Agreement between Self-Report on Smoking Cessation and Urinary Cotinine Test / 대한정신약물학회지

OBJECTIVE: Self-report is being used in most of studies investigating the therapeutic effect of smoking cessation clinics of public health centers in Korea instead of cotinine or other chemical markers of nicotine exposure. This study was conducted to evaluate the agreement between self-report and urinary cotinine test after smoking cessation program. METHODS: The study subjects were 333 adult male who visited public health center and participated in 12-week scheduled smoking cessation program. Questionnaires including demographic data and information about cigarette use, blood test, and urinary cotinine test were performed to all subjects during initial evaluation. At the end of the program, smoking status of subjects was assessed by an oral self-report and additional blood and urinary cotinine tests were done to the subjects who agreed. RESULTS: 52 participants who gave both self-report on smoking status and urine sample were included in the final analysis. The overall percentage agreement was 67.3%, and the overall Kappa index was 0.367. The sensitivity, specificity, positive predictive value, and negative predictive value of self-report in detecting smoking state were 46.43%, 91.67%, 86.67%, and 59.46%, respectively. CONCLUSION: The agreement between self-report and urinary cotinine test in detecting smoking status after smoking cessation program was relatively low on account of participants who failed to quit smoking but reported their smoking status incorrectly. Therefore, the use of objective measures such as urine cotinine should be considered in evaluation of successful smoking cessation.

Alcohol and Cognitive Disorder / 대한정신약물학회지

Despite epidemiological studies reporting no negative effects of mild to moderate alcohol drinking on cognitive functioning, a recent well-controlled study showed that chronic mild drinking diminished the volume of the brain and was associated with cognitive decline that worsened as a function of the amount of alcohol consumed. Animal studies have demonstrated that neural cell damage follows chronic alcohol intake and withdrawal. In addition, acute excessive alcohol intake has been shown to result in temporary impairment of memory, and chronic alcohol drinking is often related to neuronal damage and cognitive disorders. Even though a diverse spectrum of cognitive disorders can develop after sustained alcohol drinking, no definite diagnostic criteria existed before those proposed by Oslin; the availability of these criteria will provide more structured clinical and academic approaches to alcohol-related cognitive decline, including dementia. In general, diminished cognitive functioning has been related to excessive alcohol consumption, with cognitive functioning gradually recovering over time. With the exception of the administration of thiamine in Wernicke-Korsakoff syndrome, only supportive pharmacotherapies have been provided for patients with alcohol-related cognitive disorders. However, experimental trials with rivastigmine or donepezil have been conducted for special populations with persistent cognitive impairments, and these studies reported favorable outcomes. We administered memantine for alcohol-related dementia and observed improvements in verbal memory and scores on the mini-mental status exam. We anticipate that novel and appropriate therapeutic agents for various conditions in this domain will be developed based on systematic diagnostic criteria and the accumulation of neurobiological evidence about alcohol-related cognitive decline.