Study of the relationship between anxiety sensitivity,smoking abstinence expectancies,nicotine withdrawal,and cigarette dependence among daily smokers

Introduction: Anxiety sensitivity (AS) is the fear of anxiety symptoms related to physical, cognitive, and social concerns. AS has been implicated in amplifying negative emotional states and maintaining smoking behavior. Aims: The current cross-sectional study evaluated the lower-order facets of AS (Physical, Cognitive, Social concerns) in relation to current nicotine withdrawal symptoms, short-term consequences of abstaining from smoking, and cigarette dependence. Methods: 331 adult Italian smokers were recruited from the general population and asked to fill in scales assessing AS, nicotine withdrawal symptoms, and cigarette dependence. Results: All ASI-3 subscales were associated with psychological symptoms of nicotine abstinence (β?=?0.30–0.10; p?≥?0.001), whereas ASI-3 physical concerns (β?=?0.62; p?≥?0.001) and ASI-3 cognitive concerns (β?=?0.25; p?≥?0.001) were associated with physical symptoms of nicotine abstinence. No ASI-3 subscales were associated with short-term smoking abstinence expectancies. ASI-3 physical concerns (β?=?0.72; p?≥?0.001) and ASI-3 cognitive concerns (β?=?0.25; p?≥?0.001) were associated with cigarette dependence. Discussion: ASI-3 physical concerns and ASI-3 cognitive concerns could amplify withdrawal-related factors, thereby increasing the negative reinforcement processes which might motivate smoking.     

Differences in quit attempts between non-Hispanic Black and White daily smokers: The role of smoking motives

Introduction

The prevalence of smoking across racial/ethnic groups has declined over the years, yet racial health disparities for smoking persist. Studies indicate that non-Hispanic Black smokers attempt to quit smoking more often compared to non-Hispanic White smokers but are less successful at doing so. Research suggests that motives to quit smoking differ by race, however, less is known about the role of motives to smoke in explaining racial differences in attempts to quit smoking.

Methods

This study examined whether smoking motives accounted for the differential rates in quit attempts between non-Hispanic Black (n = 155) and non-Hispanic White (n = 159) smokers. Data were culled from a larger study of heavy-drinking smokers. The Wisconsin Index of Smoking Dependence Motives (WISDM) assessed motives to smoke.

Results

As expected, Black and White smokers reported similar smoking patterns, yet Black smokers reported higher rates of failed attempts to quit smoking than White smokers. Findings indicated that Black, compared to White, smokers endorsed lower scores in the negative reinforcement, positive reinforcement, and taste WISDM subscales and scores in these subscales mediated the relationship between race and quit attempts.

Conclusions

In this study, Blacks, compared to Whites, endorsed lower motives to smoke, which are generally associated with successful quit attempts, yet they experienced more failed attempts to quit smoking. This study demonstrates racial health disparities at the level of smoking motives and suggests that Black smokers remain vulnerable to failed quit attempts despite reporting lower motives to smoke.     

The relationship between self-efficacy and nicotine withdrawal severity among adult smokers

Cigarette smokers who have low confidence in their ability to resist temptations to smoke or to quit smoking altogether (i.e., low quitting-related self-efficacy) are more likely to relapse during an attempt to quit smoking. Therefore, it is important to understand what factors influence quitting-related self-efficacy, especially during early abstinence when relapse is most likely to occur. Social cognitive theory suggests two competing hypotheses: (1) negative emotional and physiological states, such as those associated with the nicotine withdrawal syndrome, will reduce self-efficacy related to smoking cessation; and (2) low self-efficacy will increase an individual's susceptibility to arousal, such as the negative emotions and physiological responses associated with nicotine withdrawal. The current preliminary study prospectively examined the association between nicotine withdrawal severity and self-efficacy in 21 adult, heavy smokers (23.8% female) at three time points during the first 48?h of abstinence from smoking cigarettes. Results indicated that withdrawal severity did not predict self-efficacy. Instead, self-efficacy after 24?h of abstinence showed a trend toward predicting withdrawal severity at 48?h of abstinence. Findings suggest the possibility that low self-efficacy may be associated with an increase in nicotine withdrawal severity, and also suggest the presence of a dynamic relationship between self-efficacy and nicotine withdrawal.     

Peripheral haemodynamic effects of smoking in habitual smokers. A methodological study

Summary The effect of smoking on forearm haemodynamics was studied in four groups of healthy subjects, who had all smoked cigarettes (10–15 cigarettes/day) on average for 10 years. Changes in heart rate, blood pressure, forearm blood flow, forearm vascular resistance and pulse wave velocity were determined before and every 15 min for 75 min after smoking two cigarettes within 10 min. The inhaled nicotine was about 2.2 mg. There was no significant difference between the four groups in any haemodynamic variable before or after smoking, which indicated adequate reproducibility of the parameters studied and so made it possible to pool the results from all 30 subjects.Smoking significantly increased blood pressure, heart rate and pulse wave velocity and decreased forearm blood flow. Forearm vascular resistance remained unchanged. The rises in systolic blood pressure and pulse wave velocity were transient and both peaked (7% and 28%, respectively) 15 min after smoking. In contrast, heart rate and diastolic blood pressure remained significantly elevated and forearm blood flow was significantly decreased throughout the 75 min follow-up. The maximal changes were: heart rate +34%, diastolic blood pressure +17%, and forearm blood flow –24%. It is concluded that smoking produces statistically significant changes in forearm haemodynamics affecting both small and large arteries. The reproducibility of the study design means that it can be used to evaluate substances which may antagonize the haemodynamic effects of tobacco smoking.     

The association between smoking bans and nicotine dependence: A longitudinal analysis of current smokers in Canada

Background

While a substantial body of research has examined the effects of smoking bans on smoking behavior, little is known about the relationship between smoking bans and nicotine dependence. The objective of this study was to examine whether home and workplace smoking bans are associated with reduced nicotine dependence among continuing smokers.

Methods

We used longitudinal data of 1073 adult daily smokers from the Canadian National Population Health Survey (2004–2010). Generalized estimating equations were used to examine the association between smoking bans and nicotine dependence.

Results

Smokers living in homes where smoking is restricted were less likely to be nicotine dependent (OR = 0.40, 95% CI = 0.32–0.50) than smokers living in homes with no such smoking restriction. Workplace smoking policies had no significant association with nicotine dependence (complete ban: OR = 0.79, 95% CI = 0.56–1.11; partial ban: OR = 0.82, 95% CI = 0.57–1.16). There was some evidence that workplace smoking bans were significantly associated with nicotine dependence when single items of the Fagerstrom test were considered.

Conclusions

This paper demonstrates that the presence of a home smoking ban was associated with lower nicotine dependence among continuing smokers. The relationship of workplace bans with nicotine dependence was less clear and was contingent on the measure of nicotine dependence employed. These findings further confirm the importance of bans on smoking in the home, workplace, and other public places on reducing tobacco-related harms.     

Pre-quit depression level and smoking expectancies for mood management predict the nature of smoking withdrawal symptoms in college women smokers

We assessed smoking withdrawal symptoms over a six-day period of abstinence among 21 female college students who were daily cigarette smokers [M = 20.3 (4.4); cigarettes per day] and were in the preparation stage of change for quitting smoking. We predicted that reported withdrawal symptoms would covary with baseline depression scores and baseline outcome expectancies for cigarette smoking as a mood management tool. Depression scores at baseline significantly predicted mood-related smoking withdrawal symptoms of Depression–Dejection and Vigor from the Profile of Mood States (POMS). Smoking outcome expectancies for relief of negative affect measured at baseline significantly predicted symptoms of Confusion–Bewilderment and Anger–Hostility. Neither baseline depression nor baseline smoking expectancies for mood management predicted smoking withdrawal symptoms measured by the Smoking Withdrawal Questionnaire (SWQ; [Shiffman, S. M., & Jarvik, M. E. (1976). Smoking withdrawal symptoms in two weeks of abstinence. Psychopharmacology, 50, 35–39]). Results imply that women smokers with baseline depressive symptomatology and expectancies for smoking to relieve negative mood endure greater abstinence-induced mood disturbance, but similar levels of other smoking withdrawal symptoms during initial abstinence. These results may inform smoking cessation efforts.     

Comparative mood states and cognitive skills of cigarette smokers,deprived smokers and nonsmokers

Regular cigarette smokers (n=15), overnight deprived smokers (n=15) and nonsmokers (n=20), were assessed on a battery of mood questionnaires and cognitive performance tasks, before and after a cigarette/rest period. At the initial session, deprived smokers reported significantly greater feelings of stress, irritability, depression, poor concentration and low pleasure, than both nondeprived smokers and nonsmokers (all comparisons, p<0·01). After the rest/cigarette break, the mood states of all three groups became generally similar, although the previously deprived smokers still reported elevated depression. These findings suggest that mood gains after smoking reflect the simple reversal of abstinence effects. On the cognitive tasks, there were no significant differences in letter cancellation performance between subgroups, either before or after smoking. With mental arithmetic, abstinent and nonabstinent smokers attempted more problems than nonsmokers, both before and after the rest/cigarette break. This is suggestive of faster cognitive processing in smokers, irrespective of their nicotine status. However, the cognitive performance data were untypical in various ways and need replication. © 1998 John Wiley & Sons, Ltd.     

Acute effects of cigarettes in non-deprived smokers on memory,calculation and executive functions

To determine whether smoking one or two cigarettes daily has effects on cognitive functions and the blood nicotine level, we examined 20 smokers and 20 nonsmokers as part of a normal daily smoking regimen using psychological tests for memory, calculation and association. Subjects underwent Buschke's selective reminding test, a mental arithmetic task (multiplication between two digits and one digit) and an association task (letter fluency); the duration of each task being 2 min under the condition of pre-smoking, one cigarette smoking and two cigarette smoking sessions, with an inter-session interval of 50 min. The total recall or correct responses were evaluated. The results showed that performance deteriorated in the later sessions in the memory task, whereas it improved in the later sessions in the calculation and association tasks, with no group (smoker-nonsmoker) difference, nor interaction between tasks and groups in each task. Plasma nicotine increased by 10 ng/ml immediately after smoking a cigarette, and 14 ng/ml immediately after smoking two cigarettes, but decreased to the pre-smoking level or slightly higher 10 min after smoking. These findings suggested that a daily dose of nicotine had little effect on the performance related to memory, calculation and mental association.     

Enalapril versus atenolol in the treatment of hypertensive smokers

Summary A randomised crossover study has been done to compare the antihypertensive efficacy of enalapril and atenolol in 45 smoking, hypertensive men. Treatment was started with enalapril 20 mg/d or atenolol 50 mg/d and, if necessary, the doses were doubled after 4 weeks to achieve a sitting diastolic blood pressure 95 mm Hg, after which hydrochlorothiazide was added, if necessary.Both drugs lowered blood pressure significantly. However, enalapril was more efficient in lowering both systolic and diastolic blood pressure; the mean difference was significant after both 4 and 8 weeks in the sitting systolic (11.6 mm Hg and 7.9 mm Hg) and diastolic (3.3 mm Hg and 3.0 mm Hg) pressures and in the erect systolic pressures (8.2 mm Hg and 7.2 mm Hg), and after 8 weeks in the supine systolic pressure, too (8.9 mm Hg). The effect on enalapril was especially marked in moderate (<20 cigarettes/day) smokers. The need for diuretics was also significantly less in the enalapril group.It appears that angiotensin-converting enzyme inhibitors may be superior to -adrenoceptor blockers in the treatment of hypertensive smoking patients.     

The relationship between impulsivity,risk-taking propensity and nicotine dependence among older adolescent smokers

Impulsivity and risk-taking propensity are neurobehavioral traits that reliably distinguish between smoking and non-smoking adults. However, how these traits relate to smoking quantity and nicotine dependence among older adolescent smokers is unclear. The current study examined impulsivity and risk-taking propensity in relation to smoking behavior and nicotine dependence among current older adolescent smokers (age 16–20 years; N = 107). Participants completed the Barratt Impulsiveness Scale‐11 (BIS-11), the Balloon Analogue Risk Task (BART), and self-report measures of smoking behavior and nicotine dependence. Results indicated a significant positive relationship between nicotine dependence and the Attention subscale (β = .20, t = 2.07, p < .05) and the Non-planning subscale (β = .19, t = 1.92, p < .06) of the BIS-11. Contrary to expectation, the results also indicated a significant negative relationship between performance on the BART and nicotine dependence (β = − .19, t = − 2.18, p < .05), such that greater risk-taking propensity was associated with less dependence. These data suggest that impulsivity and risk-taking propensity are related to older adolescent smoking but are separable traits with distinguishable associations with nicotine dependence among adolescents. These findings support the notion that impulsivity is related to heightened nicotine dependence, but suggest that the relationship between risk-taking propensity and nicotine dependence is more ambiguous and warrants further investigation.     

Sex differences in the relationships between childhood adversity,attachment anxiety and current smoking

Background: Smoking behavior and smoking cessation are complex. Interpersonal factors such as childhood adversity are associated with smoking, especially in women. Identifying how and in whom these individual factors contribute to smoking behavior may support individualized smoking cessation strategies. Attachment insecurity (attachment avoidance and attachment anxiety) involves biological and psychological processes in close relationships and is associated with both childhood adversity, and in select populations, smoking. This study aims to identify an association between attachment insecurity and smoking in adults and to determine if attachment insecurity is a plausible mediator between childhood adversity and smoking.

Methods: In a cross-sectional survey, 348 primary care patients reported childhood adversity, attachment insecurity and smoking status. Statistical analyses were performed using regression and PRODCLIN.

Results: Sixty-one percent of participants had experienced childhood adversity and 20% were current smokers. In women, attachment anxiety was associated with both childhood adversity (p?=?.002) and current smoking (p?=?.04). The PRODCLIN test indicated that attachment anxiety may be a mediator between childhood adversity and current smoking in women (95%CI 0.003, 0.236). In men, current smoking was not associated with childhood adversity (p?=?.673) or attachment anxiety (p?=?.29). Attachment avoidance was not related to current smoking in men (p?=?.31) or in women (p?=?.16).

Conclusions: In women but not in men, attachment anxiety is associated with current smoking and may mediate the relationship between childhood adversity and current smoking. Childhood adversity and attachment anxiety may be factors to consider in the design of cessation strategies for women.     

Cigarette smoking by women: interactions with alcohol use

Cigarette smoking increased during alcohol self-administration in comparison to an alcohol-free baseline in 24 women given access to alcohol for 21 days. Heavy smokers (25 or more cigarettes per day) increased smoking significantly during drinking (P<0.05). Analysis of tobacco smoking by level of alcohol consumption showed that both heavy and moderate alcohol users increased smoking significantly during alcohol availability (P<0.05, 0.01). The heavy and moderate smokers smoked significantly more between noon and midnight (P<0.001) than at other times when alcohol was available. The rate of cigarette smoking (defined by inter-cigarette intervals) was faster during alcohol self-administration than during the alcohol-free baseline. Heavy smokers smoked most cigarettes at intervals of 11–20 min during heavy or moderate drinking. During the pre-alcohol baseline, these women smoked most cigarettes at intervals of 21–30 or 31–40 min. Most women (70–74%) also increased tobacco smoking at the premenstruum. Both heavy and occasional smokers increased smoking at the premenstruum significantly more than the moderate smokers (P<0.05). All women reported increased psychological discomfort at the premenstruum on the Premenstrual Assessment Form (PAF) but reports of physical discomfort were more marked in women who smoked less at the premenstruum. These data extend previous findings in men that alcohol consumption is associated with increased cigarette smoking to female social drinkers.     

Effects of smoking on visual acuity of central serous chorioretinopathy patients

Background: The aim of this study was to evaluate the differences, in terms of visual outcome and treatment needs, between smokers and non-smokers central serous chorioretinopathy (CSCR) patients.

Methods: The files of 252 patients diagnosed with CSCR who had presented to the Retina Unit of the Ophthalmology Clinic at Dicle University Medical School in Turkey were retrospectively evaluated. Eighty-four smokers, with a known history of smoking of at least one pack-year, and 133 non-smokers were included, whereas 35 patients with additional pathologies were excluded from the study.

Results: Of the patients, 192 (88.5%) were male and 25 (11.5%) were female. The mean patient age was 38.8?±?8.1 years (range: 20–68 years). Visual acuity (VA) of the smoker and non-smoker groups was measured as 0.45?±?0.35 and 0.24?±?0.28 logarithm of the minimum angle of resolution (logMar), respectively, at the first visit; 0.19?±?0.29 and 0.06?±?0.14 logMar at the sixth month; and 0.07?±?0.14 and 0.02?±?0.05 logMar at the ninth month. VA measurements at presentation and during all examinations (1th, 6th and 9th month) were significantly different for the two groups. VA was lower in the smoker group. In 27 patients (12.4%), an additional treatment modality was needed. Of the 27 patients, only 8 (6%) were non-smokers, whereas 19 (22.6%) were smokers. There was no difference between groups in the recurrence rate during follow-up (p?=?0.907); 14 (16.7%) smokers and 8 (19.0%) non-smokers experienced a recurrence.

Conclusion: This study has shown that patients selected and who are current smokers have poorer vision and need longer treatment.     

Urinary biomarkers of oxidative/nitrosative stress in healthy smokers

Objective: To evaluate the effect of cigarette smoking on oxidative and nitrosative stress, we assessed urinary levels of 8-hydroxy-2′-deoxyguanosine (8-OHdG), isoprostane 15-F_2t-IsoP, thiobarbituric acid-reacting substances (TBARS), advanced glycation end-products (AGEs), dityrosine (diTyr), hydrogen peroxide, total nitrite and nitrate and trolox equivalent antioxidant capacity (TEAC) in healthy smokers.

Methods: Fluorimetric and spectrophotometric assays were performed in urine samples of 33 healthy smokers and 58 age-matched controls.

Results: Levels of 8-OHdG, 15-F_2t-IsoP and AGES were found significantly higher in smokers than in controls (10.7?ng/mg Cr vs. 8.3?ng/mg Cr, 1.41?ng/mg Cr vs. 1.01?ng/mg Cr and 189 AFU/mg Cr vs. 143 AFU/mg Cr, respectively; P?<?0.05 for all). Positive correlations were found between age and levels of AGEs and diTyr in smokers (r?=?0.380, P?<?0.035 and r?=?0.418, P?<?0.019, respectively) and also between age and AGEs, diTyr and TEAC in controls (r?=?0.474, P?<?0.001, r?=?0.463, P?<?0.001 and r?=?0.576, P?<?0.001, respectively), being this correlation negative for 8-OHdG in controls (r?=??0.295, P?=?0.041). Positive correlation between the number of cigarettes smoked per day and AGEs was also found (r?=?0.355, P?=?0.044).

Conclusion: Urinary 8-OHdG, 15-F_2t-IsoP and AGEs may represent a non-invasive quantitative index of oxidant stress in healthy smokers, being AGEs a possible indicator of tobacco toxin exposure. The increased oxidative stress in healthy smokers observed may be generated because of an excessive production of reactive oxygen species and not by exhaustion of antioxidant defenses.     

The impact of e-cigarette price changes on vaping and smoking behaviors

Background: Understanding the relations between e-cigarette prices and e-cigarette/cigarette use may shed light on the possible impact of e-cigarette regulations on public health. Objectives: This study aimed to assess potential impacts of e-cigarette price changes on vaping and smoking behaviors by smoking status (current, former, and never smokers) and e-cigarette type (pre-filled only vs. refillable). Methods: A total of 918?US-based adult e-cigarette users completed an online survey, designed to assess behavioral intention of e-cigarette/cigarette use in hypothetical situations with varying prices of e-cigarettes, in 2017. Results: With reduction in e-cigarette prices, more than 50% of current smokers reported they would reduce or quit smoking, but with greater increases in price, the rates of not only those who would quit (12.5–19.4%), but also those who would increase smoking rose (15.1–25.1%). Current smokers (vs. former/never) were more likely to increase e-cigarette use at reduced e-cigarette prices. Among current smokers, pre-filled users were less likely to quit smoking with reduced prices. At higher prices, pre-filled users were more likely to quit e-cigarettes (former smokers), but also more likely to start smoking (never smokers). Among former smokers, recent quitters were more likely to restart smoking with any e-cigarette price changes, and less likely to reduce or quit e-cigarettes with increased prices. Conclusions: Both smoking and e-cigarette use seem to be sensitive to e-cigarette price changes. Increases in e-cigarette price may have both positive and negative effects on smoking behavior, and e-cigarette price changes may disproportionately affect pre-filled users and recent quitters.     

Predictors of smoking in pregnancy and attitudes and knowledge of risks of pregnant smokers

This study examined the prevalence and predictors of smoking by pregnant women attending a public antenatal clinic. The prevalence of smoking in this population (n = 2577) was found to be 38.0% (95% CI 36.1-39.9%). A review of previous research investigating variables associated with smoking in pregnancy indicated that only three of 42 studies had used multivariate analysis. Using step-wise logistic regression analysis, five variables were found to be independent predictors of smoking in pregnancy: education (having 4 years or less high school), marital status (being unmarried), gravidity (being multigravida), age (being under 25 years) and language spoken at home (speaking English). The model correctly predicted 63.7% of cases. The knowledge and attitudes of pregnant smokers were also investigated using data from a sub-sample of consenting subjects. Three-quarters of the women claimed that they had reduced their smoking since discovering they were pregnant. However, their mean intake of 13.7 cigarettes daily remained at a hazardous level. Approximately half (51%) these smokers claimed to have tried to quit smoking in the current pregnancy. Most (61%) women said they believed smoking was definitely harmful to the unborn child. However, awareness and acceptance of specific risks were inadequate. Of the women in a current relationship, 72% said their partner was a regular smoker. Less than half (45%) the continuing smokers who had seen a doctor about their current pregnancy could recall being advised to stop smoking. There is a need for health care providers to adopt a more systematic and tailored approach to smoking cessation counselling. Efforts to convert quit attempts in pregnancy into sustained cessation represent a priority area of programme development and evaluation.