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...on nicotine
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www.ProjectCork.org
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Summer 2006
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Do smokers with alcohol problems have more difficulty quitting? (review).
Hughes JR; Kalman D. Drug and Alcohol Dependence 82(2): 91-102, 2006. (91 refs.)
This review compares nicotine dependence and the ability to stop smoking in smokers with no alcohol problems to smokers with current, past or lifetime (i.e., either current or past) alcohol problems. We searched computerized databases, meeting abstracts and made requests to listserves and grantees for comparisons of the above categories. We could not use meta-analyses and, thus, used consistency across studies to make conclusions. We located 17 articles on nicotine dependence, 12 on the ability to quit on a given attempt, 7 on lifetime quitting and 2 on quit attempts. Smokers with Current and past alcohol problems were more nicotine dependent than smokers with no alcohol problems. Surprisingly, smokers with past problems were as able to quit on a given attempt as smokers with no problems. We hypothesize this may be because such smokers learned skills in resolving their alcohol problems that neutralized their increased nicotine dependence. Smokers with current or past alcohol problems appear to be less likely to quit in their lifetime. Given their equal ability to quit on a given attempt, this could be due to fewer quit attempts; however, whether this is actually so is unclear. Our results that smokers with past alcohol problems can quit as easily as those without alcohol problems suggest that smokers with past alcohol problems may respond to minimal treatments for smoking cessation. Copyright 2006, Elsevier Science.
Smoking and erectile dysfunction: Findings from a representative sample of Australian men.
Millett C; Wen LM; Rissel C; Smith A; Richters J; Grulich A et al. Tobacco Control 15(2): 136-139, 2006. (24 refs.)
Objectives: To examine whether there is an association between smoking and erectile dysfunction in a representative sample of Australian men. Design: Secondary analysis of cross-sectional survey data from the Australian Study of Health and Relationships. Participants: 8367 Australian men aged 16-59 years. Main outcome measures: Erectile dysfunction was identified in men who reported having had trouble keeping an erection when they wanted to, a problem which persisted for at least one month over the previous year. Variables examined in multivariate logistic regression analyses included age, education, presence of cardiovascular disease and diabetes, and current alcohol and tobacco consumption. Results: Almost one in 10 of the respondents (9.1%) reported erectile dysfunction that lasted for at least one month over the previous year. More than a quarter (27.2%) of respondents were current smokers, with 20.9% smoking <= 20 cigarettes per day, and 6.3% smoking > 20 cigarettes per day. Compared with non-smokers, the adjusted odds ratios for erectile dysfunction were 1.24 (95% confidence interval (CI) 1.01 to 1.52, p = 0.04) for those smoking <= 20 cigarettes per day and 1.39 (95% CI 1.05 to 1.83, p = 0.02) for those smoking <= 20 cigarettes per day, after adjusting for other confounding factors. Older age, low level of education, and taking medications for cardiovascular disease were also independently and positively associated with erectile dysfunction. In contrast, moderate alcohol consumption (1-4 drinks per day) significantly reduced the likelihood of having erectile dysfunction. Conclusions: Erectile dysfunction is a significant health concern affecting around one in 10 Australian men aged 16-59 years. Current smoking is significantly associated with erectile dysfunction in Australian males. This association was strengthened as the number of cigarettes smoked increased. Health promotion programmes could use the link between smoking and erectile dysfunction to help reduce smoking levels among men. Copyright 2006, BMJ Publishing Group.
Aluminum in tobacco and cannabis and smoking-related disease.
Exley C; Begum A; Woolley MP; Bloor RN. American Journal of Medicine 119(3), 2006. (15 refs.)
PURPOSE: The study aimed to confirm the very high content of aluminum in tobacco and cannabis and to provide for the first time evidence that such aluminum could be biologically available. METHODS: Complete digestion of tobacco and cannabis was achieved using a 50:50 mixture of 14 M HNO3 and 0.1 M NaF. Total A1 in digests was measured by graphite furnace atomic absorption spectrometry. A bespoke cigarette smoking apparatus was used to determine if aluminum in active or passive tobacco/cannabis smoke would be trapped by a surrogate lung fluid. RESULTS: The aluminum content of tobacco and cannabis was confirmed to be high, as much as 0.37% and 0.4% by weight respectively. Aluminum in tobacco and cannabis smoke, whether actively (drawn) or passively inhaled, was shown to accumulate significantly in surrogate lung fluids, thus demonstrating its potential biological availability. CONCLUSIONS: Active and passive smoking of tobacco or cannabis will increase the body burden of aluminum and thereby contribute to respiratory, neurological and other smoking-related disease. Copyright 2006, Excerpta Medica Inc.
Ambivalence and uncertainty: Experiences of and attitudes towards addiction and smoking cessation in the mid-to-late teens.
Amos A; Wiltshire S; Haw S; McNeill A. Health Education Research 21(2): 181-191, 2006. (42 refs.)
The late teens is an important transitional period as adolescents move into new social worlds which support or challenge their smoking. This paper draws on research with 99 Scottish 16- to 19-year olds which explored their understanding of their smoking and attitudes towards quitting and cessation support. The study involved qualitative interviews mostly with friendship pairs. Interviewees also completed a brief smoking questionnaire. Most regarded themselves as smokers but few thought they were addicted. Many were interested in quitting but this was not a priority. Perceived barriers to quitting related primarily to habitual and social aspects of dependence including friends' smoking, the smoking culture at work or college, stress and boredom. Few were interested in nicotine replacement therapy or cessation services, which they felt belonged to the world of older addicted smokers. The most effective quitting strategy was thought to be will-power. Traditional cessation services are therefore in their current form unlikely to appeal to older adolescents. Services aimed at this age group need to be grounded in their understandings of smoking and the social factors which support smoking. Young smokers should also be helped to understand how support may increase quitting success and how encourage quitting before smoking becomes entrenched in their daily routines. Copyright 2006, Oxford University Press.
Do parents of urban children with persistent asthma ban smoking in their homes and cars?
Halterman JS; Fagnano M; Conn KM; Szilagyi PG. Ambulatory Pediatrics 6(2): 115-119, 2006. (45 refs.)
Objective: Environmental tobacco smoke (ETS) increases morbidity for children with asthma. One method to reduce children's ETS exposure is to completely ban smoking in the home and car. We sought to evaluate the degree to which urban children with persistent asthma are protected by household and car smoking bans, and to determine whether health care professionals are counseling parents to implement smoking bans. Methods: We asked parents of children with asthma to complete an in-person interview including questions about asthma symptoms. smokers in the home. smoking bans (home and car), and the receipt of ETS Counseling by health care professionals. Results: We included 231 children with persistent asthma symptoms (response rate 94%). Nearly half of the children lived with a snicker. Overall, only 64% of households had complete restrictions on smoking in the home and car. Even among the children with severe persistent symptoms, less than two-thirds were protected by a complete smoking ban. Among households with smokers, only 51 % had a ban on smoking in the home and 49% in the car. The majority of caregivers had been questioned by health care professionals about home smoke exposure; less were asked about exposure in the car (40%) or given suggestions to decrease the child's exposure (58%). Conclusions: To our knowledge this is the first study to establish the prevalence of smoking bans among children with persistent asthma. Many children with asthma, even those with the most severe symptoms, remain exposed to ETS in the home and in cars. Identifying and reducing smoke exposure among these children should be a health care priority. Copyright 2006, The Ambulatory Pediatric Association.
Impact of sidestream whole smoke solutions on the outcome of wound repair and related angiogenesis.
Ejaz S; Lim CW. Environmental Toxicology and Pharmacology 21(3): 308-316, 2006. (61 refs.)
Wound angiogenesis is essential to support the regenerating tissue and any setback in angiogenesis may result in retarded wound repair. Cigarette smoking causes numerous adverse effects, some of which are associated with poor healing. The current experiment was carried out to elucidate the possible detrimental effects of sidestream whole smoke solutions (SSWSS) on wound healing and related angiogenesis, using a well-defined chicken dorsum excision wound assay. Gross, histopathologic, SEM and computer based 3D image-probing modalities were utilized to quantify different detrimental effects of SSWSS on the fundamental processes of wound healing. A total of 160 chicks, aged I week, divided in eight groups were topically exposed for 8 days to SSWSS with different nicotine concentrations. At day 6 and day 8 post-wounding, very highly significant reduction (P < 0.001) in wound closure was observed among all SSWSS treated groups. Histological and SEM evaluation of SSWSS treated wounds unveiled deteriorated dermal matrix, delayed re-epithelialization and retarded neovascularization. Moreover, image-probing exploration of SSWSS treated wounds also divulge a very highly significant decrease (P < 0.001) in angular spectrum, Sa, Sy and Science, at day 6 post-wounding. Our study suggests that the cumulative effect of different components of SSWSS has a negative impact on wound healing and related angiogenesis. Furthermore, our study demonstrates the effects that can contribute to abnormal healing and may explain why people who are consistently exposed to sidestream smoke suffer from slow healing and excessive scarring of wounds, much like the smokers themselves. Copyright 2006, Elsevier Science, Inc.
Promoting repeat tobacco dependence treatment: Are relapsed smokers interested?
Fu SS; Partin MR; Snyder A; An LC; Nelson DB; Clothier B et al. American Journal of Managed Care 12(4): 235-243, 2006. (44 refs.)
Background: Promotion of repeat tobacco dependence treatment among relapsed smokers interested in "recycling" (repeat quit attempt) may be a promising approach to increase quit rates. Objective: To report relapsed smokers' interest in recycling and their treatment preferences. Study Design: Descriptive analysis of a population of relapsed smokers who were randomized to receive a recycling intervention strategy to increase tobacco dependence treatment rates, as part of a randomized controlled trial at 5 Veterans Affairs medical centers. Methods: individuals prescribed a tobacco dependence medication in 2002 were eligible and were identified from the Department of Veterans Affairs Pharmacy Benefits Management database. Intervention group participants (n = 951) were contacted for a standardized telephone interview approximately 6 months after the prescription fill date to assess smoking status, interest in recycling, and treatment preferences. Results: The response rate to the intervention telephone call was 621%, at which 61% of respondents had relapsed. Almost two thirds of relapsed smokers were interested in recycling within 30 days. Of these, 91% wanted behavioral or pharmacologic smoking cessation treatment, and 64% wanted behavioral and pharmacologic treatment. In multivariate analyses, independent predictors of interest in recycling within 30 days included black race, lower smoking level, and greater number of smoking-related medical conditions. Conclusion: Most smokers who attempt to quit but relapse want to quit again right away, and most are interested in receiving behavioral and pharmacologic treatment. Copyright 2006, American Medical Publishing.
Racial and ethnic differences in predictors of smoking cessation.
Daza P; Cofta-Woerpel L; Mazas C; Fouladi RT; Cinciripini PM; Gritz ER; Wetter DW. Substance Use & Misuse 41(3): 317-339, 2006. (77 refs.)
Racial/ethnic differences in the determinants of smoking cessation could have important treatment implications. The current study examined racial/ethnic differences in smoking cessation, prospective predictors of cessation, and whether the predictive ability of these factors differed by race/ethnicity. Participants were 709 employed adults recruited through the National Rural Electric Co-op Association or through natural gas pipeline corporations. Data were collected in 1990 and 1994. Although race/ethnicity was not predictive of abstinence, Hispanic, African American, and White smokers displayed differential on tobacco-, alcohol-, and work-related variables. These racial/ethnic differences highlight the specific factors that should be considered when providing smoking cessation treatment to specific populations. Limitations are noted. Copyright 2006, Taylor & Francis Inc.
Recruiting teen smokers in shopping malls to a smoking-cessation program using the foot-in-the-door technique.
Bloom PN; McBride CM; Pollak KI; Schwartz-Bloom RD; Lipkus IM. Journal of Applied Social Psychology 36(5): 1129-1144, 2006. (27 refs.)
Persuading teen smokers to volunteer for smoking-cessation programs is a challenging yet understudied problem. As a method of dealing with this problem, we used and tested a foot-in-the-door (FITD) approach. Teen smokers were intercepted at malls and were assigned randomly to request compliance with a small behavior request of either (a) answering a few questions (light FITD) or (b) answering the same questions and a few additional ones, plus watching a short video about the effects of nicotine (heavy FITD). Participants were then called back by telephone several weeks later and asked to comply with a large behavior request of joining a cessation program that involved the use of self-help materials and telephone counseling. Although no differences were found in responses from the light and heavy groups, consent to enter the program was obtained from 12% of the pooled qualified intercepts and their parents (for those under 18 years). This recruitment rate was considered good, given that this is one of the only reported studies that recruited teen smokers from the general population to cessation programs. Copyright 2006, Blackwell Publishing.
Smoking is associated with neurocognitive deficits in alcoholism.
Glass JM; Adams KM; Nigg JT; Wong MM; Puttler LI; Buu A et al. Drug and Alcohol Dependence 82(2): 119-126, 2006. (57 refs.)
Background: Impaired problem solving, visual-spatial processing, memory, and cognitive proficiency are consequences of severe alcoholism. Smoking is much more prevalent among alcoholics than the general population, yet the possible neurocognitive effects of cigarette smoking in alcoholism have not been studied, despite evidence that long-term smoking is associated with neurocognitive deficits. Objective: Determine whether smoking contributes to neurocognitive deficits associated with alcoholism. Design: Neurocognitive function was examined in a community-recruited (n = 172) sample of men. Alcohol problems/alcoholism were measured by the lifetime alcohol problems score (LAPS), DSM-IV diagnosis, and monthly drinking rate. Smoking was measured in pack-years. Neurocognitive function was measured with IQ (short version of WAIS-R), and cognitive proficiency (fast, accurate performance). Results: Both alcoholism and smoking were negatively correlated with neuro-cognitive function. When alcoholism and smoking were included in regression models, smoking remained a significant predictor for both measures, but alcoholism remained significant only for IQ. Conclusions: Both smoking and alcoholism were related to neurocognitive function. Smoking may explain some of the relationship between alcoholism and neurocognitive function, perhaps especially for measures that focus on proficiency. Copyright 2006, Elsevier Science.
The cigarette manufacturers' efforts to promote tobacco to the US military.
Joseph AM; Muggli M; Pearson KC; Lando H. Military Medicine 170(10): 874-880, 2005. (70 refs.)
This article describes findings from review of tobacco industry documents regarding promotion of tobacco to the military, and efforts to influence Department of Defense policies regarding the use and sale of tobacco products. The documents reveal that the industry has targeted the military for decades for reasons including: (1) the volume of worldwide military personnel; (2) the opportunity to attract young men who fit a specific socioeconomic and cultural profile; (3) potential carry-over of profits to civilian markets; and (4) the unusual price structure of commissaries and exchanges. The industry used distinctive promotion methods such as in-store merchandising, sponsorships, and even brand development to target the military, both in the United States and abroad during times of conflict. Legislative activity to protect tobacco promotion to this vulnerable population was carried out in response to smoking policy changes proposed by the Department of Defense. The tobacco industry has contributed to the high prevalence of smoking in the military and among veterans. Copyright 2005, Association of Military Surgeons.
Youth smoking prevention and tobacco industry revenue.
Healton C; Farrelly MC; Weitzenkamp D; Lindsey D; Haviland ML. Tobacco Control 15(2): 103-106, 2006. (17 refs.)
Objectives: Epidemiological surveys make it clear that youth smoking contributes to both current and future tobacco industry revenue: over 80% of adult smokers reportedly began smoking before age 18. This paper estimates annual and lifetime revenue from youth smoking, and highlights the association between declines in youth smoking and declines in tobacco Main outcome measures: This paper reports the amount of tobacco industry revenue generated by youth smoking at two points in time (1997 and 2002), and describes the distribution of youth generated tobacco income among the major tobacco companies. The authors project the amount of tobacco industry revenue that will be generated by members of two cohorts (the high school senior classes of 1997 and 2002) over the course of their lifetimes. Results: In 1997, youth consumed 890 million cigarette packs, generating $737 million in annual industry revenue. By 2002, consumption dropped to 541 million packs and revenue increased to nearly $1.2 billion. Fifty eight per cent of youth generated revenue goes to Philip Morris USA, 18% to Lorillard, and 12% to RJ Reynolds. The authors project that, over the course of their lives, the 1997 high school senior class will smoke 12.4 billion packs of cigarettes, generating $27.3 billion in revenue. The 2002 high school senior class is projected to smoke 10.4 billion packs, generating $22.9 billion in revenue over the course of their lives. Conclusions: Cigarette price increases from 1997 to 2002 have resulted in greater revenue for the tobacco industry, despite declines in youth smoking prevalence. However, in the absence of further cigarette price increases, declines in youth smoking are projected to lead ultimately to a loss of approximately $4 billion in future tobacco industry revenue from a single high school cohort. Copyright 2006, BMJ Publishing Group
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