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Longitudinal Examination of the Influence of Individual Posttraumatic Stress Disorder Symptoms and Clusters of Symptoms on the Initiation of Cigarette Smoking.

ABSTRACT: OBJECTIVES:The aim of this study was to determine whether specific individual posttraumatic stress disorder (PTSD) symptoms or symptom clusters predict cigarette smoking initiation. METHODS:Longitudinal data from the Millennium Cohort Study were used to estimate the relative risk for smoking initiation associated with PTSD symptoms among 2 groups: (1) all individuals who initially indicated they were nonsmokers (n?=?44,968, main sample) and (2) a subset of the main sample who screened positive for PTSD (n?=?1622). Participants were military service members who completed triennial comprehensive surveys that included assessments of smoking and PTSD symptoms. Complementary log-log models were fit to estimate the relative risk for subsequent smoking initiation associated with each of the 17 symptoms that comprise the PTSD Checklist and 5 symptom clusters. Models were adjusted for demographics, military factors, comorbid conditions, and other PTSD symptoms or clusters. RESULTS:In the main sample, no individual symptoms or clusters predicted smoking initiation. However, in the subset with PTSD, the symptoms "feeling irritable or having angry outbursts" (relative risk [RR] 1.41, 95% confidence interval [CI] 1.13-1.76) and "feeling as though your future will somehow be cut short" (RR 1.19, 95% CI 1.02-1.40) were associated with increased risk for subsequent smoking initiation. CONCLUSIONS:Certain PTSD symptoms were associated with higher risk for smoking initiation among current and former service members with PTSD. These results may help identify individuals who might benefit from more intensive smoking prevention efforts included with PTSD treatment.

SUBMITTER: Seelig AD

PROVIDER: S-EPMC6167135 | biostudies-literature | 2018 Sep/Oct

REPOSITORIES: biostudies-literature

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Longitudinal Examination of the Influence of Individual Posttraumatic Stress Disorder Symptoms and Clusters of Symptoms on the Initiation of Cigarette Smoking.

Seelig Amber D AD Bensley Kara M KM Williams Emily C EC Armenta Richard F RF Rivera Anna C AC Peterson Arthur V AV Jacobson Isabel G IG Littman Alyson J AJ Maynard Charles C Bricker Jonathan B JB Rull Rudolph P RP Boyko Edward J EJ

Journal of addiction medicine 20180901 5

<h4>Objectives</h4>The aim of this study was to determine whether specific individual posttraumatic stress disorder (PTSD) symptoms or symptom clusters predict cigarette smoking initiation.<h4>Methods</h4>Longitudinal data from the Millennium Cohort Study were used to estimate the relative risk for smoking initiation associated with PTSD symptoms among 2 groups: (1) all individuals who initially indicated they were nonsmokers (n = 44,968, main sample) and (2) a subset of the main sample who scre ...[more]

PMID: 29864086

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Project description:OBJECTIVES:Given that many adolescent e-cigarette users are never-smokers, the possibility that e-cigarettes may act as a gateway to future cigarette smoking has been discussed in various studies. Longitudinal data are needed to explore the pathway between e-cigarette and cigarette use, particularly among different risk groups including susceptible and non-susceptible never-smokers. The objective of this study was to examine whether baseline use of e-cigarettes among a sample of never-smoking youth predicted cigarette smoking initiation over a 2-year period. DESIGN:Longitudinal cohort study. SETTING:89 high schools across Ontario and Alberta, Canada. PARTICIPANTS:A sample of grade 9-11 never-smoking students at baseline (n=9501) who participated in the COMPASS study over 2 years. PRIMARY AND SECONDARY OUTCOME MEASURES:Participants completed in-class questionnaires that assessed smoking susceptibility and smoking initiation. RESULTS:Among the baseline sample of non-susceptible never-smokers, 45.2% of current e-cigarette users reported trying a cigarette after 2 years compared with 13.5% of non-current e-cigarette users. Among the baseline sample of susceptible never-smokers, 62.4% of current e-cigarette users reported trying a cigarette after 2 years compared with 36.1% of non-current e-cigarette users. Overall, current e-cigarette users were more likely to try a cigarette 2 years later. This association was stronger among the sample of non-susceptible never-smokers (AOR=5.28, 95% CI 2.81 to 9.94; p<0.0001) compared with susceptible never-smokers (AOR=2.78, 95% CI 1.84 to 4.20; p<0.0001). CONCLUSIONS:Findings from this large, longitudinal study support public health concerns that e-cigarette use may contribute to the development of a new population of cigarette smokers. They also support the notion that e-cigarettes are expanding the tobacco market by attracting low-risk youth who would otherwise be unlikely to initiate using cigarettes. Careful consideration will be needed in developing an appropriate regulatory framework that prevents e-cigarette use among youth.

Project description:IntroductionStudies, predominantly from the US, suggest that positive parenting, social support, academic achievement, and ethnic identity may buffer the impact of racism on health behaviours, including smoking, but little is known about how such effects might operate for ethnically diverse young people in the United Kingdom. We use the Determinants of young Adult Social well-being and Health (DASH), the largest UK longitudinal study of ethnically diverse young people, to address the following questions: a) Is racism associated with smoking? b) Does the relationship between racism and smoking vary by gender and by ethnicity? (c) Do religious involvement, parenting style and relationship with parents modify any observed relationship? and d) What are the qualitative experiences of racism and how might family or religion buffer the impact?MethodsThe cohort was recruited from 51 London schools. 6643 were seen at 11-13y and 4785 seen again at 14-16y. 665 participated in pilot follow-up at 21-23y, 42 in qualitative interviews. Self-report questionnaires included lifestyles, socio-economic and psychosocial factors. Mixed-effect models examined the associations between racism and smoking.ResultsSmoking prevalence increased from adolescence to age 21-23y, although ethnic minorities remained less likely to smoke. Racism was an independent longitudinal correlate of ever smoking throughout adolescence (odds ratio 1.77, 95% Confidence Interval 1.45-2.17) and from early adolescence to early 20s (1.90, 95% CI 1.25-2.90). Smoking initiation in late adolescence was associated with cumulative exposure to racism (1.77, 95% CI 1.23-2.54). Parent-child relationships and place of worship attendance were independent longitudinal correlates that were protective of smoking. Qualitative narratives explored how parenting, religion and cultural identity buffered the adverse impact of racism.ConclusionsRacism was associated with smoking behaviour from early adolescence to early adulthood, regardless of gender, ethnicity or socio-economic circumstances adding to evidence of the need to consider racism as an important social determinant of health across the life course.

Project description:BackgroundNearly one-in-two Vietnamese men smoke cigarettes placing them among the highest tobacco consumers in the world. Despite the need for smoking cessation to curb the burden of tobacco-related diseases in Vietnam, this rate remains at less than 30%. Therefore, this study examines individual-, social- and policy factors associated with smoking cessation among adult male smokers in Vietnam.MethodsWe established a longitudinal International Tobacco Control study of male smokers in Hanoi, Vietnam, in September 2018. This paper analyses 1525 men who participated in baseline and one-year follow-up. We applied a weighted multivariable logistic regression to examine the association between smoking cessation and individual-, social- and policy predictors.ResultsAt follow-up, 14.8% of participants had quit smoking for at least 30 consecutive days during the last year. Among the persistent smokers, 56.6% expressed intention to quit smoking. Factors associated with smoking cessation included a lower number of cigarettes smoked per day (aOR = 0.96, 95% CI: 0.94, 0.99) and having several attempts to quit smoking (aOR = 2.16, 95% CI 1.13, 4.12). Intention to quit smoking was associated with multiple quit attempts, a chronic condition diagnosis, more tobacco-related knowledge, greater self-efficacy, and more worries about their future health. The perceived impact of smoke-free policy and health warning labels were positively associated with intention to quit at any stage.ConclusionsInterventions aimed at increasing smoking cessation should focus on all aspects of individual, social, and policy factors. Persistent smokers are more motivated to quit if they have made multiple quit attempts, more self-efficacy of quitting and worried about their future health, indicating that increasing smokers' beliefs and knowledge may be important for behavioural change. Health warning labels and tobacco taxation policies should be maintained and promoted as they are perceived to be particularly useful for persistent smokers' intention to quit.

Project description:IntroductionThis study examined the association between the introduction of an e-cigarette and subsequent change in cigarette smoking among smokers who were not immediately interested in quitting.Aims and methodsThe Moment Study was a 21-day intensive longitudinal study with an online follow-up survey at 30 days. After observing baseline cigarette smoking for 1 week, participants received 10 cigalike e-cigarettes on study days 6 and 13. Participants reported cigarettes per day, e-cigarette puffs per day, and e-cigarette satisfaction using text-message-based surveys.ResultsThe sample of 96 daily smokers was majority female (53.1%), African American (67.7%), and non-Hispanic (95.8%). When e-cigarettes were provided (day 6), average cigarettes per day dropped by 1.82 cigarettes (p < .0001). The within-person e-cigarette puff effect on daily cigarette smoking was significantly negative (β = -0.023; p = .005); a participant who consumed 100 more e-cigarette puffs in a day than usual for that person was expected to smoke 2.3 fewer cigarettes that day, but this was only true for non-menthol smokers (p = .006). Smokers older than 45 and those who started smoking at a younger age rated e-cigarettes as less satisfying (ps < .05). Participants with greater than the median reported satisfaction were 6.5 times more likely to use an e-cigarette at follow-up.ConclusionsGiving e-cigarettes to smokers who did not intend to quit reduced their cigarette smoking on days when they used e-cigarette more frequently, but this relationship did not hold for menthol smokers. Satisfaction with e-cigarette use was predictive of continued use 30 days later.ImplicationsA greater amount of cigalike e-cigarette use resulted in less smoking among adult daily smokers without immediate plans to quit, but a lack of nicotine delivery and satisfaction for these devices may have limited their utility as a replacement for cigarette smoking, especially among menthol smokers. The global concept of "satisfaction" may be an important driver of e-cigarette use among adult smokers.

Project description:Racial/ethnic groups appear to differ on quit success and withdrawal is a key factor in cessation failure, yet little is known about racial/ethnic differences in withdrawal symptoms. This study of US adults examined racial/ethnic differences in current smokers' report of withdrawal symptoms and the relationship between withdrawal symptoms and quitting smoking 3 years later.Using data from the National Epidemiologic Survey on Alcohol and Related Conditions (Wave 1, 2001-2001; Wave 2, 2004-2005), analyses were conducted on participants who identified as non-Hispanic White, non-Hispanic Black, or Hispanic; reported current cigarette smoking at Wave 1; and provided smoking status information at Wave 2 (n = 7981). Withdrawal symptoms during past quit attempts were assessed at Wave 1.Among Wave 1 current smoking adults, non-Hispanic White respondents were more likely than non-Hispanic Black and Hispanic respondents to report experiencing at least one withdrawal symptom, seven out of eight withdrawal symptoms, withdrawal-related discomfort, and withdrawal-related distress (ps < .0001). While withdrawal symptoms were associated with a lower odds of quitting smoking for all groups, a stronger relationship between number of symptoms and lower odds of quitting was evident among non-Hispanic White compared to non-Hispanic Black respondents (interaction β = 0.065, p = .0001). For non-Hispanic White participants, each additional withdrawal symptom was associated with a 6% decrease in the odds of quitting.Withdrawal symptoms were more commonly reported by non-Hispanic White adults than non-Hispanic Black and Hispanic adults and appeared to have a greater impact on failure to quit smoking for non-Hispanic White compared to non-Hispanic Black adults.To our knowledge, this is the first study to use prospective, longitudinal data to examine the relationship between race and withdrawal symptoms and the impact of withdrawal symptoms on quitting smoking among adults in the United States. Non-Hispanic White adults were more likely to report withdrawal symptoms and there was a stronger relationship between greater number of withdrawal symptoms and lower odds of quitting for non-Hispanic White adults compared to non-Hispanic Black adults. Developing a better understanding of racial/ethnic differences in withdrawal and cessation can help to tailor efforts to improve outcomes for smokers in various racial/ethnic groups.

Dataset Information

Longitudinal Examination of the Influence of Individual Posttraumatic Stress Disorder Symptoms and Clusters of Symptoms on the Initiation of Cigarette Smoking.

Publications

Longitudinal Examination of the Influence of Individual Posttraumatic Stress Disorder Symptoms and Clusters of Symptoms on the Initiation of Cigarette Smoking.

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