Nicotine Dependence Research Articles

Similarities and differences in dynamic properties of brain networks between internet gaming disorder and tobacco use disorder

BackgroundInternet gaming disorder (IGD) and tobacco use disorder (TUD) are two major addiction disorders that result in substantial financial loss. Identifying the similarities and differences between these two disorders is important to understand substance addiction and behavioral addiction. The current study was designed to compare these two disorders utilizing dynamic analysis. MethodResting-state data were collected from 35 individuals with IGD, 35 individuals with TUD and 35 healthy controls (HCs). Dynamic coactivation pattern analysis was employed to decipher their dynamic patterns. ResultsIGD participants showed decreased coactivation patterns within the default mode network (DMN) and between the DMN and the salience network (SN). The SN showed reduced coactivation patterns with the executive control network (ECN) and DMN, and the ECN showed decreased coactivation patterns with the DMN. In the TUD group, the DMN exhibited decreased coactivation patterns with the SN, the SN exhibited reduced coactivation patterns with the DMN and ECN, and the ECN showed decreased coactivation patterns with the DMN and within the ECN. Furthermore, the triple network model was fitted to the dynamic properties of the two addiction disorders. Decoding analysis results indicated that addiction-related memory and memory retrieval displayed similar dysfunctions in both addictions. ConclusionThe dynamic characteristics of IGD and TUD suggest that there are similarities in the dynamic features between the SN and DMN and differences in the dynamic features between the DMN and ECN. Our results revealed that the two addiction disorders have dissociable brain mechanisms, indicating that future studies should consider these two addiction disorders as having two separate mechanisms to achieve precise treatment for their individualized targets.

Polygenic risk scores for nicotine use and family history of smoking are associated with smoking behaviour

IntroductionFormal genetics studies show that smoking is influenced by genetic factors; exploring this on the molecular level can offer deeper insight into the etiology of smoking behaviours. MethodsSummary statistics from the latest wave of the GWAS and Sequencing Consortium of Alcohol and Nicotine (GSCAN) were used to calculate polygenic risk scores (PRS) in a sample of ~2200 individuals who smoke/individuals who never smoked. The associations of smoking status with PRS for Smoking Initiation (i.e., Lifetime Smoking; SI-PRS), and Fagerström Test for Nicotine Dependence (FTND) score with PRS for Cigarettes per Day (CpD-PRS) were examined, as were distinct/additive effects of parental smoking on smoking status. ResultsSI-PRS explained 10.56% of variance (Nagelkerke-R2) in smoking status (p=6.45x10−30). In individuals who smoke, CpD-PRS was associated with FTND score (R2=5.03%, p=1.88x10–12). Parental smoking alone explained R2=3.06% (p=2.43×10−12) of smoking status, and 0.96% when added to the most informative SI-PRS model (total R²=11.52%). ConclusionThese results show the potential utility of molecular genetic data for research investigating smoking prevention. The fact that PRS explains more variance than family history highlights progress from formal to molecular genetics; the partial overlap and increased predictive value when using both suggests the importance of combining these approaches.

Voluntary nicotine consumption and reward in a subset of diversity outbred founder strains.

Nicotine is largely responsible for the initiation and maintenance of tobacco dependence and contributes to a global health problem. This study characterizes nicotine oral consumption and preference in male and female mice of several Diversity Outbred (DO) founder strains: C57BL/6J, A/J, 129S1/SvImJ, PWK/PhJ, NOD/ShiLtJ, and CAST/EiJ. It assesses the impact of nicotine concentration on intake and preference, the potential interaction of strain with sex, and estimates the degree of heritable variation in nicotine consumption. Two-bottle choice oral self-administration paradigm was used to assess nicotine intake, nicotine preference, and total fluid intake in male and female mice of each strain in a concentration-response manner. A conditioned place preference (CPP) test was performed to evaluate the rewarding and aversive effects of nicotine in certain strains after systemic administration of the drug. The highest nicotine-consuming strain was found to be 129S1/SvlmJ, and the lowest nicotine-consuming strain was A/J. Strain differences in nicotine intake were not due to differences in bitter and sweet tastes as shown in the saccharine and quinine two-bottle choice tests. A/J strain showed no significant CPP for nicotine while the 129S1/SvImJ strain showed a significant CPP for nicotine and a higher preference when compared to the C57BL/6J strain. Heritability estimates of nicotine intake were sex dependent and concentration dependent. Data support that nicotine consumption patterns are heritable with an influence of genotype in a voluntary oral self-administration paradigm. Results pave the way for future studies with the highly recombinant DO mice that might lead to the identification of novel genetic loci and genes influencing nicotine consumption.

COVID-19 Impact on Substance Use (Tobacco, Alcohol, Cannabis) and Stress in Medical Students

The COVID-19 pandemic has led to unprecedented challenges globally, impacting various aspects of daily life, including education. This study examines the effects of the pandemic on stress levels and substance use among Italian medical students. Two independent surveys were conducted: 388 medical students were interviewed before the epidemic, and 222 medical students a year after the COVID-19 epidemic began. Results revealed significant changes in stress levels, with a reduction in mild stress and an increase in severe stress during the post-pandemic period, rising from 23% (95% CI: 19%-28%) to 46% (95% CI: 39%-52%). While tobacco smoking prevalence remained stable (25% vs 27%), the proportion of students exhibiting high levels of nicotine dependence increased (3.64%) compared to the period before the pandemic (1.80%). Alcohol consumption rates remained consistent (66%), with no significant differences in the distribution of risky alcohol consumption between the two periods (<em>p</em> = 0.535). Surprisingly, there was a significant decrease in cannabis use post-pandemic (16% vs 6%), though problematic use among users persisted (49% vs 46%). Multivariable analysis confirmed associations between stress and tobacco smoking (AdjOR = 1.98, 95% CI: 1.11-3.53; <em>p</em> = 0.020), as well as alcohol consumption (AdjOR = 1.71, 95% CI: 1.01-2.89; <em>p</em> = 0.047). Furthermore, male students were more likely to engage in alcohol (AdjOR = 2.16, 95% CI: 1.47-3.19; <em>p</em> < 0.001) and cannabis use (AdjOR = 1.79, 95% CI: 1.07-3.00; <em>p</em> = 0.027). The study highlighted the complex interplay between stress and substance use among medical students, underscoring the importance of targeted interventions to address stress-related substance use and support the well-being of medical students, particularly in the context of the COVID-19 pandemic. Further research should explore longitudinal trends and the effectiveness of interventions in mitigating stress-related substance use among this vulnerable population.

Prognostic Value of Lymph Node Ratio (LNR) in Patients with Postoperative N2 Feature in Non-Small Cell Lung Cancer (NSCLC).

Introduction: One of the most important prognostic factors in non-small cell lung cancer (NSCLC), a condition with a high mortality rate, is the presence of mediastinal lymph node metastases alongside distant metastases. The aim of this study was to evaluate the prognostic value of selected parameters of N2 stage NSCLC with a special focus on lymph node ratio (LNR). Material: The study included 163 patients (61 women and 102 men) operated on due to NSCLC, postoperatively diagnosed as stage N2. The age of the patients ranged from 38 to 82 years (mean age: 62.4 years). The effects of the following factors on clinical data and survival rate were assessed: N1 stage, total number of all metastatic nodes, LNR and LNR N2 ratios, and the presence of skip, single- or multistation metastases. Results: Univariate analysis showed patient survival to be correlated with LNR and LNR N2 ratios, single/multistation metastases, and the number of nodes involved in metastasis. A multivariate model based on patient clinical data found nicotine dependence (p = 0.013), LNR > 0.26 (p = 0.004), and Charlson Comorbidity Index (CCI) value > 3 (p = 0.014) to be independent adverse prognostic factors in this group. Conclusions: LNR ratio is a significant cancer disease-derived independent prognostic factor for patients with postoperative N2 stage NSCLC. In addition, smoking and comorbidities also appear to have prognostic value.

Association of Semaglutide With Tobacco Use Disorder in Patients With Type 2 Diabetes : Target Trial Emulation Using Real-World Data.

Reports of reduced desire to smoke in patients treated with semaglutide, a glucagon-like peptide receptor agonist (GLP-1RA) medication for type 2 diabetes mellitus (T2DM) and obesity, have raised interest about its potential benefit for tobacco use disorders (TUDs). To examine the association of semaglutide with TUD-related health care measures in patients with comorbid T2DM and TUD. Emulation target trial based on a nationwide population-based database of patient electronic health records. United States, 1 December 2017 to 31 March 2023. Seven target trials were emulated among eligible patients with comorbid T2DM and TUD by comparing the new use of semaglutide versus 7 other antidiabetes medications (insulins, metformin, dipeptidyl-peptidase-4 inhibitors, sodium-glucose cotransporter-2 inhibitors, sulfonylureas, thiazolidinediones, and other GLP-1RAs). The TUD-related health care measures (medical encounter for diagnosis of TUD, smoking cessation medication prescriptions, and smoking cessation counseling) that occurred within a 12-month follow-up were examined using Cox proportional hazards and Kaplan-Meier survival analyses. The study compared 222 942 new users of antidiabetes medications including 5967 of semaglutide. Semaglutide was associated with a significantly lower risk for medical encounters for TUD diagnosis compared with other antidiabetes medications, and was strongest compared with insulins (hazard ratio [HR], 0.68 [95% CI, 0.63 to 0.74]) and weakest but statistically significant compared with other GLP-1RAs (HR, 0.88 [CI, 0.81 to 0.96]). Semaglutide was associated with reduced smoking cessation medication prescriptions and counseling. Similar findings were observed in patients with and without a diagnosis of obesity. For most of the group comparisons, the differences occurred within 30 days of prescription initiation. Documentation bias, residual confounding, missing data on current smoking behavior, body mass index, and medication adherence. Semaglutide was associated with lower risks for TUD-related health care measures in patients with comorbid T2DM and TUD compared with other antidiabetes medications including other GLP-1Ras, primarily within 30 days of prescription. These findings suggest the need for clinical trials to evaluate semaglutide's potential for TUD treatment. National Institutes of Health.

Effect of the Heaviness of Smoking Index (HSI) and Duration of Smoking on Central Neural Processing Using Brainstem Auditory Evoked Responses (BAERs).

Purpose of study The goal of this research was to find the correlation of nicotine dependence and duration of smoking with the status of central neuronal processing in chronic smokers. Our primary objective was to record brainstem auditory evoked responses (BAERs) in chronic smokers and further find their correlation to the Heaviness of Smoking Index (HSI) scores and years of non-abstained smoking of the subjects. We postulated that smoking leads to myelination abnormalities which in turn causes decreased impulse conduction velocity. Methods After obtaining informed consent, we conducted BAER on 60 male smokers who were further classified into groups based on their HSI scores (low, moderate, and high nicotine dependency) and 20 age-matched, non-smoking males. The obtained data was examined using the two-way ANOVA test and the Kruskal-Wallis test. Pearson's coefficient of correlationand the median (as a measure of central tendency) were calculated. Results We observed a non-significant negative correlation between wave I BAER latency and the degree of nicotine dependence. Wave II showed minimal correlation, whereas a positive correlation was seen in waves III, IV, and V. Interpeak latencies (IPL) I-III and III-V showed a non-significant positive correlation with the HSI score, whereas IPL I-V showed a significant positive correlation with the same. When correlated with the duration of smoking (years), the latencies (msec) of BAER waves I-V showed a pattern of progressively decreasing negative correlation, out of which waves I, II, and III were significantly affected. The IPL (msec) of waves I-III was non-significantly, yet positively, correlated, while the IPL of waves I-V and III-V showed a significant positive correlation to the duration of smoking. Conclusions The degree of nicotine dependence and duration of tobacco smoking progressively affected the latencies of BAER waves at the pontomedullary level of the brainstem. This indicates slower central neuronal processing at this level and an increased central transmission time, the extent of which is directly dependent on the extent of tobacco smoking. This is attributed to the myelination defects caused by direct and indirect effects of the toxic metabolites of tobacco smoke, chronic hypoxia, hypercapnia, and respiratory acidosis.

Reprint of: Smoking and pulmonary health in women: A narrative review and behavioral health perspective

ObjectiveCigarette smoking prevalence has declined slower among women than men, and smoking-related pulmonary disease (PD) has risen among women. Given these trends, there is a critical need to understand and mitigate PD risk among women who smoke. The purpose of this narrative review and commentary is to highlight important evidence from the literature on smoking and PD among women. MethodsThis review focuses broadly on examining cigarette smoking and PD among women within six topic areas: (1) demographic characteristics and prevalence of smoking, (2) smoking behavior, (3) lung cancer, (4) obstructive PD, (5) diagnostic and treatment disparities, and (6) gaps in the literature and potential directions for future research and treatment. ResultsGrowing evidence indicates that compared to men, women are at increased risk for developing smoking-related PD and poorer PD outcomes. Gender disparities in smoking-related PD may be largely accounted for by genetic differences and sex hormones contributing to PD pathogenesis and presentation, smoking behavior, nicotine dependence, and pathogen/carcinogen clearance. Moreover, gender disparities in smoking-related PD may be exacerbated by important social determinants (e.g., women with less formal education and those from minoritized groups may be at especially high risk for poor PD outcomes due to higher rates of smoking). ConclusionRising rates of smoking-related PD among women risk widening diagnostic and treatment disparities. Ongoing research is needed to explore potentially complex relationships between sex, gender, and smoking-related PD processes and outcomes, and to improve smoking-cessation and PD treatment for women.

Cannabis use disorder and substance use treatment among U.S. adults

IntroductionRecent expansion of cannabis legalization in multiple states calls for reexamination of the prevalence of cannabis use, cannabis use disorder (CUD), and the associations between CUD severity and substance use treatment. We used Andersen's behavioral model of healthcare use as the conceptual/analytic framework for examining treatment use. MethodsWe used data from the 2022 National Survey on Drug Use and Health (NSDUH; N = 47,100, age 18+) to describe the prevalence of past-year cannabis use, CUD and CUD severity, other substance use disorders, and substance use treatment. We compared sociodemographic, mental health, healthcare use, and cannabis and other substance use characteristics by CUD severity. Finally, we used logistic regression models to examine the associations between CUD severity and substance use treatment. ResultsOf the U.S. adult population, 23.0 % used cannabis in the past year; 7.0 % had a CUD (3.9 % mild, 1.9 % moderate, and 1.2 % severe CUD); and 4.7 % received substance use treatment. Of past-year cannabis users, 30.3 % had CUD (16.9 % mild, 8.4 % moderate, and 5.0 % severe CUD), and 9.6 % received substance use treatment. Cannabis users had 3–4 times higher rates of other substance use disorders than nonusers. Of those with CUD, 38.4 % had moderate/severe mental illness, 52.4 % had other substance use disorders, and 16.5 % received substance use treatment. Among all cannabis users, moderate (aOR [adjusted odds ratios] = 1.48, 95 % CI = 1.03–2.13) and severe (aOR = 2.57, 95 % CI = 1.60–4.11) CUDs were associated with greater odds of substance use treatment. Among cannabis users without nicotine dependence and alcohol, opioid, tranquilizer/sedative, and stimulant use disorders, only severe CUD (aOR = 6.03, 95 % CI = 3.37–10.78) was associated with greater odds of substance use treatment. ConclusionsThis study shows increased prevalence of cannabis use and CUD among U.S. adults, and with or without other substance use disorders, CUD was associated with greater odds of substance use treatment. However, the overall low rate of treatment use among those with CUD is concerning. Healthcare providers need to provide education for both medical and recreational users on the development of tolerance and dependence. Harm reduction strategies to minimize the negative consequences of CUD are also needed.

Nicotine Gum in Thai Smokers with Different CYP2A6 Enzymes: A Population Pharmacokinetic Analysis

Objective: Despite the popularity of nicotine gum in Thailand, population pharmacokinetics of nicotine gum in the Thai population has not been investigated. This study aimed to develop a population pharmacokinetic (POPPK) model of nicotine and to quantify the effects of genetic and non-genetic factors to nicotine pharmacokinetics. Materials and Methods: Secondary data collected from a previous clinical trial assessing cytochrome P450 2A6 (CYP2A6) genotypes in Thai smokers was investigated. Eighteen participants who had received a single dose of 2 mg nicotine gum were included. Blood samples were collected before, at 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 4.5 and 6 hours after nicotine administration. POPPK analysis was performed using nonlinear mixed effect modelling. Results: One-compartment with 1st order elimination and absorption with 6-transit compartments best described the data. CYP2A6 enzyme activity was a significant covariate on the nicotine clearance. Apparent elimination clearance (CL/F) for a person with 100% CYP2A6 activity was 266.0 L/h. CL/F would be 36.0 L/h in a subject with 0% CYP2A6 activity. However, the impact of non-genetic factors (monthly alcohol consumption, Fagerstrom Test for Nicotine Dependence score and the number of cigarettes per day) on pharmacokinetics of nicotine were not found. Conclusion: This first report on population pharmacokinetics of nicotine gum in Thai smokers provided the pharmacokinetic model and quantified CL/F for smokers with different CYP2A6 genotypes. A markedly lower exposure to nicotine in the Thai population compared to others highlights the need for more studies to ensure the efficacy of nicotine gum in the Thai population.

Associations between Nicotine Dependence, Smartphone Usage Patterns, and Expected Compliance with a Smoking Cessation Application among Smokers.

Smoking remains the leading cause of preventable disease. However, smokers have shown poor compliance with smoking cessation clinics. Smartphone applications present a promising opportunity to improve this compliance. This study aimed to explore the relationship between nicotine dependence, smartphone usage patterns, and anticipated compliance with a smoking cessation application among smokers, with the goal of informing future development of such applications. A total of 53 current smokers were surveyed using a questionnaire. Nicotine dependence was assessed using the Fagerstrom Test for Nicotine Dependence (FTND). Variables included the number of hours spent using a phone, willingness to quit smoking, number of previous quit attempts, desired number of text messages about smoking cessation, expected duration of application usage, and FTND scores. Kendall's partial correlation, adjusted for age, was employed for the analysis. The amount of time smokers spent on their mobile devices was negatively correlated with the number of smoking cessation text messages they wanted to receive (τ coefficient = -0.210, p = 0.026) and the duration they intended to use the cessation application (τ coefficient = -0.260, p = 0.006). Conversely, the number of desired text messages was positively correlated with the intended duration of application usage (τ coefficient = 0.366, p = 0.00012). Smokers who spent more time on their mobile devices tended to prefer using the cessation application for shorter periods, whereas those who desired more text messages about smoking cessation were more inclined to use the application for longer durations.

“Do all bisexuals have this power?”: An exploratory study of “crippling nicotine addiction,” identity, and other emergent themes in vaping messages on QueerTok

Nicotine and tobacco use disproportionally affects sexual and gender minority (SGM) populations in the United States. Social media narratives may contribute to these disparities. This qualitative study delineated perceptions and experiences depicted in SGM-related videos about nicotine vaping on TikTok. Young adult researchers engaged in every step of the research process, adding an insider perspective. Using four TikTok accounts, we used vaping and SGM-related search terms to sample videos in March–April 2022. Three TikTok accounts collected SGM-specific videos; a fourth provided non-SGM specific videos for comparison. We iteratively sorted 303 unique videos into 32 a priori and emergent codes and identified themes in SGM videos and comparison videos. In their videos, creators displayed awareness of and ambivalence toward vaping and nicotine dependence. SGM videos reflected vaping as a salient feature of identity and a consideration in romantic partnership. Studying video-based social media platforms, like TikTok, using an insider-engaged qualitative lens promotes rich interpretation of content to identify prevalent and emerging messages, which can inform appropriate interventions for SGM young people.

Exploring the association between melatonin and nicotine dependence (Review).

Due to the addictive qualities of tobacco products and the compulsive craving and dependence associated with their use, nicotine dependence continues to be a serious public health concern on a global scale. Despite awareness of the associated health risks, nicotine addiction contributes to numerous acute and chronic medical conditions, including cardiovascular disease, respiratory disorders and cancer. The nocturnal secretion of pineal melatonin, known as the 'hormone of darkness', influences circadian rhythms and is implicated in addiction‑related behaviors. Melatonin receptors are found throughout the brain, influencing dopaminergic neurotransmission and potentially attenuating nicotine‑seeking behavior. Additionally, the antioxidant properties of melatonin may mitigate oxidative stress from chronic nicotine exposure, reducing cellular damage and lowering the risk of nicotine‑related health issues. In addition to its effects on circadian rhythmicity, melatonin acting via specific neural receptors influences sleep and mood, and provides neuroprotection. Disruptions in melatonin signaling may contribute to sleep disturbances and mood disorders, highlighting the potential therapeutic role of melatonin in addiction and psychiatric conditions. Melatonin may influence neurotransmitter systems involved in addiction, such as the dopaminergic, glutamatergic, serotonergic and endogenous opioid systems. Preclinical studies suggest the potential of melatonin in modulating reward processing, attenuating drug‑induced hyperactivity and reducing opioid withdrawal symptoms. Chronotherapeutic approaches targeting circadian rhythms and melatonin signaling show promise in smoking cessation interventions. Melatonin supplementation during periods of heightened nicotine cravings may alleviate withdrawal symptoms and reduce the reinforcing effects of nicotine. Further research is required however, to examine the molecular mechanisms underlying the melatonin‑nicotine association and the optimization of therapeutic interventions. Challenges include variability in individual responses to melatonin, optimal dosing regimens and identifying biomarkers of treatment response. Understanding these complexities could lead to personalized treatment strategies and improve smoking cessation outcomes.

Smoking Habits, Loneliness and Self-esteem Among Young Adults

This study explores the relationship between smoking habits, loneliness, and self-esteem among young adults. A sample comprising 144 non-smokers and 103 smokers was assessed using the Rosenberg Self-Esteem Scale, the UCLA Loneliness Scale, and the Fagerström Test for Nicotine Dependence (FTND). Statistical analysis revealed no significant differences in self-esteem and loneliness levels between smokers and non-smokers. These findings suggest that smoking status does not significantly impact loneliness or self-esteem in young adults, challenging common perceptions about the psychological correlates of smoking behavior. Further research is recommended to explore underlying factors and potential mediators in these relationships.

Consumption of tobacco products and associated factors among outpatient visitors of two healthcare facilities in Northern Cyprus: a descriptive cross-sectional study

Background Tobacco use is one of the leading causes of preventable mortality and morbidity. Although Cyprus is considered a developed country, the tobacco prevalence and related issues have not been explored sufficiently in the general population of North Cyprus. Objective The objective of this study is to determine the rate of tobacco product consumption and related factors among the visitors of a community health center and a university hospital in Northern Cyprus. Methods The study was designed as a cross-sectional study The data were collected using a questionnaire developed in compliance with WHO guidelines. The data were analyzed using IBM-SPSS18.0 with p < 0.05 evaluated as significant. Results Out of a total of 635 individuals approached, 615 provided responses. The participation rate was 96%. The frequency of male smokers was 47.2%, while the frequency of female smokers was 34.0%, with a total smoking rate of 40.7%, much higher than world averages. The survey identified friendship influence as the primary reason for starting tobacco use, accounting for 42%, followed by being stressed at 34.6%. Male gender, being single, having no children, Turkish nationality were predictors of smoking, while financial status was not. The participants indicated a high frequency regarding exposure to passive smoke (51.1%). More than half of the respondents thought tobacco control in Northern Cyprus is not satisfactory. Conclusion More research needs to be done to determine the exact overall prevalence of tobacco consumption in the population, which was found high in this study. Moreover, implementation of comprehensive tobacco control strategies is essential to control the prevalent tobacco dependence.

The Agreement between the Fagerström Test for Nicotine Dependence and the Heaviness of Smoking Index among Iranian Male Smokers.

Nicotine dependence is one of the most significant barriers to smoking cessation. Therefore, measuring this dependence is crucial for effective smoking cessation interventions. The current study aimed to evaluate the degree of agreement between the Fagerström Test for Nicotine Dependence (FTND) and the Heaviness of Smoking Index (HSI) among Iranian smokers. We analyzed the data obtained from two previous studies among 580 daily smokers in Iran. Data were collected using the FTND scale. Cohen's kappa was utilized to assess the degree of agreement between HSI and FTND. The HSI showed significant agreement with FTND (Cohen's kappa=0.72) in assessing nicotine dependence, with a sensitivity of 88.6% and a specificity of 90.3%. The HSI is a valid and reliable tool for measuring nicotine dependence, exhibiting significant agreement with FTND. As a result, the HSI can be considered an alternative to the FTND in both clinical and research settings, particularly for heavy smokers.

Patterns of Nicotine Use Among Women in the Rural Population of Kolar: A Cross-Sectional Study.

Background The prevalence of smokeless tobacco (SLT) use among Indian women, particularly those from lower socioeconomic backgrounds with little access to formal education, has been steadily increasing, which is a cause for concern. Women frequently use various forms and companies of powdered, rubbed, and chewed SLT, with or without betelnut and flavorings, often simultaneously, starting at an early age and persisting into their reproductive years. Consequently, they are vulnerable to both the chance of developing cancer and experiencing health issues during pregnancy and childbirth. The purpose of the study was to assess the prevalence of women using SLT and the factors that were linked to these outcomes. Methodology The community-based analytical, cross-sectional study was carried out for four months (February-May 2024) in the selected rural areas of Kolar district, Karnataka, India. Women aged 15 years and above who lived in the selected rural areas of Kolar district as permanent residents and had a history of nicotine use were included. Women using smoked forms of tobaccoand bedridden or terminally ill cancer patients were excluded from the study. An interviewer administered a semistructured interview schedule to collect data. The questionnaire included sections on sociodemographic characteristics (age, education, occupation, marital status, socioeconomic status, and type of family), nicotine use patterns (types of SLT/nicotine products used and mode of use), maternal history, menstrual history, alcohol consumption history, morbidity conditions, and nicotine dependence, which were assessed by Fagerstrom Test for Nicotine Dependence (FTND). Results The participants, 92 women, ranged in age from 15 to 80 years old, with a mean age of 41.2 years. Most of the participants were diagnosed with oral cancer (n = 19, 20.7%), followed by esophageal cancer (n = 13, 14.1%). When participants were enquired about the mode of usage of tobacco, most of them used chewable form (n = 43, 46.7%). When dependence was assessed by the Fagerstrom nicotine dependence scale, high dependence was observed in 83.7% of women (n = 77), whereas low-to-moderate dependence was observed in 16.3% of women (n = 15). Among the 92 participants, only 16 participants (17.3%) made attempts to quit using SLT. The sociodemographic factors associated with nicotine dependence included age between 41 and 60 years, illiteracy, lower economic status, widowhood, unmarried status, unemployment, Hindu by religion, nuclear family, non-alcoholic, irregular menstrual cycles, and significant maternal history (P-value less than 0.05). Conclusion The development of tailored interventions that address the specific needs of illiterate, unemployed, lower-class, and unmarried women in nuclear families was observed. These interventions should incorporate mental health screening, psychoeducation, and community-based support to promote cessation of SLT and improve their overall well-being.

Nicotine dependence and symptom severity in patients with schizophrenia in Morocco

Nicotine dependence and symptom severity in patients with schizophrenia in Morocco

Determination of pregnant women’s exposure to thirdhand smoke, beliefs and affecting factors: a cross-sectional study from Turkey

ABSTRACT This study was conducted to determine pregnant women’s exposure to third-hand smoke, beliefs and influencing factors. The study included 400 pregnant women in a tertiary care obstetrics and gynecology hospital in Turkey. Data were collected using personal information form, Beliefs About Third-Hand Smoke Scale (BATHS-T) and Fagerström Test for Nicotine Dependence. 13.5% of the pregnant women smoked during pregnancy. However, 78.8% of the pregnant women were exposed to cigarette smoke at home. The mean score of BATHS-T scale and sub-scales increased in those whose spouses had university education or higher, and in pregnant women and their spouses who were public employees. The mean scores of BATHS-T scale and sub-scales were higher in pregnant women in the first trimester of pregnancy and in pregnant women with higher income levels. Community-based awareness of the effects of first, second and third-hand exposure to cigarette smoke on maternal and fetal health should be increased.

Efficacy of a Mobile Health App (eMOTIVA) Regarding Compliance With Cardiac Rehabilitation Guidelines in Patients With Coronary Artery Disease: Randomized Controlled Clinical Trial.

Cardiac rehabilitation is fundamental among patients recovering from a coronary event, and mHealth technology may constitute a useful tool that provides guidelines based on scientific evidence in an entertaining, attractive, and user-friendly format. This study aimed to compare the efficacy of an mHealth intervention involving the eMOTIVA app and that of usual care regarding compliance with cardiac rehabilitation guidelines in terms of lifestyle, cardiovascular risk factors, and satisfaction among patients with acute coronary syndrome. A randomized controlled clinical trial with a parallel group design was conducted. It included 300 patients (mHealth group, 150; control group, 150) who underwent percutaneous coronary intervention for acute coronary syndrome. Both groups underwent evaluations initially (during hospitalization) and after 3 and 6 months (face-to-face consultations). The eMOTIVA app incorporates a virtual classroom providing audio and video information about a healthy lifestyle, a section for self-recording cardiovascular risk factors, and a section for feedback messages and gamification. The primary outcome variables were (1) adherence to the Mediterranean diet and the frequency of consumption of food; (2) physical activity level, sedentary time, and exercise capacity; (3) smoking cessation and nicotine dependence; (4) level of knowledge about cardiovascular risk factors; and (5) app satisfaction and usability. The study analyzed 287 patients (mHealth group, 145; control group, 142). Most participants were male (207/300, 69.0%), and the mean age was 62.53 (SD 8.65) years. Significant improvements were observed in the mHealth group compared with the control group at 6 months in terms of (1) adherence to the Mediterranean diet (mean 11.92, SD 1.70 vs 8.92, SD 2.66 points; P<.001) and frequency of eating foods (red meat [≤1/week]: 141/143, 97.9% vs 96/141, 68.1%; industrial pastries [<2/week]: 129/143, 89.6% vs 80/141, 56.8%; oily fish [≥2/week]: 124/143, 86.1% vs 64/141, 41.4%; vegetables [≥2/day]: 130/143, 90.3% vs 78/141, 55.3%; fruit [≥2/day]: 128/143, 88.9% vs 85/141, 60.2%; all P<.001); (2) physical activity (mean 2112.66, SD 1196.67 vs 1372.60, SD 944.62 metabolic equivalents/week; P<.001) and sedentary time (mean 8.38, SD 1.88 vs 9.59, SD 2.09 hours; P<.001); (3) exercise capacity (distance: mean 473.49, SD 102.28 vs 447.25, SD 93.68 meters; P=.04); and (4) level of knowledge (mean 117.85, SD 3.83 vs 111.00, SD 7.11 points; P<.001). App satisfaction was high (mean 42.53, SD 6.38 points), and its usability was excellent (mean 95.60, SD 4.03 points). With the eMOTIVA app, favorable results were obtained in the intervention group in terms of adherence to the Mediterranean diet, frequency of eating certain foods, physical activity, sedentary time, exercise capacity, knowledge level, systolic blood pressure, heart rate, and blood sugar level. Furthermore, participants reported high app satisfaction and rated its usability as excellent. Thus, this innovative tool is very promising. ClinicalTrials.gov NCT05247606; https://clinicaltrials.gov/study/NCT05247606.