Fagerström Test For Nicotine Dependence Research Articles

Relationship between "nomophobia" and material addiction "cigarette" and factors affecting them.

Since technological devices used for communication affect communication between people, nomophobia is a disorder of a new age. In this study, we discuss the relationship between nomophobia and smoking addiction and the factors affecting them. The Demographic Information Form and Nomophobia Scale (NMP-Q), ıf they were smoking we applied The Fagerström Test for Nicotine Dependence (FTND) Scales were directed among students (n=641) at Süleyman Demirel University studying Medicine, Dental, Nursing and Physiotherapy departments in the 1st and 4th grades. Mann-Whitney U, Kruskal-Wallis test to compare the scores of the variables with more groups. Correlation analysis was performed between the NMP-Q and Fagerström Test for Nicotine Dependence Scale scores by Spearman correlation. Bonferroni test applied as Post Hoc test for multiple comparisons of groups. In our study, 267 (42.6%) of participants who had nomophobia refuse to be dependent and smartphone addiction level was found to be 99.69 for all students. Responses were received from 73.2% (n=469) female and 26.8% (n=172) male participants. There is no significant difference between smokers in terms of factors in nomophobia (P>.05). The total score of the questionnaire (P<.01*) by gender and averages scores of women were higher in all mentioned sub-dimensions and total scores. In our study, there was no correlation between nomophobia and cigarette addiction because of the low number of smokers participating in our survey. Therefore, new conflicts with wider audiences are needed to examine the relationship between these two addictions.

Relationship Between Nicotine Dependence Scores and Nicotine, Cotinine, 3′-Hydroxycotinine and Nicotine Metabolite Ratio in Chinese Male Smokers

Summary Smoking is mainly sustained by nicotine dependence (ND), which varies across ethnic groups principally due to genetic as well as environmental factors. The Fagerström Test for Nicotine Dependence (FTND) and biomarkers of tobacco exposure are two important approaches to assess ND. However, the relationship between ND and FTND of Chinese smokers has not been studied. The aim of this study was to assess the relationship between FTND scores and nicotine, cotinine, 3′-hydroxycotinine (3HC) and nicotine metabolite ratio (NMR, the concentration ratio of 3HC to cotinine) in Chinese smokers. FTND was carried out and general characteristics were collected using a self-administered smoking questionnaire with 289 smokers. Nicotine, cotinine and 3HC in urine were simultaneously determined by liquid chromatography–mass spectrometry/mass spectrometry (LC-MS/MS). The concentrations of nicotine, cotinine and 3HC in the urine of smokers with a high FTND score were higher than in the urine of those with a low FTND score. There were significant correlations between urinary biomarker and FTND scores. Except for FTND item 2 (difficulty to refrain), the other items showed significant associations with the urinary biomarkers. No relationship was found between the nicotine metabolite ratio (NMR, 3′-hydroxycotinine/cotinine) and FTND scores or general characteristics of the participants. In conclusion, biomarkers of tobacco exposure levels are significantly associated with FTND scores. However, FTND Item 2 and NMR were not found to be associated with nicotine dependence in Chinese smokers.

Nicotine Dependence Severity and Revised Reinforcement Sensitivity Theory: Assessing the Mediating Role of Risky Decision Making Using Path Analysis

Background: Gray’s revised Reinforcement Sensitivity Theory (r-RST) is a neuropsychological explanation of personality that has been broadly used in substance use disorders. Although the Behavioral Approach System (BAS) is strongly related to nicotine dependence, findings in Behavioral Inhibition System (BIS) are controversial and there is little information about the role of the Fight/Flight/Freeze System (FFFS) in nicotine dependence. The purpose of the present study was to evaluate the mediating role of Risky Decision Making (RDM) in this relationship to clarify the controversy and fill the gap. Methods: The final sample of this correlation study comprised of 347 university students (age, Mean±SD 23.2±6.7) who completed two self-report measures, including the Fagerstrom Test For Nicotine Dependence (FTND), Jackson-5 questionnaire of r-RST, and a computerized Iowa Gambling Task (IGT) to measure RDM. Pearson correlation and a path analysis framework were used to determine the simple, direct, and indirect effects of r-RST systems on nicotine dependence severity through RDM. Results: Using Amos, path analyses demonstrated significant direct and indirect effects of BAS and FFFS/BIS on tobacco use. Also, the relationship between BAS/FFFS/BIS and tobacco use was shown to be mediated by RDM. Conclusion: It was demonstrated that the relationship among BAS /FFFS/BIS and tobacco use can be partly explained using maladaptive RDM strategies, suggesting that decreasing reliance on decision-making in risky situations, while increasing the use of decision-making skills educations in risky situations, and increasing the use of alternative sensation and fun seeking by smoking and emotion regulation and mindfulness-based therapies

Expanding the genetic architecture of nicotine dependence and its shared genetics with multiple traits

Cigarette smoking is the leading cause of preventable morbidity and mortality. Genetic variation contributes to initiation, regular smoking, nicotine dependence, and cessation. We present a Fagerström Test for Nicotine Dependence (FTND)-based genome-wide association study in 58,000 European or African ancestry smokers. We observe five genome-wide significant loci, including previously unreported loci MAGI2/GNAI1 (rs2714700) and TENM2 (rs1862416), and extend loci reported for other smoking traits to nicotine dependence. Using the heaviness of smoking index from UK Biobank (N = 33,791), rs2714700 is consistently associated; rs1862416 is not associated, likely reflecting nicotine dependence features not captured by the heaviness of smoking index. Both variants influence nearby gene expression (rs2714700/MAGI2-AS3 in hippocampus; rs1862416/TENM2 in lung), and expression of genes spanning nicotine dependence-associated variants is enriched in cerebellum. Nicotine dependence (SNP-based heritability = 8.6%) is genetically correlated with 18 other smoking traits (rg = 0.40–1.09) and co-morbidities. Our results highlight nicotine dependence-specific loci, emphasizing the FTND as a composite phenotype that expands genetic knowledge of smoking.

Effect of smoking cessation with varenicline on blood pressure control in hypertensive patients

Abstract Purpose The interaction between smoking and blood pressure (BP) is complex. Despite the strong association between cigarette smoking and cardiovascular disease (CVD) risk, there is paucity about the effect of pharmacotherapies for treating tobacco dependence on BP in already established arterial hypertension. Varenicline has been shown to be an effective and well-tolerated pharmaceutical intervention for smoking cessation. Aim of the study was to investigate the improvement in BP control in smokers with a diagnosis of hypertension who quit or reduced substantially their tobacco consumption by using varenicline and the association of nicotine dependence with BP changes. Methods A total of 89 (mean age:48±7, 52 males) regular smokers (28±9 pack-years) with a diagnosis of hypertension and on anti-hypertensive drugs were studied. All patients received low-intensity counseling and pharmacotherapy with varenicline (1 mg twice daily) for 12 weeks. Point prevalence smoking abstinence was defined by self-report of complete abstinence in the 7 days before the 12 week clinic visit (end of therapy). Office BP was measured at baseline and each follow-up visit (4 and 12 weeks) office BP. The Fagerström Test for Nicotine Dependence (FTND) was used for assessing nicotine dependence. High nicotine dependence (ND) was defined as a FTND score ≥6. Results At 12 weeks, 60 (67%) patients were abstinent from smoking and 14 (16%) were non-abstainers who reduced daily consumption to 50% of baseline. The mean time interval between the initiation of treatment with varenicline and smoking abstinence was 1.8±0.6 weeks. There were not significant differences in age, baseline BP level, severity of nicotine dependence and total cigarette consumption (pack-years) between the two groups. Systolic BP (SBP) and diastolic BP (DBP) decreased significantly in abstainers (by 7.2 and 5.5 mmHg at 12 weeks, P&amp;lt;0.01 and P&amp;lt;0.05, respectively) while the decrease in BP level in non-abstainers was minimal. Among patients with sustained tobacco abstinence, 18 were highly ND and 42 had mild and moderate ND. The two ND groups had similar age and BP levels at baseline. Changes in SBP and DBP from baseline in smokers with arterial hypertension between the two ND groups are illustrated in Figure. The observed reductions in SBP and DBP were significant (P&amp;lt;0.05, both for SBP and DBP) when comparing the high ND group to the mild/moderate ND group at 12 weeks. No severe adverse reactions were reported with varenicline use throughout the entire follow-up duration. Conclusion Varenicline may help smokers with arterial hypertension under antihypertensive therapy to remain abstinent from tobacco cigarette smoking. A novel and important message of this study is also the substantial improvements in office SBP and DBP in highly nicotine dependent sustained tobacco abstainers. ND-BP changes after varenicline therapy Funding Acknowledgement Type of funding source: None

Nicotine Dependence in Dual Users of Cigarettes and E-Cigarettes: Common and Distinct Elements.

In a sample of dual users of cigarettes and electronic nicotine delivery systems (ENDS; e-cigarettes), we evaluated psychometric properties of ENDS versions of the Nicotine Dependence Syndrome Scale (NDSS), the brief Wisconsin Inventory of Smoking Dependence Motives (WISDM), and the Fagerström Test for Nicotine Dependence (FTND). Using the NDSS, we tested the hypothesis that there would be one common underlying factor of dependence across the cigarette and ENDS scales and other product-specific factors. Adult dual users (N = 404) completed baseline cigarette and ENDS versions of the NDSS, WISDM, and FTND, and biweekly surveys of their smoking and vaping. Analyses included bifactor modeling, which helps to identify both a general and product-specific factor for each item, and exploratory factor analyses of the combined cigarette and ENDS NDSS items and examinations of concurrent and predictive validity. The bifactor model was not a good fit, suggesting the lack of one common underlying dependence factor. Factor analyses revealed separate, similar factors for both products, with only one factor (priority) showing overlap of cigarette and ENDS items. ENDS scales significantly predicted ENDS use over time, but not cigarette use. Cigarette scales did not predict ENDS use over time. Although the cigarette and ENDS NDSS versions showed similar factor structure, there was not a primary common underlying factor reflecting drive or tolerance, but rather product-specific factors. The cigarette scales were not valid for predicting ENDS use. These results highlight the importance of separately assessing dependence for cigarettes and ENDS in dual users. Although underlying dimensions of nicotine dependence may be similar for ENDS and cigarettes, separate, product-specific measures may be needed to understand differences in product-specific dependency and predict changes in use of each product over time.

INTEGRATING TOBACCO HEALTH INTO MAINSTREAM PULMONARY CLINIC: A NOVEL APPROACH

SESSION TITLE: Tobacco Cessation and Prevention Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Tobacco related health conditions account for a large cohort of chronic health conditions. Tobacco/Nicotine users are currently stigmatized and hence find it difficult to seek treatment. Our institution has an electronic best practice advisory which automatically populates in all smokers identified in the electronic medical record and generates a referral to the QUIT line if patient is interested in quitting. However only 25% of these patients actually engage with the QUIT line. The Tobacco Health Assessment and Treatment (THAT) Clinic is a new initiative to integrate tobacco health into mainstream pulmonary health, 1:1 patient provider interaction, engaging patients who are interested in quitting and destigmatizing tobacco treatment. METHODS: There is 1: 1 pulmonologist, tobacco nurse and patient interaction. Patients evaluated for overall tobacco health: history and physical, the Fagerström Test for Nicotine Dependence(FTND), Framingham Risk Score, prior quit attempts, obstacles, environmental triggers and severity of tobacco dependence based on the ACCP Tobacco toolkit. PFT's ordered when appropriate.The toxic effects of tobacco, nature of the addiction, nicotine hijacking the survival instincts , countering ambivalence and helping patients bring the tobacco treatment and medication interactions with proposed tobacco treatment are discussed. Patients who are newly diagnosed with COPD , ILD, asthma, other pulmonary conditions are triaged appropriately to respective clinics. A comprehensive medication review, potential medication interactions with proposed tobacco treatment and potential side effects are discussed before offering therapy. The patients who qualify for lung cancer screening are referred to low-dose CT screening for lung cancer. RESULTS: 60 pts 70%-1 visit, 27% >2 visits. Mean age 58.5 yrs, 53% women & 82% African-American.(46%) high nicotine dependence using FTND, 80% multiple quit attempts . Common triggers :stress, depression, anxiety, proximity to smokers, boredom, staying home & coffee. Comorbidities - hypertension (63%), COPD (47%), and (18%) cancer. 20/60 patients -LDCT lung cancer screening. Median Maryland area deprivation index:9 (10- worst). 40/60 active follow up , 8 quit,12 trying to quit, 20 lost to follow up. All had follow-up outreach,-total of 640 encounters of which 81% tobacco health check-in .Common combinations-nicotine patch & lozenge/gum/inhaler; Chantix & lozenge/gum/inhaler; Chantix with nicotine patch & lozenge/gum/inhaler; or Wellbutrin with nicotine patch & lozenge/gum/inhaler.Compliance with controller& rescue medications, associated with higher quit / trying to quit rates. CONCLUSIONS: 30% patients have quit/cut down- higher success rate than many other initiatives. CLINICAL IMPLICATIONS: Integrating tobacco as mainstream pulmonary health condition & treating it as one. DISCLOSURES: No relevant relationships by Janaki Deepak, source=Web Response No relevant relationships by Julia Melamed, source=Web Response

Poor Quality of Sleep Among HIV-Positive Persons in Ethiopia.

BackgroundIn comparison to the general population, persons living with HIV show a higher prevalence of poor quality of sleep, with estimates from 24.1–100% vs in the normal population 10–40%. There are not enough data on the poor quality of sleep among HIV-infected persons in Ethiopia.MethodsHospital-based cross-sectional study design was conducted among 336 HIV-infected persons in Mettu Karl Referral Hospital. Pittsburgh sleep quality index (PSQI), social phobia inventory (SPIN), changes in sexual functioning questionnaire short-form (CSFQ-14), Fagerstrom test for nicotine dependence (FTND), severity of dependence scale (SDS), and CAGE questionnaire (cut down, annoyed, guilty, eye opener) was used. Data were analyzed by SPSS 20 version. Bivariate and multivariable regressions were computed, and a significance level was declared at a point P-value of <0.05.ResultsA total of 336 respondents completed all questionnaires with response rate 98.53%. A total of 192 participants (57.1%) had poor sleep quality. Concerning associated factors; positive for social phobia, sexual dysfunction, living alone, poor antiretroviral (ARV) treatment adherence, and drunken alcohol had a positive association with poor sleep quality.ConclusionOf the persons living with HIV (PLWH) in Mettu Karl Referral Hospital, 57.1% experienced poor sleep quality. Social phobia, living arrangement, sexual dysfunction, poor ARV treatment adherence, and use of alcohol showed a significant association with poor quality of sleep. The findings suggest that a longitudinal study will be needed to elucidate the causal relationship of variables, and routine screening of poor sleep quality among PLWH is highly recommended. Furthermore, integrating and launching mental health services at ART clinic is greatly important.

The Effect of Individual and Group Education Done by Nurses on Smoking Dependency and Smoking Cessation Motivation in Patients with Coronary Artery Disease.

BackgroundThis study was carried out to reveal the effect of individual and group education done by a nurse on smoking dependency and smoking cessation motivation in patients with coronary artery disease (CAD).MethodsThe present randomized controlled trial study was conducted in Iran. A total of 255 patients were randomly divided into three groups: 1) individual education, 2) group education, and 3) control. Data were collected using the Fagerstrom Test of Nicotine Dependence (FTND) and Smoking Cessation Motivation Questionnaire (Q-MAT) one time before the intervention and two times after intervention (1st and 3rd months).FindingsThe mean scores of motivation for smoking cessation and smoking dependency in patients in the individual and group education were significantly better than the control group after the intervention (1st and 3rd months) (P < 0.05). Although there was no significant difference in the mean scores of smoking cessation motivation and smoking dependency in patients in the individual education and group education groups after education, the status of the patients in the group education was slightly better.ConclusionEducation by nurses might have a significant impact on smoking cessation motivation and smoking dependency in patients with CAD. Further studies are recommended.

KOAH Hastalarında Sigara Bağımlılık Düzeyinin Hastaların Kaygı Düzeylerine Etkisi

Aim: COPD is a significant public health problem that also affects the mental aspect. In this study we aimed to show the effects of smoking on anxiety in COPD patients by measuring anxiety levels. Materials and Methods: Our study was conducted in outpatient clinics of Family Medicine Department and Chest Diseases Department at Ankara Training and Research Hospital between March-June 2016. 147 individuals with COPD were included in the study. Demographic questions, ‘‘State- Trait Anxiety Inventory’’ and pulmonary function test were applied to all patients while ‘‘Fagerstrom Test for Nicotine Dependence’’ was only for the current smokers. The data were analyzed using SPSS statistical software version 16.0. Results: 147 COPD patients in the age range of 35-80 years including 56 females (%38,1) and 91 males (%61,9) were enrolled in the study. State- Trait Anxiety Inventory was applied to all patients. Current smokers with a number of 86 (%58,5) also performed Fagerstrom Test for Nicotine Dependence. The average anxiety scores of COPD patients were higher than the normal values. COPD severity, presence of comorbid chronic illness and age were significantly correlated with anxiety levels of the patients. Increasing severity of COPD, the presence of comorbid chronic illness and higher ages increased the levels of anxiety in COPD patients. Conclusion: Anxiety levels are increased in patients with COPD. Family physicians who see the patients first and most frequent should also evaluate the COPD patients psychologically and should lead them to a psychiatrist if necessary. Besides all COPD patients should be encouraged to quit smoking independently of anxiety levels.

The Chinese version of obsessive compulsive drug use scale: validation in outpatient methadone maintenance treatment program

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

Association between Tobacco Dependence and Tooth Loss among Patient Visiting Private Dental College And Hospital-A Cross-Sectional Study

Oral health contributes to personal wellbeing and quality of life. Use of tobacco in smoke or smokeless form is one of the driving reasons for global mortality. Also, it plays a major role in causing morbidity of major non- communicable diseases, including tooth morbidity in the form of periodontitis and tooth mortality. Therefore, the aim of the study is to find out the prevalence and association of nicotine dependence and tooth loss. A retrospective study was done using the case records of outpatients attending a private Dental College and Hospital. One month case records with a total of 100 case sheets of current smoker males were retrieved. Case sheets which recorded nicotine dependence using the Fagerstrom Test for Nicotine Dependence (FTND) and the number of tooth loss were used for data analysis. Descriptive and chi-square association were the statistical tests done. Patients of age more than 45 (27%) have a lesser dependency for the tobacco of 22.2% when compared to 15 to 30 years (39%) have tobacco dependency of 50%. In between lies the age group of 30-35 years (34%) had tobacco dependency of (27.7%), and there was no statistically significant association between level of nicotine dependency and tooth loss (P&amp;gt;0.05). Patients with high nicotine dependency of age 15-30 years had minimum tooth loss than patients of age more than 45years with a low level of nicotine dependency.

Anxiety in social interactions and nicotine dependence in nicotine-dependent men: The role of metacognitions about smoking

Anxiety in social interactions is an important factor in cigarette use and nicotine dependence. Metacognitions about smoking have been found to predict smoking behavior and may help understand the relationship between anxiety in social interactions and nicotine dependence. In the current study, we evaluated the direct effect of anxiety in social interactions on nicotine dependence and its indirect effect through metacognitions (controlling for anhedonia and depression) in nicotine-dependent men (n = 388). Participants completed measures of anxiety in social interactions [the Social Interaction Anxiety Scale (SIAS)], anhedonia [the Snaith HamiltonPleasure Scale (SHAPS)], metacognitions about smoking [e.g., theMetacognitions aboutSmoking Questionnaire (MSQ)] nicotine dependence [the Fagerström Test for Nicotine Dependence (FTND)], and clinical factors related to smoking including depressive symptoms [e.g., the Beck Depression Inventory-II (BDI-II)]. As expected, after controlling for depressive symptoms and anhedonia, anxiety in social interactions indirectly affected nicotine dependence through negative metacognitions about smoking, but not positive metacognitions. These findings are discussed in relation to the metacognitive model of addictive behaviors.

Selective Influence of Smoking on Periodontal Treatment Outcomes after 3 Years of Follow-up.

The impact of smoking habits on periodontal treatment has not been clearly elucidated. This study aimed to specify the effects of cigarette consumption and nicotine addiction on periodontal therapy. In this retrospective case-control study, 20 moderate smokers and 20 non-smokers with severe periodontitis were examined after initial diagnosis, and non-surgical active and supportive therapies for 1-6 years (mean follow-up = 3.37 years). Fagerström's test of nicotine dependence (FTND) was evaluated at re-examination. Treatment efficacy was assessed by periodontal pocket probing depth (PPD) changes and number of teeth lost per year (TL). Bayesian multilevel and regression analyses were performed at site, tooth, and patient levels. During the mean follow-up period of > 3 years including active and supportive periodontal therapies, mean PPD, PPD > 3 mm and PPD > 7 mm percentage reductions were 1.03, 1.48 and 2.57 times statistically significantly less pronounced, respectively, in smokers than in non-smokers. Multilevel analysis showed that the variability of PPD > 7 mm reduction was mainly associated with patient-level factors. Smokers presented a higher risk for periodontitis progression. In smokers, periodontal parameter improvement was less pronounced in the maxilla and molars. The mean TL was related to the FTND score, not to cigarette consumption. Regression analysis did not demonstrate other influences of demographic and periodontal treatment characteristics on treatment outcomes, except patient age. Smoking negatively impacted periodontal treatment outcomes at specific tooth sites (deep pockets, maxillary molars) and periodontitis progression, independent of other risk factors.

Preparing for the Quit Day: Comparing Beliefs of Nondaily Versus Daily Young Adult Smokers as They Prepare for a Quit Attempt.

Most smoking cessation approaches are modeled on heavy daily smoking. With increasing prevalence of nondaily smoking, it may be necessary to modify these approaches for nondaily smokers. To provide information about beliefs and attitudes relevant to smoking cessation for nondaily smokers. Secondary analysis of two prospective studies on young adult smokers (18-24 years of age) provided brief advice to quit smoking. Measures include baseline levels of constructs relevant to smoking cessation counseling and perceived benefits of and barriers to smoking cessation. Participants (n = 40 nondaily, 122 daily smokers) were predominantly White (70% and 84%, respectively), gender-balanced (50% and 43% female), full-time college students (89% and 95%). At baseline, nondaily smokers reported lower levels of nicotine dependence (p < .001; nondaily: Fagerström Test for Nicotine Dependence (FTND) = 0.8 ± 1.5, daily: FTND = 3.1 ± 1.9), lower urge to smoke (p < .001), greater self-efficacy when facing external smoking stimuli (p = .03), expecting to experience fewer positive effects (reduced negative affect, p = <.001, stimulation, p = .02), and valuing the importance of smoking effects less (ps < .01) than daily smokers. During counseling, nondaily smokers generated both fewer benefits of cessation (Wald X2(df = 1) = 4.91, p = .027) and fewer barriers (Wald X2(df = 1) = 5.99, p =.014) than daily smokers. Withdrawal was not listed by nondaily smokers as a barrier (p < .01). Constructs relevant to smoking cessation for daily smokers were less salient to young nondaily smokers, compared with moderately addicted young daily smokers, as indicated by responses to standardized scales and by the generation of fewer benefits and barriers in counseling. Interventions may need to find novel ways to engage nondaily smokers, particularly young adult, in smoking cessation efforts. This study is unique in eliciting benefits and barriers from nondaily smokers as they are about to make a quit attempt. This is a critically important point in time, as this is the point in time in which an action plan is formed and can be informed and enhanced by smoking cessation support. Our study further allowed direct comparison to daily smokers undergoing the same procedures, which allowed the identification of unique factors that may impact nondaily smokers in their quit attempt, which may guide intervention efforts. Use of a mixed method design further strengthen the rigor of this study.

Smoking prevalence, nicotine dependence, and intention to quit among cigarettes smokers

Abstract Introduction Tobacco consumption remains a challenging issue to the global and public health that requires close monitoring of the spread of this epidemic and its impact. This study aims to assess the national prevalence and determinates of cigarette smoking and nicotine dependence in Saudi Arabia. Methods A cross-sectional national survey of a sample of 5148 of Saudi residents' ages 18 years or older was conducted through web-based-computer assisted telephone interviews. The two main measurements were current cigarette smoking status and nicotine dependence assessed using the Fagerstrom Test for Nicotine Dependence. Data was weighted by age, gender, and region to account for the different probabilities of selection. Descriptive and logistic regression analyses were used to assess cigarette smoking and nicotine dependence determinants. Results The national prevalence of cigarette smoking was 16.18% (95% CI:14.59-17.77) with 14.12% (95% CI:12.64-15.59) current daily smoking prevalence. Almost 72% of smokers started smoking before the age of 22 and 27% of smokers were highly dependent on nicotine. Having a smoker parent (AOR=1.84[95%CI:1.31-2.58], P &amp;lt; 0.001) or a smoker close friend (AOR=6.49[95%CI:3.89-10.81], P &amp;lt; 0.001) were significantly associated with being a smoker. Higher nicotine dependence level was significantly associated with early onset of regular smoking (ages&amp;lt;18) (AOR=2.71 [95%CI:1.38-5.34],P&amp;lt;0.001) and lower attempting to quit (AOR=0.51[95% CI:0.32-0.83],P&amp;lt;0.01). Conclusions Cigarettes smoking and nicotine dependence are prevalent in Saudi Arabia. The study found the majority of smokers started regular smoking before the age of 22 and the early onset of smoking was associated with a higher nicotine dependence level. Restrict access to tobacco products to those below the age of 22 will help reduce smoking prevalence and lifetime addiction to nicotine. Key messages Majority of smokers initiated smoking by the age of 21 and early regular smoking initiation was associated with higher nicotine dependence. Strategies to prevent initiation before the age of 21 will help prevent addiction to nicotine.

Assessment of Nicotine Dependence, Cotinine Level and Carbon Monoxide Levels among Tobacco Users Employed in Private Automobile Companies in Chennai

Background and Aim: Tobacco is a leading preventable cause of death which causes death of six millions each year worldwide. One of the most effective methods of preventing this are tobacco counseling sessions as it provides a platform for the patient and the dental professionals to map out a plan for the patient to lead a tobacco free life. Therefore, the study was conducted to assess nicotine dependence, cotinine level and carbon monoxide levels among tobacco users employed in private automobile companies in Chennai.&#x0D; Study Design: Cross-sectional study.&#x0D; Subject and Methods: A cross sectional study of 53 males was conducted among automobile company employees, using simple random sampling technique in Chennai, India. A detailed questionnaire assessing their demographic data, pattern of usage of tobacco, Fagerstrom test for Nicotine Dependence was recorded, carbon monoxide levels were recorded using Smokerlyzer, and presence of urine cotinine was recorded. Descriptive statistics and Chi square test were used to analyze the data.&#x0D; Results: The mean age of the study participants was 31.7±11.32. Prevalence of smoking tobacco (64.20%) was higher among the study participants. Majority of the smoker study participants were highly dependent on tobacco, according to the FNTD scale. No statistical significance was found between dependency on nicotine and carbon monoxide levels among users of smoking tobacco (p &lt;0.05). A statistical significant association (p &lt;0.05) was found between dependency on nicotine and presence of urine cotinine among smokers.&#x0D; Conclusion: High level of nicotine dependence was observed in the smoker participants, and cotinine in urine was found to be a prominent marker of nicotine among users of smoking tobacco. Carbon monoxide levels were high among people with higher dependency on smoking.

Fagerström test for nicotine dependence as an indicator in tobacco-related studies in periodontology.

Smoking is considered a risk factor for periodontitis genesis and progression. Numerous clinical studies have demonstrated the negative effect of smoking, in particular the number of cigarettes consumed (NCC), on periodontal clinical parameters. However, smoking addiction assessed by the Fagerström test for nicotine dependence (FTND) has received little attention in periodontal research. In smoking patients presenting with periodontitis, the periodontal clinical features were measured and correlated with smoking status. The ability of FTND and NCC to predict periodontitis severity was assessed and compared. Thirty-four smoking patients aged 46.5 ± 11.5 years were included. The means of NCC and FTND were 16.6 ± 5.5 and 5.2 ±1.8, respectively. NCC and FTND were correlated with each other (r=0.57, P<0.001). Patients had stage III (44.1%) or stage IV (55.9%) periodontitis and 73.5% presented a generalized extension of periodontitis. The combination of FTND and NCC in discerning disease severity (ROC curve analysis: AUC=0.746, P=0.027) was superior to each indicator separately. A discriminant score based on both indicators (D=-0.42 - 0.15 × NCC + 0.63 × FTND) derived by logistic regression showed the opposite role of the indicators and the greater relevance of FTND (P=0.031) compared to NCC (P=0.084) in the relationship. This study shows that FTND could substantially complement NCC as an indicator of smoking status in periodontal research.

Association and Possible Correlations Between Tobacco Smoking and Symptoms of ADHD in an Egyptian Medical College Students’ Sample

Objectives: Attention deficit and hyperactivity disorder (ADHD) and tobacco smoking start in near same developmental life stages and are highly comorbid disorders. Little research has focused on this comorbidity and its correlates, especially in the Arab world. This study aimed to find the relation between tobacco smoking and ADHD symptoms and to understand how ADHD profile can affect its persistence. Materials and Methods: We recruited our sample from fifth year medical students attending their psychiatry undergraduate training program at the Institute of Psychiatry, Faculty of Medicine, Ain Shams University Hospitals, Cairo, Egypt. All attending students for 3 rounds were approached and asked to participate. All candidates were above 20 years old and from both sexes. For the purpose of this study, tobacco smoking included cigarettes, water pipe (sheesha), Cigar, and/or pipe smoking. All the participants were assessed using 1, General Health Questionnaire (GHQ-28); 2, The Adult ADHD Self-Report Scale (ASRS); 3, Fagerstrom Test for Nicotine Dependence (FTND); 4, Smoking Consequences Questionnaire-Adult (SCQ-A). Results: An overall 12.7% had symptoms of ADHD. Participants who were tobacco smokers and had symptoms of ADHD showed nicotine dependence scores higher than the non-ADHD symptom smokers. There was significant correlation between ASRS inattention and hyperactive-impulsive subscale scores and FTND scores (P=0.003 and 0.04), respectively. Moreover, there were statistically significant correlations between ASRS scores and smoking outcome variables with P-value of ≤0.00. Conclusion: ADHD symptoms were correlated to adult tobacco smoking outcome variables, providing further evidence of a likely link between ADHD symptoms and tobacco smoking risk.

Evaluation of a Web-Based Self-Management Program for Patients With Cardiovascular Disease: Explorative Randomized Controlled Trial.

BackgroundWeb-based self-management programs have the potential to support patients with cardiovascular disease (CVD) in their self-management (eg, by focusing on behavior change and improving physical activity). The intervention mapping framework was used to develop a web-based program called Vascular View. The Vascular View program contained 6 modules (coping with CVD, setting boundaries, lifestyle, healthy nutrition, being physically active, interaction with health professionals) aiming to increase self-management behavior by tailoring to the perceived problems and (support) needs of patients after CVD.ObjectiveThe aim was to test the effectiveness of Vascular View before embarking on a full-scale randomized clinical trial (RCT) by evaluating the potential effectiveness and effect sizes of the Vascular View program and identifying outcome measures most likely to capture the potential benefits.MethodsAn explorative RCT was performed. Both control and intervention groups received care as usual and, in addition, the intervention group received 12 months of access to a web-based self-management program. Assessment occurred at baseline, 6 months, and 12 months. Outcome measures included general patient-reported outcome measurements: Illness Perception Questionnaire (IPQ), Rand-36, Patient Activation Measure, and patient self-efficacy. Module-specific patient-reported outcome measurements were Beliefs about Medicines Questionnaire, International Physical Activity Questionnaire, Dutch Healthy Diet Index, Fagerström Test for Nicotine Dependence (FTND), Alcohol Use Disorders Identification Test, and Perceived Efficacy in Patient-Physician Interaction. Linear mixed models for repeated measures using intention-to-treat and per-protocol analysis were applied to study differences between the patients in the intervention and control groups. Floor and ceiling effects were explored to give insight into the outcome measures most likely to capture the potential benefits.ResultsA total of 105 patients in the control group and 103 patients in the intervention group participated in the study. A positive direction of change between baseline and 12 months was shown for most outcome measurements in favor of the intervention group, of which 2 out of 10 outcomes showed a significant effect: attribution of cause of the disease to risk factors and immunity factors (IPQ) and dependency of nicotine (FTND). Floor and ceiling effects were seen in the IPQ, Rand-36, and the self-efficacy questionnaire.ConclusionsNo conclusion for the efficacy of the Vascular View program or selection of outcome measurements can be taken yet. A process evaluation will be conducted to gain thorough insight into the working elements of the program, patient needs in eHealth, and the use of the program by patients. This can determine for whom web-based self-management programs will work and help to adapt the program.Trial RegistrationDutch Trial Register NTR5412; https://www.trialregister.nl/trial/5303International Registered Report Identifier (IRRID)RR2-10.2196/resprot.6352