Regular Tobacco Use Research Articles

Le sommeil des adolescents et ses troubles une enquête en milieu scolaire

Numerous studies emphasized the high prevalence of sleep problems in adolescents. However, it remains to be seen whether these problems are developmental or if they are related to pathological conditions. In order to try to answer this question, we conducted an epidemiological study investigating the prevalence and correlates of sleep disorders in a population of high school adolescents. The sample for this investigation consisted of 652 high school students (344 males and 308 females), aged 13 to 19 years (mean age: 15.1 1.2 years), attending colleges in the North of France. Data for the study were obtained by means of revised versions of the INSERM self-report questionnaires for adolescents. One questionnaire included 113 response choice items investigating the sleep parameters and the sociodemographic, behavioural, health, and environmental condition of the subject. This questionnaire was completed by a self-portrait questionnaire including 27 response choice items about mood, anxiety, instability and the quality of relations with others. In addition, a clinical examination was performed by the clinicians of the school health department in order to investigate the medical history of the subject and his (her) pubertal development. In a first step, statistical analysis showed some significant differences in sleep rates and troubles between males and females. If the total sleep time was found similar in males and females, females were found exhibiting significantly earlier bedtime (p<0.01) and waking time (p<0.005) than males. In addition, trouble falling asleep (p<0.0001), nightmares (p<0.001), need for daytime sleep (p<0.05), and stimulant pill intake (p<0.05) were found significantly more frequent in females. Then, the adolescents were classified into two subgroups. "Insomnia group" included the students who answered "often" or "always" to one of the five questions about: having trouble falling asleep, the occurrence of early awakenings, their need for daytime sleep, sleeping pill intake, and bad sleep quality. "Non insomnia group" included those who answered "never" or "sometimes" in response to the five questions. Results showed that 233 adolescents (35.7%) exhibited persistent sleep disorders, insomnia type. 40.2% of females and 31.6% of males were included in the "insomnia group" (p<0.05). Pubertal development was found significantly more advanced in the "insomnia group" adolescents, more particularly in females. In the same way, concerns about body weight (46.7% vs 38.8%; p<0.005), size and shape (15% vs 8%; p<0.01) were found significantly more frequent in the "insomnia group"; 32.3% of the "insomnia group" adolescents vs 17.9% in the "non insomnia group" reported health problems (p<0.0001). School difficulties were found significantly more frequent in the "insomnia group" compared to the "non insomnia group". The proportion of subjects who have previously repeated at least one school year (p<0.01), who reported bad school performances (p<0.01), and who reported to be "sometimes" or "often" away from school (p<0.01) was significantly higher in the "insomnia group" than in the "non insomnia group". In the same way, data showed that school investing was also significantly weaker in the "insomnia group" adolescents (p<0.01). The proportion of subjects who believed that their relations with parents (12.4% vs 6%; p<0.05), teachers (21.4% vs 10.5%; p<0.0001), or peers (10.2% vs 4.1%; p<0.002) was found significantly higher in the "insomnia group". Risk behaviours were also significantly more frequent in the "insomnia group" adolescents: suicidal ideation (25.1% vs 11.7%; p<0.001), suicide attempt (7.3% vs 3.6%; p<0.05), psychotropic drug use (11% vs 4.9%; p<0.02), regular stimulant drug use (10% vs 5.1%; p<0.005), regular tobacco use (7.8% vs 2.2%; p<0.001), regular alcohol use (13.3% vs 8.3%; p<0.05), and illicit drug use (5.2% vs 1%; p<0.001). Lastly, all the dimensions of the self-portrait were found significantly more affected or negative in the "insomnia group" than in the "non insomnia group". For example, the proportion of subjects who described themself usually sad (10.2% vs 3.4%; p<0.001), anxious (54.9% vs 40.5%; p<0.0001), downcast (41.1% vs 32.6%; p<0.05), or instable (56.9% vs 41.7%; p<0.0001) was significantly higher in the "insomnia group". In this descriptive study, if some data suggest that pubertal development may be involved in the sleep rates or troubles observed in adolescents, the results also show that persistent sleep disorders are significantly associated with physical, psychological or social difficulties. In summary, this study shows that it is essential to take an interest in the quality of sleep in adolescents, which may be a way to approach their psychosocial difficulties.

Maternal smoking during pregnancy: risk factor for ADHD in the offspring?

To examine the specifity of the association between maternal smoking during pregnancy and child behaviour problems. In a prospective longitudinal study of a birth cohort of 362 children at risk parental tobacco use, cognitive and social-emotional child outcome and characteristics of family environment were assessed. About a quarter of mothers reported regular tobacco use during pregnancy. Children in this group exhibited enhanced rates of ADHD. This association held even after adjustment for a number of covariates. The findings suggest that maternal smoking during pregnancy may represent an independent risk factor for ADHD in the offspring.

Risk and protection factors for different intensities of adolescent substance use: when does the Prevention Paradox apply?

The 'Prevention Paradox' applies when low-risk individuals in a population contribute the most cases of a condition or problem behaviour by virtue of their being in the majority, thereby recommending a universal or whole of population approach to prevention. The applicability of a universal as opposed to a targeted high-risk approach to the prevention of youth substance use was examined in two studies of children and adolescents conducted in Victoria, Australia. These studies were reanalysed by recombining developmental, social and individual measures to form cumulative risk indices for substance use. In Study 1, a cross-sectional survey of students, most regular tobacco, alcohol and cannabis use by 15/16-year-olds occurred in the moderate and low-risk groups, recommending a universal prevention strategy. However, the majority of illicit drug use occurred in the highest-risk group (top 15%). Furthermore, in younger age groups both legal and illegal drug use was concentrated mainly in the highest risk group. Study 2 used data from a major longitudinal study where risk factors at around age 11/12 years were used to predict substance use at age 17/18 years. Most students who admitted involvement in frequent smoking, heavy drinking and, although to a lesser degree, cannabis were classified as low or average risk. It is concluded that universal prevention strategies are needed for late adolescent alcohol, tobacco and cannabis use and more targeted strategies for addressing harm related to early age drug use, frequent cannabis use and illegal drug use.

Drinking and drug use in VDPs

Objective This study was designed to investigate the prevalence of alcohol and drug use in vocational dental practitioners (VDPs). Design Anonymous self-report questionnaire. Subjects and methods All UK vocational dental practitioners (n = 719) who started practice in the summer of 1999 were questioned on their use of alcohol, tobacco, cannabis and other illicit drugs whilst a VDP and before graduation. Results Eighty-nine per cent of males and 88% of females reported alcohol use. Of these, 35% of males and 36% of females drank above sensible levels (up to 21 units per week for males, 14 units for females), with 48% of males and 52% of females 'binge drinking'. Thirty-three per cent of respondents reported cannabis use whilst a VDP. Regular drug use (use at least once a month) other than cannabis whilst a VDP was found to be highest among males, with regular ecstasy use reported by 4% and regular cocaine use reported by 2%. Regular tobacco use (ten or more cigarettes per day) was reported by 9% of VDPs. Regular tobacco users were found to be six times more likely to use cannabis on a regular basis, three times more likely to use ecstasy on a regular basis and four times more likely to use cocaine on a regular basis than those VDPs who reported non regular tobacco use. Conclusion VDPs are drinking above sensible limits, binge drinking, using tobacco and indulging in illicit drug use to a degree that will cause health problems. However, use of all substances had reduced since qualification.

Alcohol and drug use among vocational dental practitioners.

This study was designed to investigate the prevalence of alcohol and drug use in vocational dental practitioners (VDPs). Anonymous self-report questionnaire. All UK vocational dental practitioners (n = 719) who started practice in the summer of 1999 were questioned on their use of alcohol, tobacco, cannabis and other illicit drugs whilst a VDP and before graduation. Eighty-nine per cent of males and 88% of females reported alcohol use. Of these, 35% of males and 36% of females drank above sensible levels (up to 21 units per week for males, 14 units for females), with 48% of males and 52% of females "binge drinking". Thirty-three per cent of respondents reported cannabis use whilst a VDP. Regular drug use (use at least once a month) other than cannabis whilst a VDP was found to be highest among males, with regular ecstasy use reported by 4% and regular cocaine use reported by 2%. Regular tobacco use (ten or more cigarettes per day) was reported by 9% of VDPs. Regular tobacco users were found to be six times more likely to use cannabis on a regular basis, three times more likely to use ecstasy on a regular basis and four times more likely to use cocaine on a regular basis than those VDPs who reported non regular tobacco use. VDPs are drinking above sensible limits, binge drinking, using tobacco and indulging in illicit drug use to a degree that will cause health problems. However, use of all substances had reduced since qualification.

Regular smokeless tobacco use is not a reliable predictor of smoking onset when psychosocial predictors are included in the model

Regular smokeless tobacco use is not a reliable predictor of smoking onset when psychosocial predictors are included in the model

Assessment and Diagnosis of Nicotine Dependence in Mental Health Settings

This study evaluated the frequency of documented assessment of smoking status and the diagnosis of nicotine dependence in a random sample of 153 mental health records and 152 medical records. The results indicated that tobacco use was routinely documented in the mental health records (88%) and medical records (87%). However, a diagnosis of nicotine dependence was given in only 2% of the mental health records (1/49) and 7% of the medical records (2/30) for those patients with documented regular tobacco use. These results suggest that clinicians do not routinely diagnose Nicotine Dependence even when diagnostic criteria are met.

Distal Biceps Tendon Ruptures

The purpose of the current study was to determine the incidence of distal biceps tendon ruptures within a defined population, to describe the demographics of affected individuals, and to identify potential risk factors. The healthcare system in this study provides care to a known number of members in an area defined by zip codes and proximity to the medical center. Medical records for all members who presented with injuries about the elbow during a 5-year period were reviewed. Thirteen men and one woman with an average age of 47 years comprised the study population. The dominant extremity was involved in 86% of patients. All patients described a mechanism involving excessive eccentric tension as the arm was forced from a flexed position. The incidence of injury in the membership population averaged 1.2 ruptures per 100,000 patients per year. Forty-three percent reported regular tobacco use, whereas only 9% of all members were smokers. A Poisson regression analysis revealed a 7.5 times greater risk of distal biceps tendon rupture in patients who smoke. The incidence of distal biceps tendon ruptures is 1.2 per 100,000 patients, with the majority in the dominant elbow of men who smoke and who are in their fourth decade of life.

The joint analysis of personal interview and family history diagnoses: evidence for validity of diagnosis and increased heritability estimates.

Psychiatric diagnoses obtained at personal interview are only moderately reliable and depend critically on accurate self-observation. Reports by family members provide additional information but may be biased. It is unclear how best to combine these two sources of diagnostic data. Using complete data on lifetime prevalence for six disorders in approximately 1200 male-male twin pairs from a population based registry, we first applied a standard bivariate twin model--which treats self-diagnoses and informant-diagnoses as separate phenotypes--and then examined a 'multiple-rater' model--which assumes that self-report and co-twin-report are fallible indices of one underlying disease liability. Best-fit models were chosen using Akaike's information criterion. Standard bivariate analyses indicated that the same genetic factors accounted for variation in self-reported and co-twin-reported diagnoses. The multiple-rater model produced a substantial decrease in variance attributed to individual-specific environment and a proportional increase in heritability of liability for major depression, generalized anxiety disorder, alcohol dependence and adult antisocial behaviour, but not for drug abuse/dependence or regular tobacco use. The best-fit model consistently included either a 'bias' or a 'correlated error' path. No evidence for family environmental risk factors was found for any disorder. The genetic factors that influence self-report psychiatric illness also influence psychiatric illness as described by relatives. For many psychiatric disorders, incorporation of self-report and family history data in a single model may reduce measurement error and increase estimates of heritability. However, account must be taken of the fact that family history reports are systematically biased. While promising, these results are preliminary and require replication.

Parotid abscess caused by Salmonella enteriditis in a patient with parotid masses

Parotid abscess is a condition resulting from the progression of acute bacterial parotitis. It may be distinguished from acute parotitis by fluctuance, pitting, and loculated suppuration. Predisposing factors include dehydration, certain medications, some medical conditions, and an immunocompromised state. The typical bacterial organisms of a parotid abscess are similar to those seen with acute parotitis. The most common organism isolated is Staphylococcus aureus. Additional bacterial pathogens include Streptococcus pneumoniae, Streptococcus pyogenes, Escherichia coli, Haemophilus influenzae, and oral anaerobes (Bacteroides and Peptostreptococcus). Infection of the parotid gland by Salmonella species has been reported in immunocompromised individuals, as well as patients with histories of recent gastrointestinal illness. We describe a case of parotid abscess caused by Salmonella enteriditis in an otherwise healthy patient with known parotid masses. A 75-year-old white man with a 5-year history of bilateral parotid masses presented to the otolaryngology clinic with complaints of a new onset of right-sided facial pain. During his initial evaluation 5 years previous, an (MRI) Magnetic resonance Imaging scan showed bilateral intraparotid masses consistent with Warthin’s tumor. The MRI estimated the right parotid neoplasm to be 4 3 4 cm, and the left to be 3 2 3 cm. The patient was asymptomatic and declined surgical intervention at that time. Two days before the most recent presentation, he experienced a sudden onset of right-sided facial pain, for which he took acetaminophen with adequate relief. The pain became progressively worse over the following 2 days and was refractory to acetaminophen and ibuprofen. The day before presentation he reported having a fever, which was not measured. On the day of presentation he noted a significant increase in pain and the size of the right parotid/facial mass. He denied any nausea, vomiting, diarrhea, or abdominal cramps. The patient denied regular use of alcohol or tobacco. Past surgical history, past medical history, family history and social history were noncontributory. The patient is not an intravenous drug user and has never received a blood transfusion. He denied recent ingestion of eggs or poultry. He had no recent exposure to reptiles. On physical examination, the patient was in mild distress. Visual inspection showed significant facial assymetry. There was a protuberance of tissue in the parotid regions bilaterally, especially on the right. Gross examination showed a 6 by 8 cm right parotid mass with decreased mobility and no skin fixation. There was a small amount of skin erythema near the mass center. On palpation, the area was found to be firm and tender without discrete nodules or fluctuance. No purulence was expressed from Stensen’s duct, and there was flow of clear saliva. The left parotid mass was 3 by 4 cm; it was soft and nontender without erythema. Facial nerve function was intact bilaterally. The remainder of the examination, including flexible fiberoptic laryngoscopy, was unremarkable. The patient underwent fine needle aspiration and a second MRI of the lesion. The fine From the Naval Medical Center Portsmouth, Portsmouth, VA. Address reprint requests to Shawn D. Kosnik, DO, LT MC USN, Naval Medical Center Portsmouth, Charette Health Care Center, 27 Effingham Street, Portsmouth, VA 23708-5000. This is aUSgovernmentwork. There are no restrictions on its use. 0196-0709/02/2302-0001$0.00/0 doi:10.1053/ajot.2002.31217

Chewing tobacco: who uses and who quits? Findings from NHANES III, 1988-1994. National Health and Nutrition Examination Survey III.

This study identified mutually exclusive groups of men at high and low risk for use of chewing tobacco and for quitting. Analyses used a national sample of 1340 non-Hispanic Black, 1358 Mexican American, and 1673 non-Hispanic White men, aged 25 to 64, who participated in the National Health and Nutrition Examination Survey III from 1988 to 1994. Signal detection analysis was used to delineate high- and low-risk subgroups; survival analysis was used to estimate hazard curves for comparing age at onset for chewing tobacco use with that for smoking. Rural, lower-income Black and White men had the highest regular use of chewing tobacco (33.3%), followed by rural, higher-income men regardless of race/ethnicity (14.9%). Southern men who began using chewing tobacco during adulthood had the lowest quit rate (22.5%). In sharp contrast to smoking, chewing tobacco showed a continued onset throughout adulthood. Because subgroups of men show highly different chewing tobacco use and quit rates and because age at chewing tobacco onset occurs across the life span, prevention and cessation programs should be specific to different risk groups and distinct from smoking programs.

Nicotine Dependence and Regular Nicotine Use in Adult Children of Alcoholics

In this study the relation between parental alcoholism and tobacco use and nicotine dependence in adult children is explored. Data were used from the National Comorbidity Survey (NCS), a nationwide survey of the US population aged 15 to 54. A sample of 2,728 subjects was selected who could answer all relevant questions about either their father or mother. Regular tobacco use and nicotine dependence are found to be strongly related to having an alcoholic parent. Among subjects who used tobacco regularly at some time, adult children of alcoholics (ACOAs) had a higher risk of developing nicotine dependence (attributable risk: 13.3%), and ACOAs had started regular nicotine use earlier (mean age 18.22 years in ACOAs versus 16.60 in non-ACOAs). The relation between parental alcholism and nicotine dependence in ACOAs can be related to a genetic predisposition or to environmental factors.

Prevalencia de tabaquismo y bajo desempeño escolar, en estudiantes de 11 a 24 años de edad del estado de Morelos, México

Objective. To assess the association between self-reported academic performance and tobacco experimentation and established tobacco use among adolescents and young adults in Morelos State, Mexico. Material and Methods. A population-based, cross-sectional study was carried out in 72 administrative areas from all 33 municipalities of Morelos State (urban, semi-urban and rural areas). A total of 13 293 adolescents and young adults aged 11 to 24 years were randomly selected from public schools. Data were collected using a self-administered questionnaire. Multinomial logistic regression models were fitted with smoking habit as the dependent variable with three categories (never a smoker, occasional smoker, and regular smokers). Results. The prevalence of occasional smokers was 14.9% (95% CI: 14.115.7) among females and 27.3% (95% CI: 26.1-28.4) among males. The corresponding figures for females and males for established smokers were 6.1% (95% CI: 5.6-6.6) and 13.1% (95% CI: 12.2-13.9), respectively. Academic performance selfreports were found to be inversely proportional to occasional or regular tobacco use. In women, the association with current tobacco consumption was 5.1 times higher

The relationship of early-onset regular smoking to alcohol use, depression, illicit drug use, and other risky behaviors during early adolescence: results from the youth supplement to the third national health and nutrition examination survey.

Recently we found that the early onset of regular tobacco use is as predictive of lifetime drug use and depressive disorders as it is of alcohol use disorders [Alcohol.: Clin. Exp. Res. 23 (1999) 513.]. This finding, which paralleled findings regarding early onset of alcohol use [J. Subst. Abuse 10 (1998) 59.], suggested that early regular use of any drug might simply be an indicator of risk for a constellation of problem behaviors. The purpose of the present study is to test this hypothesis as well as to study the strength and patterns of associations among these problem behaviors already present among youth. The results will permit description of more precise profiles to identify groups of children at risk. Using data for respondents aged 12-16 from the Third National Health and Nutrition Examination Survey (NHANES III), descriptive statistics were calculated and logistic regression models were estimated. Descriptive analyses indicated that in comparison with those who never smoked, or who simply experimented, early-onset regular smokers, both those who began at age 13 or younger and those who did so between 14 and 16, were those most likely to use alcohol and other drugs as well as have school problems and early sexual experiences culminating in pregnancy. Multivariate logistic regression analyses were conducted to assess the associations among these high-risk behaviors. These results support the hypothesis that early onset of smoking is but an indicator of a syndrome of problem behaviors already in place during childhood. They also suggest that the significance of an age onset variable may differ depending on the age of the sample used. As follow-up data are collected, we expect to learn much about the natural course of the distinct risk groups identified in the analyses by studying longitudinally this nationally representative group of early adolescents.

Association Between Psychiatric Disorders and the Progression of Tobacco Use Behaviors

To examine the progression of tobacco use and the patterns of comorbidity of tobacco use and psychiatric disorders. The authors conducted analyses of prospective and retrospective reports, collected from 1988 to 1998, of a sample of high- and low-risk youths identified on the basis of the presence or absence of a parental history of substance abuse or dependence. A parental history of substance use disorders was associated with regular tobacco use and nicotine dependence, but not with experimentation for all youths. Individual and composite psychiatric diagnoses were strongly associated with nicotine dependence, but not with regular use or experimentation. While the presence of an affective disorder and drug abuse/dependence generally increased the risk for co-occurring nicotine dependence, analyses based on the temporal onset of disorders showed that it was the initiation of alcohol or drug use that predicted the progression to nicotine dependence. For low-risk youths, oppositional defiant disorder was the single psychiatric risk factor that predicted the transition to nicotine dependence. This study adds to the accumulating evidence that has implicated comorbid psychiatric disorders in the etiology and subsequent course of nicotine dependence. In addition, family history may represent an important indicator of an increased risk for nicotine dependence.

The association between psychosis and problematical drug use among Australian adults: findings from the National Survey of Mental Health and Well-Being.

The present paper aimed to: (a) provide Australian estimates of the population-level association between psychotic 'caseness' and substance use; (b) examine liability to problematical substance use according to 'caseness' via the conditional prevalence (prevalence among users); and (c) examine associations between problematical substance use and the number of psychotic symptoms using ordinal logistic regression. Data were from the National Survey of Mental Health and Well-Being (NSMHWB), a stratified multi-stage probability sample of Australian adults, using a subset of persons under the age of 50 years (N = 6722). A screener assessed the presence of characteristic psychotic symptoms. Associations between 'case' status and DSM-IV alcohol, cannabis and other drug use disorders were examined. Ordinal logistic regressions predicting psychosis scores were carried out, including demographic, mental health and drug use variables. Ninety-nine persons (1.2%) screened positively for psychosis. Regular tobacco, alcohol and cannabis use were much more common among persons screening positively, as were alcohol, cannabis and other drug use disorders. Among alcohol and cannabis users, psychosis 'cases' were much more likely to be dependent. Ordinal logistic regressions revealed that regular tobacco use, cannabis and alcohol dependence, and opiate abuse were predictors of psychosis scores. The mental health risks of problematical substance use need to be disseminated to persons at risk of, or suffering from, psychotic illness, and to heavy substance users. Work is needed to develop effective treatment approaches for problematical substance use among persons with psychosis.

Cannabis use among Australian adolescents: findings of the 1998 National Drug Strategy Household Survey

ObjectiveTo describe the prevalence, context and recent trends in cannabis use among Australian adolescents. MethodData was collected from 1,581 adolescents aged 14–19 years as part of the 1998 National Drug Strategy Household Survey, and comparisons were made with data from 350 adolescents who participated in the 1995 survey. ResultsAmong 14–19 year olds, 47.8% have had the opportunity to use cannabis in the past year and 45.2% have used cannabis at least once in their lifetime. Substantial increases have occurred since 1995 in the prevalence of use among young females. While most cannabis use was fairly infrequent, a minority of 14–19 year olds (9.4%) used cannabis at least weekly. Cannabis use was associated with regular tobacco and alcohol use, and other illicit drug use. Regular cannabis users had lower levels of health on the general health and vitality dimensions of the SF‐36. ImplicationsThese results show that cannabis availability and use is common among Australian adolescents, and confirm that there has been an increase in use between 1995 and 1998, although only among young females. Future research is required to understand why this recent increase has occurred, and trends in cannabis uptake and use patterns among this group should be carefully monitored. Interventions may need to be developed and made available to the group of young people who are using cannabis heavily.

Health status and risk behavior of adolescents in the north of Madrid, Spain.

To study the health status and risk behavior in an adolescent population of Madrid, Spain. An anonymous self-administered questionnaire was completed by 2831 pupils aged 14-20 years from urban, suburban, and rural populations in the north of Madrid. A large number of questions were from the Minnesota Adolescent Health Survey questionnaire, which included sociodemographics, health status, drug use, sexual practices, suicidal thoughts, emotional problems, and injury risk. Student's t-test, analysis of variance, and Chi-square statistics are used for analyzing associations between the different variables. A majority (80%) of students thought they are in good or very good health (better for males than females); 18.3% had had intercourse, the average age of the first intercourse was 15.4 years +/- 1.68 SD for males and 16.1 years +/- 1.46 SD for females. Most (73%) had used some kind of contraception. Eighty-five percent had tried alcohol, and regular use (frequently or every day) was as high as 24%. Males drank more than females (28% vs. 20%); 58.2% of the population drink only during weekends, the percentage increasing with age. Seventy percent of the sample had smoked at least once; 34. 5% reported regular tobacco use and this increased with age. Males smoked less than females (27% vs. 42%); 3.2% smoked more than 20 cigarettes/day. The consumption of illegal drugs was very low (20% had tasted cannabis and use by males was higher). Cocaine, heroin, etc. were used by less than 5%. In general, our adolescents are in good health with most problems being preventable. Sexual activity was lower than in other European and American countries. The consumption of tobacco and alcohol started early and in general was high. Our study confirms the relationship among different health-compromising behaviors. There is a need to implement health promotion and preventive programs for adolescents.

Tobacco consumption in Swedish twins reared apart and reared together.

Prior studies of twins reared together suggest that regular tobacco use (RTU) is substantially heritable. However, strong social influences on RTU might have biased these results. We examine the self-report lifetime history of RTU in members of 778 male-male and female-female twin pairs, raised together and apart, born from 1890 to 1958 and ascertained through the population-based Swedish Twin Registry. In men, the pattern of twin resemblance for RTU suggested both genetic and rearing-environmental effects, which, in the best-fit biometrical model, accounted for 61% and 20% of the variance in liability to RTU, respectively. For women, overall results were hard to interpret, but became clearer when divided by birth cohort. In women born before 1925, rates of RTU were low and twin resemblance was environmental in origin. In later cohorts, rates of RTU in women increased substantially, as did heritability. For women born after 1940, heritability of RTU was similar to that seen in men (63%). Genetic factors play an important etiologic role in RTU. In women, the impact of genetic factors increased in more recent cohorts, suggesting that, as social restrictions on female tobacco use relaxed over time, heritable influences increased in importance.

Personality, motivational and situational determinants of regular and occasional use of smokeless tobacco

Abstract This study evaluated the effects of personality, motivational, and situational factors on Regular (n=191) and Occasional (n=80) users of smokeless tobacco (SLT) products. The participants completed the Eysenck Personality Questionnaire (EPQ), Spielberger’s State-Trait Personality Inventory (STPI) and Anger Expression (AX) Scale, and questionnaires designed to evaluate the reasons why SLT-Users begin, continue, and are motivated to use smokeless tobacco. Occasional Users had higher scores than Regular Users on the EPQ Extraversion scale; no other personality differences were found between these groups. Ratings of the importance of the reasons for beginning to use tobacco products were quite similar for the Regular and Occasional Users; novelty and enjoyment were ranked highest by both groups. In contrast, Regular Users rated 7 of the 10 reasons for continuing to use tobacco as significantly more important than Occasional Users; enjoyment, stimulation and management of emotions were ranked as most important by both groups. Findings that smokeless tobacco products enhanced positive affect and intellectual stimulation, and reduced anxiety and boredom were generally consistent with Eysenck’s Diathesis Stress Model.