.

Fagerstrom score predicts smoking status six months after hospitalization for acute myocardial infarction: a prospective study

BackgroundFagerstrom score is a validated marker of nicotine addiction in smokers. MethodsIn a prospective study, we investigated a) the predictive value of Fagerstrom score for the smoking status in patients early after acute myocardial infarction (AMI) and b) the effectiveness of medically assisted smoking cessation programs in the prevention of relapsing to smoking post discharge. In 103 smokers (58 ± 12 years, 79.6% males), we assessed Fagerstrom score during hospitalization for AMI. Patients filled a dedicated questionnaire including data on family, marital and educational status, habits related to smoking and were followed-up at 3 and 6 months after discharge. ResultsTwenty-eight patients (27.2%) did not quit smoking throughout the 6-months follow-up period (Fagerstrom score:8.1 ± 1.6), 39 patients (37.8%) ceased smoking at 3 months but relapsed to smoking at 6 months (score:6.8 ± 2.1), and only 34 patients (33%) had ceased smoking for 6 consecutive months (score:5.2 ± 2 p < 0.05 for all comparisons between subgroups). By multivariate analysis, Fagerstrom score remained a significant predictor of smoking cessation at 6 months (OR: 0.72, 95%CI: 0.60--0.86, p < 0.001). Out of 73 patients who abstained from smoking for the first 3 months post-AMI, those who participated in a smoking cessation program displayed lower rate of relapsing to smoking compared with those who opted to cease smoking without any support (33.3% vs 61.8% p = 0.012). ConclusionFagerstrom score is a useful predictor of smoking cessation 6 months post-AMI. Patients participating in a smoking cessation program display lower relapse rates post-discharge suggesting the need of well-organized smoking cessation clinics for secondary prevention of heart disease.

Implementing a Tobacco Cessation Program for Pregnant Women in an Antenatal Care Setting: A Mixed Methods Study

Background: Tobacco use during pregnancy has deleterious effects on the woman and child. Many pregnant women make quit attempts but few are successful. Antenatal Care (ANC) services create an opportunity to identify tobacco users and provide cessation services. The aim of the study was to assess the feasibility of implementing LifeFirst tobacco cessation services for pregnant women attending ANC clinic. Methods: We used mixed methods study design. All pregnant women attending ANC services during one year were screened verbally for tobacco use. Current tobacco users (last 30 days) registered voluntarily for LifeFirst and a detailed first session was conducted. Telephonic follow-up sessions were conducted over six months. An in-depth interview was conducted with the counselor to identify the influencing factors. Results: Of the 1431 pregnant women screened, 41 were current tobacco users (40 used smokeless) and all enrolled for the service. 56% of them were highly dependent (Fagerstrom score) and 35(85%) had never made a quit attempt. At the end of the intervention, 48% were lost to follow-up mostly due to change in contact phone numbers. All the remaining women self-reported that they had stopped using tobacco. ANC clinic setting and a female counsellor were considered as facilitators. Loss to follow-up, non-implementation of guidelines to screen and offer brief advice and the resultant late tobacco use screening acted as barriers. Social myths added to these complications. Conclusion: Integration of tobacco cessation with ANC services is feasible. Creating awareness about ill-effects of tobacco during pregnancy and providing cessation support is required. Integration through trainings will provide additional benefit.

The midterm differential effects of heat-not-burn and conventional cigarettes on coronary flow, vascular function and oxidative stress are independent of nicotine levels

Abstract Introduction Heat-not-burn cigarette (HNBC) constitutes a non-combustible smoke product linked to reduced exposure to carbon monoxide (CO). Methods We compared the effects of HNBC to those of tobacco cigarette (TCig) on endothelial and coronary function as well as on nicotine levels, oxidative stress and platelet activation after 1 month of switching to HNBC. We examined 75 smokers. Of those, 50 were switched to HNBC and 25 continued Tcig for 1 month. At baseline and at 1 month, we assessed a) coronary flow reserve (CFR) by echocardiography b) flow-mediated dilation (FMD) c) Cotinine blood levels, a stable metabolite of nicotine d) malondialdehyde (MDA), a marker of oxidative stress and thromboxane B2 (TXB2), a marker of platelet activation e) the exhaled CO and the number of cigarettes and/or heat stick of HNBC used. Fagerstrom score, a marker of dependence from smoking habit was also calculated. Results Compared to Tcig smoking, switching to HNBC for 1-month improved CO (difference in CO between groups: 10.42 ppm; 95% CI 3.07 to 17.76, p=0.007), FMD (difference in FMD=4.3%; 95% CI: 1.23 to 7.51, p=0.009; and CFR (difference in CFR =0.98; 95% CI: 0.23 to 1.80, p=0.02). MDA and TXB2 concentration significantly decreased in subjects switching to HNBC compared to tobacco smokers (difference MDA=0.38 nmol/L; 95% CI 0.10 to 0.66, p=0.009, 45pg/mL; 95% CI 5.28 to 86.31, p=0.03). None of the aforementioned parameters changed in the control group at 1 month compared to baseline (p&amp;gt;0.05). Cotinine blood levels were similar between the TC cig and HNBC group both at baseline and after one month of use (p&amp;gt;0.05). However, cotinine blood levels at baseline and 1 month correlated with the number cigarettes used at baseline (r=0.45 p=0.04) or the number of heat sticks used at one month (r=0.50, p=0.03) respectively, Baseline Fagerstrom score was also associated with number of heat sticks used at 1 month (r=0.48, p=0.04) and cotinine levels at baseline and at 1 month (p=0.50, p=0.03 and r=0.57, p=0.01 respectively). Conclusions HNBCs exert a less detrimental effect on vascular function platelet activation and oxidative stress than tobacco smoking that is independent of nicotine levels and is linked with the parallel reduction the exhaled of CO. Funding Acknowledgement Type of funding sources: None.

Cardiovascular Autonomic Functions and Its Association with Oxidative Stress Marker in Heavy Smoking and Smokeless Tobacco Users of Low Socioeconomic Status

Background: Tobacco usage is a major preventable cause for cardiovascular morbidity and mortality.Tobacco is used in both smoking and smokeless forms. Alteration in cardiac autonomic function is amajor predisposing factor for cardiovascular risk. There are only limited studies available which assessedautonomic functional status in smokeless tobacco users. This study was aimed to assess and compare thecardiac autonomic activity and oxidative stress in smoking and smokeless tobacco users with controls.Methods: Sixty seven apparently healthy volunteers from the construction workers of low socioeconomicstatus were recruited. Those who are having habit of using tobacco in any form (n=42) were categorizedinto smoking tobacco group (n = 22) based on the smoking index and fagerstrom score for smokelesstobacco group (n = 20). Those who never used tobacco in any form were included as control group (n= 25).Cardiovascular autonomic function tests were performed and serum malondialdehyde was measured fromvenous blood sample.Conclusion: In this study we found that there is definite alteration in cardiac autonomic function which isin correlation with the level of oxidative stress in heavy tobacco users. This alteration is seen more in heavysmokeless tobacco users in compare with smoking tobacco users.

Evaluation of Smoking and Asymptomatic COVID-19 Disease in Health Professionals

Aim: This study was conducted to assess smoking status and COVID-19 clinical severity in health professionals of a pandemic health center. Methods: A retrospective study design based on data reports of a tertiary hospital between March 2020 and June 2020 was realized. A comparison between the clinical disease severity and smoking status was analyzed by the SPSS 22.0 software statistic program at a significance level of p &lt;0.05 value. Results: 150 participants (age 31.19±8.92 years; 48% female) were evaluated for the COVID disease clinical severity between the smokers (10.6%; 16/150) and non-smokers. The presence of asymptomatic (carriers) clinical disease (24%; 36/150) was found to be statistically significant in favor of smokers (8/16) versus non-smokers (28/134). Nicotine dependence level and Fagerstrom score had no clinical difference. Also, the occupation was significant for disease severity. Smokers among permanent workers with COVID versus doctors and nurses had a higher percentage in belong to the asymptomatic clinic (26/36) despite the higher rate of smoking (11/16). Conclusion: It was emphasized that higher rates of asymptomatic disease among smokers than that of symptomatic disease. Our study might contribute to epidemic control efforts that would help to explain the asymptomatic clinic and the different rates between smokers and non-smokers. Keywords: COVID-19, medical staff, nicotine dependence, smoking

Ketergantungan merokok dan hubungannya dengan tingkat motivasi berhenti merokok pada sivitas akademika Universitas Riau

One of the success factors in quitting smoking is motivation. while smoking dependence makes quitting smoking more difficult. The purpose of this study was to determine whether smoking dependence was related to the motivation to quit smoking. A survey was conducted on 137 Riau University academicians who had or wre currently smokers. Samples were taken using side voluntaries. The smoking dependence questionnaire used the Fagerstrom Test for Cigarettes Dependence (FTCD) and the motivation to quit smoking from the Center for Tobacco Independence which was distributed online. The relationship between fagerstrom score and motivation to quit smoking was tested by means of the spearmen correlation test. research showed that most respondents were at a low level of smoking dependence with level 8 motivation (ready to quit smoking). There was a significant relationship in the opposite direction between smoking dependence and motivation to quit smoking

Smoking characteristics and lung functions among university athletes

Cigarette smoking has negative effects on the respiratory system, particularly pulmonary functions. This study aimed to determine smoking prevalence and characteristics among university athletes. We conducted a cross-sectional study of Thammasat University athletes in Thailand from July to October 2018. Demographic and smoking data were recorded. Exhaled carbon monoxide (CO) levels and lung function data were analysed. A total of 433 subjects (56% men) were included. Mean age was 19.8 ± 1.3 years. Asthma was reported in 5.5%. The prevalence of current cigarette smoking was 23.8%. Tobacco use was 3.0 ± 3.2 cigarettes per day. The Fagerstrom score for nicotine dependence was 0.76 ± 1.47. Compared to non-smokers, smokers were predominately males (70.6% vs 29.4%, P < 0.001), had higher exhaled CO levels (3.75 ± 3.08 ppm vs 2.18 ± 0.73 ppm, P < 0.001), higher FVC (89.65 ± 17.61% vs 83.22 ± 15.72%, P = 0.001), higher FEV1 (92.60 ± 15.36% vs 87.77 ± 11.23%, P = 0.002), but lower FEV1/FVC (78.21 ± 5.38% vs 79.70 ± 5.60%, P = 0.015). Moreover, athletes who smoke, were more likely to: drink alcohol, have a family member who smokes, have a friend who smokes or have a university instructor who smokes. In conclusion, smoking prevalence among university athletes was relatively high, although low nicotine addiction level and good lung functions were found. Home and institute environments had important influences on cigarette use in students.Trial registration: TCTR20180917001

The prevalence of smoking among secondary school students in Baghdad and application of Fagerstrom score for nicotine addiction

The prevalence of smoking among secondary school students in Baghdad and application of Fagerstrom score for nicotine addiction

Effectiveness of cognitive behavioral therapy and basic health education for tobacco cessation among adult tobacco users attending a private tobacco cessation center.

Background:India being major consumer of tobacco faces various problems involved for its cessation. Over the time enormous methods have been evolved which may aid in tobacco cessation.Materials and Methods:The present study was conducted among 100 adult tobacco users attending tobacco cessation clinic. The individuals where randomized into 2 counselling groups: Group A - Basic health education (BHE) and Group B Cognitive Behavioral Therapy (CBT). Baseline evaluation of demographic parameters, smoking/smokeless behavior was recorded and Fagerstrom's test for Nicotine Dependence (FTND) was utilized to assess subjects’ nicotine addiction levels. Follow up was done at intervals of 2 weeks and 4 weeks to assess the reduction in the mean FTND score. Appropriate statistical test was utilized to evaluate the results.Results:The majority of individuals in the study were male in age group of 41-60 years. The reduction in mean FTND score was found in both Group A and B on follow-up. But when both groups were compared, reductions in mean Fagerstrom scores were found to be more in CBT group than in BHE group at all time intervals.Conclusion:Individuals in both the group have quit the tobacco use by both the interventions followed by proper schematic follow up.

Demographic characteristics, clinical presentation, risk factors and pathological types of lung cancer: A prospective study

Background: Sparse published data are available regarding the epidemiology of lung cancer from Rayalaseema area of Andhra Pradesh State. Methods: Consecutive patients (n = 133) diagnosed to have and treated for lung cancer in medicine and medical oncology departments at our tertiary care teaching hospital in Tirupati, South India from March 2017 to June 2018, were prospectively studied. In all patients, risk factors, clinical manifestations, method of confirmation of diagnosis and histopathological and cytopathological types were documented. Results: Their mean age was 56.4 ± 11.2 years; there were 93 (70%) males. No risk factors were evident in 110 (83%) patients. Tobacco smoking (n = 69, 52%) (all males) was the most frequently evident risk factor; other risk factors included exposure to arsenic, silicone, passive smoking, environmental exposure, old pulmonary tuberculosis. Their mean Fagerstrom score for nicotine dependence was 8.2 ± 1.7. In 17% of patients, lung cancer was incidentally detected; the remaining 83% were symptomatic. Chief presenting complaints were cough (59%), dyspnoea (50%), haemoptysis (11%), amongst others. Cytopathological and histopathological diagnosis was done in 3% and 97%, respectively. Majority (n = 123, 92%) had non-small cell lung cancer (NSCLC) (60% adenocarcinoma and 17% squamous cell carcinoma), while small cell lung cancer was evident in 10 (8%). Most of them (52%) had presented in stage 4. Conclusions: Our observations suggest that tobacco smoking still remains the most common risk factor for lung cancer; majority of the patients had NSCLC, and most patients presented late with stage 4 disease.

Association between post-cessation weight gain and eating behavior changes.

OBJECTIVE:Fear of post-cessation weight gain may be a barrier to cessation therapy or may lead to smoking relapse. This study aimed to evaluate the relationship between the change in eating behavior and post-cessation weight gain.METHODS:A prospective study that included 103 cigarette smokers, who visited the family medicine clinics of a training and research hospital for smoking cessation treatment between June 2018 and December 2018, was planned. A face to face survey (including Turkish version of Dutch Eating Behaviour Questionnaire-DEBQ and weight measures) was applied to all individuals at first and the final visits for the assessment of restrained, emotional, and external eating behaviors. Statistical analyses were completed using the IBM SPSS Statistics 22 program.RESULTS:Of 103 patients screened (M age=38.3 years SD=9.28), 58.3% were male, and 40.8% were in heavy nicotine dependence level (NDL) group. The mean weight increased by 4.74±2.63 kg in three months of smoking cessation. In the high NDL group, three subscales score (restrained p<0.001, emotional p=0.007, external p=0.005) of the DEBQ increased. Weight gain was significative associated with NDL (p=0.01). There was a positive correlation between Fagerstrom score and weight (kg) gain (r: 0.34; p=0.001). Weight change according to the emotional eating behavior was significantly different by gender (female p=0.005; male p=0.04). Women had a higher difference in emotional eating behavior score than men. Obese smokers had a higher initial restrained eating score than non-obese smokers (p=0.009). Weight gain of nicotine replacement therapy group had a similar result in the pharmacotherapy (varenicline) group (p=0.26). Both of treatment types concluded with a significant weight change (p=0.001).CONCLUSION:This study obtained that post-cessation weight gain is related to high nicotine dependence, and quit smoking causes increased scores of emotional, restrained, external eating behavior subscales. Post-cessation eating behavior is negatively affected by quit smoking.

Dose Response and Prediction Characteristics of a Methylation Sensitive Digital PCR Assay for Cigarette Consumption in Adults.

The tobacco use disorders are the largest preventable cause of morbidity and mortality in the world. A substantial barrier to the development of better intervention and screening measures is the lack of clinically employable biomarkers to detect the existence and extent of tobacco consumption. In prior work, we and others have shown that array based assessment of DNA methylation status at cg05575921 is a sensitive and quantitative method for assessing cigarette consumption. Unfortunately, in general, arrays are not practical clinical tools. Herein, we detail the prediction performance metrics and dose dependency of a clinically implementable droplet digital PCR (ddPCR) assay for cigarette consumption in adults. First, we demonstrate that measurements of cg05575921 as determined by Illumina array and ddPCR are highly correlated (R2 = 0.98, n = 92). Second, using clinical data and biomaterial from 177 subjects ranging from 18 to 78 years of age, we show that the Receiver Operating Characteristic (ROC) area under the curve (AUC) for classifying smoking status using methylation status at cg05575921 is 0.99. Finally, we conduct modeling analyses of cigarette consumption over discrete time periods to show that methylation status is best correlated with mean cigarette consumption over the past year (R2 = 0.5) and that demethylation at cg05575921 is dose dependent with a demethylation (delta beta) of 1% being equivalent to 1.2 cigarettes per day. But we do not find a relationship between Fagerstrom score and DNA methylation. We conclude that ddPCR assessment of cg05575921 methylation is an accurate method for assessing the presence and extent of cigarette consumption in adult subjects. We suggest that skillful clinical implementation of this approach alone or in combination with other assessment methods could lead to substantial reduction of cigarette consumption related morbidity and mortality.

Tobacco Smoking and Brain Endogenous Opioid Release: More Than Nicotine Alone.

The effects of smoking denicotinized (denic) and average nicotine (avnic) tobacco cigarettes were studied on brain mu opioid receptor binding by positron emission tomography with 11C carfentanil. The results indicated the importance of physiological and psychological effects induced by denic smoking. Regional mu opioid binding potential (nondisplaceable binding potential, BPND) was measured in 20 adult male overnight abstinent chronic tobacco smokers. The denic sessions were conducted about 8:00 am followed by avnic sessions about 2 hours later. Venous plasma nicotine levels and scores of craving to smoke were assessed before and after each smoking session. Fagerstrom scores of nicotine dependence were determined. Pearson's and Spearman's correlation tests were used to examine associations between BPND and other smoking parameters. Surprisingly, the very low plasma nicotine peak levels after denic smoking (mean ± SD: 3.3 ± 1.8 ng/mL) were significantly correlated with BPND after denic and avnic smoking. Equally surprising no association was found between nicotine levels after avnic smoking and BPND. Delta craving scores and Fagerstrom scores were correlated with both BPND after denic and avnic in several brain regions. Very small amounts of nicotine, psychological and behavioral effects of denic smoking appear to have important actions on the endogenous mu opioid system. Associations between very low venous plasma nicotine levels after denic smoking and regional brain mu opioid receptor availability are a surprising "placebo" effect. Delta craving and Fagerstrom scores were correlated with BPND in several brain regions including amygdala, hippocampus, insula, nucleus accumbens, putamen, and ventral striatum. This study is limited by modest Power (mean 1 - β = 0.6) for all correlation analyses.

Evaluation of pharmacologic therapies accompanied by behavioural therapy on smoking cessation success: a prospective cohort study in Turkey

ABSTRACTOBJECTIVE: The main objective of this study is to compare the rate of smoking cessation in the first month, third month, sixth month, first-year, and second year among those who quit smoking following different pharmacological and behavioural therapies administered at the Selcuk University’s Smoking Cessation Clinic in Turkey.METHODS: In this study, 3322 people who presented to the clinic in order to quit smoking were advised one of the most suitable medical treatments (varenicline, bupropion, NRT) accompanied by behaviour therapy after their health queries and examinations were made and Fagerstrom scores were evaluated. Smoking cessation patients were followed up clinically and by making calls after smoking cessation.RESULTS: The smoking cessation success rate in the cases using varenicline in the first month was 63.5% (766/1206), in the third month 46.8% (548/1170), in the sixth month 32.1% (386/1201), first year 25.6% (298/1163), and 19.9% (211/1059) in the second year. The success rate in the ...