Higher Levels Of Nicotine Dependence Research Articles

Factors associated with substance use among preclinical medical students in Turkey: a cross-sectional study

Introduction: Medical students experience high levels of stress due to their rigorous training, which can negatively affect their mental health. This study aimed to investigate substance use habits of medical students at Istanbul University-Cerrahpaşa and the association on their mental health and demographic factors. Methods: This cross-sectional survey study was conducted in March-April 2022 among preclinical medical students (years 1-3 of a 6-year program). A confidential, anonymous online survey consisting of four sections on sociodemographic and educational characteristics, nicotine use and dependence [Fagerström Test for Nicotine Dependence (FTND)], alcohol use [Alcohol Use Disorders Identification Test (AUDIT)], mental health status [12-item General Health Questionnaire (GHQ-12)], was distributed to 1131 students via WhatsApp and Telegram text messages. Mann-Whitney U and Kruskal Wallis tests compared variables’ distribution in the questionnaire categories. Spearman's correlation assessed associations between scales. Significance was p < 0.05. Results: The study included 190 medical students. A total of 26.3% of the participants were smokers, with 8.4% showing moderate to high levels of nicotine dependence. An estimated 45.8% and 8.4% reported low-risk consumption and risky usage of alcohol, respectively. There were statistically significant associations between substance use and demographic factors such as sex, GPA, and religious belief. The study found a statistically significant correlation between FTND scores and GHQ-12 scores, and, between FTND scores and AUDIT scores. Conclusion: The findings of this study will inform the development of interventions to improve the mental health and academic performance of medical students at Istanbul University-Cerrahpaşa. Furthermore, it will raise awareness about the importance of addressing substance use among medical students in Turkey.

Psychometric properties of the FTCD and Brief WISDM: support for validity in a legal-system-involved sample.

The Fagerstrom Test of Cigarette Dependence (FTCD) and Brief Wisconsin Index of Smoking Dependence Motives (WISDM) are widely-used measures of smoking dependence. The FTCD was previously found to have 1- and 2-factor structures and Brief WISDM has been found to have an 11-factor and 11-factor hierarchical structure. As such, the current study sought to further investigate the psychometric properties of the FTCD and Brief WISDM with a novel criminal-legal system-involved sample using both a factor-analytic and an Item Response Theory (IRT) approach. Data from 517 criminal-legal system-involved adults (i.e., 18 years of age or older) who smoke from Alabama, USA were analyzed. Confirmatory factor analyses (CFA) were conducted on 1-factor and 2-factor structures of the FTCD and 1-factor, 11-factor, and 11-factor hierarchical structures of the Brief WISDM. IRT analyses investigating item discrimination and threshold parameters were also conducted on the Brief WISDM. The CFA showed poor fit for a single-factor structure, and mixed results for two 2-factor results for the FTCD. CFA also showed poor fit for a single-factor, and mixed results for the 11-factor model. Initial IRT investigations using the 11-factor model showed strong item discrimination, but non-ordered threshold parameters. Two-factor structures for the FTCD and the 11-factor model for the Brief WISDM were partially supported in a criminal-legal population, suggesting continued support for the multidimensional structure of the measures. Additionally, exploratory IRT analyses suggested good discrimination across the use spectrum for the Brief WISDM. The Fagerstrom Test of Cigarette Dependence (FTCD) and Brief Wisconsin Index of Smoking Dependence Motives WISDM are two widely used measures of nicotine dependence, though previous research has shown mixed results for their internal consistency and factor structure. The current study used a unique sample of criminal-legal-involved participants who generally have moderate to high levels of nicotine dependence. The current study found that the FTCD displayed poor internal consistency, poor fit for a single-factor model, but mixed support for two two-factor models. The Brief-WISDM was found to have strong internal consistency, poor fit for a single-factor model, but mixed fit for an 11-factor model and good item discrimination.

LEVELS OF NICOTINE ADDICTION IN CONSUMERS OF THE LATEST TOBACCO PRODUCTS

Aim. Determining the level of nicotine addiction in consumers of the latest tobacco products.
 Materials and Methods. We have surveyed 817 young people (from 18 to 45 years of age) living in Lviv region. Among them, two focus groups were distinguished: 96 respondents who indicated that they use electronic cigarettes with nicotine (ECN) for smoking and 93 respondents who indicated that they use tobacco products for electric heating (TPEHs). The Fagerstr?m test for determining nicotine addiction was used for the survey. The study uses the methods of structural-logical analysis, system approach and analysis, calculation of average and relative values, correlation analysis.
 Results and Discussion. The average score of nicotine addiction for TPEH smokers (4.00 (2.00; 6.00) points) is higher (p>0.05) than for classic cigarette smokers (3.00 (1.00; 6.00) points) and ECN smokers (3.00 (1.00; 5.00) points). Regarding classic cigarette smokers and ECN smokers, the median nicotine addiction score is higher in men, whereas in TPEH smokers it is the same for both men and women. About a quarter of the surveyed TPEH smokers (23.66± 4.41%) have a high level of nicotine addiction. Regarding male smokers, the largest share of individuals with a high level of nicotine addiction is observed in the group of TPEH smokers - more than a third (36.36±7.25%) of men in this group. The greatest number of women with a high level of nicotine dependence is observed among smokers of ECN, namely a quarter of the surveyed respondents of this group (25.93±5.96%).
 Conclusions. The findings of the study will be used in the development of a model for preventing the spread of the latest methods of tobacco consumption among the young population.

Factors associated with smoking cessation in exclusive smokers and dual users of e-cigarette and conventional cigarettes from CDTnet registry

Dual use of electronic cigarettes and conventional cigarettes may be a transitional state towards cigarette smoking cessation. However, maintaining dual use may increase tobacco-related consequences as smoking behavior persists. The aim of our study was to describe characteristics of dual users and explore factors associated with their one-month abstinence in comparison to exclusive smokers in French smoking cessation services (SCS). We retrospectively studied 5116 smokers registered in a national SCS registry between 2015 and 2018 and who attended at least two visits. We matched the retained exclusive smokers and dual users by age, sex, professional status and education level. We compared baseline information and validated smoking abstinence at one-month follow-up between the two groups. Predictors of abstinence were assessed using a multivariate model. Retained exclusive smokers and dual users had similar cessation rates (37%). Compared to exclusive smokers, dual users presented more comorbidities and a higher level of nicotine dependence. Factors positively associated with cessation in dual users were: being employed or retired, declaring three or more previous quit attempts, presenting with low nicotine dependence and high motivation to quit and benefiting from at least four follow-up consultations. Our results suggest that dual users seeking help to quit in SCS seem to benefit from support as much as exclusive smokers to reach abstinence, despite a higher level of nicotine dependence and comorbidities. Further research, especially qualitative, is needed on this specific group of smokers to provide tailored interventions to quit.

Effectiveness of a Smoking Cessation Program during the COVID-19 Pandemic.

The coronavirus disease-2019 pandemic has caused major obstacles for effective smoking cessation programs by significantly limiting access to healthcare. This cross-sectional analysis aimed to assess the effectiveness of a self-developed smoking cessation program during the pandemic. The program was based on remote lectures, educational interventions, and hybrid services provided by an outpatient clinic. We assessed 337 participants enrolled to the program between January 2019 and February 2022. Data on demographic characteristics, medical history, and smoking status at baseline and after at least 1-year follow-up were collected from medical records and a standardized self-developed questionnaire. Participants were classified into two groups according to their current smoking status. The smoking cessation rate at 1 year was 37% (95% confidence interval [CI]: 31-42%). Major predictors of smoking cessation were the place of residence, ability to refrain from smoking during severe illness, and the number of cigarettes smoked per day. The proportion of participants with high levels of nicotine dependence at baseline was 40.8% (95% CI: 34.5-47.5%) vs. 29.1% (95% CI: 23.4-35.5%) after the program. In the group that did not quit smoking, there were more participants who smoked within 5 min after waking up than before the program (40.4% [95% CI: 34.0-47.1%] vs. 25.4% [95% CI: 19.9-31.6%]). Effective smoking cessation interventions can be performed using remote counseling and education.

Socioeconomic Factors Related to Nicotine Dependence in Mongolia

Objectives: This study is aimed to investigate potential socio-economic risk factors associated with Nicotine Dependence among UB residents. It is important to identify and understand the various elements that may make people more susceptible to the negative health effects of smoking. Methods: We applied a cross-sectional study design to define the level of nicotine dependence on 875 participants. In addition, risk factors associated with nicotine dependence were assessed through a questionnaire survey. Results: Higher nicotine dependence in this study was associated with being a female (OR=1.208), older age groups (OR=1.5-2.9), divorced (OR=1.091), living in a house (OR=1.602), having a high school education level (OR=1.794), not having a regular job (OR=1.137), having a higher alcohol consumption level (OR=1.18-1.62), and age at initiation of smoking at 18 or younger (OR=1.796). Conclusion: According to the results of our research, countries with low and moderate levels of income, such as Mongolia, have a significant problem with high levels of nicotine dependence. In addition to this, it underscores the importance of developing smoking cessation programs that consider the extent of nicotine dependence while placing a greater emphasis on early interventions of the linked factors.

Smoking cessation and vaccination.

A significant proportion of COPD patients (∼40%) continue smoking despite knowing that they have the disease. Smokers with COPD exhibit higher levels of nicotine dependence, and have lower self-efficacy and self-esteem, which affects their ability to quit smoking. Treatment should be adapted to the needs of individual patients with different levels of tobacco dependence. The combination of counselling plus pharmacotherapy is the most effective cessation treatment for COPD. In patients with severe COPD, varenicline and bupropion have been shown to have the highest abstinence rates compared with nicotine replacement therapy. There is a lack of evidence to support that smoking cessation reduction or harm reduction strategies have benefits in COPD patients. The long-term efficacy and safety of electronic cigarettes for smoking cessation need to be evaluated in high-risk populations; therefore, it is not possible to recommend their use for smoking cessation in COPD. Future studies with the new generation of nicotine vaccines are necessary to determine their effectiveness in smokers in general and in COPD patients.

Nicotine Dependence among Current Cigarette Smokers Who Use E-Cigarettes and Cannabis

Background Co-use of tobacco and cannabis and dual use of cigarettes and e-cigarettes are very common among young adults. However, it is unclear whether co-use of cigarettes, e-cigarettes, and/or cannabis is associated with higher levels of nicotine dependence than cigarette-only use. We investigated the relationship between cigarette/nicotine dependence and co-use of tobacco and cannabis among 4 groups of cigarette smokers aged 18–35: cigarette-only smokers, cigarette-e-cigarette (CIG-ECIG) co-users, cigarette-cannabis (CIG-CAN) co-users, and cigarette-e-cigarette-cannabis (CIG-ECIG-CAN) co-users. Methods Data were from a 2018 cross-sectional survey based on a national convenience sample of smokers aged 18–35 (n = 315). Cigarette/nicotine dependence was measured by the Fagerstrom Test of Nicotine Dependence (FTND) and e-cigarette dependence was measured by the Penn State E-cigarette Dependence Index. Bivariate analyses examined sociodemographic and tobacco/other substance use characteristics by co-use status and multivariable linear regression assessed the relationship between co-use and nicotine dependence. Results In the sample, 27.6% were cigarette-only smokers, 24.8% were CIG-ECIG, 27.6% were CIG-CAN, and 20.0% were CIG-ECIG-CAN co-users. Significant differences were observed in sociodemographic and tobacco/other substance use characteristics by co-use status. E-cigarette co-users had low e-cigarette dependence, but moderate FTND scores. In adjusted analyses, only CIG-ECIG co-use was associated with higher FTND scores compared to cigarette-only smoking. However, CIG-ECIG and CIG-ECIG-CAN co-use were associated with higher FTND scores compared to CIG-CAN co-use. Conclusions Co-use of cigarettes and e-cigarettes was associated with greater nicotine dependence among smokers aged 18–35. Additional research is needed to understand the underlying mechanisms of these relationships and inform prevention efforts.

E-Cigarettes Used by Adolescents to Try to Quit Smoking Are Associated With Less Quitting: A Cross-Sectional Analysis of the National Youth Tobacco Survey

PurposeThis paper determines the association between youth e-cigarette use “to try to quit using other tobacco products, such as cigarettes” and having stopped smoking cigarettes (defined as an ever cigarette smoker who did not smoke in the past 30 days). MethodsThis study uses data from the NYTS from 2015 through 2021, focusing on youth who started smoking cigarettes before they started using e-cigarettes. Associations between using e-cigarettes to quit and having stopped smoking were computed using logistic regression accounting for the complex survey design and adjusting for level of nicotine dependence, year, age, gender, and race/ethnicity. Sensitivity analyses allowed for having started cigarettes and e-cigarettes in the same year and without regard for starting sequence. ResultsThe primary analytic subsample included 6435 United States middle and high school students (mean age 15.9 years, 55.4% male). Using e-cigarettes to quit was associated with significantly lower odds of having stopped smoking cigarettes (odds ratio, 0.62; 95% confidence interval, 0.45–0.85), controlling for nicotine dependence and demographics. Youth with higher levels of nicotine dependence also had lower odds of having stopped smoking. The results were stable over time. Sensitivity analyses produced similar results. DiscussionEver-smoking youth who used e-cigarettes “to try to quit using other tobacco products, such as cigarettes” had lower odds of having stopped smoking cigarettes than those who did not use e-cigarettes as to try to quit. Physicians, regulators, and educators should discourage youth from attempting to use e-cigarettes as a way to stop smoking cigarettes.

Analysis of nicotine dependence among daily smokers in China: evidence from a cross-sectional study in Zhejiang Province

ObjectiveThe current study aimed to assess the level of nicotine dependence and its influencing factors among daily smokers in Zhejiang, China.SettingThe 2020 Global Adult Tobacco Survey was conducted in Zhejiang,...

EFFECT OF SELF-ESTEEM & SELF-EFFICACY ON LEVELS OF NICOTINE DEPENDENCE AMONG CURRENT SMOKERS IN BANGALORE - A CROSS-SECTIONAL STUDY

Objectives: The study aimed to assess the inuence of self-efcacy and self-esteem on tobacco addiction among current smokers by assessing their effect on levels of nicotine dependence. Materials and methods: A cross-sectional study was conducted on smokers recruited from the tobacco cessation units of KLE Institute of Dental Sciences, Bangalore using convenience sampling. Self-esteem and self-efcacy were assessed using the Rosenberg Selfesteem Scale and the General Self-efcacy scale respectively. The outcome variable Nicotine Dependence was assessed using the Fagerstrom Test for Nicotine Dependence. Statistical analysis was performed on SPSS version 26 (p-value <0.05). Results: Low self-esteem and low self-efcacy were associated with severely high levels of nicotine dependence. Conclusions:Tobacco cessation Programs need to assess and alleviate low self-esteem and self-efcacy among smokers for better results and lesser relapses.

National Cancer Institute Smoking Cessation at Lung Examination Trials Brief Report: Baseline Characteristics and Comparison With the U.S. General Population of Lung Cancer Screening–Eligible Patients

IntroductionThe National Cancer Institute Smoking Cessation at Lung Examination (SCALE) Collaboration includes eight clinical trials testing smoking cessation interventions delivered with lung cancer screening (LCS). This investigation compared pooled participant baseline demographic and smoking characteristics of seven SCALE trials to LCS-eligible smokers in three U.S. nationally representative surveys. MethodsBaseline variables (age, sex, race, ethnicity, education, income, cigarettes per day, and time to the first cigarette) from 3614 smokers enrolled in SCALE trials as of September 2020 were compared with pooled data from the Tobacco Use Supplement–Current Population Survey (2018–2019), National Health Interview Survey (2017–2018), and Population Assessment of Tobacco and Health (wave 4, 2016–2017) using the U.S. Preventive Services Task Force 2013 (N = 4803) and 2021 (N = 8604) LCS eligibility criteria. ResultsSCALE participants have similar average age as the U.S. LCS–eligible smokers using the 2013 criteria but are 2.8 years older using the 2021 criteria (p < 0.001). SCALE has a lower proportion of men, a higher proportion of Blacks, and slightly higher education and income levels than national surveys (p < 0.001). SCALE participants smoke an average of 17.9 cigarettes per day (SD 9.2) compared with 22.4 (SD 9.3) using the 2013 criteria and 19.6 (SD 9.7) using the 2021 criteria (p < 0.001). The distribution of time to the first cigarette differs between SCALE and the national surveys (p < 0.001), but both indicate high levels of nicotine dependence. ConclusionsSCALE participants smoke slightly less than the LCS-eligible smokers in the general population, perhaps related to socioeconomic status or race. Other demographic variables reveal small but statistically significant differences, likely of limited clinical relevance with respect to tobacco treatment outcomes. SCALE trial results should be applicable to LCS-eligible smokers from the U.S. population.

Nicotine dependence and quitting stages of smokers in Nepal: A community based cross-sectional study.

IntroductionNicotine dependence is an addiction to tobacco products caused by the chemical nicotine present in tobacco. 80% of premature deaths due to nicotine dependence come from low-and middle-income countries. Since most of the public health studies have focused solely on psychological and behavioral factors associated with tobacco smoking, this study aims to assess the nicotine dependence and stages of change of quitting smoking.MethodologyA community based quantitative cross-sectional study was conducted among 280 smokers aged 15–69 years in Bharatpur metropolitan, Nepal. A semi-structured and validated questionnaire was used during the face-to-face interviews. Nicotine dependence among participants was assessed using the six-item Fagerstrom Test for Nicotine Dependence (FTND). Chi-square test and multivariate logistic regression analysis were performed to assess the associations between variables at the significance level α = 0.05.ResultIn the study population, the mean score of FTND was 5.15 ± 2.34. 33.9% participants had a high level of nicotine dependence and nearly half of the participants felt difficulty to refrain smoking even in No-smoking areas. Almost three out of ten respondents were prepared for smoking cessation. It was found that age group 20–39 years were more likely to have nicotine dependence (AOR 3.308, 95% CI = 1.039–10.534), those who initiated smoking before age of 15 were associated with a greater risk of nicotine dependence (AOR 3.68, 95% CI = 1.826–7.446), participants spending more on tobacco products (more than Rs 2400 monthly) were associated with an increased risk of nicotine dependence (AOR 4.47, 95% CI = 2.225–8.991), those who initiated smoking due to mental stress were more likely to have nicotine addiction (AOR 2.522, 95% CI = 1.004–6.028), and those who had no thought of quitting smoking were more associated with nicotine dependence (AOR 4.935, 95% CI = 1.458–16.699).ConclusionOur study showed that high level of nicotine dependence is a major public health problem in low-and middle-income countries like Nepal. It also highlights that effective smoking cessation programs should be developed considering the level of nicotine dependence with more focus on early interventions of its associated factors.

Rates of Smoking Cessation at 6 and 12 Months after a Clinical Tobacco Smoking Cessation Intervention in Head and Neck Cancer Patients in Northern Ontario, Canada.

Smoking during cancer treatment is associated with reduced treatment response and cancer recurrence in patients with tobacco-related cancers. The purpose of this study was to examine smoking characteristics in head and neck cancer patients (n = 503) with a history of smoking and examine the impact of an intensive clinical tobacco intervention to patients who were currently smoking. All participants completed an interviewer-administered questionnaire at study enrollment which examined smoking behaviours, motivations to quit, and strategies used to cessate smoking. Follow-up assessments were completed at 6- and 12-months which monitored whether patients had quit smoking, remained cessated, or continued to smoke since study recruitment. For those who were currently smoking (n = 186, 37.0%), an intensive clinical tobacco intervention that utilized the 3A’s—Ask, Advise, Arrange—and the Opt-Out approach was offered to assist with smoking cessation at their new patient visit and followed-up weekly during their head and neck radiation therapy for 7 weeks. At 6 months, 23.7% (n = 41) of those who were smoking successfully quit; 51.2% quit ‘cold turkey’ (defined as using no smoking cessation assistance, aids or pharmacotherapy to quit), while 34.9% used pharmacotherapy (varenicline (Champix)) to quit. On average, it took those who were smoking 1–5 attempts to quit, but once they quit they remained cessated for the duration of the study. Although the head and neck cancer patients in this study reported high levels of nicotine dependence, many were able to successfully cessate.

Smoking and nicotine dependence in relation to depression, anxiety, and stress in Egyptian adults: A cross-sectional study.

BACKGROUND:Much research has found that smoking is one of the major risk factors for a variety of physical diseases and mental disorders; however, few studies have been conducted on smoking in Egypt. Furthermore, to the researcher's best knowledge, no study in Egypt has compiled data on smoking prevalence, motives, and levels of nicotine dependency. In order to fill in this gap, the current study has attempted to summarize the situation and construct an accurate picture of smoking in Egypt.MATERIALS AND METHODS:This cross-sectional study included 2000 Egyptian adults in Fayoum through a multistage cluster sampling technique. For data collection, the Socioeconomic Status Scale was deployed. In addition, Depression, Anxiety, Stress Scale (DASS), the Modified Reasons for Smoking Scale (MRSS), and Fagerstrom Test for Nicotine Dependence (FTND) were used. Data analysis performed using SPSS version 22.0. For qualitative data, Chi-square test was used to determine statistical significance. Bivariate Pearson correlation was used to test for the association between quantitative variables.RESULTS:Of the total sample of 2000 adults, 40.4% had anxiety and 24.3% had stress, and 19.5% showed severe to extremely severe level of depression. For MRSS, tension reduction or relaxation was found in 46.5% adults while 9.8% had high level of nicotine dependence. There was a statistically significant association between psychometric disorders, on one hand, and both smoking motivation and nicotine dependence, on the other (P < 0.001). The DASS score had a statistically significant correlation with age, smoking duration, nicotine dependence level, and MRSS subscales.CONCLUSION:Smoking is linked to psychological symptoms and shows a moderate to high level of nicotine dependence, with a higher level of dependency, smoking pleasure, stress reduction/ relaxation, and hand-mouth movement as motives for smoking. Furthermore, there was a correlation between nicotine dependence, on one hand, and depression and stress on the other.

The role of self-discontentment and impulsivity for youth smoking behavior, nicotine dependence and future smoking intention in a clinical sample of Turkish adolescents.

Smoking is one of the most important public health problems among young people. Potential risk factors that may cause vulnerability to smoke in youth should be well known and investigated. The aim of the present study was to evaluate the associations of current smoking behavior and future smoking intention with high-risk personality traits for substance abuse in a clinical sample of Turkish adolescents, and also evaluate nicotine dependence and smoking characteristics with the personality traits in a subsample of regular smokers. A cross-sectional study was adopted in which 196 participants took part (aged 14-18 years with a mean of 16.7 years). The assessment consisted of a sociodemographic questionnaire that also questions current smoking behavior and future smoking intention; and additionally, two self-administered instruments including the Substance Use Risk Profile Scale (SURPS) for all participants, and Fagerström Test for Nicotine Dependence (FTND) for only regular smokers. Regular smokers scored higher than never smokers on the lack of self-contentment subscale of SURPS (F(2)=3.30, p=.039). Future smoking intention was found to be associated with nicotine dependence (F(3)=6.67, p=.001). Regular smokers with high levels of nicotine dependence had higher levels of impulsivity and smoked more cigarettes per day than those with low levels of nicotine dependence (t=2.489, p=.017; and t=3.530, p=.001, respectively). The structural equation models (SEM) were created based on these results and the personality theory for substance abuse. The SEM results showed that the first evidence that lack of selfcontentment positively influences regularly smoking behavior and impulsivity positively influences future smoking intention through nicotine dependence. Lack of self-contentment and impulsivity may mediate the transition from current smoking behavior to future tobacco use disorders in Turkish adolescents. The assessment and intervention of selfdiscontentment and impulsivity can be beneficial in reducing the current smoking behavior in Turkish adolescents.

Predicting smoking and nicotine dependence from the DSM-5 alternative model for personality pathology.

Individuals with personality disorders (PDs) have higher morbidity and mortality than the general population, which may be due to maladaptive health behaviors such as smoking. Previous studies have examined the links between categorical PD diagnoses/personality traits and smoking/nicotine dependence, but little is known about how the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition alternative model for personality disorders relates to smoking and nicotine dependence. The current study examined this question in a sample of 500 participants using the Levels of Personality Functioning Scale to assess general personality pathology, the Personality Inventory for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition to measure specific traits, the Fagerström test for Nicotine Dependence to assess nicotine dependence, and questions about current and past smoking to assess smoking status (i.e., current, former, never). Multinomial logistic regression results demonstrated that general personality pathology (Criterion A) was not related to smoking status, and there were no reliable associations between traits (Criterion B) and smoking status. However, correlations showed that higher negative affectivity and disinhibition were related to higher levels of nicotine dependence within smokers. Findings are discussed in regard to previous findings linking personality pathology to smoking/nicotine dependence as well as the general validity of this new personality disorder diagnostic system. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Smoking cessation adherence:recurrent cardiovascular events after five years of first manifestation

Abstract Background Smoking is an established risk factor for cardiovascular events, such as myocardial infarction, stroke and cardiovascular death. Although the harmful effects of smoking on health are widely known. Smoking is highly addictive and cessation can be extremely difficult, even after a life-threatening vascular event. Objective The present study aimed to assess the relation between smoking status and risk of recurrent Cardiovascular events 5 years after the first hospitalization for acute coronary syndrome. Methods A cross sectional study was conducted in the Smoking Cessation Service at University Hospital of Monastir, Tunisia during February 2020. The smoking status and recurrent cardiovascular events were assessed 5 years after the first hospitalization for acute coronary syndrome by phone call among patients attended the tobacco cessation consultation. The statistical analysis was conducted with SPSS software, version 21.0. A p value of &amp;lt; 0.05 was considered statistically significant. Results A total of 112 patients were included in our study. All participants were male and the mean age was 56 ±10 years. Most patients (67%) had a high level of nicotine dependence. The rate of smoking abstinence declined from 35.7% at one year to 21.1% at 5 years. During the study period, 4 patients died(3.5%) and 17 (15.17%) had a recurrent cardiovascular event. The recurrent cardiovascular event occurred more in smoking patients but the difference was not significant. Conclusions Smoking cessation after a first cardiovascular event should be a key objective for both patients and physicians to reduce the risk for recurrent vascular events. More efforts are needed to maintain smoking cessation in patients at very high cardiovascular risk. Key messages Smoking cessation consultation can increase adherence to smoking cessation and helps in reducing the excess risk of recurrent cardiovascular events. Smoking is highly addictive and cessation can be extremely difficult, even after a life-threatening vascular event.

Tobacco use and nicotine dependence among patients with diabetes and hypertension in Ballabgarh, India.

Tobacco use is one of the most important modifiable risk factors for cardiovascular mortality and has a synergistic effect with diabetes and hypertension. This study was conducted to estimate the prevalence of tobacco use and nicotine dependence among adult diabetic and/or hypertensive patients. We conducted a cross-sectional study among 419 consecutively enrolled patients from the non-communicable diseases (NCDs) outpatient clinic of a secondary level hospital in Ballabgarh, India between July 2018 and January 2019. We administered a pre-tested questionnaire to assess tobacco use and Fagerstrom Test for Nicotine Dependence (FTND) to assess nicotine dependence. Current tobacco users were defined as those who smoked in the past seven days. Nicotine dependence was classified as low, moderate or high for the FTND score of 0 -3, 4-6, and 7-10, respectively.Seventy-nine patients had diabetes, 226 had hypertension, and 114 had both. The prevalence of tobacco use was 20.8% (95% CI : 17.1 - 24.9); prevalence of smoking was 15% (95% CI: 11.9 â€" 18.8) and smokeless tobacco use was 7.2% (95% CI: 5 - 10.1). Moderate to high nicotine dependence was found among 59.7% of tobacco users; 75.9% tobacco users attempted to quit tobacco in the past one month. One-fifth of attendees of a NCD clinic in a secondary level hospital used tobacco, most of whom had moderate-to-high nicotine dependence. High level of nicotine dependence and inability to quit despite making an attempt for it necessitates the inclusion of tobacco cessation services in the management of patients with non-communicable diseases.

Investigation of Surgical Nurses’ Cigarette Use, Nicotine Dependence Levels, and the Affecting Factors

Aim: This study aims to investigate surgical nurses’ cigarette use, their nicotine dependence levels, and the affecting factors. Material and Methods: This descriptive and correlational research was carried out in a university hospital with the participation of nurses (n = 108) who work in surgical units and smoke. The data were collected with a Personal Information Form, Smoking Information Form, and the Fagerström Test for Nicotine Dependence. SPSS for IBM 25 was used for statistical analysis. Descriptive statistics, independent t-test, one-way variance and regression analysis, and the Bonferroni test were used in the analysis of the data. Results: The results were evaluated at a 95% confidence interval and p &lt;0.05 significance level. 34% of surgical nurses were between 21-29 years old, 65% were women, 58% were single, and 86% had bachelor degrees. 65% of the nurses were smoking due to stress, 53% due to enjoyment, and 80% were smoking more than 10 cigarettes per day. It was found that the nurses working in the intensive care unit smoked more cigarettes than the operating room and service nurses. Conclusion: As a result of this research, it was found that surgical nurses had a high level of nicotine dependence. Strategies for surgical nurses to quit smoking should be developed and training should be provided.