Associations of clinical, psychological, and socioeconomic characteristics with nicotine dependence in smokers.
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SUBMITTER: Sim YS
PROVIDER: S-EPMC8448893 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundSocioeconomic status (SES) is a major determinant of tobacco use but little is known whether SES affects nicotine exposure and the degree of nicotine dependence.MethodsThe Pennsylvania Adult Smoking Study is a cross-sectional study of smoke exposure and nicotine dependence among adults conducted in central Pennsylvania between June 2012 and April 2014. The study included several measures of SES, including assessments of education and household income, as well as occupation, home ownership, health insurance, household density and savings accounts. Measurements included saliva for the nicotine metabolites cotinine (COT), 3-'hydroxycotinine (3HC) and total metabolites (COT +3HC). Puffing behavior was determined using portable smoking topography devices.ResultsThe income levels of lighter smokers (< 20 cigarettes per day) was $10,000 more than heavier smokers. Higher Fagerström Test for Nicotine Dependence scores were associated with lower income and job status, scores ranged from 5.4 in unemployed, 4.4 in blue-collar, and 3.8 in white-collar workers. In principal components analysis used to derive SES indicators, household income, number in household, and type of dwelling were the major SES correlates of the primary component. Job category was the major correlate of the second component. Lower SES predicted significantly higher adjusted total nicotine metabolite levels in the unemployed group. Job category was significantly associated with total daily puffs, with the highest level in the unemployed, followed by blue-collar workers, after adjustment for income.ConclusionsAmong smokers, there was a relationship between lower SES and increased nicotine dependence, cigarettes per day and nicotine exposure, which varied by job type.
| S-EPMC6448228 | biostudies-literature
Project description:To examine the inter-relationships between cigarette consumption and DSM-IV nicotine dependence (ND) criteria from smoking onset in adolescence up to 7 years later, adjusting for alcohol consumption and DSM-IV alcohol dependence (AD) criteria.A cohort drawn from grades 6-10 in an urban school system was interviewed five times at 6-month intervals (waves 1-5) and 4.5 years later (wave 6). A parent was interviewed three times.Chicago, Illinois.Recent smokers (n?=?409).Structured household interviews ascertained number of cigarettes smoked, DSM-IV ND symptoms, drinks consumed, DSM-IV AD symptoms, and selected covariates. Reciprocal prospective associations between number of cigarettes smoked and ND criteria, controlling for time-varying alcohol consumption and dependence criteria, were examined with cross-lagged models.Reciprocal associations between number of cigarettes smoked and ND criteria were both significant. Cigarette consumption had stronger associations with later ND [??=?0.25, 95% confidence interval (CI)?=?0.17-0.32] than dependence had with later cigarette consumption (??=?0.09, 95% CI?=?0.01-0.16). Alcohol and cigarette consumption influenced each other; AD scores were associated with later ND scores but not the reverse. Reports of pleasant initial experiences from smoking were associated positively with cigarette consumption and ND the first year after smoking onset; later smoking onset was negatively associated with cigarette consumption the seventh year after onset; parental ND predicted cigarette consumption and ND throughout.In adolescent smokers, higher cigarette consumption predicts later severity of DSM-IV nicotine dependence more than the reverse. Smoking and drinking also influence each other mutually over time.
| S-EPMC4127143 | biostudies-literature
Project description:INTRODUCTION:Smoking prevalence among adults with opioid dependence far exceeds that of the general population, and cessation outcomes in this group are one-fourth that of smokers without a substance use disorder. Understanding the reasons underlying these poor outcomes is critical for developing more effective smoking interventions in this group. Elevated baseline severity of nicotine dependence is associated with lower rates of smoking cessation over time. We examined whether nicotine dependence severity among smokers may vary as a function of opioid dependence status using nationally representative samples of adult smokers. METHODS:Data were derived from multiple years of the National Survey on Drug Use and Health (NSDUH, 2006-2014; n?=?58,971). Nicotine dependence was measured by the Nicotine Dependence Syndrome Scale (NDSS) and the first item (i.e., time to first cigarette) of the Fagerström Test for Nicotine Dependence (FTND). Opioid dependence was assessed using the Diagnostic and Statistical Manual of Mental Disorders criteria. RESULTS:Opioid-dependent smokers exhibited greater severity of nicotine dependence compared to non-opioid dependent smokers, as evidenced by higher mean NDSS scores (p?<?0.05). On both NDSS and FTND measures of nicotine dependence, opioid-dependent smokers were also approximately twice as likely to be dependent on nicotine than those not dependent on opioids (p's?<?0.05). CONCLUSIONS:Opioid dependence is associated with increased severity and prevalence of nicotine dependence among smokers. Considering the disproportionate societal and economic burdens of smoking and smoking-related consequences in this vulnerable population, continued investigations are needed to better understand opioid-dependent individuals' poor cessation outcomes.
| S-EPMC5911224 | biostudies-literature
Project description:IntroductionNicotine dependence (ND) is a maladaptive pattern of tobacco smoking with withdrawal symptoms similar to other drug addictive disorders. It is very common in clinical practice that smokers always have different degrees of nicotine dependence with the same amount of tobacco consumption. Behaviors may influence daily cigarette consumption or smoking status. Hence it is critical to ascertain the association between concurrent behaviors and high nicotine dependence among smokers.MethodsA total of 343 patients who attended a clinic for smoking cessation were recruited, and the information on concurrent behaviors were recorded. Factors associated and not associated with nicotine dependence were recorded. Nicotine dependence was determined by Fagerström test for nicotine dependence (FTND).ResultsHigh ND patients (FTND >5) showed significant behaviors distribution compared with mild and moderate ND patients (FTND ≤5). There is no single behavior that was significantly different between high ND and mild and moderate ND smokers. However, the combined effects of nicotine dependence influencing behaviors of caffeine drinking and mental activities after dinner have an association with high ND (OR=1.939; 95% CI: 1.154-3.258, p=0.012). In addition, the combined effects of inadequate sleep time (<8 hours), caffeine drinking and mental activities after dinner significantly distinguished patients of high ND from those of low ND (OR=2.208; 95% CI: 1.032-4.737, p=0.042).ConclusionsInteraction effects of mental activities after dinner and caffeine drinking have an association with high nicotine dependence. Sleep of less than 8 hours with behaviors of mental activities after dinner and caffeine drinking have the same effect.
| S-EPMC8573533 | biostudies-literature
Project description:IntroductionEvidence-based treatments for tobacco dependence are significantly less effective for smokers of lower socioeconomic status which contributes to socioeconomic disparities in smoking prevalence rates and health. We aimed to reduce the socioeconomic gradient in treatment outcomes by systematically adapting evidence-based, cognitive-behavioral treatment for tobacco dependence for diverse lower socioeconomic smokers.MethodsParticipants were randomized to adapted or standard treatment, received six 1-h group treatment sessions, and were followed for six months. We examined the effectiveness of the adapted treatment to improve treatment outcomes for lower socioeconomic groups.ResultsParticipants (n=227) were ethnically, racially, and socioeconomically diverse. The adapted treatment significantly reduced the days to relapse for the two lowest socioeconomic groups: SES1: M=76.6 (SD 72.9) vs. 38.3 (SD 60.1) days to relapse (RR=0.63 95% CI, 0.45, 0.88, p=0.0013); SES2: M=88.2 (SD 67.3) vs. 40.1 (SD 62.6 days to relapse (RR=0.57 95% CI, 0.18, 0.70, p=0.0024). Interactions between socioeconomic status and condition were significant for initial abstinence (OR=1.26, 95% CI 1.09, 1.46, p=0.002), approached significance for 3-month abstinence (OR=0.90, 95% CI 0.80, 1.01, p<0.071), and were not significant for 6-month abstinence (OR=0.99 95% CI 0.88, 1.10, p=0.795). No significant differences in long-term abstinence were observed.ConclusionSystematic adaption of evidence-based treatment for tobacco dependence can significantly improve initial and short-term treatment outcomes for diverse lower socioeconomic smokers and reduce inequities in days to relapse. Novel methods of providing targeted extended support are needed to improve long-term outcomes.
| S-EPMC7780926 | biostudies-literature
Project description:We utilized a cohort of 828 treatment-seeking self-identified white cigarette smokers (50% female) to rank candidate gene single nucleotide polymorphisms (SNPs) associated with the Fagerström Test for Nicotine Dependence (FTND), a measure of nicotine dependence which assesses quantity of cigarettes smoked and time- and place-dependent characteristics of the respondent's smoking behavior. A total of 1123 SNPs at 55 autosomal candidate genes, nicotinic acetylcholine receptors and genes involved in dopaminergic function, were tested for association to baseline FTND scores adjusted for age, depression, education, sex, and study site. SNP P-values were adjusted for the number of transmission models, the number of SNPs tested per candidate gene, and their intragenic correlation. DRD2, SLC6A3, and NR4A2 SNPs with adjusted P-values <0.10 were considered sufficiently noteworthy to justify further genetic, bioinformatic, and literature analyses. Each independent signal among the top-ranked SNPs accounted for approximately 1% of the FTND variance in this sample. The DRD2 SNP appears to represent a novel association with nicotine dependence. The SLC6A3 SNPs have previously been shown to be associated with SLC6A3 transcription or dopamine transporter density in vitro, in vivo, and ex vivo. Analysis of SLC6A3 and NR4A2 SNPs identified a statistically significant gene-gene interaction (P=0.001), consistent with in vitro evidence that the NR4A2 protein product (NURR1) regulates SLC6A3 transcription. A community cohort of N=175 multiplex ever-smoking pedigrees (N=423 ever smokers) provided nominal evidence for association with the FTND at these top ranked SNPs, uncorrected for multiple comparisons.
| S-EPMC3558036 | biostudies-literature
Project description:PurposeWaterpipe (WP) smoking patterns and setting can result in a unique trajectory of nicotine dependence (ND) compared with cigarette smoking. This longitudinal study compared the development of ND symptoms among adolescent WP and cigarette smokers.MethodsA cohort of 647 eighth and ninth graders in Lebanon were followed over 5 years. This study was based on 283 current exclusive WP and 146 current exclusive cigarette smokers. Kaplan-Meier survival analyses were conducted to evaluate 50% cumulative probability for the development of initial Hooked on Nicotine Checklist symptoms and the International Classification of Diseases, 10th revision (ICD-10) ND.ResultsAn initial Hooked on Nicotine Checklist symptom was endorsed by 59% of WP and 50% of cigarette smokers after smoking onset. Among those, 50% of both WP and cigarette smokers did so within 9.7 and 18.5 months, respectively. Approximately 28% of WP smokers and 22% of cigarette smokers developed ICD-10 ND. Among those, 50% of both WP and cigarette smokers did so within 15 and 22 months, respectively. The most common first to fourth ICD-10 criteria reported by WP smokers were "a strong desire to use tobacco," "difficulties in controlling tobacco taking behavior," "neglect of alternative pleasure," and "use despite harm." The most common first to fourth ICD-10 criteria reported by cigarette smokers were "a strong desire to use tobacco," "difficulties in controlling tobacco taking behavior," "withdrawal," and "tolerance".ConclusionsCompared with adolescent cigarette smokers, initial ND symptoms and ICD-10 ND can develop sooner after starting to smoke and progress more rapidly among adolescent WP smokers. Developing, implementing, and evaluating intervention programs with adolescent WP smokers should be guided by the WP-specific trajectory of ND.
| S-EPMC7683372 | biostudies-literature
Project description:BackgroundCo-use of tobacco and cannabis and dual use of cigarettes and e-cigarettes are very common among young adults. However, it is unclear whether co-use of cigarettes, e-cigarettes, and/or cannabis is associated with higher levels of nicotine dependence than cigarette-only use. We investigated the relationship between cigarette/nicotine dependence and co-use of tobacco and cannabis among 4 groups of cigarette smokers aged 18-35: cigarette-only smokers, cigarette-e-cigarette (CIG-ECIG) co-users, cigarette-cannabis (CIG-CAN) co-users, and cigarette-e-cigarette-cannabis (CIG-ECIG-CAN) co-users.MethodsData were from a 2018 cross-sectional survey based on a national convenience sample of smokers aged 18-35 (n = 315). Cigarette/nicotine dependence was measured by the Fagerstrom Test of Nicotine Dependence (FTND) and e-cigarette dependence was measured by the Penn State E-cigarette Dependence Index. Bivariate analyses examined sociodemographic and tobacco/other substance use characteristics by co-use status and multivariable linear regression assessed the relationship between co-use and nicotine dependence.ResultsIn the sample, 27.6% were cigarette-only smokers, 24.8% were CIG-ECIG, 27.6% were CIG-CAN, and 20.0% were CIG-ECIG-CAN co-users. Significant differences were observed in sociodemographic and tobacco/other substance use characteristics by co-use status. E-cigarette co-users had low e-cigarette dependence, but moderate FTND scores. In adjusted analyses, only CIG-ECIG co-use was associated with higher FTND scores compared to cigarette-only smoking. However, CIG-ECIG and CIG-ECIG-CAN co-use were associated with higher FTND scores compared to CIG-CAN co-use.ConclusionsCo-use of cigarettes and e-cigarettes was associated with greater nicotine dependence among smokers aged 18-35. Additional research is needed to understand the underlying mechanisms of these relationships and inform prevention efforts.
| S-EPMC10249428 | biostudies-literature
Project description:IntroductionThe Food and Drug Administration issued an advanced notice of proposed rulemaking for setting a product standard for nicotine levels in cigarettes, with an emphasis on minimally or non-addicting very low nicotine content (VLNC).MethodsA 33 week, two-arm, double-blind randomized trial conducted in Hershey, Pennsylvania, USA and Washington, DC, USA included adult daily cigarette smokers (≥5 cigarettes per day) with less than a college degree, and who had no plans to quit within the next six months. Participants were randomized to either reduced nicotine content (RNC) study cigarettes tapered every three weeks to a final VLNC (0.2 mg/cigarette) for six weeks or to usual nicotine content (UNC) study cigarettes (11.6 mg/cigarette). Outcomes included acceptability of study cigarettes measured by attrition (primary outcome), compliance, reduction in cigarette dependence and tobacco biomarkers, and post-intervention cessation.ResultsThe RNC (n = 122) versus UNC (n = 123) group had higher attrition (adjusted Hazard Ratio 3.4; 95% confidence interval [CI] 1.99 to 5.81). At the end of the intervention, cotinine levels were 50% lower in the RNC group (mean group difference -137 ng/mL; 95% CI -172, -102). The RNC group smoked fewer CPD (-4.1; 95% CI -6.44, -1.75) and had lower carbon monoxide levels (-4.0 ppm; 95% CI -7.7, -0.4). Forty seven percent (29/62) of the RNC group were biochemically-confirmed compliant with smoking VLNC cigarettes (mean cotinine = 8.9 ng/ml). At three month follow-up, only compliant VLNC smokers quit with an assisted quit attempt (N = 6/22, 27%).ConclusionsThis study supports a VLNC standard in cigarettes.ImplicationsDifferential dropout and noncompliance indicate some smokers had difficulty transitioning to cigarettes with reduced nicotine. These smokers will benefit from supplemental nicotine in medicinal or noncombustible tobacco products if a nicotine reduction standard is established. Other smokers successfully transitioned to very low nicotine content cigarettes exclusively and substantially reduced their exposure to nicotine.
| S-EPMC8150128 | biostudies-literature
Project description:Current theoretical models of nicotine dependence assume a close relationship between use and dependence; however, previous data suggest that many daily smokers fail to develop nicotine dependence.To determine what percentage of daily smokers fail to meet DSM-IV criteria for nicotine dependence within their lifetime, how non-dependence relates to duration and quantity of cigarette use, and whether other tobacco use and/or specific dependence criteria differentiate never-dependent and dependent smokers.Cross-sectional data collected via personal interview from a nationally representative sample of 8213 past year daily smokers were analyzed.Approximately 39.4% of daily smokers never reached nicotine dependence. While the probability of remaining non-dependent decreased with smoking quantity and duration since the onset of daily smoking, a substantial portion of individuals (37.7%) who reported smoking >or=10 cigarettes per day and began smoking daily >or=10 years prior, remained never nicotine dependent.The absence of nicotine dependence in heavy daily smokers may result from limitations in the measurement of dependence and/or nicotine exposure. Alternatively, some individuals may be relatively resistant to becoming nicotine dependent despite extensive use. The latter explanation would have important implications for understanding the nature of nicotine dependence.
| S-EPMC1924493 | biostudies-literature