Heaviness Of Smoking Index Research Articles

Prevalence and determinants of tobacco, e-cigarettes, and cannabis use among nursing students: A multicenter cross-sectional study

BackgroundNurses are important agents in public health, which includes being active in tobacco control. Studies show that nurses who smoke are less inclined to offer smoking cessation aid. Nursing students, as the future labor force of nursing, are one of the key groups to monitor. ObjectivesTo identify the prevalence and determinants of use of several tobacco products, e-cigarettes, and cannabis among nursing students in Catalonia. DesignCross-sectional multicenter study. Settings15 university nursing schools in Catalonia (Spain) in 2015–2016. ParticipantsNursing students attending class at the day of the survey. MethodsAn anonymous, self-administered questionnaire based on the Global Health Professional Survey was designed. The questions included information on consumption of several tobacco products (manufactured cigarettes, roll your own cigarettes, etc.), e-cigarettes, and cannabis. We estimated the prevalence of use (%) and computed multilevel logistic regressions models, at two levels, to calculate the odds ratios (OR) and their corresponding 95% confidence intervals (CI), adjusting for several individual sociodemographic variables and the nursing school as a grouping variable. Results4381 students participated in the study (57.2% of Nursing students in Catalonia at the time of the survey). 29.7% (95%CI: 27.2–32.2) were smokers (18.4% daily and 11.3% occasionally). 66.4% smoked manufactured cigarettes, 47.0% roll your own cigarettes, 10.0% waterpipe, and 0.4% e-cigarettes. The main predictors of smoking were: being ≥25 years (OR = 2.57, 95%CI: 2.03–3.26) and belonging to other Spanish regions (OR = 1.82, 95%CI: 1.30–2.54). 71.5% had low nicotine dependence as defined by the Heavy Smoking Index. Among 11.5% (95%CI: 10.6–12.4) of students used cannabis (daily or occasionally), and men presented higher odds of use (OR = 2.81, 95%CI: 2.11–3.73) than women. ConclusionsTobacco and cannabis use is high among nursing students. It is necessary to carry out early tobacco and cannabis cessation programs among young nursing students.

Anhedonia and smoking cessation among Spanish-speaking Mexican-Americans.

Smoking cessation is associated with improved health and reduced risk of disease. Understanding specific factors that are associated with smoking cessation is important both for identifying those who may have the greatest difficulty quitting smoking and tailoring smoking cessation interventions accordingly. Low positive affect/anhedonia, a key transdiagnostic symptom of several psychiatric disorders, is associated with lower levels of smoking cessation in the general population, but to date, few studies have examined factors influencing smoking cessation among Spanish-speaking Mexican-American smokers. The current study examined whether low positive affect/anhedonia was inversely related to cessation status across 3 time points among Spanish-speaking Mexican-American smokers (N = 199) who were making a smoking quit attempt. Using multilevel modeling, the between-person low positive affect/anhedonia score was found to be inversely associated with smoking at quit day, 3 and 26 weeks after quit while controlling for relevant covariates (i.e., age, gender, education, income, relationship status, heaviness of smoking index) but not when controlling for other symptoms of depression. Contrary to prior research, the results of this study did not confirm the unique predictive role of low positive affect/anhedonia among Mexican Americans, suggesting that risk factors for this group may be different from other populations and cessation approaches may also need to differ. (PsycINFO Database Record

Use of Cigarettes With Flavor-Changing Capsules Among Smokers in the United Kingdom: An Online Survey.

IntroductionCigarettes with flavor-changing capsules in the filter have experienced phenomenal global growth in the last decade. We explore sociodemographic and smoking-related factors associated with using capsule cigarettes, how frequently users burst the capsule, and reasons for using them.MethodsAn online survey was conducted in the United Kingdom between April and May 2016 with 6234 factory-made and/or hand-rolled cigarette smokers. This analysis focuses on 3620 factory-made cigarette smokers, aged 18 years and over, who had smoked in the past month.ResultsThirteen percent smoked capsule cigarettes, with younger smokers more likely than older smokers to do so. Capsule use was significantly more common among White non-British than White British and among those planning to quit in the next 6 months than those not planning to quit. Most capsule users who crushed the capsule did so always (51%) or most of the time (18%), with more frequent crushing of capsules more common among females, younger and middle-aged participants, White British, and those with a lower score on the Heaviness of Smoking Index. The most common reasons for using capsule cigarettes were that they taste better (52%), are smoother (41%), provide a choice of flavors (32%), and the enjoyment of clicking the capsule (25%). Capsule and noncapsule smokers did not differ significantly in their perceptions of the harmfulness of their brand relative to other brands.ConclusionsOur study provides an insight into how and why smokers of capsule cigarettes use these products, with the key drivers of use being taste, flavor choice, and interactivity.ImplicationsCigarettes with capsules in the filter that can be burst to change the flavor have experienced remarkable growth since being introduced in 2007, but little is known about how and why smokers use these products. Thirteen percent of factory-made cigarette smokers in our sample smoked a brand with a capsule in the filter, with approximately two-thirds crushing the capsule all or most of the time. Capsule use was more likely among younger participants. The main reasons for smoking capsule cigarettes were related to how they taste, having a choice of flavors, and enjoyment of clicking the capsule (interactivity).

Limited contribution of health behaviours to expanding income-related chronic disease disparities based on a nationwide cross-sectional study in China

This study estimated the association of income and prevalence of cardiovascular diseases (CVD) and hypertension, and then quantified the contribution of health behaviors to the association in China. Using the 2013 survey of the China Health and Retirement Longitudinal Study (CHARLS), a logit model was applied to examine income-related health disparities in relation to CVD and hypertension. A four-step regression method was then constructed to measure the role of health behaviors in income-related health disparities. Using indirect effects, mediation by health behaviors was examined. Income-related health disparities in chronic diseases were found to exist in China. Specifically, individuals in the high-income group had a 14% (OR = 0.86; 95% CI 0.73–1.02) and 14% (OR = 0.86; 95% CI 0.76–0.97) lower odds of suffering from CVD and hypertension than those in the low-income group. However, limited evidence shows this association was mediated by health behaviors. The Heaviness of Smoking Index (HSI), heavy drinking, irregular eating, and nap time did not significantly mediate the association of income and prevalence of CVD and hypertension. To curb the rising prevalence of CVD and hypertension in China, policies should focus on the low-income subpopulation. However, healthy behaviors interventions targeting smoking, heavy drinking, unhealthy napping and irregular eating habits among low-income people may be ineffective in reduction of income-related disparities in prevalence of CVD and hypertension.

The moderating effect of perceived social support on the relation between heaviness of smoking and quit attempts among adult homeless smokers

BackgroundOver 70% of homeless adults smoke cigarettes. Despite the desire to quit, this group rarely receives the external support to make or maintain a successful quit attempt (SQA; intentional quit attempt lasting >24 h). The Heaviness of Smoking Index (HSI) is a cigarette dependence measure that independently predicts SQAs among domiciled adults. For homeless adults, social support may be a way to buffer the impact of cigarette dependence on SQAs. MethodsThe association of the HSI and past-year SQAs, and the potential moderating role of social support, was examined among 445 homeless smokers (Mage = 43.2 + 11.8, 65% male, 57.5% white). Support was measured by the International Support Evaluation List (ISEL-12) and its 3 subscales: tangible, belonging, & appraisal support. ResultsThe HSI was negatively correlated with SQAs (r=−.283, p < .01) and in a regression model controlling for age, sex, and race/ethnicity, appraisal support significantly moderated this relationship (p < .05). The HSI was significantly related to SQAs across low, moderate, and high levels of appraisal support [mean, +1 SD; low (β=−.657, p < .001), medium (β=−.457, p < .001), and high (β=−.258, p < .05)]. Neither the ISEL-12 total nor the other subscales were moderators. ConclusionThe perceived availability of someone to talk to about one's problems appeared to attenuate the strength of the inverse relationship between the heaviness of smoking and SQAs. Fostering appraisal support for homeless smokers through group treatment may reduce the impact of cigarette dependence on making quit attempts. Social support coupled with the increased availability of empirically-supported cessation aids may improve dismal quit rates among homeless adults.

Tobacco Dependence Predicts Higher Lung Cancer and Mortality Rates and Lower Rates of Smoking Cessation in the National Lung Screening Trial

Incorporating tobacco treatment within lung cancer screening programs has the potential to influence cessation in high-risk smokers. We aimed to better understand the characteristics of smokers within a screening cohort, correlate those variables with downstream outcomes, and identify predictors of continued smoking. This study is a secondary analysis of the National Lung Screening Trial randomized clinical study. Tobacco dependence was evaluated by using the Fagerstrӧm Test for Nicotine Dependence, the Heaviness of Smoking Index, and time to first cigarette (TTFC); descriptive statistics were performed. Clinical outcomes (smoking cessation, lung cancer, and mortality) were assessed with descriptive statistics and χ2 tests stratified according to nicotine dependence. Logistic and Cox regression models were used to study the influence of dependence on smoking cessation and mortality, respectively. Patients with high dependence scores were less likely to quit smoking compared with low dependence smokers (TTFC OR, 0.50 [95%CI, 0.42-0.60]). Indicators of high dependence, as measured according to all three metrics, were associated with worsening clinical outcomes. TTFC showed that patients who smoked within 5min of waking (indicating higher dependence) had higher rates of lung cancer (2.07%for > 60min after waking vs5.92%≤ 5min after waking; hazard ratio [HR], 2.56 [95%CI, 1.49-4.41]), all-cause mortality (5.38%for >60min vs11.21%≤ 5 min; HR, 2.19 [95%CI, 1.55-3.09]), and lung cancer-specific mortality (0.55%for > 60min vs2.92%for≤ 5 min; HR, 4.46 [95%CI, 1.63-12.21]). Using TTFC, a one-question assessment of tobacco dependence, at the time of lung cancer screening has implications for personalizing tobacco treatment and improving risk assessment.

Response to reduced nicotine content cigarettes among smokers differing in tobacco dependence severity

This study examines whether tobacco dependence severity moderates the acute effects of reducing nicotine content in cigarettes on the addiction potential of smoking, craving/withdrawal, or smoking topography. Participants (N = 169) were daily smokers with mild, moderate, or high tobacco-dependence severity using the Heaviness of Smoking Index. Following brief abstinence, participants smoked research cigarettes varying in nicotine content (0.4, 2.4, 5.2, 15.8 mg nicotine/g tobacco) in a within-subject design. Results were analyzed using repeated measures analysis of co-variance. No main effects of dependence severity or interactions with nicotine dose were noted in relative reinforcing effects in concurrent choice testing or subjective effects on the modified Cigarette Evaluation Questionnaire. Demand for smoking in the Cigarette Purchase Task was greater among more dependent smokers, but reducing nicotine content decreased demand independent of dependence severity. Dependence severity did not significantly alter response to reduced nicotine content cigarettes on the Minnesota Tobacco Withdrawal Scale nor Questionnaire of Smoking Urges-brief (QSU) Factor-2 scale; dependence severity and dose interacted significantly on the QSU-brief Factor-1 scale, with reductions dependent on dose among highly but not mildly or moderately dependent smokers. Dependence severity and dose interacted significantly on only one of six measures of smoking topography (i.e., maximum flow rate), which increased as dose increased among mildly and moderately but not highly dependent smokers. These results suggest that dependence severity has no moderating influence on the ability of reduced nicotine content cigarettes to lower the addiction potential of smoking, and minimal effects on relief from craving/withdrawal or smoking topography.

Smoking cessation treatment outcomes among people with and without mental and substance use disorders: An observational real-world study

BackgroundThere is a lack of studies evaluating smoking cessation treatment protocols which include people with and without mental and substance use disorders (MSUD), and which allows for individuals with MSUD undergoing their psychiatric treatment. MethodsWe compared treatment success between participants with (n = 277) and without (n = 419) MSUD among patients in a 6-week treatment provided by a Brazilian Psychosocial Care Center (CAPS) from 2007 to 2013. Sociodemographic, medical and tobacco use characteristics were assessed at baseline. Tobacco treatment consisted of 1) group cognitive behavior therapy, which included people with and without MSUD in the same groups, and 2) pharmacotherapy, which could include either nicotine patches, nicotine gum, bupropion or nortriptyline. For participants with MSUD, tobacco treatment was integrated into their ongoing mental health treatment. The main outcome was 30-day point prevalence abstinence, measured at last day of treatment. ResultsAbstinence rates did not differ significantly between participants with and without MSUD (31.1% and 34.4%, respectively). Variables that were significantly associated with treatment success included years smoking, the Heaviness of Smoking Index, and use of nicotine patch or bupropion. ConclusionThe inclusion of individuals with and without MSUD in the same protocol, allowing for individuals with MSUD undergoing their psychiatric treatment, generates at least comparable success rates between the groups. Predictors of treatment success were similar to those found in the general population. Facilities that treat patients with MSUD should treat tobacco use in order to reduce the disparities in morbidity and mortality experienced by this population.

Tobacco Related Knowledge Is Associated with Heaviness of Smoking Index (HSI) and Intention to Quit among Korean Smokers: Findings from 2016 ITC Korea Survey

Tobacco Related Knowledge Is Associated with Heaviness of Smoking Index (HSI) and Intention to Quit among Korean Smokers: Findings from 2016 ITC Korea Survey

The Cigarette Dependence Scale and Heaviness of Smoking Index as predictors of smoking cessation after 10 weeks of nicotine replacement therapy and at 6-month follow-up

IntroductionThe reliability and validity of the Cigarette Dependence Scale (CDS) has been tested in online studies and compared with other tobacco dependence measures. Findings regarding its ability to predict smoking cessation have been mixed. We examined whether the CDS predicted cessation among a sample that received nicotine replacement therapy (NRT) at a community workshop and assessed the incremental predictive validity of the CDS-5 and CDS-12 over the 2-item Heaviness of Smoking Index (HSI). MethodsIndividuals 18 or older, smoking at least 10 cigarettes daily and intending to quit within 30days received 10weeks of NRT at a smoking cessation workshop. A total of 2661 individuals attended workshops throughout Ontario, Canada from 2007 to 2008 and completed the CDS and HSI at baseline. Follow-up surveys were conducted at end of treatment and 6months post-treatment. Smoking cessation outcome was 7-day point prevalence abstinence. ResultsThe CDS-5, CDS-12 and HSI total scores predicted abstinence at end-of-treatment and 6-month follow-up. The HSI was a slightly better predictor of abstinence according to pseudo-R2 and area under the receiver operating characteristic curve (AUC) values. In hierarchical regression analyses, both HSI items were independent predictors of cessation. Only one additional CDS item was a significant independent predictor of cessation at end of treatment, though higher scores were associated with greater odds of abstinence. ConclusionThe HSI had similar or marginally better predictive ability with respect to quit outcome compared to the CDS-5 and CDS-12 in a sample motivated to make a quit attempt using NRT.

Baseline Cigarette Smoking Status as a Predictor of Virologic Suppression and CD4 Cell Count During One-Year Follow-Up in Substance Users with Uncontrolled HIV Infection.

Cigarette smoking is prevalent in people living with HIV/AIDS (PLHIV) who abuse alcohol and/or illicit substances. This study evaluated whether smoking is predictive of virologic non-suppression (>200 copies/mL) and low CD4 count (<200 cells/mm3) during 1-year follow-up in medically hospitalized, substance-using PLHIV recruited for a multi-site trial. Smoking status was assessed with the Heaviness of Smoking Index (HSI). Analyses revealed that, controlling for baseline differences and adherence to antiretroviral therapy, non-smokers (n=237), compared to smokers scoring in the medium-to-high range on the HSI (n=386), were significantly more likely to achieve viral suppression (OR 1.50, 95% CI 1.02, 2.20). There was a significant smoking-by-time interaction for CD4 cell count (χ2(1)=4.08, p<.05), with smokers less likely to have low CD4 count at baseline and 6-month follow-up, but more likely to have low CD4 count at 12-month follow-up. The results suggest that smoking may play a role in immunological functioning in HIV-infected substance users. ClinicalTrials.gov Identifier: NCT01612169.

Item Response Theory analysis of Fagerström Test for Cigarette Dependence

IntroductionThe Fagerström Test for Cigarette Dependence (FTCD) and the Heaviness of Smoking Index (HSI) are the gold standard measures to assess cigarette dependence. However, FTCD reliability and factor structure have been questioned and HSI psychometric properties are in need of further investigations. The present study examined the psychometrics properties of the FTCD and the HSI via the Item Response Theory. MethodsThe study was a secondary analysis of data collected in 862 Italian daily smokers. Confirmatory factor analysis was run to evaluate the dimensionality of FTCD. A Grade Response Model was applied to FTCD and HSI to verify the fit to the data. Both item and test functioning were analyzed and item statistics, Test Information Function, and scale reliabilities were calculated. Mokken Scale Analysis was applied to estimate homogeneity and Loevinger's coefficients were calculated. ResultsThe FTCD showed unidimensionality and homogeneity for most of the items and for the total score. It also showed high sensitivity and good reliability from medium to high levels of cigarette dependence, although problems related to some items (i.e., items 3 and 5) were evident. HSI had good homogeneity, adequate item functioning, and high reliability from medium to high levels of cigarette dependence. Significant Differential Item Functioning was found for items 1, 4, 5 of the FTCD and for both items of HSI. ConclusionsHSI seems highly recommended in clinical settings addressed to heavy smokers while FTCD would be better used in smokers with a level of cigarette dependence ranging between low and high.

Significantly more intense pain in methadone-maintained patients who are addicted to nicotine.

Pain and cigarette smoking are very common in heroin-dependent patients (HDPs) receiving methadone maintenance treatment (MMT) and both have substantial negative effects on HDPs' physical and mental health. Nevertheless, very few studies have assessed the relationship between the two in HDPs. This study examined the association between pain intensity and smoking in Chinese methadone-maintained HDPs. A total of 603 HDPs were consecutively recruited from three MMT clinics in Wuhan, China, and administered with a socio-demographic and drug use questionnaire, a smoking questionnaire concerning average number of cigarettes smoked daily and Heaviness of Smoking Index, and Zung's Self-rating Depression Scale. We used a five-point Verbal Rating Scale to rate the intensity of pain. To determine whether pain's associations with smoking and nicotine dependence were independent, an analysis of covariance was adopted to control for the potential confounding effects of socio-demographic variables, drug use characteristics, and depressive symptoms. Net of potential confounders, in methadone-maintained HDPs, pain intensity was significantly higher in smoker than non-smokers (F = 11.836, P = 0.002) but the pain intensity did not differ significantly across patients with various levels of cigarette consumption (F = 1.992, P = 0.137), while the pain intensity significantly differed across patients with different levels of nicotine dependence (F = 3.252, P = 0.013). Pain is significantly associated with smoking in HDPs receiving MMT, this phenomenon may be explained by the association between nicotine dependence and pain.

Internalized smoking stigma in relation to quit intentions, quit attempts, and current e-cigarette use

ABSTRACTBackground: Reducing the social acceptability of smoking is associated with lowered smoking prevalence. However, denormalization strategies can also contribute to the stigmatization that some smokers may feel about their smoking. Smoking stigma may be more acute if smokers are also members of other stigmatized groups, such as racial/ethnic minorities. This study examined correlates of smoking self- and felt-stigma and discrimination, among current smokers. Methods: Participants were recruited in the United States via a national commercial consumer panel to complete a cross-sectional, Web-based survey. Participants were 1528 current cigarette smokers aged 14 and older. Measures included the Internalized Stigma of Smoking Inventory (ISSI), Heaviness of Smoking Index, quit intentions, past-year quit attempts, and current use of electronic cigarettes (e-cigarettes). Results: Self-stigma was significantly associated with higher intent to quit in the next 6 months (odds ratio [OR] = 2.47, P < .01) and in the next 30 days (OR = 4.21, P < .01), relative to no intention to quit, as well as having made 1 or 2 quit attempts in the past year (OR = 1.60, P < .01) or 3 or more quit attempts (OR = 1.74, P < .01) and associated with daily e-cigarette use (OR = 1.73, P < .05). Felt-stigma was positively associated with intent to quit in the next 30 days (OR = 1.54, P < .01), having made 3 or more quit attempts in the past year (OR = 1.35, P < .01), and both daily (OR = 2.05, P < .05) and some-day (OR = 1.30, P < .05) e-cigarette use. Discrimination was associated only with increased odds of daily e-cigarette use (OR = 1.83, P < .05). Conclusions: Smokers who reported greater feelings of stigmatization about their smoking were more likely to report having made recent quit attempts, report a stronger intention quit smoking in the future, and report use of e-cigarettes, suggesting that feelings of self-and felt-stigmatization are related to greater motivation to stop smoking.

Evaluating the role of smokeless tobacco use indices as brief measures of dependence

IntroductionThere is considerable interest in using brief measures of dependence for evaluation and treatment of tobacco dependence. The Heaviness of Smoking Index (HSI) is a validated measure of dependence among cigarette smokers. However, a similar index has not been studied among ST users. The aim of this study is to develop similar ST use indices and evaluate their utility as concise dependence measures. Time to first chew/dip of the day (TTFD), number of cans of ST used per week (CPW), and number of dips/chews per day (DPD) were used to create three ST use indices; heaviness of ST use index (HSTI), ST dependence index (STDI), and ST quantity frequency index (ST-QFI). MethodsThe study was based on data collected from a community based sample of exclusive ST users living in Oklahoma. Participants completed the self-administered survey which included dependence scales and questionnaires to measure sociodemographic factors and tobacco use characteristics. Saliva samples were obtained to measure cotinine concentration. Method of scoring for TTFD and DPD was similar to the scoring scheme employed for HSI items. DPD was transformed by a series of statistical tests into a three category scoring variable. Concurrent validity and reliability of the ST use indices were evaluated and overall accuracy of ST use indices was assessed. Level of agreement between the ST use indices and Fagerström Test for Nicotine Dependence for ST users (FTND-ST) was calculated to find the extent these indices were equivalent to FTND-ST in measuring dependence. ResultsST use indices were significantly correlated with FTND-ST. ST users who had higher HSTI or STDI scores were more likely to have Tobacco Dependence Screener (TDS) based dependence diagnosis (OR: 1.50, 95%CI: 1.12, 2.02 and OR: 1.53, 95%CI: 1.16, 2.02, respectively). Study findings showed that all ST use indices were predictors of cotinine concentration. The internal consistency assessed by Cronbach's alpha indicated that STDI had acceptable reliability. At the optimal cutoff scores, both HSTI and STDI had good level of agreement with FTND-ST (k=0.81, p<0.0001 and k=0.71, p≤0.0001, respectively). ConclusionsComponents of physical dependence are interrelated and each ST use item, TTFD, CPW, and DPD, explains a different dependence feature. Significant association of HSTI and STDI with other tobacco dependence measures and FTND-ST suggests that these indices are valuable brief measures of dependence among ST users and can be used as a substitute for FTND-ST, similar to HSI in smoking dependence studies. A concise dependence measure like HSTI or STDI has reduced response burden and is an effective tool in clinical and research setting.

Impact of smoking on fertility and age of menopause: a population-based assessment

Background and aimsStudies in patients seeking medically assisted reproduction have shown that smoking reduces fertility, but little information is available in the general population. We assessed the associations between smoking...

Comparison of the Fagerström Test for Cigarette Dependence and the Heaviness of Smoking Index in the Second and Third Trimester of Pregnancy

Smoking cessation at any stage of pregnancy can benefit the mother and fetus. Cigarette dependence is a significant factor in women who continue to smoke during pregnancy and accurate assessment of cigarette dependence can be helpful in planning smoking cessation programs. The objective of our study was to investigate the validity of the Fagerstrom Test for Cigarette Dependence (FTCD) and Heaviness of Smoking Index (HSI) as measures of cigarette dependence in the second and third trimesters of pregnancy by comparing them to serum cotinine levels. Prospective cohort study of 167 women in their second and third trimester of pregnancy who self-reported cigarette smoking. They were administered the FTCD questionnaire and blood was drawn for cotinine measurements using a direct enzyme linked immunoassay. Linear regression was used to adjust for maternal age, body mass index, gestation, and parity to investigate the association between cotinine levels and the two scores. Both the FTCD and HSI correlated significantly with serum cotinine levels (Spearman coefficient 0.42 and 0.37, respectively, p < .001). The correlation coefficients of both scores were higher in primigravidas (n = 51) compared to multigravidas, but the difference was statistically nonsignificant. Using multiple linear regression, both scores were significantly related to serum cotinine levels. For each unit increase in the FTCD and HSI, the serum cotinine level increased by 21.4 ng/mL (95% confidence interval 10.1-32.7, p <0.001) and 37 ng/mL (95% confidence interval 18.6-55.4, p < 0.001), respectively. Both the FTCD and HSI can be used to assess cigarette dependence in the second and third trimester of pregnancy. There is lack of data on the validity of the FTCD and the HSI as markers of cigarette dependence during the second and third trimester of pregnancy. Our study suggests that both the FTCD and HSI perform well in assessing cigarette dependence in the second and third trimester of pregnancy and can be used to plan smoking cessation programs.

Which measures of cigarette dependence are predictors of smoking cessation during pregnancy? Analysis of data from a randomized controlled trial.

AimsTo examine the ability of different common measures of cigarette dependence to predict smoking cessation during pregnancy.DesignSecondary analysis of data from a parallel‐group randomized controlled trial of physical activity for smoking cessation. The outcomes were biochemically validated smoking abstinence at 4 weeks post‐quit and end‐of‐pregnancy.SettingWomen identified as smokers in antenatal clinics in 13 hospital trusts predominantly in southern England, who were recruited to a smoking cessation trial.ParticipantsOf 789 pregnant smokers recruited, 784 were included in the analysis.MeasurementsUsing random‐effect logistic regression models, we analysed the effects of baseline measures of cigarette dependence, including numbers of cigarettes smoked daily, Fagerström Test of Cigarette Dependence (FTCD) score, the two FTCD subscales of Heaviness of Smoking Index (HSI) and non‐Heaviness of Smoking Index (non‐HSI), expired carbon monoxide (CO) level and urges to smoke (strength and frequency) on smoking cessation. Associations were adjusted for significant socio‐demographic/health behaviour predictors and trial variables, and area under the receiver operating characteristic (ROC) curve was used to determine the predictive ability of the model for each measure of dependence.FindingsAll the dependence variables predicted abstinence at 4 weeks and end‐of‐pregnancy. At 4 weeks, the adjusted odds ratio (OR) (95% confidence interval) for a unit standard deviation increase in FTCD was 0.59 (0.47–0.74), expired CO = 0.54 (0.41–0.71), number of cigarettes smoked per day 0.65 (0.51–0.84) and frequency of urges to smoke 0.79 (0.63–0.98); at end‐of‐pregnancy they were: 0.60 (0.45–0.81), 0.55 (0.37–0.80), 0.70 (0.49–0.98) and 0.69 (0.51–0.94), respectively. HSI and non‐HSI exhibited similar results to the full FTCD.ConclusionsFour common measures of dependence, including number of cigarettes smoked per day, scores for Fagerström Test of Cigarette Dependence and frequency of urges and level of expired CO, all predicted smoking abstinence in the short term during pregnancy and at end‐of‐pregnancy with very similar predictive validity.

Association Between CHRNA3 and CHRNA5 Nicotine Receptor Subunit Gene Variants and Nicotine Dependence in an Isolated Populationof Kashubians in Poland

BackgroundGenome-wide and allelic association studies have shown the contribution of CHRNA5-A3-B4 nicotinic receptor subunit gene cluster within chromosome 15 to nicotine dependence (ND). While an association between several single-nucleotide polymorphisms (SNPs) at that locus and smoking quantity (cigarettes per day; CPD) has been well recognized, there are some inconsistencies in demonstrating the influence of these SNPs on other ND phenotypes. This uncertainty motivated us to examine the association of 3 selected SNPs (CHRNA3 rs1051730, rs6495308, and CHRNA5 rs55853898) with ND in an isolated population of Kashubians from Poland.Material/MethodsThe study sample consisted of 788 current daily smokers. ND was assessed by CPD, the Fagerstrom Test for Nicotine Dependence (FTND), its brief version - Heavy Smoking Index (HSI), and time to first cigarette after waking (TTF). The correlation between studied SNPs and dichotomized values of ND measures was assessed in the regression analysis. Bonferroni corrected p-value of 0.017 was set for a type 1 error.ResultsWe found a robust association between risk allele A of rs1051730 and CPD >10 (odds ratio (OR)=1.77, 95% confidence interval (CI): 1.20–2.59, p=0.004), and a weak association, which did not survive correction for multiple testing, with FTND ≥4. No associations between studied SNPs and HSI or TTF were demonstrated.ConclusionsOur findings confirm that rs1051730 influences ND phenotype, as defined by CPD.

Patterns of nicotine dependence in four Eastern European countries.

BackgroundEvidence of patterns of nicotine dependence, although crucial for developing and implementing effective tobacco control strategies, is limited in the Eastern European countries. The purpose of this study was to evaluate the correlates of high nicotine dependence among adults in Poland, Romania, the Russian Federation and Ukraine.MethodsThe data used in the current analysis is available from the Global Adult Tobacco Survey (2009–2011). Nicotine dependence was assessed using the Heaviness of Smoking Index (HSI), which covers two measures: reported cigarettes smoked per day and time to the first cigarette upon waking. Based on a six-point scale of HSI, nicotine dependence was categorized into low to moderate (score 0–3), and high dependence (score 4–6). Out of 31,936 completed interviews, we used data from 8229 daily smokers.ResultsThe study results indicate that more than 25 % of daily smokers were highly dependent on nicotine. Higher odds of high nicotine dependence were identified for males (OR = 1.5 in Poland and Romania, OR = 2.7 in Russia; p ≤ 0.001), people between 50–59 years of age (the highest odds in Romania; OR = 4.8; p ≤ 0.001) and those who had started smoking at a young age (the highest odds in Romania, OR = 5.0; p ≤ 0.001). Having fewer restrictions on smoking at home was significantly associated with a high level of nicotine dependence (the highest odds in Romania, OR = 3.0; p ≤ 0.001). A high proportion of the participants had no interest in quitting smoking, with a statistically significantly higher percentage observed among smokers highly dependent on nicotine compared to the less addicted (p ≤ 0.01).ConclusionsSmokers highly dependent on nicotine constitute a quarter of the Romanian group of daily smokers and even more in the remaining three analyzed countries. Similar patterns of nicotine dependence were observed in all of the investigated countries showing that male gender, younger age at the smoking onset, and fewer restrictions on smoking at home were significantly associated with higher nicotine dependence. The study highlighted the fact that a high proportion of the participants had no interest in quitting smoking. These results underscore importance of policy measures as well as prevention and cessation interventions for smokers who are highly dependent on nicotine, which need to take into account the social gradient in smoking patterns.