Up in Smoke? A Preliminary Open-Label Trial of Nicotine Replacement Therapy and Cognitive Behavioral Motivational Enhancement for Smoking Cessation Among Youth in Los Angeles

In 2008–2009, we conducted a 6-week, open-label trial of transdermal nicotine replacement therapy and practical counseling for 34 adolescents seeking smoking cessation in Los Angeles. Dependent outcomes were study retention, use of the patch, and 7-day quit status at the end-of-study and at follow-up visits. Predictors of outcomes included cigarette dependence, withdrawal symptoms, demographic and psychiatric measures, and other substance use. Variables significant in bivariate analysis (p < .10) were retained in a multivariate model. Subjects had significant pre-to-post reductions in quit rates, dependence, and withdrawal symptoms. Subjects also reported a high number of comorbidities. Implications for clinicians are discussed.     

Developmental toxicity of nicotine: A transdisciplinary synthesis and implications for emerging tobacco products

While the health risks associated with adult cigarette smoking have been well described, effects of nicotine exposure during periods of developmental vulnerability are often overlooked. Using MEDLINE and PubMed literature searches, books, reports and expert opinion, a transdisciplinary group of scientists reviewed human and animal research on the health effects of exposure to nicotine during pregnancy and adolescence. A synthesis of this research supports that nicotine contributes critically to adverse effects of gestational tobacco exposure, including reduced pulmonary function, auditory processing defects, impaired infant cardiorespiratory function, and may contribute to cognitive and behavioral deficits in later life. Nicotine exposure during adolescence is associated with deficits in working memory, attention, and auditory processing, as well as increased impulsivity and anxiety. Finally, recent animal studies suggest that nicotine has a priming effect that increases addiction liability for other drugs. The evidence that nicotine adversely affects fetal and adolescent development is sufficient to warrant public health measures to protect pregnant women, children, and adolescents from nicotine exposure.     

Combined Ecological Momentary Assessment and Global Positioning System Tracking to Assess Smoking Behavior: A Proof of Concept Study

Objective: Ecological momentary assessment (EMA) methods have provided a rich assessment of the contextual factors associated with a wide range of behaviors including alcohol use, eating, physical activity, and smoking. Despite this rich database, this information has not been linked to specific locations in space. Such location information, which can now be easily acquired from global positioning system (GPS) tracking devices, could provide unique information regarding the space-time distribution of behaviors and new insights into their determinants. In a proof of concept study, we assessed the acceptability and feasibility of acquiring and combining EMA and GPS data from adult smokers with attention deficit hyperactivity disorder (ADHD). Methods: Participants were adults with ADHD who were enrolled in a larger EMA study on smoking and psychiatric symptoms. Among those enrolled in the latter study who were approached to participate (N = 11), 10 consented, provided daily EMA entries, and carried a GPS device with them during a 7-day assessment period to assess aspects of their smoking behavior. Results: The majority of those eligible to participate were willing to carry a GPS device and signed the consent (10 out of 11, 91%). Of the 10 who consented, 7 participants provided EMA entries and carried the GPS device with them daily for at least 70% of the sampling period. Data are presented on the spatial distribution of smoking episodes and ADHD symptoms on a subset of the sample to demonstrate applications of GPS data. Conclusions: We conclude by discussing how EMA and GPS might be used to study the ecology of smoking and make recommendations for future research and analysis.     

长期吸烟者脑网络及度中心度的研究进展

吸烟与呼吸系统疾病、心脑血管疾病等密切相关，已成为当今社会最大的公共卫生问题之一。大范围控烟势在必行，了解吸烟的内在机制，有针对性地指导、干预戒烟则是首要任务。近年来研究显示尼古丁所致脑功能与结构改变是烟草成瘾形成的关键。本文针对长期吸烟者脑结构、功能、网络及度中心度的研究进展进行综述。     

基于内标微透析技术同步分析尼古丁透皮贴剂在血液与皮肤的药动学

目的：利用内标微透析采样技术,同步研究尼古丁透皮贴剂的血液和皮肤局部药动学特征,获得其较全面的体内药动学规律。方法：以健康SD大鼠为实验动物,将尼古丁透皮贴剂经皮给药,磷酸可待因作为微透析采样的内标物,采集不同时间点血液和皮肤微透析样品,用高效液相色谱法（HPLC）进行测定,利用DAS 2.1药动学软件计算相关药动学参数。结果：尼古丁在血液和皮肤的平均滞留时间（MRT_0-∞）分别为（16 986.00±486.00）min和（1 597.00±851.00）min,药时曲线下面积（AUC_0-∞）分别为（19 235.42±1 801.92）mg·mL^-1·min和（56 328.82±24 900.42）mg·mL^-1·min,达峰浓度（C_max）分别为（2.00±0.50）mg·L^-1和（32.00±5.00）mg·L^-1,达峰时间（t_max）分别为（325±200）min和（570±106）min。尼古丁在血液与皮肤的药动学参数相比,AUC_0-∞、C_max、t_max在皮肤中较大,MRT_0-∞在血液中较大。结论：尼古丁透皮贴剂经皮给药后,在血液与皮肤的药动学规律存在明显的差异与联系,药动学参数证明尼古丁通过透皮渗透在皮肤中以相对较高的浓度蓄积,能达到快速、有效的吸收,进入血液后血药浓度相对较低且维持稳定,发挥显著长效作用。     

Understanding the implications of the “vaping epidemic” among adolescents and young adults: A call for action

In the past 5 years, the use of nicotine delivered through electronic cigarettes (“e-cigarettes”) has sky-rocketed among adolescents and young adults. E-cigarettes, with their high nicotine content, appealing flavors, low costs, wide availability, and discreet designs threaten 5 decades of progress in the fight against tobacco use. Aside from the increased risk of subsequent use of traditional cigarettes, marijuana, opioids, and other illicit drugs, building evidence indicates that e-cigarette use also exposes youth to several acute and long-term health risks that greatly outweigh the as-yet unfounded potential benefits from the use of e-cigarettes as a smoking reduction or cessation tool in this age group. We discuss some of the latest research on e-cigarettes, highlighting risks and harms associated with their use in adolescents and young adults, and suggest opportunities for action, including the enforcement of age, sales and marketing limitations, and concerted research and public health efforts to help curb what has become a new nicotine epidemic among youth.