Intermittent Smokers Research Articles

Smoking patterns and chronic kidney disease in US Hispanics: Hispanic Community Health Study/Study of Latinos.

Intermittent smoking is prevalent among Hispanics, but little is known about whether this smoking pattern associates with increased chronic kidney disease (CKD) risk in this population. The objective of the present study is to identify patterns of exposure associated with CKD in US Hispanics. We used cross-sectional data on 15 410 participants of the Hispanics Community Health Study/the Study of Latinos, a population-based study of individuals aged 18-74 years, recruited in 2008 to 2011 from four US field centers (Bronx, NY; Chicago, IL; Miami, FL; San Diego, CA). Smoking exposure was obtained through a questionnaire. CKD was defined by an estimated glomerular filtration rate of <60 mL/min/1.73 m(2) or a urine albumin-to-creatinine ratio of ≥30 mg/g. Approximately 14% of individuals were daily and 7% were intermittent smokers, and 16% were past smokers. There was a significant interaction between smoking status and pack-years of exposure (P = 0.0003). In adjusted models, there was an increased odds of CKD among daily, intermittent and past smokers by pack-years compared with never smokers. The association of intermittent smokers was significant at 10 pack-years [odds ratio (OR) = 1.38, 95% confidence intervals (CI) 1.06, 1.81], whereas for daily smokers this association was observed at 40 pack-years (OR = 1.43, 95% CI 1.09, 1.89). Our findings of increased risk of CKD among Hispanics who are intermittent smokers support screening and smoking cessation interventions targeted to this population for the prevention of CKD. It also suggests novel mechanistic pathways for kidney toxicity that should be further explored in future studies.

Intermittent smoking and chronic kidney disease.

Intermittent smoking and chronic kidney disease.

How Do Light and Intermittent Smokers Differ from Heavy Smokers in Young Adulthood: The Role of Smoking Restraint Strategies

ABSTRACTLight and intermittent smoking has become a prevalent pattern of use among young adults. Little is known about which factors differentiate light and intermittent smokers (LITS) from heavy smokers (HS) in young adulthood. In this study, we compare young adult LITS with HS with regard to demographic- and smoking-related variables, self-control abilities, and concrete strategies of smoking restraint. The data were collected as part of an Ecological Momentary Assessment (EMA) study with 137 German young adult smokers (M Age = 21.1 years, 46.0% female; 76 HS [≥10 cigarettes/day] and 61 LITS [≤5 cigarettes/day]). Participants were recruited over the Internet and completed a baseline questionnaire online. Several variables differentiated LITS and HS in a multiple logistic regression analysis: LITS reported fewer smoking friends (p < .001) and a higher self-efficacy to resist smoking (p < .01). Further, LITS smoking status was associated with reporting a past quit attempt (p < .05) and the use of smoking restraint strategies (counting, limiting, and purposefully not smoking cigarettes; p < .05). Notably, nicotine dependence and trait self-control abilities did not differentiate between LITS and HS. Our results point to the role of smoking restraint strategies and self-monitoring of smoking to limit the daily number of cigarettes smoked.

Attentional bias to smoking and other motivationally relevant cues is affected by nicotine exposure and dose expectancy.

We investigated the effects of acute nicotine dose and expected dose on attentional bias (AB) to smoking and affective cues in overnight nicotine-deprived smokers (n=51; 24 women) using a balanced placebo design, which counterbalanced given nicotine dose (Given-NIC vs. Given-DENIC) with instructed nicotine dose expectancy (Told-NIC vs. Told-DENIC). Before and after smoking a study cigarette, smokers completed a vigilance task where they pressed buttons to every third consecutive even or odd digit, while ignoring intermittent smoking, pleasant, unpleasant, and neutral picture distracters. We examined the early posterior negativity (EPN) and late positive potential (LPP) components of the event-related potentials (ERPs) to the distracters, reaction time (RT) to the target digits, and ratings of the study cigarettes. The EPN was sensitive to both given and instructed nicotine dose, while the instructed dose moderated the impact of given dose for the LPP. The RT metrics were sensitive to given but not to instructed dose. The effects of given dose on ratings following cigarette smoking (e.g. enjoyment) were moderated by the instructed dose. The ERP findings suggest that the anticipated effects of nicotine improve attention much like receiving actual nicotine.

Social contexts of momentary craving to smoke among Korean American emerging adults

IntroductionKorean American emerging adult (KAEA) smokers represent a culturally and developmentally unique population constituted of primarily light, intermittent smokers. Sociocultural contexts might play an important role in contributing to instances of acute cigarette craving and motivation to smoke in this population; yet, research testing such hypotheses is scant. The current study tests whether and how social contexts are associated with the craving among KAEA smokers. MethodsSeventy-eight daily KAEA smokers, who smoke 4+ cigs/day, participated in a 7-day ecological momentary assessment (EMA), in which participants responded to both signal-contingent (random) and event-contingent (smoking) prompts to answer surveys on their mobile phones (prompt-level n=1377; 603 random +774 smoking prompts). Nicotine dependence was measured at baseline; cigarette craving, negative affect, presence of others smoking, social contexts were measured with EMA. ResultsModeling of within-participant variation and covariation showed that being with Korean friends (vs. alone) was associated with increased levels of momentary craving. This association between Korean friends and craving disappeared when adjusted for presence of others smoking, which was a strong predictor of momentary craving. The positive association between Korean friends and craving was amplified immediately prior to smoking (vs. non-smoking random) instances. ConclusionsBeing with Korean friends might serve as a culturally-specific salient smoking cue, which might have been learned throughout their smoking history. Our data also showed that increased craving associated with Korean friends may represent social settings that primarily involve cigarette smoking. Given our findings on cigarette use among KAEA's social network, addressing cigarette use as a group behavior might be a fruitful intervention strategy.

Combined Influence of Smoking Frequency and Intensity on Suicidal Ideation and Attempts in Korean High School Students

Purpose: The purpose of this study was to investigate the combined influence of the frequency and the intensity of smoking on suicidal ideation and attempts in Korean high school students. Methods: This cross sectional study used secondary data from the 2014 Adolescent Health Behavior Online Survey. A total of 35,094 high school students were included in the study. The study set up two categories for the frequency of smoking - intermittent and daily - and another two for the intensity of smoking - heavy and light. Complex samples logistic regression was used to analyze the combined influence of smoking frequency and intensity on suicidal ideation and attempts. Results: Regardless of frequency and intensity, smoking was more likely to increase suicidal ideation and attempts than non-smoking. Among smokers, intermittent heavy smokers (suicidal ideation: Adjusted Odds Ratio [AOR]: 1.406, 95% Confidence Interval [CI]: 1.015~2.161, p=.012; suicidal attempts: AOR: 2.977, 95% CI: 1.814~4.886, p<.001) or daily heavy smokers (suicidal ideation: AOR: 1.274, 95% CI: 1.017~1.596, p=.035; suicidal attempts: AOR: 1.717, 95% CI: 1.250~2.359, p=.001) had significantly higher odds of suicidal ideation and attempts than intermittent light smokers. Conclusion: Based on the results, smoking prevention and cessation are essential to preventing suicides in adolescents. Especially, smoking intervention programs are needed to reduce smoking intensity in smokers.

Stimulus control in intermittent and daily smokers.

Many adult smokers are intermittent smokers (ITS) who do not smoke daily. Prior analyses have suggested that, compared with daily smokers (DS), ITS smoking was, on average, more linked to particular situations, such as alcohol consumption. However, such particular associations assessed in common across subjects may underestimate stimulus control over smoking, which may vary across persons, due to different conditioning histories. We quantify such idiographic stimulus control using separate multivariable logistic regressions for each subject to estimate how well the subject's smoking could be predicted from a panel of situational characteristics, without requiring that other subjects respond to the same stimuli. Subjects were 212 ITS (smoking 4-27 days/month) and 194 DS (5-30 cigarettes daily). Using ecological momentary assessment, subjects monitored situational antecedents of smoking for 3 weeks, recording each cigarette in an electronic diary. Situational characteristics were assessed in a random subset of smoking occasions (n = 21,539), and contrasted with assessments of nonsmoking occasions (n = 26,930) obtained by beeping subjects at random. ITS showed significantly stronger stimulus control than DS across all context domains: mood, location, activity, social setting, consumption, smoking context, and time of day. Mood and smoking context showed the strongest influence on ITS smoking; food and alcohol consumption had the least influence. ITS smoking was under very strong stimulus control; significantly more so than DS, but DS smoking also showed considerable stimulus control. Stimulus control may be an important influence on maintaining smoking and making quitting difficult for all smokers, but especially among ITS.

Tobacco smoking: From 'glamour' to 'stigma'. A comprehensive review.

In this narrative review, we explore the history of tobacco smoking, its associations and portrayal of its use with luxury and glamour in the past, and intriguingly, its subsequent transformation into a mass consumption industrialized product encouraged by advertising and film. Then, we describe the next phase where tobacco in parts of the world has become an unwanted product. However, the number of smokers is still increasing, especially in new markets, and increasingly younger individuals are being attracted to it, despite the well-known health consequences of tobacco use. We also explore current smoking behaviors, looking at trends in the prevalence of consumption throughout the world, discrimination against smokers, light and/or intermittent smokers, and the electronic cigarette (e-cigarette). We place these changes in the context of neuroscience, which may help explain why the cognitive effects of smoking can be important reinforcers for its consumption despite strong anti-smoking pressure in Western countries.

Relationship of Smokefree Laws and Alcohol Use with Light and Intermittent Smoking and Quit Attempts among US Adults and Alcohol Users

IntroductionLight and intermittent smoking (LITS) has become increasingly common. Alcohol drinkers are more likely to smoke. We examined the association of smokefree law and bar law coverage and alcohol use with current smoking, LITS, and smoking quit attempts among US adults and alcohol drinkers.MethodsCross-sectional analyses among a population-based sample of US adults (n = 27,731) using restricted data from 2009 National Health Interview Survey and 2009 American Nonsmokers' Rights Foundation United States Tobacco Control Database. Multivariate logistic regression models examined the relationship of smokefree law coverage and drinking frequency (1) with current smoking among all adults; (2) with 4 LITS patterns among current smokers; and (3) with smoking quit attempts among 6 smoking subgroups. Same multivariate analyses were conducted but substituted smokefree bar law coverage for smokefree law coverage to investigate the association between smokefree bar laws and the outcomes. Finally we ran the above analyses among alcohol drinkers (n = 16,961) to examine the relationship of smokefree law (and bar law) coverage and binge drinking with the outcomes. All models controlled for demographics and average cigarette price per pack. The interactions of smokefree law (and bar law) coverage and drinking status was examined.ResultsStronger smokefree law (and bar law) coverage was associated with lower odds of current smoking among all adults and among drinkers, and had the same effect across all drinking and binge drinking subgroups. Increased drinking frequency and binge drinking were related to higher odds of current smoking. Smokefree law (and bar law) coverage and drinking status were not associated with any LITS measures or smoking quit attempts.ConclusionsStronger smokefree laws and bar laws are associated with lower smoking rates across all drinking subgroups, which provides further support for these policies. More strict tobacco control measures might help reduce cigarette consumption and increase quit attempts.

Latino Cigarette Smoking Patterns by Gender in a US-National Sample.

Latino smokers are a rising public health concern who experience elevated tobacco-related health disparities. Additional information on Latino smoking is needed to inform screening and treatment. Latent class analysis using smoking frequency, cigarette preferences, onset, smoking duration, cigarettes per day, and minutes to first cigarette was used to create multivariate latent smoking profiles for Latino men and women. Final models found seven classes for Latinas and nine classes for Latinos. Despite a common finding in the literature that Latino smokers are more likely to be low-risk intermittent smokers, the majority of classes for both males and females described patterns of high-risk daily smoking. Gender variations in smoking classes were noted. Several markers of smoking risk were identified among both male and female Latino smokers, including long durations of smoking, daily smoking, and preference for specialty cigarettes, all factors associated with long-term health consequences.

Nondaily smokers' experience of craving on days they do not smoke.

Nondaily, or intermittent smokers (ITS), represent a growing pattern in adult smoking that needs to be explained by models of drug dependence. ITS regularly and voluntarily abstain from smoking, yet have difficulty quitting. We examine potential accounts of ITS' smoking by exploring their experience of craving and withdrawal on the days they abstain. For 3 weeks, 146 ITS and 194 daily smokers used the Ecological Momentary Assessment (EMA) to monitor craving, withdrawal, and smoking in real-time. ITS' craving (p < .001) and arousal (p < .001) were significantly lower on the 34.4% of days when they abstained (compared with days they smoked), and they experienced no increases in withdrawal symptoms. ITS who abstained for longer experienced lower craving, even on their first day of abstinence (p < .001). Within strata defined by longest duration of abstinence (1, 2-3, 4-6, ≥7 days), craving did not change over time, demonstrating no increase as resumption of smoking approached. Craving increased only at the moment smoking resumed. Furthermore, duration of abstinence runs varied more within persons than across persons. These findings contradict the predictions of a model positing that craving recurs at fixed intervals. Findings are consistent with the hypothesis that ITS' smoking is cued or primed by particular stimuli rather than by temporal cycles. These analyses demonstrate that ITS do not experience increased craving or withdrawal on days they do not smoke, and show neither signs of classical dependence nor regular cycles of craving and smoking.

Social smoking among intermittent smokers

Background“Social smoking” – smoking mostly or even only with others – may be an important pattern that implies smoking motivated extrinsically by social influences. Non-daily smokers (intermittent smokers; ITS) are often assumed to be social smokers, with some authors even assuming that all ITS are social smokers (SS+). We sought to identify and characterize social smokers in a sample of ITS. Methods204 adult ITS (smoking 4–27 days/month) recorded the circumstances of smoking in their natural settings using Ecological Momentary Assessment, while also recording their circumstances in nonsmoking moments. SS+ were defined as ITS who were with others when they smoked most of their cigarettes, and who were ≥50% more likely to be with others when smoking than when not. ResultsOnly 13% of ITS were SS+. Although defined solely on the basis of presence of others, SS+ showed a distinct pattern of smoking across multiple dimensions: compared to other ITS (who were significantly less likely to smoke when with others), SS+ smoking was more associated with socializing, being with friends and acquaintances, drinking alcohol, weekends, evening or nighttime, being in other people's homes, but not their own home. SS+ smoking was low in the morning and increased in the evening. SS+ smoked fewer days/week and were less dependent, but did not differ demographically. ConclusionsSocial smoking does constitute a highly distinct smoking pattern, but is not common among adult ITS.

Poor Mental Health and Reduced Decline in Smoking Prevalence.

Although smoking prevalence has been declining for smokers without mental illness, it has been static for those with mental illness. The purpose of this study is to examine differences in smoking rates and trajectories of smoking prevalence in the often-overlooked population of smokers with poor mental health, compared with those with better mental health. Data were obtained from the Behavioral Risk Factor Surveillance System from 2001 to 2010 to examine the relationship between poor mental health and current, daily, and intermittent tobacco use in New Jersey. Data were analyzed in 2014. During 2001-2010, current, daily, and intermittent smoking prevalence was higher in participants with poor mental health than those with better mental health. In addition, with the exception of 2 years, prevalence rates remained unchanged in this 10-year period for those with poor mental health while they significantly decreased for those with better mental health. The disparity in which smokers with poor mental health are more likely to be current smokers and less likely to be never smokers as compared with those with better mental health has increased over time. These data suggest the need to more closely examine tobacco control and treatment policies in smokers with behavioral health issues. It is possible that tobacco control strategies are not reaching those with poor mental health, or, if they are, their messages are not translating into successful cessation.

BMI and smoking: interrelated factors among cessation website users.

To investigate the relationship between body mass index (BMI) and smoking. Participants (N = 2243) provided demographic, height, weight, smoking information through a survey conducted on smokefree.gov and women.smokefree.gov websites. Analysis assessed associations among BMI, smoking status, and cigarettes smoked per day (CPD). The average (SD) BMI of never, former, intermittent, and daily smokers was 26.3 (6.2), 27.9 (6.5), 27.4 (6.7) and 28.1 (6.8) respectively. Daily (31.2%) and former (32.3%) were more likely to be to be obese compared to never (22.0%) and intermittent (26.1%) smokers. Odds of being obese increased with number of CPD adjusting for potential confounders. Smokers may currently have BMIs similar to the general population. BMI and CPD were positively correlated.

Intervenções de Cessação de Tabagismo em Fumantes Leves: Uma Revisão Sistemática

Despite decreases in the prevalence of smoking, the number of low-rate smokers - commonly called light or intermittent smokers - is increasing. Any dose of tobacco can be hazardous to health. Research about this population is scarce and little is known about tobacco cessation interventions that focus on these groups. The aim of the present paper is to conduct a systematic review to describe research on interventions for light and intermittent smokers. Searches were conducted in PubMed, PsycInfo, SciELO and Pepsic. Search terms included: (light smoker, non -daily smoker, intermittent smoker; social smoking, occasional smoking, low-level smoking) AND (intervention studies, clinical trial and evaluation studies) AND (tobacco use cessation, tobacco use disorder). Nine studies met the inclusion criteria. Successful interventions included counseling and pharmacotherapy such as brief intervention, health education, nicotine replacement, and varenicline. Int erventions for light smokers are in the early stages of development. Future studies should test interventions specifically designed for low -

Does Vaping in E-Cigarette Advertisements Affect Tobacco Smoking Urge, Intentions, and Perceptions in Daily, Intermittent, and Former Smokers?

Visual depictions of vaping in electronic cigarette advertisements may serve as smoking cues to smokers and former smokers, increasing urge to smoke and smoking behavior, and decreasing self-efficacy, attitudes, and intentions to quit or abstain. After assessing baseline urge to smoke, 301 daily smokers, 272 intermittent smokers, and 311 former smokers were randomly assigned to view three e-cigarette commercials with vaping visuals (the cue condition) or without vaping visuals (the no-cue condition), or to answer unrelated media use questions (the no-ad condition). Participants then answered a posttest questionnaire assessing the outcome variables of interest. Relative to other conditions, in the cue condition, daily smokers reported greater urge to smoke a tobacco cigarette and a marginally significantly greater incidence of actually smoking a tobacco cigarette during the experiment. Former smokers in the cue condition reported lower intentions to abstain from smoking than former smokers in other conditions. No significant differences emerged among intermittent smokers across conditions. These data suggest that visual depictions of vaping in e-cigarette commercials increase daily smokers’ urge to smoke cigarettes and may lead to more actual smoking behavior. For former smokers, these cues in advertising may undermine abstinence efforts. Intermittent smokers did not appear to be reactive to these cues. A lack of significant differences between participants in the no-cue and no-ad conditions compared to the cue condition suggests that visual depictions of e-cigarettes and vaping function as smoking cues, and cue reactivity is the mechanism through which these effects were obtained.

Smoking Trends and Disparities Among Black and Non-Hispanic Whites in California.

The current study examined disparities in smoking trends across Blacks and non-Hispanic Whites in California. Data from the 1996 to 2008 California Tobacco Survey were analyzed to examine trends in smoking behaviors and cessation across Blacks and non-Hispanic Whites. A decrease in overall ever and current smoking was observed for both Black and non-Hispanic Whites across the 12-year time period. A striking decrease in proportions of heavy daily smokers for both Black and non-Hispanic Whites were observed. Proportions of light and intermittent smokers and moderate daily smokers displayed modest increases for Blacks, but large increases for non-Hispanic Whites. Increases in successful cessation were also observed for Blacks and, to a lesser extent, for non-Hispanic Whites. Smoking behavior and cessation trends across Blacks and non-Hispanic Whites were revealing. The decline in heavy daily and former smokers may demonstrate the success and effectiveness of tobacco control efforts in California. However, the increase in proportions of light and intermittent smokers and moderate daily smokers for both Blacks and non-Hispanic Whites demonstrates a need for tobacco cessation efforts focused on lighter smokers.

Adolescents’ Perceptions of Light and Intermittent Smoking in the United States

Light smoking, consuming a few cigarettes daily, and intermittent, or nondaily, smoking patterns are increasingly common but carry health risks comparable to heavier smoking patterns. Nearly all smokers begin smoking as adolescents, who are at risk for developing these smoking patterns. Previous research suggests that smokers underestimate the risks associated with smoking. The extent to which adolescents perceive light and intermittent smoking as harmful has not been previously assessed. Data from 24,658 US adolescents sampled by the 2012 National Youth Tobacco Survey, a national, school-based, cross-sectional survey, were examined. Cross-tabulations and multivariate ordered probit regression models were constructed to describe correlates of US adolescents' perception of light and intermittent smoking. Although most adolescents (88.0%; 95% confidence interval [CI], 87.2% to 88.8%) reported beliefs that a heavier smoking pattern is very harmful, only 64.3% (95% CI; 63.2% to 65.3%) and 33.3% (95% CI; 32.0% to 34.6%) reported that light and intermittent smoking, respectively, are very harmful. Conversely, nearly one-quarter of US adolescents believed intermittent smoking causes little or no harm. Males, younger adolescents, Hispanics, and non-Hispanic blacks were more likely than their peers to view light and intermittent smoking patterns as less harmful. Those who were already light or intermittent smokers, those who used other tobacco products, and those who had a family member who used tobacco were also less likely to view their smoking patterns as harmful. Misconceptions about the safety of light and intermittent smoking are widespread among US adolescents. Significant public health attention is needed to redress these misperceptions.

Adolescents' Perceptions of Light and Intermittent Smoking in the United States

Adolescents' Perceptions of Light and Intermittent Smoking in the United States

Investigating correlates of synthetic marijuana and Salvia use in light and intermittent smokers and college students in a predominantly Hispanic sample.

Few studies have examined correlates related to the use of synthetic cannabinoids (e.g., Spice, K2) and Salvia divinorum. Two studies were conducted to investigate whether demographic, smoking-related, and substance-related variables were associated with the use of synthetic cannabinoids and Salvia. In Study 1, 185 participants (50% female; 83% Hispanic; Mage = 32 years; SD = 13.68) were recruited from a local health clinic and a university on the U.S./Mexico border for a smoking-cessation study targeting light and intermittent smokers. In Study 2, 675 participants (62.4% female; 89.1% Hispanic; Mage = 21.0, SD = 8.56) were recruited from a university on the U.S./Mexico border for an online study. In Study 1, 10% of the sample indicated they had ever used either synthetic cannabinoids or Salvia in their lifetime. Being male and dual/multiple use of tobacco products were significantly associated with having ever used synthetic cannabinoids or Salvia. In Study 2, 9%, 5%, and 3% of the sample indicated lifetime, past-year, and past 30-day use of synthetic cannabinoids, respectively. Five percent, 2%, and 1% of the sample indicated lifetime, past-year, and past 30-day use of Salvia, respectively. Logistic regression analyses revealed that past 30-day marijuana use and past 30-day ecstasy use were significantly associated with use of synthetic cannabinoids and Salvia in one's lifetime. These findings suggest that the assessment of synthetic marijuana and Salvia use is warranted in studies of other addictive behaviors, particularly among current marijuana and ecstasy users.