Risk For Heavy Smoking Research Articles

Correlates of current and heavy smoking among U.S. soldiers returning from combat.

Smoking rates are higher in U.S. soldiers than civilians, with combat-experienced soldiers particularly at risk for heavy smoking (≥20 cigarettes/day). While heavy smoking is correlated with mental health symptoms in civilian samples, the extent to which these symptoms, background variables, and unit climate (self-reported assessments of cohesion, organizational support, and leadership) are linked to smoking in at-risk soldiers remains unclear. The present study examines a range of correlates of smoking-related behavior. Cross-sectional, anonymous surveys were collected from 3,380 soldiers following a deployment in 2008-2009. Measures included demographics, combat exposures, unit climate (e.g., unit cohesion, perceived organizational support, leadership), short sleep duration, and behavioral health variables (e.g., posttraumatic stress disorder, depression, anxiety, alcohol misuse, aggression, adverse childhood experiences [ACEs]). Logistic regression modeled the effects of these variables on two outcome variables: daily smoking and heavy smoking. In the current sample, nearly half (47%) of soldiers reported smoking daily, with 35% of all smokers reporting heavy smoking (17% of the entire sample). Daily smoking was associated with demographic (age, gender, education, rank), behavioral health (ACE, alcohol misuse, sleep duration, aggression), and unit characteristics (unit cohesion); only increased combat exposures and aggression were specifically associated with heavy smoking. Interventions focused on the postdeployment period could incorporate messages about alternatives to smoking as a coping strategy while unit interventions or individual counseling addressing aggression could also address smoking as a negative coping strategy. (PsycINFO Database Record

Longitudinal Associations of Local Cigarette Prices and Smoking Bans with Smoking Behavior in the Multi-Ethnic Study of Atherosclerosis.

Few studies have examined associations of geographically proximal cigarette prices with within-person changes in smoking outcomes or assessed interactions between cigarette prices and smoking bans. We linked neighborhood cigarette prices (inflation-adjusted) at chain supermarkets and drug stores and bar/restaurant smoking ban policies to cohort participants (632 smokers from the Multi-Ethnic Study of Atherosclerosis, 2001-2012, baseline mean age 58 years) using geocoded retailer and participant addresses. We used fixed-effects models to investigate associations of within-person changes in price and ban exposures with within-person changes in five smoking outcomes: current smoking, heavy (≥10 cigarettes) smoking, cessation, relapse, and intensity (average number of cigarettes smoked per day, natural log transformed). We assessed intensity associations among all smokers, and heavy (≥10 cigarettes per day) and light (<10) baseline smokers. Finally, we tested interactions between cigarette price and bans. A $1 increase in price was associated with a 3% reduction in risk of current smoking (adjusted risk ratio [aRR]: 0.97; 95% confidence interval [CI] = 0.93, 1.0), a 7% reduction in risk of heavy smoking (aRR: 0.93; CI = 0.87, 0.99), a 20% increase in risk of smoking cessation (aRR: 1.2; CI = 0.99, 1.4), and a 35% reduction in the average number of cigarettes smoked per day by heavy baseline smokers (ratio of geometric means: 0.65; CI = 0.45, 0.93). We found no association between smoking bans and outcomes, and no evidence that price effects were modified by the presence of bans. Results underscore the importance of local prices, but not hospitality smoking bans, in influencing older adults' smoking behaviors.

A CHRNA5 Smoking Risk Variant Decreases the Aversive Effects of Nicotine in Humans.

Genome-wide association studies have implicated the CHRNA5-CHRNA3-CHRNB4 gene cluster in risk for heavy smoking and several smoking-related disorders. The heavy smoking risk allele might reduce the aversive effects of nicotine, but this hypothesis has not been tested in humans. We evaluated the effects of a candidate causal variant in CHRNA5, rs16969968, on the acute response to nicotine in European American (EA) and African American (AA) smokers (n=192; 50% AA; 73% male). Following overnight abstinence from nicotine, participants completed a protocol that included an intravenous (IV) dose of saline and two escalating IV doses of nicotine. The outcomes evaluated were the aversive, pleasurable, and stimulatory ratings of nicotine's effects, cardiovascular reactivity to nicotine, withdrawal severity, and cognitive performance before and after the nicotine administration session. The heavy smoking risk allele (rs16969968*A; frequency=28% (EA) and 6% (AA)) was associated with lower ratings of aversive effects (P<5 × 10(-8)) with marked specificity. This effect was evident in EA and AA subjects analyzed as separate groups and was most robust at the highest nicotine dose. Rs16969968*A was also associated with greater improvement on a measure of cognitive control (Stroop Task) following nicotine administration. These findings support differential aversive response to nicotine as one likely mechanism for the association of CHRNA5-CHRNA3-CHRNB4 with heavy smoking.

Social relationships and subsequent health‐related behaviours: linkages between adolescent peer status and levels of adult smoking in a Stockholm cohort

Peer status reflects the extent to which an individual is accepted by the group. Some studies have reported that low peer status in adolescence is associated with a higher risk of smoking, while others found the reverse. No studies have investigated peer status influences on adult smoking. The aim of the study was therefore to examine the relationship between adolescents' peer status and the intensity of smoking in adulthood. Prospective cohort study. Stockholm, Sweden. A subsample (n = 2329) of the cohort with information about adult smoking. Peer status was assessed sociometrically at age 13 and information on smoking was gathered through a questionnaire at age 32. Relative risks (RR) for self-reported level of smoking were calculated using multinomial logistic regression. Several family-related and individual variables were included as control variables. Lower peer status in adolescence was associated with smoking of any intensity in adulthood. For example, the risk of heavy smoking was more than threefold (RR = 3.67) among individuals in the lowest status positions. The association with occasional smoking was abolished by controlling for factors related to adolescents' attitude to school and cognitive ability. For regular and heavy smoking the relationship was attenuated by controlling for these factors. Low peer status in adolescence appears to be a risk factor for smoking in adulthood. Part of this association may be explained by adolescents' feelings towards school and cognitive ability. However, being unpopular in adolescence remains a strong risk factor for regular and heavy smoking in adulthood.

Abstract 2756: Heavy smoking in Northeastern Ontario women is associated with polymorphisms in nicotinic acetylcholine receptor genes

Abstract Smoking is a leading cause of premature death and is a risk factor for many serious diseases. Recent studies suggest that the nicotinic acetylcholine receptor gene region of CHRNA5-CHRNA3-CHRNB4 on chromosome 15 is associated with nicotine dependence (ND). Single nucleotide polymorphisms (SNPs) in this region may be associated with heaviness of smoking, a strong predictor of nicotine dependence. This study investigated the association of SNPs in two nicotinic acetylcholine receptor genes, CHRNA5 rs16969968 and CHRNA3 rs578776, with heaviness of smoking in primarily caucasian women in Northeastern Ontario, Canada. This study used previously collected data from a population-based case-control study designed to assess smoking and breast cancer risk in 347 women with breast cancer and 775 population-based controls using a mailed study package with questionnaire and buccal swab. The smoking phenotype, heaviness of smoking, was defined based on available self-reported questionnaire data. The 617 ever-active smoking women (who smoked at least 100 cigarettes) were refined into “heavy” or “light” smokers; heavy smokers (n=200) reported smoking 20 or more cigarettes per day (CPD) for 5 or more years; light smokers (n=71) reported smoking less than 5 CPD for one or more years. Genotyping assays and the ABI 7900 Sequence Detection System (Applied Biosystems, CA) defined SNPs. Odds Ratios (OR) and 95% Confidence Intervals (CI)s were estimated using logistic regression. Women with the homozygous variant genotype AA for CHRNA5 rs16969968 were at significantly increased risk of heavy smoking, with an age-adjusted OR of 3.2 (95% CI 1.05-10.00) in the codominant model; risks increased in a model additionally adjusted for education level and alcohol intake, with an OR of 3.9 (95% CI 1.21-12.32). Women with the homozygous variant genotype TT for CHRNA3 rs578776 were at significantly decreased risk of heavy smoking, with an age-adjusted OR of 0.33 (95% CI 0.12-0.90) and similar risk for the additionally adjusted model. The SNPs were in high linkage disequilibrium (D’ 1.0) with low correlation (r2=0.2) between the risk and protective SNPs suggesting independent associations. When assessing the combined influence of both SNPs, women with the CHRNA5 rs16969968 GG genotype and the CHRNA3 rs578776 TT genotype had the lowest risk of heavy smoking with an age-adjusted OR of 0.57 (95% CI 0.18-1.79). The AA high risk homozygous genotype for CHRNA5 rs16969968 only occurred in association with the CC genotype of CHRNA3 rs578776 and was associated with the highest risk, with an age-adjusted OR of 3.23 (0.90-11.62) and additionally adjusted OR of 3.85 (1.03-14.47). In conclusion, there was a significant positive association of the CHRNA5 rs16969968 and significant negative association of CHRNA3 rs578776 with heaviness of smoking in a population of women in Northeastern Ontario, Canada. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 2756. doi:10.1158/1538-7445.AM2011-2756

Contrast Effects in Perceived Risk of Substance Use

Adolescent perceptions of the risks associated with the use of licit and illicit substances have important implications for policy and research. However, the methodological properties of the most popular risk measures in school surveys in Europe and the United States are not well understood. This study examines the potential contrast effects of risk measures of “heavy” and frequent substance use on perceived risks of occasional, moderate, and “experimental” use. Responses to 11 measures of the perceived risk of occasional smoking, moderate drinking, and experimental use of illicit substances were compared between two question forms administered to a split-half sample of all Icelandic ninth (14–15 years of age) and tenth (15–16 years of age) grade students present in class on the day of administration in March 2003 (N = 7099). In one form, only these 11 questions were used, while the other form also contained 13 questions on the perceived risk of heavy smoking, heavy drinking, and regular use of illicit substances. The longer form is found to decrease response rates and suppress estimates of perceived risk of experimental illicit substance use. Question form and perceived risks of heavy and regular use generally do not affect the multivariate effects of perceived risks of occasional, moderate, and experimental substance use on lifetime abstinence from each substance. It is argued that measures of perceived risks of heavy and regular substance use are less useful for prevention policy and research than are corresponding measures of occasional, moderate, and experimental substance use, and including the former in the same instrument may adversely affect the measurement of the latter constructs.

Does a reduced sensitivity to bitter taste increase the risk of becoming nicotine addicted?

Cigarette smoking appears to be on the increase in adolescents. The initiation of regular smoking nearly always begins before adulthood. It is therefore crucial to find ways of identifying those children most vulnerable to nicotine addiction and prioritizing them for preventive measures. We hypothesized that individuals who, in a simple taste test, perceive phenylthiocarbamide (PTC) as bitter may find the taste of cigarettes aversively bitter and could therefore have a reduced vulnerability to nicotine addiction compared to nontasters, who would be the group at greater risk of addiction. We studied 242 Plains American Indians, 136 women and 106 men aged 18-59 years, and found that (allowing for gender differences and the possible direct effects of smoking on taste) the proportion of PTC nontasters to tasters in smokers, even light smokers, was significantly greater than in both nonsmokers and social smokers (chi2= 15.875, 4 df; P=.003), suggesting that nontasters, who are not aversive to the bitter taste of cigarettes, may be more at risk for heavy smoking and therefore more vulnerable to nicotine addiction.