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1.
BMC Public Health ; 21(1): 959, 2021 05 20.
Artigo em Inglês | MEDLINE | ID: mdl-34016066

RESUMO

BACKGROUND: While rates of e-cigarette use ('vaping') continue to potentiate concern, there is limited data on common symptoms of e-cigarette dependence among young adults who vape. This study sought to critically explore how young adults experience, manifest, and conceptualize vaping dependence symptoms in their everyday lives. METHODS: Between June 2018 and 2019, in-depth qualitative interviews were conducted with 62 young adults who use e-cigarettes (aged 18-25) and live in Southern California. We explored participants' product preferences, daily e-cigarette use patterns, vaping history, withdrawal experiences, and quit attempts or periods of cessation. We used a thematic analysis approach to interpret the transcripts. RESULTS: Young adults discussed nine dimensions of vaping dependence that were organized into two categories: 1) general nicotine dependence symptoms, and 2) unique dependence symptoms related to vaping. Nicotine dependence symptoms included cravings and urgency to use, increased use to achieve desired effects, and unsuccessful quit attempts and withdrawal. Symptoms unique to vaping dependence included greater nicotine consumption due to accessibility and lack of restrictions, habitual vaping, inability to track vaping frequency, immediate gratification and comfort, social acceptability and norms, and awareness of vaping dependency. CONCLUSIONS: In addition to nicotine dependence symptoms that have been characterized for other tobacco products, young adult e-cigarette users described unique symptoms of vaping dependence that necessitate the need for more refined measures. All dimensions of vaping dependence should be considered in discussions of policies as well as treatment and education efforts intended to protect young people from e-cigarette dependence.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Abandono do Hábito de Fumar , Tabagismo , Vaping , Adolescente , Adulto , Humanos , Nicotina , Tabagismo/diagnóstico , Tabagismo/epidemiologia , Vaping/efeitos adversos , Adulto Jovem
2.
Drug Alcohol Depend ; 221: 108612, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33631543

RESUMO

PURPOSE: To investigate the role of consumption phenotypes as genetic proxies for alcohol misuse and nicotine dependence. METHODS: We leveraged GWAS data from well-powered studies of consumption, alcohol misuse, and nicotine dependence phenotypes measured in individuals of European ancestry from the UK Biobank (UKB) and other population-based cohorts (largest total N = 263,954), and performed genetic correlations within a medical-center cohort, BioVU (N = 66,915). For alcohol, we used quantitative measures of consumption and misuse via AUDIT from UKB. For smoking, we used cigarettes per day from UKB and non-UKB cohorts comprising the GSCAN consortium, and nicotine dependence via ICD codes from UKB and Fagerström Test for Nicotine Dependence from non-UKB cohorts. RESULTS: In a large phenome-wide association study, we show that smoking consumption and dependence phenotypes show similar strongly negatively associations with a plethora of diseases, whereas alcohol consumption shows patterns of genetic association that diverge from those of alcohol misuse. CONCLUSIONS: Our study suggests that cigarette smoking consumption, which can be easily measured in the general population, may be good a genetic proxy for nicotine dependence, whereas alcohol consumption is not a direct genetic proxy of alcohol misuse.


Assuntos
Consumo de Bebidas Alcoólicas/genética , Alcoolismo/genética , Fumar Cigarros/genética , Tabagismo/genética , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Alcoolismo/epidemiologia , Fumar Cigarros/epidemiologia , Estudos de Coortes , Bases de Dados Genéticas , Grupo com Ancestrais do Continente Europeu/genética , Feminino , Estudo de Associação Genômica Ampla , Humanos , Masculino , Fenótipo , Produtos do Tabaco/estatística & dados numéricos , Tabagismo/epidemiologia , Reino Unido/epidemiologia
3.
Asian J Psychiatr ; 57: 102562, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: covidwho-1039257

RESUMO

BACKGROUND: To date, no study has evaluated the association of alcohol dependence with the outcome of the COVID-19 infection. AIM: The current study aimed to evaluate the association of substance dependence (alcohol and tobacco) with the outcome (i.e., time to have two consecutive negative test reports) of the COVID-19 infection. RESULTS: The mean age of the study participants (n = 95) was 37.2 yrs (SD-13.2). More than half of the participants were males. About one-fourth (N = 25; 26.3 %) were consuming various substances in a dependent pattern. Alcohol dependence was present in 21 participants (22.1 %), and Tobacco dependence was present in 10.5 % of participants. Even after using gender, age, and physical illness as covariates, patients with any kind of substance dependence had a significantly lower chance of having a negative report on RT-PCR on 14th day, 18th 23rd day. CONCLUSION: Persons with substance dependence takes a longer time to test negative on RT-PCR, once diagnosed with COVID-19 infection. Mental health professionals involved in the care of patients with COVID-19 should accordingly prepare these patients for a possible longer hospital stay to reduce the distress associated with prolongation of hospital stay.


Assuntos
Alcoolismo/epidemiologia , Teste de Ácido Nucleico para COVID-19/estatística & dados numéricos , COVID-19/diagnóstico , COVID-19/epidemiologia , Tabagismo/epidemiologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Adulto Jovem
4.
JAMA Netw Open ; 4(2): e2036512, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33538824

RESUMO

Importance: Substance use disorders are a major source of morbidity and mortality in the United States. National data comparing the prevalence of substance use disorder diagnoses (SUDDs) among transgender and cisgender individuals are lacking in the United States. Objectives: To investigate the prevalence of SUDDs among transgender and cisgender adults and to identify within-group and between-group differences by age, gender, and geographic location. Design, Setting, and Participants: This cross-sectional study used the OptumLabs Data Warehouse to analyze deidentified claims from approximately 74 million adults aged 18 years or older enrolled in commercial or Medicare Advantage insurance plans in 2017. A total of 15 637 transgender adults were identified based on a previously developed algorithm using a combination of International Classification of Diseases, Tenth Revision (ICD-10) transgender-related diagnosis and procedure codes and sex-discordant hormone prescriptions. A cohort of 46 911 cisgender adults was matched to the transgender cohort in a 3:1 ratio based on age and geographic location. Main Outcomes and Measures: SUDDs, based on ICD-10 codes, were assessed overall and compared between transgender and cisgender cohorts and by geographic region (ie, Northeast, Midwest, South, and West); age groups (eg, 18-25, 26-30, 31-35 years), and gender (ie, transfeminine [TF; assigned male sex at birth, identify along feminine gender spectrum], transmasculine [TM; assigned female sex at birth, identify along masculine gender spectrum], male, and female). Results: In this study of 15 637 transgender adults (4955 [31.7%] TM) and 46 911 cisgender adults (23 247 [50.4%] men), most (8627 transgender adults [55.2%]; 51 762 cisgender adults [55.2%]) were aged between 18 and 40 years, and 6482 transgender adults (41.5%) and 19 446 cisgender adults (41.5%) lived in the South. Comparing transgender to cisgender groups, significant differences were found in the prevalence of a nicotine (2594 [16.6%] vs 2551 [5.4%]; P < .001), alcohol (401 [2.6%] vs 438 [0.9%]; P < .001), and drug (678 [4.3%] vs 549 [1.2%]; P < .001) SUDDs. Among transgender adults, cannabis was the most prevalent drug SUDD (321 [2.1%]), followed by opioid SUDD (205 [1.3%]) and cocaine SUDD (81 [0.5%]), whereas among cisgender adults, cannabis and opioid SUDDs were equally prevalent (cannabis, 186 [0.4%]; opioid, 207 [0.4%]), followed by cocaine SUDD (59 [0.1%]). Conclusions and Relevance: In this study, the prevalence of SUDDs was significantly elevated among transgender adults relative to their cisgender peers. These findings underscore the need for culturally tailored clinical interventions to treat substance use disorder in transgender populations.


Assuntos
Alcoolismo/epidemiologia , Transtornos Relacionados ao Uso de Cocaína/epidemiologia , Abuso de Maconha/epidemiologia , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Tabagismo/epidemiologia , Pessoas Transgênero/estatística & dados numéricos , Adolescente , Adulto , Estudos de Casos e Controles , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Estados Unidos/epidemiologia , Adulto Jovem
5.
Asian J Psychiatr ; 57: 102562, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33571916

RESUMO

BACKGROUND: To date, no study has evaluated the association of alcohol dependence with the outcome of the COVID-19 infection. AIM: The current study aimed to evaluate the association of substance dependence (alcohol and tobacco) with the outcome (i.e., time to have two consecutive negative test reports) of the COVID-19 infection. RESULTS: The mean age of the study participants (n = 95) was 37.2 yrs (SD-13.2). More than half of the participants were males. About one-fourth (N = 25; 26.3 %) were consuming various substances in a dependent pattern. Alcohol dependence was present in 21 participants (22.1 %), and Tobacco dependence was present in 10.5 % of participants. Even after using gender, age, and physical illness as covariates, patients with any kind of substance dependence had a significantly lower chance of having a negative report on RT-PCR on 14th day, 18th 23rd day. CONCLUSION: Persons with substance dependence takes a longer time to test negative on RT-PCR, once diagnosed with COVID-19 infection. Mental health professionals involved in the care of patients with COVID-19 should accordingly prepare these patients for a possible longer hospital stay to reduce the distress associated with prolongation of hospital stay.


Assuntos
Alcoolismo/epidemiologia , Teste de Ácido Nucleico para COVID-19/estatística & dados numéricos , COVID-19/diagnóstico , COVID-19/epidemiologia , Tabagismo/epidemiologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Adulto Jovem
6.
Soc Psychiatry Psychiatr Epidemiol ; 56(6): 981-992, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33386872

RESUMO

PURPOSE: To characterize the association of social class discrimination with the timing of first cigarette use and progression to DSM-IV nicotine dependence (ND) in Black and White youth, examining variation by race, parent vs. youth experiences of discrimination, socioeconomic status (SES), and stage of smoking. METHODS: Data were drawn from 1461 youth (55.2% Black, 44.8% White; 50.2% female) and mothers in a high-risk family study of alcohol use disorder and related conditions. Cox proportional hazard regression analyses were conducted, using youth's and mother's social class discrimination to predict first cigarette use and progression to ND, stratifying by race. Interactions between discrimination and SES indicators (parental education and household income) were tested. Adjusted models included psychiatric covariates. RESULTS: In the adjusted first cigarette use models, neither youth's nor mother's social class discrimination was a significant predictor among Black youth, but mother's discrimination was associated with increased risk [HR = 1.53 (1.18-1.99)] among White youth. In the adjusted ND models, mother's discrimination was associated with reduced ND risk for Black youth in middle-income families [HR = 0.29 (CI 0.13-0.63)], but neither youth's nor mother's discrimination predicted transition to ND among White youth. CONCLUSIONS: The observed race and smoking stage-specific effects suggest that social class discrimination is more impactful on early stages of smoking for White youth and later stages for Black youth. The robustness of links with mother's discrimination experiences further suggests the importance of considering family-level effects and the need to explore possible mechanisms, such as socialization processes.


Assuntos
Produtos do Tabaco , Tabagismo , Adolescente , Afro-Americanos , Grupo com Ancestrais do Continente Europeu , Feminino , Humanos , Masculino , Classe Social , Tabagismo/epidemiologia
7.
Am Heart J ; 234: 111-121, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33453161

RESUMO

BACKGROUND: Among patients with severe aortic stenosis (AS), there are limited data on aortic valve replacement (AVR), reasons for nonreceipt and mortality by race. METHODS: Utilizing the Duke Echocardiography Laboratory Database, we analyzed data from 110,711 patients who underwent echocardiography at Duke University Medical Center between 1999 and 2013. We identified 1,111 patients with severe AS who met ≥1 of 3 criteria for AVR: ejection fraction ≤50%, diagnosis of heart failure, or need for coronary artery bypass surgery. Logistic regression models were used to assess the association between race, AVR and 1-year mortality. χ2 testing was used to assess potential racial differences in reasons for AVR nonreceipt. RESULTS: Among the 1,111 patients (143 AA and 968 CA) eligible for AVR, AA were more often women, had more diabetes, renal insufficiency, aortic regurgitation and left ventricular hypertrophy. CA were more often smokers, had more ischemic heart disease, hyperlipidemia and higher median income levels. There were no racial differences in surgical risk utilizing logistic euroSCORES. Relative to CA, AA had lower rates of AVR (adjusted odds ratio 0.46, 95% CI 0.3-0.71, P < .001) yet similar 1-year mortality (aHR 0.81, 95% CI 0.57-1.17, P = .262). There were no significant differences in reasons for AVR nonreceipt. CONCLUSIONS: We identified 143 African Americans (AA) and 968 Caucasian Americans(CA) with severe AS who met prespecified criteria for AVR.. AA relative to CA were more often women, had more diabetes, renal insufficiency, and left ventricular hypertrophy, however had less tobacco use, ischemic heart disease, hyperlipidemia and lower median income levels. Among patients with severe AS, AA relative to CA had lower rates of AVR (adjusted odds ratio 0.46, 95% CI 0.3-0.71, P < .001) without significant differences in reasons for AVR nonreceipt and similar 1-year mortality.


Assuntos
Afro-Americanos/estatística & dados numéricos , Estenose da Valva Aórtica/cirurgia , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Implante de Prótese de Valva Cardíaca/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Estenose da Valva Aórtica/diagnóstico por imagem , Estenose da Valva Aórtica/etnologia , Estenose da Valva Aórtica/mortalidade , Distribuição de Qui-Quadrado , Ponte de Artéria Coronária/estatística & dados numéricos , Diabetes Mellitus/epidemiologia , Ecocardiografia , Feminino , Implante de Prótese de Valva Cardíaca/mortalidade , Humanos , Hiperlipidemias/epidemiologia , Hipertrofia Ventricular Esquerda/epidemiologia , Renda , Modelos Logísticos , Masculino , Isquemia Miocárdica/epidemiologia , Insuficiência Renal/epidemiologia , Fatores Sexuais , Volume Sistólico , Tabagismo/epidemiologia , Estados Unidos/epidemiologia , Estados Unidos/etnologia
8.
Nicotine Tob Res ; 23(2): 327-333, 2021 01 22.
Artigo em Inglês | MEDLINE | ID: mdl-32877533

RESUMO

INTRODUCTION: Very light daily smoking is increasingly common among young adults. Evidence suggests that levels of nicotine dependence vary significantly among young adults who engage in very light daily smoking. However, the links between dependence and clinically relevant outcomes (eg, lapse) in this population remain unclear. The goal of this study was to address this gap by evaluating how well different nicotine dependence scales predict lapse behavior among very light daily smoking young adults. AIMS AND METHODS: Very light daily smokers (1-5 cigarettes/day) aged 18-25 participated in an initial laboratory session, during which nicotine dependence was assessed using four commonly used measures: the FagerstrÓ§m Test for Cigarette Dependence (FTCD), the Hooked On Nicotine Checklist (HONC), the Transdisciplinary Tobacco Use Research Centers (TTURC) Nicotine Dependence Inventory, and the Wisconsin Inventory of Smoking Dependence Motives (WISDM). After a baseline period, eligible participants (n = 40) completed a 10-day abstinence incentive period in which they attempted to refrain from smoking to earn monetary rewards. Cox proportional hazards models were used to test whether dependence predicted days to first lapse. RESULTS: FTCD scores significantly predicted days to lapse, as did scores on the FTCD item assessing time to first cigarette of the day (TTFC). No other dependence measures predicted time to lapse. Both the FTCD and TTFC continued to independently predict time to lapse after controlling for smoking frequency and duration. CONCLUSIONS: The FTCD may be a particularly useful tool for capturing clinically meaningful variability in nicotine dependence among young adults who engage in very light daily smoking. IMPLICATIONS: This is the first study to directly link self-reported nicotine dependence with the ability to achieve and maintain abstinence among very light daily smoking young adults. The results may aid clinicians in selecting among variable measures of nicotine dependence when assessing and treating this population.


Assuntos
Fumantes/psicologia , Fumar/epidemiologia , Produtos do Tabaco/estatística & dados numéricos , Tabagismo/epidemiologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Motivação , Autorrelato , Fumar/psicologia , Abandono do Hábito de Fumar/métodos , Tabagismo/psicologia , Wisconsin/epidemiologia , Adulto Jovem
9.
Drug Alcohol Depend ; 218: 108394, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-33203525

RESUMO

INTRODUCTION: A growing body of literature suggests daily, but not non-daily, e-cigarette use is associated with greater odds of quitting combustible cigarettes in the general adult population. However, it is unknown if these findings generalize to treatment-seeking smokers who are receiving a behavioral intervention. Our primary aim was to examine whether frequency of e-cigarette use was associated with subsequent cessation among treatment-seeking smokers who are receiving a behavioral smoking cessation intervention. METHODS: Participants (N = 2637) enrolled in a RCT of web-based smoking treatments reported their use of e-cigarettes at baseline, 3-, and 6-months. Three groups were created based on e-cigarette use: (1) non-users, (2) intermittent users, and (3) daily users. The primary outcome was complete-case, self-reported 30-day point prevalence abstinence at 12 months. RESULTS: Compared to non-users, daily e-cigarette users were significantly less likely to be abstinent (21.39 % vs. 29.68 %; p = .006). Quit rates for intermittent users (24.56 %) were not significantly different from non-users (p = .092). Nicotine dependence moderated the results such that among smokers with low nicotine dependence, those who used e-cigarettes (intermittently or daily) were less likely to quit than non-users; these differences were not significant among those with high nicotine dependence. Post hoc analyses indicated that initiating daily e-cigarette use after baseline, but not daily e-cigarette use at baseline, was associated with lower odds of cessation. CONCLUSIONS: Daily e-cig use may be associated with lower odds of quitting smoking among treatment-seeking smokers, particularly among those with lower nicotine dependence and who initiate daily use after beginning an intervention.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Abandono do Hábito de Fumar/métodos , Tabagismo/epidemiologia , Vaping/epidemiologia , Adulto , Terapia Comportamental , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fumantes , Fumar/epidemiologia , Inquéritos e Questionários , Produtos do Tabaco , Fumar Tabaco , Tabagismo/terapia
10.
Drug Alcohol Depend ; 218: 108341, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-33268228

RESUMO

BACKGROUND: The association between short-term emotion dynamics and long-term psychopathology has been well established in the psychology literature. Yet, dynamic measures for inertia and instability of negative and positive affect have not been studied in terms of their association with cigarette dependence. This study builds an important bridge between the psychology and substance use literatures by introducing these novel measures and conducting a comprehensive examination of such association with intervention implications. METHODS: This study conducted secondary analysis on the data from a community sample of 136 dual users (e-cigarette + cigarette) and 101 exclusive smokers who completed both the two-week ecological momentary assessment (EMA) and cigarette dependence assessments in a recent study. RESULTS: Among dual users, a higher average level of negative affect, lower inertia of negative affect (i.e., less sustained negative affect), and higher instability of positive affect (i.e., greater magnitude of changes in positive affect) were associated with higher cigarette dependence. The patterns of associations among exclusive smokers were, however, different. Higher inertia of negative affect, lower instability of positive affect, and higher variability of negative affect were associated with higher dependence. CONCLUSIONS: The results illustrate the importance of examining not only negative affect but also positive affect in order to fully understand the association between emotion dynamics and cigarette dependence. The different patterns of association between emotion dynamics and cigarette dependence across the two groups of cigarette users also call for future research that is designed to compare cigarettes and e-cigarettes in terms of their effects on emotion regulation.


Assuntos
Emoções , Produtos do Tabaco , Tabagismo/epidemiologia , Adulto , Avaliação Momentânea Ecológica , Sistemas Eletrônicos de Liberação de Nicotina , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fumantes/psicologia , Tabagismo/psicologia , Vaping/psicologia
11.
Nicotine Tob Res ; 23(4): 662-668, 2021 03 19.
Artigo em Inglês | MEDLINE | ID: mdl-33097952

RESUMO

INTRODUCTION: In a sample of dual users of cigarettes and electronic nicotine delivery systems (ENDS; e-cigarettes), we evaluated psychometric properties of ENDS versions of the Nicotine Dependence Syndrome Scale (NDSS), the brief Wisconsin Inventory of Smoking Dependence Motives (WISDM), and the Fagerström Test for Nicotine Dependence (FTND). Using the NDSS, we tested the hypothesis that there would be one common underlying factor of dependence across the cigarette and ENDS scales and other product-specific factors. AIMS AND METHODS: Adult dual users (N = 404) completed baseline cigarette and ENDS versions of the NDSS, WISDM, and FTND, and biweekly surveys of their smoking and vaping. Analyses included bifactor modeling, which helps to identify both a general and product-specific factor for each item, and exploratory factor analyses of the combined cigarette and ENDS NDSS items and examinations of concurrent and predictive validity. RESULTS: The bifactor model was not a good fit, suggesting the lack of one common underlying dependence factor. Factor analyses revealed separate, similar factors for both products, with only one factor (priority) showing overlap of cigarette and ENDS items. ENDS scales significantly predicted ENDS use over time, but not cigarette use. Cigarette scales did not predict ENDS use over time. CONCLUSIONS: Although the cigarette and ENDS NDSS versions showed similar factor structure, there was not a primary common underlying factor reflecting drive or tolerance, but rather product-specific factors. The cigarette scales were not valid for predicting ENDS use. These results highlight the importance of separately assessing dependence for cigarettes and ENDS in dual users. IMPLICATIONS: Although underlying dimensions of nicotine dependence may be similar for ENDS and cigarettes, separate, product-specific measures may be needed to understand differences in product-specific dependency and predict changes in use of each product over time.


Assuntos
Fumar Cigarros/psicologia , Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Nicotina/administração & dosagem , Tabagismo/psicologia , Vaping/psicologia , Adulto , Fumar Cigarros/epidemiologia , Feminino , Humanos , Illinois/epidemiologia , Estudos Longitudinais , Masculino , Inquéritos e Questionários , Tabagismo/diagnóstico , Tabagismo/epidemiologia , Vaping/epidemiologia
12.
Arch Environ Occup Health ; 76(1): 37-44, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32469291

RESUMO

Smoking at workplace (WP) is common among healthcare workers. A cross-sectional study was conducted upon resident physicians and nurses to determine the prevalence of WP smoking and its associated factors. A questionnaire was used to collect socio-demographic and occupational data, smoking history, nicotine dependence, and attitude toward smoking and its control in WP. More than one-fifths (22.7%) of residents and nurses were current WP smokers. Significant independent predictors are having shift work, high nicotine dependence, and having positive attitude toward smoking with AOR (95% CI): 29.4 (4.9-177.1), 18.2 (3.3-101.1), and 0.16 (0.02-0.84), respectively. The prevalence of smoking among resident physicians and nurses in Mansoura University Hospital is relatively high. Enforcement of WP smoking-free policies is required together with encouragement of positive attitude toward smoking cessation.


Assuntos
Fumar Cigarros/epidemiologia , Hospitais Universitários/estatística & dados numéricos , Internato e Residência/estatística & dados numéricos , Enfermeiras e Enfermeiros/estatística & dados numéricos , Local de Trabalho/estatística & dados numéricos , Adulto , Atitude do Pessoal de Saúde , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Saúde do Trabalhador , Fatores Socioeconômicos , Tabagismo/epidemiologia
13.
J Community Health ; 46(1): 225-231, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32474805

RESUMO

While surveillance on a global scale has been showing a decline in tobacco smoking in the past decade, rates in the Eastern Mediterranean Region (EMR) remained stable with some countries showing rising trends. This study aimed to analyze the landscape of tobacco research in the EMR, present data on publication trends, and identify research gaps and opportunities to guide future tobacco research in the region. We conducted a scoping review of tobacco research in seven countries from January 2000 to December 2013. Three hundred and forty eight studies were identified, the majority of which were published in international journals and in English language. There was an increase in publications over time, with a significant positive linear trend (p = 0.03). Descriptive cross-sectional and case-control studies were the most common study designs (67.0%), and only 8% were longitudinal studies. Papers that reported, in part or solely, on waterpipe tobacco smoking (WTS) constituted 25.6% of the total publication pool. Tobacco consumption was treated as an exposure variable in half of the papers and mostly in relation to cancer and cardiovascular diseases, as an outcome measure in 37.7%, and as a confounding variable in 14.7% of the papers. Studies that examined associations of tobacco with other behaviors (5.3%) were lacking. The scarcity of high-evidence tobacco research in the EMR, together with the relatively deficient data on WTS and associations with other factors warrant the need for discussions on research priority setting and guidance on funding allocations in the region.


Assuntos
Produtos do Tabaco/estatística & dados numéricos , Poluição por Fumaça de Tabaco/estatística & dados numéricos , Tabagismo/epidemiologia , Uso de Tabaco/epidemiologia , Estudos de Casos e Controles , Estudos Transversais , Humanos , Região do Mediterrâneo/epidemiologia , Prevalência , Fumar/epidemiologia , Abandono do Hábito de Fumar
14.
Nicotine Tob Res ; 23(1): 171-178, 2021 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-31867605

RESUMO

INTRODUCTION: The legalization of nonmedical cannabis in 2018 may have important implications for tobacco use in Canada. There is a risk of renormalizing tobacco use with co-use of tobacco and cannabis introducing nontobacco users to tobacco. Co-use is the use of both substances by the same individual at the same time or on different occasions, as well as mixed together. This study assessed the prevalence of co-use and mixing of tobacco and cannabis among Ontario adults and the characteristics of the users. AIMS AND METHODS: Data from the 1996 to 2017 cycles of the Centre for Addiction and Mental Health Monitor (n = 4481) were used to examine trends in prevalence and the proportion of Ontario adults co-using and mixing tobacco and cannabis. Logistic regression was used to study associations between user characteristics and co-use and mixing. RESULTS: Co-use of cigarettes and cannabis among cannabis users declined from 59.8% in 1996 to 41.7% in 2017. Past-year e-cigarette use was the only predictor of co-use. From 2015 to 2017, 31.1% (95% confidence interval 27.0, 35.9) of Ontario adults who used cannabis reported mixing it with tobacco in the past year. Being white, past-year e-cigarette use, having moderate or high nicotine dependence, and having moderate or high risk for cannabis problems were significant predictors of mixing among cannabis users. CONCLUSION: Given the well-established negative health effects associated with tobacco use, alongside a growing evidence base for negative health effects of cannabis smoking, co-use and mixing could pose a considerable public health concern in the context of legalization. IMPLICATIONS: Considerable effort has been expended to reduce tobacco smoking. However, current efforts to reduce tobacco smoking may be diminished since this study found the prevalence of mixing tobacco and cannabis among cannabis users in Ontario to be higher than expected. Mixing tobacco and cannabis may introduce nontobacco smokers to tobacco, exposing them to health risks associated with both cannabis and tobacco smoke. Therefore, there is a need to monitor changes in tobacco use and understanding implications for tobacco control and cessation programs within the changing environment of cannabis legalization in Canada and other jurisdictions.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Fumar Maconha/epidemiologia , Fumantes/psicologia , Uso de Tabaco/epidemiologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ontário/epidemiologia , Prevalência , Tabagismo/epidemiologia , Adulto Jovem
15.
J Relig Health ; 60(3): 1766-1779, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30879207

RESUMO

This longitudinal study assesses the associations between developmental trajectories of religious service attendance from mean age 14 to mean age 43 and nicotine dependence and alcohol dependence/abuse at mean age 43 (N = 548). Six trajectories of religious service attendance were identified. As compared with belonging to weekly stable trajectory group, a higher probability of belonging to the weekly/none decreasing, occasional stable, and non-attendance trajectory group was significantly associated with a higher likelihood of nicotine dependence. In addition, as compared with belonging to weekly stable trajectory group, a higher probability of belonging to the weekly/none decreasing, weekly/occasional decreasing, occasional stable, and non-attendance trajectory group was significantly associated with a higher likelihood of alcohol dependence/abuse. These findings are consistent with the hypothesis that religious service attendance protects against nicotine dependence and alcohol dependence/abuse in early midlife.


Assuntos
Alcoolismo , Tabagismo , Adolescente , Adulto , Alcoolismo/epidemiologia , Humanos , Estudos Longitudinais , Tabagismo/epidemiologia , Tabagismo/terapia
16.
Telemed J E Health ; 27(1): 20-29, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32649266

RESUMO

Background: The (COVID-19) pandemic resulted in sudden disruption of routine clinical care necessitating rapid transformation to maintain clinical care while safely reducing virus contagion. Introduction: Memorial Sloan Kettering (MSK) experienced a rapid evolution from delivery of in-person cessation counseling services to virtual telehealth treatments for our tobacco-dependent cancer patients. Aim: To examine the effect of rapid scaling of tobacco treatment telehealth on patient engagement, as measured by attendance rates for in-person counseling visits versus remote telehealth counseling visits. We also describe the patient, clinician, and health care system challenges encountered in rapid expansion of individual and group tobacco telehealth services. Methods: Data collected from the electronic medical record during the first 4 months of the COVID-19 pandemic were examined for tobacco treatment counseling. Results: From January 1, 2020 to March 30, 2020, markedly improved patient engagement was observed in ambulatory tobacco treatment services with greater attendance at scheduled telehealth visits than in-person visits, 75% versus 60.3%, odds ratio 1.84 (confidence interval: 1.26-2.71; p < 0.001). In addition, bedside hospital counseling visits were transformed into inpatient telephone visits with high levels of sustained patient engagement. Lastly, group telehealth services were launched rapidly to increase capacity and provide greater psychosocial support for cancer patients struggling with tobacco dependence. Discussion: Clinical, Information Technology (IT), and hospital system barriers were successfully addressed for most cancer patients seeking individual telehealth treatment. Group telehealth services were found to be feasible and acceptable. Conclusions: MSK's rapid leap into virtual care delivery mitigated disruption of tobacco treatment services and demonstrated strong feasibility and acceptance for managing complex tobacco-dependent patients.


Assuntos
COVID-19/epidemiologia , Aconselhamento/organização & administração , Neoplasias/epidemiologia , Telemedicina/organização & administração , Tabagismo/epidemiologia , Tabagismo/terapia , Adulto , Idoso , Registros Eletrônicos de Saúde , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cidade de Nova Iorque/epidemiologia , Pandemias , SARS-CoV-2 , Telefone
17.
Nicotine Tob Res ; 23(4): 765-769, 2021 03 19.
Artigo em Inglês | MEDLINE | ID: mdl-33029618

RESUMO

INTRODUCTION: We investigated the influence of COVID-19 on smoking patterns in Pakistan. METHODS: In a longitudinal survey, we asked cigarette smokers in Pakistan about their smoking behaviors before and since COVID-19. Smokers were recruited before COVID-19 using two-stage random probability sampling. Since COVID-19, three subsequent waves were conducted over the telephone, asking additional questions on social determinants, mental health, and well-being. Based on the first two waves, we estimated the proportion of smokers who stopped, decreased, maintained, or increased smoking. We also explored any factors associated with the change in smoking patterns. In those who stopped smoking soon after COVID-19, we estimated the proportion relapsed in subsequent waves. We estimated all proportions based on complete-case analysis. RESULTS: We recruited 6014 smokers between September 2019 and February 2020; of these, 2087 (2062 reported smoking outcomes) were followed up in May 2020 after COVID-19. Since COVID-19, 14% (290/2062) smokers reported quitting. Among those who continued smoking: 68% (1210/1772) reduced, 14% (239/1772) maintained, and 18% (323/1772) increased cigarette consumption; 37% (351/938) reported at least one quit attempt; 41% (669/1619) were more motivated; while 21% (333/1619) were less motivated to quit. Changes in smoking patterns varied with nicotine dependence, motivation to quit, and financial stability since COVID-19. Among those reporting quitting soon after COVID-19, 39% (81/206) relapsed in the subsequent months (June-July 2020). CONCLUSIONS: There have been significant bidirectional changes in smoking patterns since COVID-19 in Pakistan. Although many people stopped, reduced, or tried quitting smoking, some increased smoking and some relapsed after quitting. IMPLICATIONS: We observed significant and complex changes in people's smoking patterns, which are likely to be attributable to the COVID-19 pandemic and replicated in similar events in the future. Assessing these changes is essential for most low- and middle-income countries like Pakistan, where the vast majority of tobacco users live, but cessation support is still rudimentary. If provided routinely, smoking cessation interventions can potentially support millions of highly motivated individuals in quitting successfully both in general and in global events like COVID-19, in particular.


Assuntos
COVID-19/epidemiologia , Motivação , Fumar Tabaco/psicologia , Adulto , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Paquistão , Pandemias , Fumantes/psicologia , Abandono do Hábito de Fumar/psicologia , Tabagismo/epidemiologia
19.
J Addict Dis ; 39(2): 241-247, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33283686

RESUMO

INTRODUCTION AND OBJECTIVE: Coronavirus disease 2019 (COVID-19) epidemic had exhibited negative effects on patients with a nicotine use disorder because of social stress situations. The objective of this study is to investigate the changes that occurred in the smoking habits of the patients who applied to our smoking cessation clinic because of the COVID-19 outbreak's effect (coronaphobia) on their mental health. METHOD: In this study, we included the patients who applied to our smoking cessation clinic between January 1 and June 30, 2020. We conducted telephonic and face-to-face interviews with the patients during the outbreak, and inquired about the changes in their smoking habits. RESULTS: In total, 114 volunteers (mean age: 41.2 years [min-max: 18-82 years], M/F: 70/44 [61.4/38.6%]) who registered in the smoking cessation clinic of Chest Diseases Clinic were included in the study. The number of people with and without coronaphobia was 64 (56.1%) and 50 (43.9%), respectively. The analyses of the changes in smoking behaviors because of coronaphobia demonstrated that people with coronaphobia exhibited a significantly higher decrease or cessation of smoking as compared to no change in smoking behavior or increase in the number of cigarettes (p: .006). CONCLUSIONS: Success in smoking cessation can be increased with the accurate analyses of the anxiety effects caused by coronaphobia after COVID-19 outbreak on the desire of smoking cessation. This resolution depends on the solution-oriented strategies that will increase the awareness of physicians and patients, a close follow-up of patients with tools such as telemedicine, and a quick determination of their needs.


Assuntos
COVID-19/epidemiologia , COVID-19/psicologia , Epidemias , Medo , Fumar/epidemiologia , Fumar/psicologia , Tabagismo/epidemiologia , Tabagismo/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Entrevista Psicológica , Masculino , Pessoa de Meia-Idade , Prevalência , Abandono do Hábito de Fumar/estatística & dados numéricos , Turquia , Adulto Jovem
20.
Addict Behav ; 115: 106787, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33383566

RESUMO

BACKGROUND: Adult smokers with symptoms of any mental illness (AMI) are highly dependent on nicotine and may face additional difficulty quitting smoking. While there is evidence that adult smokers with AMI have high dependence, there is insufficient evidence regarding the unique role that AMI may play in moderating the relationship between dependence and cessation outcomes over time. METHODS: 7290 current established adult smokers at Wave 1 (2013-2014) of the PATH Study also participated in data collection in Waves 2-4 (2014-2018). Linear probability models with individual-level random effects were fit to the data, modeling associations between AMI, nicotine dependence, and the 1) likelihood of achieving cessation during the study period, 2) making a cessation attempt within the previous 12 months, and 3) log of past 30-day total consumption of cigarettes. RESULTS: Adults who experienced both AMI symptoms and high dependence were 4.7 percentage points (PP) less likely to achieve cessation at any point during the study period (p < 0.01) and smoked more cigarettes per month (ß = 0.214, p < 0.05) than adults with AMI who were not highly dependent, despite being as likely to attempt to quit. Adults with AMI who were not highly dependent were 4.6 PP more likely to report a quit attempt and 1.6 PP more likely to achieve cessation than those with neither AMI nor high dependence. CONCLUSIONS: Adults with AMI are particularly affected by the burden of tobacco use, in part because of the likely interaction between nicotine dependence and AMI. Tobacco control efforts that focus on this interplay may provide an opportunity to better target interventions for this vulnerable population.


Assuntos
Abandono do Hábito de Fumar , Tabagismo , Adulto , Humanos , Saúde Mental , Fumar/epidemiologia , Tabaco , Tabagismo/epidemiologia
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