Tobacco Use Problems Research Articles

Generalized genetic liability to substance use disorders.

Lifetime and temporal co-occurrence of substance use disorders (SUDs) is common and compared with individual SUDs is characterized by greater severity, additional psychiatric comorbidities, and worse outcomes. Here, we review evidence for the role of generalized genetic liability to various SUDs. Coaggregation of SUDs has familial contributions, with twin studies suggesting a strong contribution of additive genetic influences undergirding use disorders for a variety of substances (including alcohol, nicotine, cannabis, and others). GWAS have documented similarly large genetic correlations between alcohol, cannabis, and opioid use disorders. Extending these findings, recent studies have identified multiple genomic loci that contribute to common risk for these SUDs and problematic tobacco use, implicating dopaminergic regulatory and neuronal development mechanisms in the pathophysiology of generalized SUD genetic liability, with certain signals demonstrating cross-species and translational validity. Overlap with genetic signals for other externalizing behaviors, while substantial, does not explain the entirety of the generalized genetic signal for SUD. Polygenic scores (PGS) derived from the generalized genetic liability to SUDs outperform PGS for individual SUDs in prediction of serious mental health and medical comorbidities. Going forward, it will be important to further elucidate the etiology of generalized SUD genetic liability by incorporating additional SUDs, evaluating clinical presentation across the lifespan, and increasing the granularity of investigation (e.g., specific transdiagnostic criteria) to ultimately improve the nosology, prevention, and treatment of SUDs.

Pleiotropy and genetically inferred causality linking multisite chronic pain to substance use disorders.

Individuals suffering from chronic pain develop substance use disorders (SUDs) more often than others. Understanding the shared genetic influences underlying the comorbidity between chronic pain and SUDs will lead to a greater understanding of their biology. Genome-wide association statistics were obtained from the UK Biobank for multisite chronic pain (MCP, Neffective = 387,649) and from the Million Veteran Program and the Psychiatric Genomics Consortium meta-analyses for alcohol use disorder (AUD, Neffective = 296,974), cannabis use disorder (CanUD, Neffective = 161,053), opioid use disorder (OUD, Neffective = 57,120), and problematic tobacco use (PTU, Neffective = 270,120). SNP-based heritability was estimated for each of the traits and genetic correlation (rg) analyses were performed to assess MCP-SUD pleiotropy. Bidirectional Mendelian Randomization analyses evaluated possible causal relationships. Finally, to identify and characterize individual loci, we performed a genome-wide pleiotropy analysis and a brain-wide analysis using imaging phenotypes available from the UK Biobank. MCP was positively genetically correlated with AUD (rg = 0.26, p = 7.55 × 10-18), CanUD (rg = 0.37, p = 8.21 × 10-37), OUD (rg = 0.20, p = 1.50 × 10-3), and PTU (rg = 0.29, p = 8.53 × 10-12). Although the MR analyses supported bi-directional relationships, MCP had larger effects on AUD (pain-exposure: beta = 0.18, p = 8.21 × 10-4; pain-outcome: beta = 0.07, p = 0.018), CanUD (pain-exposure: beta = 0.58, p = 2.70 × 10-6; pain-outcome: beta = 0.05, p = 0.014) and PTU (pain-exposure: beta = 0.43, p = 4.16 × 10-8; pain-outcome: beta = 0.09, p = 3.05 × 10-6) than the reverse. The genome-wide analysis identified two SNPs pleiotropic between MCP and all SUD investigated: IHO1 rs7652746 (ppleiotropy = 2.69 × 10-8), and CADM2 rs1248857 (ppleiotropy = 1.98 × 10-5). In the brain-wide analysis, rs7652746 was associated with multiple cerebellum and amygdala imaging phenotypes. When analyzing MCP pleiotropy with each SUD separately, we found 25, 22, and 4 pleiotropic variants for AUD, CanUD, and OUD, respectively. To our knowledge, this is the first large-scale study to provide evidence of potential causal relationships and shared genetic mechanisms underlying MCP-SUD comorbidity.

Implementation Questions of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) in Georgia

The World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) is an international treaty established by WHO to address the global health issue of tobacco consumption, necessitating implementation at the national legislative level.
 The article explores the global problem of tobacco use and how it led to the creation of an international treaty to regulate it. It discusses how the FCTC was planned and Georgia's role in it. The analysis covers the legal side of the FCTC, including international and local rules for putting it into action. The article also talks about the challenges that have made it difficult to meet the FCTC's obligations from both legal and political viewpoints. This is the first attempt to explain the FCTC and the issues it faces in being adopted and carried out in Georgia.

The Type of Tobacco Consumption Habits & Related Health Problem Among the Tobacco Users – A Retrospective Study

Background: Tobacco is the leading preventable cause of death in Bangladesh and worldwide. Tobacco use leads most common diseases affecting the heart and lungs. Smoking being a major risk factor for heart attacks, strokes, chronic obstruc-tive pulmonary disease (COPD), emphysema, and cancer. The aim of this study was to evaluate tobacco consump tion habits among users and identify associated health problems. Material & Methods: This cross-sectional study was conducted in the Department of Health Education of National Institute of Preven-tive and Social Medicine, Dhaka, Bangladesh. Results: In total respondents who were adult male and female were included in the study. We found the Mean ± SD of age was 38.93 ±2.04. According to Sex, 89.30% were male and 10.70% were female and the majority 103.36% respondents of pattern of tobacco consumtion were smokless. 58.68% consumed Zarda, 54.67% cigarette, 27.34% Gul, 17.34% white tobacco, 8.67% Bidi, and rest of 3.34% consumed tobacco as various method. Tobacco con-sumption showed that a majority of knowledge of problem 50.67% were had cough and health problem the majori-ty 34.67% had dental pain. Conclusion: Health problem of tobacco use among the respondents they still consumed tobacco, so an effective awareness pro-gram to discourage the consumption of tobacco to protect people from the devastating consequences of tobacco usages for own and for the passive smoker.

Administrative liability of juveniles for smoking

The research relevance is determined by the prevalence of smoking among minors, as well as by the insufficient effectiveness of administrative liability measures taken against minors if they have committed an administrative offence – smoking in prohibited places. The research aims to determine the theoretical and legal features of administrative liability and to analyse the measures taken against juvenile offenders. The research aim was achieved by a comprehensive and in-depth analysis of Ukrainian and foreign scientific sources and provisions of current legislation. The author examines the peculiarities of administrative liability of minors for smoking. It is established that, according to the current Ukrainian legislation, administrative liability of minors for smoking may be imposed on persons aged 16-18 years, and the main measure is an administrative penalty (fine) paid by parents. The author provides arguments in favour of lowering the age limit for administrative liability of minors to 13-15 years. The author substantiates the expediency of educational influence on minors through pedagogical and social training aimed at solving the problem of tobacco use among minors. It is noted that such measures will be preventive in nature and will help to reduce the number of cases when minors smoke in prohibited places and will also contribute to solving the problem of smoking among minors in general. It is emphasised that the issue raised in this paper is not only legal but also pedagogical, social, and medical in nature. The practical significance of the results obtained is that they identify gaps in Ukrainian legislation and provide recommendations for improving approaches to the administrative liability of minors for smoking and addressing the problem of smoking among minors

Multivariate genome-wide association meta-analysis of over 1 million subjects identifies loci underlying multiple substance use disorders.

Genetic liability to substance use disorders can be parsed into loci that confer general or substance-specific addiction risk. We report a multivariate genome-wide association meta-analysis that disaggregates general and substance-specific loci for published summary statistics of problematic alcohol use, problematic tobacco use, cannabis use disorder, and opioid use disorder in a sample of 1,025,550 individuals of European descent and 92,630 individuals of African descent. Nineteen independent SNPs were genome-wide significant (P < 5e-8) for the general addiction risk factor (addiction-rf), which showed high polygenicity. Across ancestries, PDE4B was significant (among other genes), suggesting dopamine regulation as a cross-substance vulnerability. An addiction-rf polygenic risk score was associated with substance use disorders, psychopathologies, somatic conditions, and environments associated with the onset of addictions. Substance-specific loci (9 for alcohol, 32 for tobacco, 5 for cannabis, 1 for opioids) included metabolic and receptor genes. These findings provide insight into genetic risk loci for substance use disorders that could be leveraged as treatment targets.

Suicidal crisis in the adolescent: About 3 clinical cases

IntroductionSuicide is the third most common cause of death among adolescents. It is linked to several mental pathologies. Early detection and effective and rapid management are essential elements to improve the mental health of the adolescent and prevent suicidal behaviour.ObjectivesOur objective is :-To discuss through these medical observations the risk factors and pathologies at high risk of suicide,-To detail the urgent course of action to be taken in the event of suicide attempts and-To underline the importance of early management to prevent suicide in adolescentsMethodsWe report hereafter the clinical cases of 3 adolescents followed in child psychiatry for the management of a suicidal crisis.Results1st clinical case :This is a 13 year old girl, brought back by the staff of the Lalla Meryem child protection centre, where she has been living since her separation from her family following abuse by her mother. She reports a reliving of scenes where her mother burned her private parts. She reports disturbed sleep with night terrors and nightmares. In addition, the centre’s staff reported irritability, crying spells and verbalized suicidal threats.2nd clinical case:This is a 15 year old girl referred by the paediatric service for management of a suicide attempt by ingestion of rat poison. She stopped her schooling 2 years ago to take care of her mother who had cervical cancer and died 6 months ago. Since then, she has experienced sadness of mood, low self-esteem with ideas of devaluation. During the first psychiatric interview, she did not criticize her suicidal act and said that she wanted to kill herself, which she considered the only solution to her suffering.3rd clinical case:This is a 12-year-old adolescent, followed in child psychiatry for conduct disorder with problematic use of tobacco, cannabis and benzodiazepines. He had stopped going to school since the third grade.He consulted for a suicide attempt by ingesting 30 antihypertensive tablets. After somatic care, he was referred to us from the medical emergency department for psychiatric care.ConclusionsSuicide among adolescents is on the increase in Morocco. It is necessary to take into account the risk of suicide in the face of any mental or somatic pathology. A rapid and urgent course of action is necessary to avoid recurrence.Disclosure of InterestNone Declared

Os jovens seguem usando narguilé apesar do conhecimento dos possíveis riscos à saúde

Abstract Objective Although the scientific literature show that waterpipe tobacco smoking causes irreversible damage to health, users continue to use it. Method This study evaluates the users’ perceptions about the effect of this consumption on health. This is a qualitative study. A purposeful sample of current users was recruited. Participants were invited to undertake an in-depth semi-structured interview. The interviews were evaluated by content analysis method. Results Most speeches pointed out that the interviewees are aware of the harm to health from using waterpipe tobacco smoking. Although most interviewees were already developing a problematic use of tobacco, alcohol or other drugs, they rarely related waterpipe tobacco smoking with mental health consequences. The essential motivators for its continued use were the perception of control over waterpipe tobacco smoking use, the reinforcing tobacco effects, and the absence of negative health experiences in life. Conclusion Understand that educational campaigns and control measures should be encouraged.

The addiction risk factor: A unitary genetic vulnerability characterizes substance use disorders and their associations with common correlates.

Substance use disorders commonly co-occur with one another and with other psychiatric disorders. They share common features including high impulsivity, negative affect, and lower executive function. We tested whether a common genetic factor undergirds liability to problematic alcohol use (PAU), problematic tobacco use (PTU), cannabis use disorder (CUD), and opioid use disorder (OUD) by applying genomic structural equation modeling to genome-wide association study summary statistics for individuals of European ancestry (Total N = 1,019,521; substance-specific Ns range: 82,707-435,563) while adjusting for the genetics of substance use (Ns = 184,765-632,802). We also tested whether shared liability across SUDs is associated with behavioral constructs (risk-taking, executive function, neuroticism; Ns = 328,339-427,037) and non-substance use psychopathology (psychotic, compulsive, and early neurodevelopmental disorders). Shared genetic liability to PAU, PTU, CUD, and OUD was characterized by a unidimensional addiction risk factor (termed The Addiction-Risk-Factor, independent of substance use. OUD and CUD demonstrated the largest loadings, while problematic tobacco use showed the lowest loading. The Addiction-Risk-Factor was associated with risk-taking, neuroticism, executive function, and non-substance psychopathology, but retained specific variance before and after accounting for the genetics of substance use. Thus, a common genetic factor partly explains susceptibility for alcohol, tobacco, cannabis, and opioid use disorder. The Addiction-Risk-Factor has a unique genetic architecture that is not shared with normative substance use or non-substance psychopathology, suggesting that addiction is not the linear combination of substance use and psychopathology.

Епідеміологічне дослідження поширеності тютюнокуріння серед сучасних підлітків

Мета дослідження — уточнити ситуацію щодо поширеності та статусу тютюнокуріння серед сучасних підлітків за даними анкетування. Матеріали та методи. Проведено дослідження з ви­вчення поширеності тютюнокуріння серед підлітків м. Дніпра (n = 2299 осіб). Результати. За результатами анкетування, активними курцями були 20,8 % підлітків, із них щоденно курили 89,1 %, у тому числі 24,9 % хлопців і 14,6 % дівчат. У середньому підлітки починають регулярно курити в 14,40 ± 0,12 року. Середній стаж тютюнокуріння в підлітків становив 3,4 ± 0,1 року. Середня кількість викурених підлітками за день сигарет становила 9,1 ± 0,3 штуки. Вивчаючи вид тютюнової продукції, установили, що 48,6 % підлітків курять легкі сигарети. Середній індекс курця становив 109,1 ± 3,3 і був вірогідно вищим у юнаків (125,5 ± 4,9), ніж у дівчат (91,9 ± 4,0) (р &lt; 0,001). Вивчаючи мотивацію кинути курити, установили, що лише 20,6 % підлітків мають високу мотивацію кинути курити, тоді як у 31,7 % серед них мотивація кинути курити була взагалі відсутня. Висновки. Проведене дослідження показало, що проблема тютюнокуріння залишається вкрай актуальною — у місті курить кожний п’ятий підліток. Отримані дані обумовлюють необхідність широкого запровадження антисмокінгових програм серед підлітків, що повинні бути направлені насамперед на зниження інтенсивності тютюнокуріння та посилення мотивації кинути курити, пропаганду здорового способу життя, а також проведення ретельного диспансерного огляду підлітків-курців із метою виявлення груп ризику з розвитку хронічного обструктивного захворювання легень.

Associations between Substance Use and Depressive Symptoms among Women Experiencing Intimate Partner Violence

ABSTRACT Associations between substance use and depression among women experiencing intimate partner violence (IPV) have received limited empirical attention. This study examined how demographics, frequency of IPV and problematic substance use were related to depressive symptoms among women exposed to recent IPV. Participants included 112 women (Mage = 32.26; 67% Black) recruited from community organizations in the U.S. Midsouth, many of whom had used substances (80.2%) and were living below the poverty threshold (71.3%). Results from a hierarchical multiple regression analysis revealed that, after accounting for age and income, more frequent IPV and more problematic tobacco use were associated with higher depressive symptoms. Neither alcohol nor illicit substance use were significantly associated with depressive symptoms. These findings highlight a meaningful connection between problematic tobacco use and depressive symptoms, indicating the potential benefits of incorporating tobacco use psychoeducation and cessation strategies into treatment programs for women experiencing depression in the context of IPV.

Role legitimacy, comfort and confidence providing tobacco, alcohol and other drug care: a cross-sectional study of Australian early-career general practitioners

ABSTRACT Australian general practitioners (GPs) see most Australians each year and, as tobacco, alcohol and other drug use (substance use) are common, GPs often see problematic, risky or dependent substance use. This study aimed to explore early-career GPs’ role legitimacy, comfort and confidence managing patients with problematic use of tobacco, alcohol, psychoactive pharmaceutical or illicit substances. Using the ‘5A’s framework: Ask, Assess, Advise, Assist and Arrange, we surveyed 251 early-career GPs (GP registrars) on role legitimacy, confidence managing patient substance use, and sources of clinical information, advice and support. There was strong agreement that managing substance use is a GP’s role, with high levels of confidence ‘Asking’ (screening) about tobacco and alcohol use, which decreased across other substance classes. Early-career GPs reported lower levels of confidence ‘Assessing’ and ‘Advising’ (brief interventions); and much lower levels of confidence ‘Assisting’ (treating) and ‘Arranging’ (follow up and/or referral) for patients with substance issues across all substances, including tobacco. Participants were most likely to seek advice from senior colleagues in their practice. Early-career GPs reported lower than optimal levels of confidence for all substances. Our findings have important implications for educators globally. Education that improves confidence across all 5As for high-prevalence substances (tobacco and alcohol) while focusing on increasing comfort screening and improving understanding of referral pathway options for low-prevalence substances may improve early-career GPs’ confidence. This could increase engagement in managing substance use issues potentially leading to better health and wellbeing outcomes for patients.

Exposure to tobacco smoke among pupils from Sopot primary schools. SOPKARD study results

Abstract Background The problem of tobacco use among minors and in their immediate environment remains a significant challenge in Poland. Although Poland has passed smoke free law children are still being exposed to tobacco smoke. The purpose of this study was to analyze the phenomenon of tobacco use by children in City of Sopot and in their surroundings. Methods The cross-sectional study was conducted as part of the SOPKARD program for early detection of risk factors for civilization diseases in children and adolescents. A limited GYTS questionnaire was utilized to conduct the study. Data was collected from all the fifth grade students (9-11 yo) attending to Sopot primary schools in 2017 and 2018. Results The study involved 385 students (161 in 2017 and 224 in 2018). Only few students tried to smoke traditional cigarettes (3%) or use electronic e-cigarettes (2%). Despite the legal ban, 24% of students saw smokers in the school premises. In addition, 34% of children said that one or both of their parents smokes and that in only slightly more than ¾ of the houses smoking is completely prohibited. As many as 66% of students reported smoking incidents in the cars they travel. There were 16% students who think they could start smoking in the future. Conclusions The results suggest that Sopot children are still exposed to tobacco smoke inhalation. It happens in private, non-smoking areas (homes and family cars). It is worth conducting educational activities and considering legislative initiatives such as smoking ban in vehicles carrying children to stimulate parents to take care more of the health of their children. Key messages Although tobacco legislation in Poland protects people from passive smoking in public places children are still exposed in private premises. Ban on smoking should be extended to privates cars at minimum.

Data Visualization Tools of Tobacco Product Use Patterns, Transitions and Sex Differences in the PATH Youth Data.

Evaluations of multiple tobacco product use and temporal changes in patterns of use are complicated by a large number of combinations and transitions. Visualization tools could easily identify most common patterns and transitions. Set intersection bar plots describe ever use of five tobacco products among 12-17 years old youth in wave 1 of the Population Assessment of Tobacco and Health (PATH) study (N = 11 497). Heat maps visualize unweighted frequencies of transitions from ever use at wave 1 (2013-2014) to past 12-month use at wave 2 (2014-2015). Weighted calibrated heat maps assess differences in relative frequencies of transitions by pattern at wave 1 and identify differences in transitions by sex. The most common tobacco product ever use patterns in wave 1 were of cigarettes only, e-cigarettes only or hookah only, followed by ever use of both cigarettes and e-cigarettes. Initiation of use between waves was uncommon. The most frequent transition among those who reported use at wave 2 but not at wave 1 (N = 971) was to e-cigarette use (N = 301). However, among e-cigarette-only ever users at wave 1 (N = 260), about half did not report any product use at wave 2. Use of three or more products remained stable. Adolescent girls compared to boys appeared more likely to report hookah use at both waves. Set intersection bar plots and heat maps are useful for visualizing tobacco product use patterns and transitions, especially for multiple products. Both techniques could identify common problematic tobacco use patterns across and within populations. Given the growing complexity of the youth tobacco use landscape, approaches to efficiently communicate patterns of multiple tobacco product use should be used more often. This study introduces set intersection bar plots and modified versions of heat maps to the tobacco product literature and illustrates their use in the PATH youth sample. These techniques are useful for visualizing absolute and relative frequencies of multiple possible patterns and transitions. They also suggest targets for subsequent statistical inference such as sex differences in hookah use. The methods can be applied more generally for data visualization wherever large number of combinations occurs.

E-Cigarette Use in a Country With Prevalent Tobacco Smoking: A Population-Based Study in Taiwan.

BackgroundThe different profiles of e-cigarette users in different age groups have seldom been investigated, particularly in populations facing a high prevalence of cigarette smoking. This study aims to examine the prevalence and correlates of e-cigarette use separately for adolescents and adults in nationally representative samples in Taiwan.MethodsAmong 17,837 participants in the 2014 National Survey of Substance Use in Taiwan, 4445 were aged 12 to 17 years and 13,392 were aged 18 to 64 years. Individuals’ lifetime tobacco use was divided into four groups: non-use, exclusive e-cigarette use, exclusive cigarette use, and dual use. Questions on sociodemographic features, use and problematic use of tobacco, alcohol, and other drugs, and psychosocial distress, among others, were administered using a computer-assisted self-interview on tablet computers.ResultsAmong lifetime users of e-cigarette (2.2% for adults and 0.8% for adolescents), 4.5% for adults and 36.6% for adolescents were exclusive e-cigarette users. From use of exclusive e-cigarettes to use of exclusive cigarettes to dual use, those usage groups were related to an increasing trend of adjusted odds ratios for use of other psychoactive substances, particularly problematic use of alcohol or drugs, and with more depressive symptoms. Two correlates were specific to e-cigarette use: alcohol use had stronger relationships with e-cigarette use among adolescents, and younger adults (18–34) were more likely to try e-cigarettes compared to older adults.ConclusionsThese results provide essential information regarding e-cigarette use in the general population, and future prevention strategies should account for its specific correlates in young people.

Transcendendo: A Cohort Study of HIV-Infected and Uninfected Transgender Women in Rio de Janeiro, Brazil

Purpose: Worldwide, the burden of adverse health conditions is substantial among travestis and transgender women (trans women). Transcendendo, the first trans-specific cohort in a low- or middle-income country, is an open cohort established in August 2015 to longitudinally evaluate the health aspects of trans women aged ≥18 years in Rio de Janeiro, Brazil.Methods: Study visits occur on an annual basis. Data on sociodemographics, behavioral, gender transition, affirmation procedures, hormone use, discrimination, violence, clinical and mental health, HIV prevention, and care (for those HIV-infected) are collected. Physical examination, anthropometric measurements, and laboratory tests are performed.Results: As of July 2017, 322 trans women were enrolled in the cohort with a median age of 31.5 years (interquartile range 25.7–39.5), of whom 174 (54%) were HIV-infected. The Transcendendo baseline information reinforces the scenario of marginalization and deprivation surrounding trans women. Most participants had low income (62.0% were living with below US$ 10.00/day), showed a very high engagement in sex work (78.6%), and reported increased occurrence of sexual (46.3%) and physical (54.0%) violence. Pre-exposure peophylaxis (PReP) was used by 18.8% of the HIV-uninfected trans women, only through research participation. Positive screening for depression (57.8%) and problematic use of tobacco (56.6%), cannabis (28.9%), cocaine (23.8%), and alcohol (21.5%) were high. Almost all participants (94.8%) reported hormone use at some point, mostly without medical supervision (78.7%).Conclusion: Our results describe a context of exclusion experienced by trans women, exposing vulnerabilities of this population in a middle-income country, with poor access to trans-specific care, HIV prevention and care, and mental health care. Addressing transgender experiences and needs can help the development of strategies to diminish stigma, improve health care environment, guide future research on trans morbidities, substance use, and trans-specific interventions to support health-related recommendations. Ultimately, it contributes to close the gaps concerning transgender health and reinforces that trans care cannot be disentangled from the social environment that surrounds trans women.

Electronic cigarette use after the adoption of a tobacco-free campus policy

Electronic (e)-cigarette use has increased markedly across groups in the past few years. For this reason, risk factors associated with e-cigarette use warrant further research. This study presents secondary data analyses on e-cigarette use from a large cross-sectional database assessing attitudes toward a tobacco-free campus (TFC) policy prior to policy implementation (n = 1188), one-month post policy (n = 1442), and one-year post policy(n = 1125). Students from a U.S. university located on the border with Mexico (Mage = 25.02 years, SD = 7.99; 59.2% female) were recruited via email to complete an online assessment of their tobacco use, attitudes toward TFC policies, perceived problematic tobacco use, and knowledge of tobacco use risk. The prevalence of any past-30-day e-cigarette use significantly increased from 4.4% to 26.6% between baseline and one-month post-policy, and reduced to 17.3% between one-month post-policy and one-year post policy. Weekly alcohol use was associated with e-cigarette use at each assessment point. There was some evidence of higher e-cigarette use among younger students and current smokers. Additional studies are needed to understand the influence of comprehensive TFC policies on both e-cigarette use and polysubstance use (i.e., alcohol and combustible cigarettes).

Substance use among Danish psychiatric patients: a cross-sectional study

Background: Patients with psychiatric disorders have a greater risk of mortality than the general population. Use or abuse of substances, including alcohol, play a crucial part in this context. Moreover, it is well known that drug use can worsen psychopathology and reduce treatment compliance. However, the magnitude of these problems among Danish psychiatric patients has not been studied previously.Aims: The aim of this study is to investigate substance use among psychiatric patients in the Capital Region of Denmark.Methods: Outpatients from five psychiatric units were asked to complete a questionnaire regarding their use of alcohol and other drugs of abuse. The questionnaire was based on the Alcohol Use Disorder Identification Test (AUDIT), supplemented by questions regarding use of tobacco and illicit drugs. The results were compared with those uses in the general population.Results: In total, 412 psychiatric patients participated in the study, and 33% had an AUDIT-score ≥8, indicating problematic alcohol use according to the AUDIT guidelines. The mean weekly alcohol intake was 9.7 ± 28.3 standard drinks, and 47% were current smokers with a mean daily use of 19.9 ± 13.8 cigarette equivalents. Compared to the general population, the psychiatric patients had higher odds of being current smokers and having used illicit drugs within the past month. Women with psychiatric disorders were twice as likely to binge drink on a monthly basis. No significant difference was found in the patients’ AUDIT scores compared to the general population.Conclusions: Our findings demonstrate a substantial and problematic use of tobacco and illicit drugs among Danish psychiatric patients, greater than in the general population.

Substance use, criminal behaviour and psychiatric symptoms following childhood traumatic brain injury: findings from the ALSPAC cohort

Recent research suggests a link between traumatic brain injury (TBI) in youth and later risk behaviour. We explored the association between mild TBI and psychiatric symptoms, substance use and criminal behaviour using data from a longitudinal birth cohort. Participants with mild TBI (n = 800), orthopaedic injuries (n = 2305) and no injuries (n = 8307) were identified from self and parent reports up to age 16 years. Self-report measures of substance use (alcohol, tobacco and cannabis) and criminal behaviours, and parent-reported psychiatric symptoms were collected at age 17 years. Analyses were adjusted for pre-birth and early childhood confounders. Participants with a TBI showed increased odds of hazardous alcohol use compared to those with no injury and those with an orthopaedic injury. Relative to those with no injury, participants with a TBI showed increased odds of problematic use of tobacco and cannabis, being in trouble with the police and having more parent-reported conduct problems. Sustaining either a TBI or an orthopaedic injury increased the odds of offending behaviour compared to having no injuries. There was no clear evidence of association between orthopaedic injury and the other risk outcomes. The increased odds of risk behaviour associated with TBI relative to no injury replicated previous research. However, the inclusion of a non-brain-related injury group adds evidence for a possible causal pathway between mild TBI in youth and later hazardous alcohol use only. This highlights the importance of including an additional negative control injury group in mild TBI research.

A baseline assessment of attitudes toward tobacco free campus policies in a U.S./México border university

In recent years there has been an increase in the number of smoke/tobacco free settings, including university campuses. Given the benefits associated with the implementation of smoke and tobacco free campus policies, it is important to study attitudes toward these due to their potential association with subsequent implementation issues. The present study assessed potential predictors of attitudes toward tobacco free campus (TFC) policies, tobacco use risk perception, and perceived problematic campus tobacco use at a university located on the U.S./México border. University faculty, staff, and students (N=3002; Mage=30.4; 60% female; 67.1% Hispanic) completed an online survey regarding tobacco use history, attitudes toward TFC policies, tobacco use risk perception, perception of problematic tobacco use on campus, and awareness of the current tobacco use campus policy. Male gender, non Hispanic white ethnicity, smoking behavior (history/current), and identifying the current tobacco use policy were associated with less positive attitudes toward TFC policies and lower tobacco use risk perception. Non Hispanic white ethnicity and current smoking were associated with a lower perception of problematic campus tobacco use. Attitudes toward TFC policies and perceptions were generally positive, yet educating about the risks associated with tobacco use and addressing misconceptions about the dangers of secondhand smoke to potentially promote TFC policies seem warranted.