OBJECTIVES: This study tested the hypothesis that high daily cigarette consumption and addiction to smoking are risk factors for the long-term continuation of smoking. METHODS: Using longitudinal data from 986 male smokers, we entered cigarettes per day, psychological addiction, age, and education into a survival analysis as predictors of continued smoking over a 25-year period. RESULTS: Younger men and those who smoked more cigarettes per day were more likely to remain smokers in the long term. Addiction and education level were not significant predictors of continued smoking. CONCLUSIONS: Heavier smokers are more at risk than lighter smokers for long-term smoking. It is therefore very important to provide smoking cessation treatments for heavy smokers as early as possible after the initiation of smoking.
OBJECTIVE—To assess the feasibility of reducing tobacco-caused disease by gradually removing nicotine from cigarettes until they would not be effective causes of nicotine addiction. DATA SOURCES—Issues posed by such an approach, and potential solutions, were identified from analysis of literature published by the US Food and Drug Administration (FDA) in its 1996 Tobacco Rule, comments of the tobacco industry and other institutions and individuals on the rule, review of the reference lists of relevant journal articles, other government publications, and presentations made at scientific conferences. DATA SYNTHESIS—The role of nicotine in causing and sustaining tobacco use was evaluated to project the impact of a nicotine reduction strategy on initiation and maintenance of, and relapse to, tobacco use. A range of potential concerns and barriers was addressed, including the technical feasibility of reducing cigarette nicotine content to non-addictive levels, the possibility that compensatory smoking would reduce potential health benefits, and whether such an approach would foster illicit ("black market") tobacco sales. Education, treatment, and research needs to enable a nicotine reduction strategy were also addressed. The Council on Scientific Affairs came to the following conclusions: (a) gradually eliminating nicotine from cigarettes is technically feasible; (b) a nicotine reduction strategy holds great promise in preventing adolescent tobacco addiction and assisting the millions of current cigarette smokers in their efforts to quit using tobacco products; (c) potential problems such as compensatory over-smoking of denicotinised cigarettes and black market sales could be minimised by providing alternate forms of nicotine delivery with less or little risk to health...
More than 1 billion people around the world smoke, with 10 million cigarettes sold every minute. Cigarettes contain thousands of harmful chemicals including the psychoactive compound, nicotine. Nicotine addiction is initiated by the binding of nicotine to nicotinic acetylcholine receptors, ligand-gated cation channels activated by the endogenous neurotransmitter, acetylcholine. These receptors serve as prototypes for all ligand-gated ion channels and have been extensively studied in an attempt to elucidate their role in nicotine addiction. Many of these studies have focused on heteromeric nicotinic acetylcholine receptors containing α4 and β2 subunits and homomeric nicotinic acetylcholine receptors containing the α7 subunit, two of the most abundant subtypes expressed in the brain. Recently however, a series of linkage analyses, candidate-gene analyses and genome-wide association studies have brought attention to three other members of the nicotinic acetylcholine receptor family: the α5, α3 and β4 subunits. The genes encoding these subunits lie in a genomic cluster that contains variants associated with increased risk for several diseases including nicotine dependence and lung cancer. The underlying mechanisms for these associations have not yet been elucidated but decades of research on the nicotinic receptor gene family as well as emerging data provide insight on how these receptors may function in pathological states. Here...
Primary care providers should be aware of two new developments in nicotine addiction and smoking cessation: 1) the emergence of a novel nicotine delivery system known as the electronic (e-) cigarette; and 2) new reports of residual environmental nicotine and other biopersistent toxicants found in cigarette smoke, recently described as “thirdhand smoke”. The purpose of this article is to provide a clinician-friendly introduction to these two emerging issues so that clinicians are well prepared to counsel smokers about newly recognized health concerns relevant to tobacco use. E-cigarettes are battery powered devices that convert nicotine into a vapor that can be inhaled. The World Health Organization has termed these devices electronic nicotine delivery systems (ENDS). The vapors from ENDS are complex mixtures of chemicals, not pure nicotine. It is unknown whether inhalation of the complex mixture of chemicals found in ENDS vapors is safe. There is no evidence that e-cigarettes are effective treatment for nicotine addiction. ENDS are not approved as smoking cessation devices. Primary care givers should anticipate being questioned by patients about the advisability of using e-cigarettes as a smoking cessation device. The term thirdhand smoke first appeared in the medical literature in 2009 when investigators introduced the term to describe residual tobacco smoke contamination that remains after the cigarette is extinguished. Thirdhand smoke is a hazardous exposure resulting from cigarette smoke residue that accumulates in cars...
Self-control plays an important role in several health-related behaviors, including cigarette smoking. There is some evidence that individual differences in self-control are negatively associated with overall levels of nicotine dependence but, to our knowledge, more nuanced relationships between these constructs have not been explored. This is an important knowledge gap, as nicotine dependence is thought to be comprised of separate dimensions that motivate smoking behavior in relatively unique ways. The goal of this preliminary study was to begin to characterize the potentially nuanced associations between self-control and facets of nicotine dependence using data pooled from two previous studies (n = 282). Specifically, we examined the correlation between self-control and the following dimensions of nicotine dependence: compulsion to smoke due to craving and desire to avoid withdrawal symptoms; preference for smoking over other reinforcers; reduced sensitivity to the effects of smoking; consistency of smoking patterns; and smoking behavior that is rigid and immutable. In line with prior research, self-control was negatively correlated with overall levels of dependence. As predicted, however, self-control was differentially associated with distinct dimensions of nicotine dependence. Specifically...
Nicotine cigarette smoke is a large public health burden worldwide, contributing to various types of disease. Anti-tobacco media campaigns and control programs have significantly reduced smoking in the United States, yet trends for menthol cigarette smoking have not been as promising. Menthol cigarette smoking is particularly prevalent among young adults and African Americans, with implications for long-term impacts on health care. Continuing high rates of menthol cigarette addiction call into question the role of menthol in nicotine addiction. To date, a biological basis for the high rate of addiction and relapse among menthol cigarette smokers has not been defined. Studies have demonstrated a role for menthol in the metabolism of nicotine in the body. More recent findings now reveal an interaction between menthol and the nicotinic acetylcholine (nACh) receptor in cells. This receptor is central to the actions of nicotine in the brain, and plays an important role in nicotine addiction. The newly discovered effect of menthol on nACh receptors may begin to explain the unique addictive properties of menthol cigarettes.
Electronic cigarette (e-cigarette) use, or vaping, in the United States and worldwide is increasing. Their use is highly controversial from scientific, political, financial, psychological, and sociological ideologies. Given the controversial nature of e-cigarettes and vaping, how should medical care providers advise their patients? To effectively face this new challenge, health care professionals need to become more familiar with the existing literature concerning e-cigarettes and vaping, especially the scientific literature. Thus, the aim of this article is to present a review of the scientific evidence-based primary literature concerning electronic cigarettes and vaping. A search of the most current literature using the pubmed database dating back to 2008, and using electronic cigarette(s) or e-cigarette(s) as key words, yielded a total of 66 highly relevant articles. These articles primarily deal with (1) consumer-based surveys regarding personal views on vaping, (2) chemical analysis of e-cigarette cartridges, solutions, and mist, (3) nicotine content, delivery, and pharmacokinetics, and (4) clinical and physiological studies investigating the effects of acute vaping. When compared to the effects of smoking, the scant available literature suggests that vaping could be a “harm reduction” alternative to smoking and a possible means for smoking cessation...
The influence of sucrose combustion products on smoking and nicotine addiction is still controversial because the presence of the sucrose may be treated as a source of aldehydes and organic acids. In e-liquids used as refills for electronic cigarettes, which are made primarily of poly(propylene glycol), glycerine and ethanol, sucrose may be present at trace levels, and its impact on mainstream smoke formation, and hence on human health and smoking/nicotine addiction is unknown. An analytical method was developed where high-performance liquid chromatography in hydrophilic interaction liquid chromatography mode and tandem mass spectrometry were used for fast and simple determination of sucrose and other saccharides in e-liquids for electronic cigarettes. Minimal effort was required in the sample preparation step, and satisfactory results were obtained, and the sample matrix had an insignificant impact. The chromatographic separation was done using an Ascentis Express OH5 column (150 mm × 2.1 mm, 2.7 μm). The coefficients of variation for within-day precision for three concentrations were 2.4 %, 1.6 % and 2.3 %, and the between-day coefficients of variation for a single concentration were 2.1 %, 2.5 % and 1.7 % measured on the next 3 days. The detection limit was 0.73 μg/g...
This paper examines the historical
experience of tobacco control in the last five decades and
shares important lessons of public health interventions to
inform current and future tobacco control programs in other
countries. The paper is divided into four parts. The first
part gives an overview of the political economy, principal
influences and interventions in tobacco control in the
United States. It stresses the importance of information
shocks and the role played by grassroots organizations. The
current situation of tobacco control in the United States is
further discussed in the second part, with emphasis on the
economic case that led to litigation, as well as the
response of the industry and the States. The third part
focuses on the present efforts of multilaterals like the
World Bank, technical United Nation (UN) agencies such as
the World Health Organization, in the context of the new
global governance structure: the Framework Convention on
Tobacco Control (FCTC). The last section discusses lessons
learned and provides recommendations for comprehensive
tobacco control programs.
This paper analyzes smoking prevalence
and smoking behaviors in Papua New Guinea. Using the
2009–10 Papua New Guinea Household Income and Expenditure
Survey, the paper analyzes the determinants of tobacco use
and tobacco choices in Papua New Guinea. The results show
that adults (18 years and above) in the poorest quartile are
more likely to smoke. Tobacco consumption imposes a large
financial burden to poor households. Tobacco consumption
accounts for about 23 percent of total household food
expenditure for households in the poorest quartile, compared
with 15 percent for the entire sample. However, most of
these households consume non-processed tobacco. The study
reveals the urgency to control tobacco consumption in Papua
New Guinea and considers some practical challenges that the
country may face.
Einleitung: Nikotin und Alkohol sind die am weitesten verbreiteten Suchtstoffe und treten sehr häufig als kombinierte Abhängigkeit auf. Dabei findet man für beide Substanzen stärkere Abhängigkeiten als beim isolierten Konsum. Auch die gesundheitlichen Folgen potenzieren sich beim kombinierten Gebrauch. Eine Therapie beider Abhängigkeiten ist demzufolge von immenser Bedeutung.
Fragestellung: In der vorliegenden Studie wurde bei N=90 (von 94) stationär aufgenommenen Patienten untersucht, wie gut eine parallel zu einer Alkoholentwöhnung angebotene Tabakentwöhnungstherapie von den Patienten angenommen wird und wie sich die Tabakabstinenz auf das Outcome nach drei Monaten auswirkt. Ebenso wurden weitere mögliche Prädiktoren für einen Rückfall in die beiden Abhängigkeiten untersucht.
Methoden: Neben dem Rauchstatus und Rauchcharakteristika wurden die Stärke der Alkohol- (AUDIT) und Tabakabhängigkeit (FTND), die Bereitschaft und Motivation zur Abstinenz, Entzugssymptome (QSU), der Grad der Depressivität (BDI) und der Abstinenzverlauf drei Monate nach Ende der stationären Therapie erhoben.
Ergebnisse: Insgesamt waren 77 % der befragten Patienten Raucher. Die angebotene Tabakentwöhnung wurde von 40,6 % der rauchenden Patienten durchgeführt. Die Motivation und Bereitschaft zur Teilnahme liegt hier um das Dreifache höher als in der Gesamtbevölkerung. Als ein ausschlaggebender Faktor konnten dabei die Gewissensbisse der Patienten identifiziert werden. Nach sechs Wochen waren 26 % aller Teilnehmer abstinent. Ohne die vorzeitigen Therapieabbrecher liegt die Erfolgsrate bei fast 37 %. Nach drei Monaten rauchen bei einer im Schnitt um 20 % geringeren Zigarettenzahl alle Teilnehmer wieder...
The report is organized as follows. The
information about the Global Youth Tobacco Survey (GYTS) is
provided in the first part. The second part gives some
descriptive statistics about the prevalence rate of students
and their consumption based on several characteristics
observed in the survey. The third part presents the
empirical model and the variables used to estimate the
probability of smoke and the quantity consumed. The fourth
part presents the empirical results obtained from the
analysis. The last part summarizes the results and concludes
the paper with some policy recommendations. A total of 202
schools and 15,957 students were surveyed in the analysis.
The GYTS questionnaire asks about the general
characteristics of students, such as age, grade, sex, income
level, region, and their family whether their parents work,
and their education levels. Other questions ask about
smoking habits, accessibility, smoking habits of their
family members and friends; as well as exposure to pro /
anti cigarette promotions and their thoughts about tobacco
control measures. The results of this study have some
important policy implications. First...
The tobacco epidemic is a worldwide
phenomenon with significantly destructive effects on
developing, transitional, and industrialized nations. The
first scientific evidence on the health consequences of
tobacco consumption-specifically, smoking-was discovered in
industrialized nations. As a result, the economic analysis
of tobacco control issues began and was developed in these
countries. This tool attempts to explain the process of
analysis of demand for tobacco products as simply as
possible. It includes discussions of basic economic and
analysis principles (written for non-specialists such as
policy makers and analysts) and more advanced technical
points (intended for use by the economists and
econometricians who will undertake the actual demand
analysis). Consumption of tobacco products includes both
smoked categories (e.g., cigarettes, hand-rolled tobacco,
pipe tobacco, cigars, bidis, kreteks, etc.) and smokeless
types (such as snuff and chewing tobacco). In industrialized
countries, cigarettes disproportionately influence tobacco
epidemics. This tool discusses and presents...
The note looks at tobacco from the
health perspective, and at how to reduce its use, since
smoking is becoming the single biggest cause of death
worldwide, particularly affecting the developing countries,
where most of the world's smokers live. It thus looks
at the correlation between smoking and poverty, stating
smoking prevalence tends to be higher among men with less
education, and with lower incomes, hence bearing greater
health risks. Because of the highly addictive factor of
nicotine, smoking initiation should be discouraged,
persuading particularly the young, in an aim to reduce
disease, and death resulting from tobacco use. Towards this
effort, the World Health Organization, the Bank, and other
agencies are becoming partners to improve health, and to
this end, an International Framework Convention on Tobacco
Control is being negotiated, while further efforts are led
by nongovernmental organizations, and nationally
particularly as taxation is the most effective way to reduce
tobacco use. The note also outlines evidence that results
are best achieved within comprehensive measures to reduce
tobacco use; that job losses in tobacco farming...
Contexte: Plusieurs études ont démontré que les indices environnementaux associés à la cigarette peuvent provoquer des envies de consommer (« cravings ») chez les fumeurs, ce qui nuit aux efforts d’abandon de la substance et favorise le maintien du tabagisme. Un bon nombre d’études en imagerie cérébrale ont examiné les bases neurophysiologiques de cette caractéristique clinique. Le tabagisme se caractérise aussi par l’incapacité des représentations négatives de la consommation (méfaits médicaux et sociaux) d’influencer la consommation des fumeurs. Étonnamment toutefois, très peu de travaux de recherche se sont intéressés à examiner les bases neurophysiologiques de cette insouciance envers les méfaits de la cigarette chez les fumeurs. En utilisant l'imagerie cérébrale fonctionnelle, l'objectif de cette étude était: d’examiner la réponse neurophysiologique des fumeurs chroniques à des images qui illustrent les effets négatifs de la cigarette (campagne anti-tabac); d’examiner le caractère affectif de cette réactivité utilisant des conditions contrôles (c.-à-d., images aversives non-liées au tabac et appétitives liées au tabac); d'examiner la connectivité fonctionnelle durant cette tâche entre les systèmes affectifs et exécutifs (une interaction qui peut favoriser ou entraver l'impact des évènements aversifs). Méthodes: 30 fumeurs chroniques ont passé une session de neuroimagerie durant laquelle ils devaient regarder des images appétitives et aversives de cigarettes...
This study estimated the expected smoking duration for young smokers who have started recently. Data from National Health Interview Surveys were combined to model the ages at which smoking prevalence will decline to various percentages of the peak smoking prevalence for each successive birth cohort. Smoking-cessation ages were then estimated for the males and females born from 1975 through 1979. The median cessation age for those in this cohort who start smoking as adolescents is expected to be 33 years for males and 37 years for females. Thus, 50% of these adolescent males may smoke for at least 16 years and 50% of these adolescent females may smoke for at least 20 years, based on a median age of initiation of 16 to 17 years. Despite the decline in the median age of US smokers who quit, these data predict that smoking will be a long-term addiction for many adolescents who start now.
The neurobiology of tobacco use is poorly understood, possibly in part because the relevant mechanisms might differ depending on past nicotine exposure and degree of addiction. In the present study we investigated whether these factors might affect the role of dopamine (DA). Using the acute phenylalanine/tyrosine depletion method (APTD), DA synthesis was transiently decreased in three groups of abstinent smokers (n=47): (1) early low-frequency smokers, who had smoked a maximum of five cigarettes per day for less than one year, (2) stable low-frequency smokers smoking at the same level as early low-frequency smokers for at least 3 years, and (3) stable high-frequency smokers, who smoked a minimum of 10 or more cigarettes per day for at least 5 years. Motivation to obtain tobacco was measured using a progressive ratio breakpoint schedule for nicotine-containing and de-nicotinized cigarettes. Compared with a nutritionally balanced control mixture, APTD decreased the self-administration of nicotine-containing cigarettes, and this occurred in all three groups of smokers. The results suggest that DA influenced the willingness to sustain effort for nicotine reward, and this was seen in participants at all three levels of cigarette addiction. In the transition from sporadic to addicted use...
O tabagismo é uma doença crônica resultante da dependência à nicotina estando classificado no Código Internacional de Doenças Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde4. Ao fumar, o tabagista se expõe a uma intoxicação permanente, pois as doses múltiplas de nicotina que inala, embora degradadas, em parte, acumulam-se de tal maneira, que a intoxicação é contínua durante as 24 horas do dia. Assim permanece constante por toda a vida do tabagista¹². Dentre as terapias, existem as medicamentosas e as não medicamentosas. Faz parte das terapias não medicamentosas a terapia cognitivo-comportamental, sendo uma abordagem que combina intervenções cognitivas com treinamento de habilidades comportamentais. Esta se divide em terapia breve, básica e intensiva. Outras terapias que não utilizam medicamentos são a acupuntura, a hipnoterapia e a prática de exercícios físicos. As terapias medicamentosas são diversas e são diferenciadas com a nicotina e as sem nicotina. Os medicamentos com nicotina fazem parte das terapias de reposição de nicotina que podem ser o adesivo o adesivo transdérmico (patch), o inalador, a goma de mascar, o spray nasal, os PREP’s ou pseudocigarros e a nicotina sublingual. Os medicamentos sem nicotina são os antidepressivos...
Consumidores de álcool são mais propensos a experimentar e desenvolver dependência do cigarro. Esta revisão crítica sobre reatividade cruzada a pistas (RCP) no consumo de álcool e cigarro explorou a influência da RCP no uso concomitante destas substâncias. Realizou-se busca nos bancos de dados Medline, Psycinfo e Lilacs; os descritores utilizados foram alcohol (álcool), smoking (fumar) e cues (pistas). Critérios para inclusão foram: estudo empírico, envolver exposição a pistas associadas e co-ocorrência do consumo de álcool e cigarro. Como resultado foram encontrados 144 artigos, destes foram selecionados oito. Sugere-se que pistas associadas a uma droga podem gerar craving por outra. Conclui-se que a RCP pode ser relevante para a prevenção e tratamento ao abuso e dependência de cigarro e álcool. Palavras-chave: álcool; tabagismo; pistas.; Alcohol consumers are more prone to experiment and develop dependence on cigarettes. This critical review on cross-cue-reactivity (CCR) to cues associated with alcohol and tobacco aimed to explore the influence of CCR on the concomitant use of these substances. We searched the databases Medline...
Fonte: SAMJ: South African Medical JournalPublicador: SAMJ: South African Medical Journal
Tipo: Artigo de Revista CientíficaFormato: text/html
Publicado em 01/01/2013EN
Relevância na Pesquisa
Electronic cigarettes (e-cigarettes) are relatively new in South Africa and their popularity is increasing. Their appearance coincides with intensifying attempts by government and society to reduce tobacco smoking through stricter limitation on its sale, advertising and use. Debate has been triggered on their use regarding the potential risks of increasing nicotine addiction and encouraging people to start smoking, or whether e-cigarettes might serve rather as an efficient means of treating addiction, thus assisting smokers to quit. Opinions among doctors regarding e-cigarettes vary, some seeing potential for good, others condemning them outright. Several professional medical societies have taken the stand that, whatever their potential as a smoking-cessation method, they cannot be encouraged since they are produced and promoted by the tobacco industry. Also, that research supported by the manufacturers of e-cigarettes may not be presented at their meetings or in their medical journals. We present the following arguments for the potential benefit and harms of e-cigarettes, based on the currently available evidence.