Smoking rates and smoking cessation among individuals with multiple sclerosis.

PURPOSE: Adults with physical disabilities tend to smoke at higher rates than smokers in the general population. No study to date, however, has assessed smoking prevalence and cessation among individuals with multiple sclerosis (MS). Such information is critically needed because smoking is more deleterious for individuals with MS than for smokers without MS and increases MS risk. METHOD: Questionnaires were sent to 700 National Multiple Sclerosis Society Rhode Island Chapter members. RESULTS: Based on a 50% response rate, results demonstrated a 15.2% current smoker prevalence rate, which is lower than USA and Rhode Island general adult population averages. Individuals who smoked, however, tended to be heavy smokers, consuming 20 - 30 cigarettes daily, and had been smoking 10 years or longer. Smokers varied in their interest in quitting but seemed confident in their ability to do so. Respondents reported that it was difficult to quit because smoking was pleasurable; smoking was helpful in coping with boredom and with having MS; withdrawal symptoms were unpleasant; and treatment for tobacco dependence was expensive. CONCLUSIONS: Efficacious smoking cessation interventions for smokers with MS should be developed to address a critical health need for a population of highly nicotine-dependent smokers who face numerous obstacles to quitting.

A simulation model of tobacco youth access policies.

Empirical studies have found that policies aimed at reducing youth access to tobacco have been successful at increasing retail compliance, but their effects on actual tobacco use are mixed. This article presents a model of youth access policies that helps explain the apparently conflicting results in the extant literature, provides a framework for future empirical studies, and suggests implications for public policy. Our model highlights the interaction of components in a well-designed policy, including sufficient compliance checks, penalties, and community involvement. It also illustrates why it will be difficult to eliminate all of youth supply. Nonretail sources, such as borrowing or stealing from parents and siblings and purchasing from older peers through black markets, are an important component of youth supply and become more important as retail access is reduced. The analysis is limited to policies that affect the retail supply of cigarettes but suggests the need for other policies that affect the demand for cigarettes, such as taxes and cessation policies, in order to further reduce youth smoking rates.

Language functions in patients with multiple sclerosis.

Few studies have demonstrated language impairment in patients with multiple sclerosis (MS) compared to healthy controls. The purpose of this investigation was to examine language functions, specifically naming, comprehension, and verbal fluency, in patients with MS and healthy controls to (1) determine if patients with MS demonstrate language impairment, and (2) provide clarification of MS-related language disturbance, particularly in patients with MS of differing courses. Results showed that both chronic-progressive and relapsing-remitting patients with MS performed significantly more poorly than controls on naming, aural comprehension, letter fluency, and category fluency, as well as other language-based cognitive measures. Chronic-progressive patients obtained significantly lower scores than relapsing-remitting patients on the latter three tests. The language disturbance in this MS sample may be partly explained by impairment in other verbal cognitive functions. These findings highlight the importance of assessing language abilities in patients with MS.

Use of the North American Adult Reading Test to estimate premorbid intellectual function in patients with multiple sclerosis.

The North American Adult Reading Test (NART-R) has proven to be a valid means of estimating premorbid intellectual function in a variety of neurologic patient samples. The NART-R was administered to a group of patients with multiple sclerosis (MS) varying in course and degree of physical disability and healthy controls as part of an extensive neuropsychological battery examining numerous verbal cognitive functions, particularly language. The MS sample demonstrated significantly worse NART-R performance than did controls which could not be explained by differences in estimated premorbid intellectual function. Patients with a chronic-progressive course specifically obtained significantly lower scores than did controls, whereas there were no differences in the scores obtained by patients with chronic-progressive and relapsing-remitting courses or by patients with a relapsing-remitting course and controls. Thus, NART-R performance may not be a valid estimate of baseline IQ for patients with neurologic disorders with suspected language impairment.

Olfactory functioning in temporal lobectomy patients.

Seventeen patients who received unilateral excision of the temporal lobe for intractable epilepsy were compared to 46 normal controls on a battery of tests of olfactory functioning. Tests included quality discrimination, immediate and delayed recognition memory, matching an odor to its visually or haptically presented source, and verbal identification of odors and the function of stimulus objects. In spite of clinically normal absolute sensitivity, the patients performed significantly worse than controls on all tests of olfactory functioning. There were no significant differences in performance between dominant and non-dominant lobectomy patients. Likely explanations for the uniformly impaired performance of patients include deficits in quality discrimination and minor lapses of attention.