Psychosocial and metabolic function by smoking status in individuals with binge eating disorder and obesity

Individuals with binge eating disorder (BED) report smoking to control appetite and weight. Smoking in BED is associated with increased risk for comorbid psychiatric disorders, but its impact on psychosocial functioning and metabolic function has not been evaluated. Participants were 429 treatment-seeking adults (72.4% women; mean age 46.2 ± 11.0 years old) with BED comorbid with obesity. Participants were categorized into current smokers (n = 66), former smokers (n = 145), and never smokers (n = 218). Smoking status was unrelated to most historical eating/weight variables and to current eating disorder psychopathology. Smoking status was associated with psychiatric, psychosocial, and metabolic functioning. Compared with never smokers, current smokers were more likely to meet lifetime diagnostic criteria for alcohol (OR = 5.51 [95% CI = 2.46–12.33]) and substance use disorders (OR = 7.05 [95% CI = 3.37–14.72]), poorer current physical quality of life, and increased risk for metabolic syndrome (OR = 1.80 [95% CI = 0.97–3.35]) and related metabolic risks (reduced HDL, elevated total cholesterol). On the other hand, the odds of meeting criteria for lifetime psychiatric comorbidity or metabolic abnormalities were not significantly greater in former smokers, relative to never smokers. Our findings suggest the importance of promoting smoking cessation in treatment-seeking patients with BED and obesity for its potential long-term implications for psychiatric and metabolic functioning.     

E-cigarette advertisements,and associations with the use of e-cigarettes and disapproval or quitting of smoking: Findings from the International Tobacco Control (ITC) Netherlands Survey

BackgroundMuch attention has been directed towards the possible effects of e-cigarette advertisements on adolescent never smokers. However, e-cigarette advertising may also influence perceptions and behaviours of adult smokers. The aim of our study was to examine whether noticing e-cigarette advertisements is associated with current use of e-cigarettes, disapproval of smoking, quit smoking attempts, and quit smoking success.MethodsWe used longitudinal data from two survey waves of the ITC Netherlands Survey among smokers aged 16 years and older (n = 1198). Respondents were asked whether they noticed e-cigarettes being advertised on television, on the radio, and in newspapers or magazines in the previous 6 months.ResultsThere was a significant increase in noticing e-cigarette advertisements between 2013 (13.3%) and 2014 (36.0%), across all media. The largest increase was for television advertisements. There was also a substantial increase in current use of e-cigarettes (from 3.1% to 13.3%), but this was not related to noticing advertisements in traditional media (OR = 0.99, p = 0.937). Noticing advertisements was bivariately associated with more disapproval of smoking (Beta = 0.05, p = 0.019) and with a higher likelihood of attempting to quit smoking (OR = 1.37, p = 0.038), but these associations did not reach significance in multivariate analyses. There was no significant association between noticing advertisements and quit smoking success in either the bivariate or multivariate regression analysis (OR = 0.92, p = 0.807).ConclusionNoticing e-cigarette advertisements increased sharply in the Netherlands between 2013 and 2014 along with increased e-cigarette use, but the two appear unrelated. The advertisements did not seem to have adverse effects on disapproval of smoking and smoking cessation.     

Patterns of intermittent smoking: An analysis using Ecological Momentary Assessment

Non-daily smokers comprise a substantial proportion of US smokers, but there has been little study of their patterns of smoking, which are often assumed to reflect “social smoking.” We used Ecological Momentary Assessment methods to study smoking patterns in 27 non-daily smoking adults who recorded each cigarette smoked over three weeks by leaving a voice mail message indicating their circumstances at the time of smoking. All told, 689 cigarettes were recorded over 589 person-days of observation. On average, participants smoked on 67% of days, averaging 2.1 (SD = 0.91) cigarettes per day on days they smoked; 22% of all cigarettes were smoked in bouts (within an hour of another cigarette). Altogether, 19% of cigarettes were smoked when drinking alcohol and 29% when participants were socializing. Smoking patterns varied widely across participants. A pair of hierarchical cluster analyses distinguished three groups: Those who smoked primarily (81% of cigarettes) in the daytime (Early smokers; n = 15, 58% of total sample), those who smoked primarily (75% of cigarettes) at night (Late smokers; n = 7, 27%), and a distinct, classic “Social smoking” group (n = 4, 15% of total sample), who smoked mostly at night but also primarily when socializing or drinking (86% of their cigarettes), in the evening (71% of their cigarettes), on weekends (65% of their cigarettes), and in bouts (71% of their cigarettes). Overall, results suggest that non-daily smoking patterns are quite heterogeneous, and that many non-daily smokers may not be primarily social smokers.     

The relationship of waterpipe use with cigarette smoking susceptibility and nicotine dependence: A cross-sectional study among Hong Kong adolescents

IntroductionWaterpipe smoking has become increasingly popular in adolescents. We examined the association of waterpipe smoking with cigarette smoking susceptibility and nicotine dependence among adolescents in Hong Kong.MethodsWe analyzed the data of School-based Survey on Smoking among Students 2012/13 from a representative sample of 45,857 secondary school students (US grades 7–12) in Hong Kong. Among never cigarette smokers (n = 37,740), we conducted chi-square test to compare cigarette smoking susceptibility by current (past 30-day) waterpipe smoking status, and used multivariate logistic regression to examine the association between current waterpipe smoking and cigarette smoking susceptibility controlling for age, sex, peer cigarette smoking, and living with a cigarette smoker. Then we conducted chi-square test and multivariate logistic regression among current cigarette smokers (n = 1694) to examine the relationship of current waterpipe smoking with two nicotine dependence outcomes, including heavier smoking (≥ 5 cigarettes/day) and first cigarette within 30 min of waking, controlling for demographics and the number of smoking days in the past 30 days.ResultsAmong never cigarette smokers, current waterpipe use was associated with cigarette smoking susceptibility (adjusted odds ratio [AOR] = 3.58, 95% confidence interval [CI]: 1.61–7.97). Of current cigarette smokers, waterpipe use was associated with heavier smoking (AOR = 1.56, 95% CI: 1.00–2.43) and first cigarette within 30 min of waking (AOR = 2.08, 95% CI: 1.35–3.19).ConclusionsSurveillance, prevention, and intervention programs should address waterpipe use in addition to cigarette smoking. Educational programs need to inform youth about the harmful and addictive effects of waterpipe smoking. Public health campaigns deglamourizing waterpipe use may help reduce waterpipe smoking among youth.     

The relationship of dysthymia,minor depression,and gender to changes in smoking for current and former smokers: Longitudinal evaluation in the U.S. population

BackgroundAlthough data clearly link major depression and smoking, little is known about the association between dysthymia and minor depression and smoking behavior. The current study examined changes in smoking over 3 years for current and former smokers with and without dysthymia and minor depression.MethodsParticipants who were current or former daily cigarette smokers at Wave 1 of the National Epidemiologic Survey on Alcohol and Related Conditions and completed the Wave 2 assessment were included in these analyses (n = 11,973; 46% female). Analyses examined the main and gender-specific effects of current dysthymia, lifetime dysthymia, and minor depression (a single diagnostic category that denoted current and/or lifetime prevalence) on continued smoking for Wave 1 current daily smokers and continued abstinence for Wave 1 former daily smokers.ResultsWave 1 current daily smokers with current dysthymia (OR = 2.13, 95% CI = 1.23, 3.70) or minor depression (OR = 1.53, 95% CI = 1.07, 2.18) were more likely than smokers without the respective diagnosis to report continued smoking at Wave 2. Wave 1 former daily smokers with current dysthymia (OR = 0.44, 95% CI = 0.20, 0.96) and lifetime dysthymia (OR = 0.37, 95% CI = 0.15, 0.91) were less likely than those without the diagnosis to remain abstinent from smoking at Wave 2. The gender-by-diagnosis interactions were not significant, suggesting that the impact of dysthymia and minor depression on smoking behavior is similar among men and women.ConclusionsCurrent dysthymia and minor depression are associated with a greater likelihood of continued smoking; current and lifetime dysthymia are associated with a decreased likelihood of continued smoking abstinence.     

Effects of cigarette smoke on Holter ECG recordings in patients with arterial hypertension. Part 2: Parameters of heart rate turbulence

The studies aimed at evaluation of cigarette smoke effect on heart rate turbulence (HRT) in patients with arterial hypertension (AH). 223 consecutive individuals were qualified to the studies. The following groups of patients not suffering from other disease which may affect HRT were distinguished: 1 – patients with AH (n = 145); 2 – patients without AH (n = 48). In group 1 the following patient subgroups were studied: A – active smokers (n = 42), B – non-smokers exposed to cigarette smoke (n = 30), C – non-smokers not exposed to tobacco smoke (n = 34), D – former smokers who had quit smoking (n = 26). In every participant HRT analysis was conducted. Subgroup A manifested significantly higher values of TO and lower values of TS as compared to analogous values obtained in subgroups B–D. Subgroups B and D were characterized also by significantly higher values of TO and lower values of TS as compared to subgroup C. Active and passive cigarette smoking were found to represent independent risk factors for an abnormal HRT.ConclusionBoth active and passive exposure to tobacco smoke induces causes abnormal HRT in patients with arterial hypertension.     

Effects of cigarette smoke on Holter ECG recordings in patients with arterial hypertension. Part 1: Time domain parameters of heart rate variability

This report was intended to evaluate the effect of cigarette smoke on heart rate variability (HRV) in patients with arterial hypertension (AH). 223 individuals were qalified to the studies. The following groups of patients not suffering from other disease which may affect HRV were delineated: 1 – patients with AH (n = 145); 2 – patients without AH (n = 48). In group 1 the following patient groups were studied: A – active smokers (n = 42), B – non-smokers exposed to cigarette smoke (n = 30), C – non-smokers not exposed to tobacco smoke (n = 34), D – former smokers (n = 26). A time domain HRV analysis was carried out. Group 1 versus group 2 manifested significantly lower mean values of most parameters in the HRV time domain analysis. Subgroups A, B and D versus subgroup C also exhibited significantly lower mean values of most parameters in the HRV time domain analysis. Active cigarette smoking and passive exposure to tobacco smoke represented independent risk factors for a decreased HRV. Conclusions: Active and passive exposure to cigarette smoke decreases HRV in hypertensive patients.     

Impact of quitting smoking and smoking cessation treatment on substance use outcomes: An updated and narrative review

BackgroundHistorically, smoking cessation was thought to negatively impact substance use outcomes among smokers who use other substances. We sought to synthesize recent reports on this association.MethodsGoogle Scholar, PubMed, and Cinahl were searched for studies published from 2006 to March 29, 2016 that reported impact of smoking cessation treatment or quitting smoking on substance use or substance use disorder treatment outcomes in the general population and among those in substance abuse treatment. Studies were grouped by reported impact as follows: “positive” (i.e. improved), “null” (i.e. no change), or “negative” (i.e. worsened).ResultsTwenty-four studies were included. Eighteen reported the impact of quitting smoking and six reported the impact of smoking cessation treatment intervention, independent of quitting, on substance use outcomes. Eleven studies (46%) reported solely positive impact; four (17%) reported solely null impact; eight (33%) reported mixed positive and null impact by analysis (combined and subgroup, n = 1); substance (n = 4); length of follow-up (n = 2); and comparison group (n = 1). One study (4%) reported mixed negative and null impact by ethnic group. No studies reported increased substance use.ConclusionSmoking cessation does not appear to have a negative effect, and often has a positive effect on substance use outcomes. Smoking cessation advice should be offered, without hesitation, to smokers who report substance use and those in treatment for substance use disorder.     

Respiratory problems and anxiety sensitivity in smoking lapse among treatment seeking smokers

PurposeThe current study examined whether the interaction of lower respiratory symptoms and anxiety sensitivity is related to smoking lapse in the context of smoking cessation.MethodParticipants were adult daily smokers (N = 60) exposed to the World Trade Center (WTC) disaster who were in a smoking cessation treatment program (75.0% male, 50.6 years old [SD = 9.2], and current smoking rate was 17.6 cigarettes per day (SD = 10.6).ResultsResults indicated that the interaction between lower respiratory symptoms and anxiety sensitivity was a significant predictor of greater risk for lapse (i.e., lower survival time; B = 0.005, OR = 1.01, p = 0.039). Follow-up analysis showed that greater respiratory symptoms were a significant predictor of lapse risk among those with high (B = 0.116, OR = 1.12, p = 0.025), but not those with low (B = − 0.048, OR = 0.95, p = 0.322), levels of anxiety sensitivity.DiscussionThe findings from the current study suggest that smokers with greater respiratory symptoms and higher levels of anxiety sensitivity may be associated with early lapse to smoking following smoking cessation treatment. Future work has the potential to inform the development of tailored cessation interventions for smokers who experience varying levels of lower respiratory symptoms and anxiety sensitivity.     

Associations between smoking cessation and anxiety and depression among U.S. adults

Many studies have shown a relationship between smoking and depression. However, few studies have examined the association between current depression and smoking and even fewer used large cross-sectional data to support these findings. Using the 2006 Behavioral Risk Factor Surveillance System data (n = 248,800), we compared rates of lifetime depression, lifetime anxiety, current depression, and current depressive symptoms among smokers who unsuccessfully attempted to quit (unsuccessful quitters), former smokers (successful quitters), and smokers who made no attempts to quit (non-quitters).Unsuccessful quitters experienced more lifetime depression and anxiety than non-quitters (OR = 1.2; 95% CI, 1.0–1.4), whereas successful quitters experienced less (OR = 0.7, 95% CI, 0.6–0.8). Current depression prevalence was 14.3% among non-quitters, 18.8% among unsuccessful quitters, and 8.0% among successful quitters. On average, unsuccessful quitters also experienced more days of depressive symptoms during the previous month than either non-quitters or successful quitters.Our results suggest that smokers who attempt to quit unsuccessfully may experience lifetime depression as well as current depression at a higher rate than other smokers and former smokers.     

Predictors of tobacco abstinence in outpatient smokers with schizophrenia or bipolar disorder treated with varenicline and cognitive behavioral smoking cessation therapy

BackgroundThe estimated mortality gap between those with and without serious mental illness (SMI) is increasing, now estimated at 28 years, which is largely due to smoking-related diseases.AimsWe sought to identify predictors of 14-day continuous abstinence in stable outpatient smokers with SMI.MethodAdult smokers with schizophrenia spectrum (n = 130) or bipolar disorder (n = 23) were enrolled in a 12-week course of varenicline and cognitive-behavioral therapy for smoking cessation.ResultsIndependent predictors of abstinence included reduction in withdrawal symptoms prior to the quit day, fewer cigarettes smoked per day at baseline, better baseline attention, remitted alcohol dependence, and lower expectation of peer support to aid quitting.ConclusionsInterventions that consider these targets may improve smoking cessation outcomes in those with SMI.     

Breakdowns of eye movement control toward smoking cues in young adult light smokers

BackgroundMany studies suggest that dependent smokers have a preference or attentional bias toward smoking cues. The purpose of this study was to test the ability of infrequent non-dependent light smokers to control their eye movements by look away from smoking cues. Poor control in the lightest of smokers would suggest nicotine cue-elicited behavior occurring even prior to nicotine dependency as measured by daily smoking.Methods17 infrequent non-dependent light smokers and 17 lifetime non-smokers performed an antisaccade task (look away from suddenly appearing cue) on smoking, alcohol, neutral, and dot cues.ResultsThe light smokers, who were confirmed light smokers and non-dependent (M_{Faegerström Dependency Score} = 0.35), were significantly worse at controlling their eye movements to smoking cues relative to both neutral cues (p < .04) and alcohol cues (p < .02). Light smokers made significantly more errors to smoking cues than non-smokers (p < .004).ConclusionsThese data suggest that prior to developing clinical symptoms of severe dependence or progressing to heavier smoking (e.g., daily smoking), the lightest of smokers are showing a specific deficit in control of nicotine cue-elicited behavior.     

Hormonal contraceptive use in smokers: Prevalence of use and associations with smoking motives

IntroductionWhile endogenous sex hormones influence smoking-related outcomes, little is known about the role of hormonal contraceptives (HCs). This is despite dated estimates suggesting that HC use is prevalent among female smokers. Therefore, we sought to update estimates of the prevalence of HC use among female smokers and explore the association of HC use with various smoking motives (SMs).MethodsThis online cross-sectional survey recruited female smokers between the ages of 18–35. Survey questions assessed smoking behavior, SMs, use of HCs, and menstrual cycle regularity.ResultsParticipants (n = 734) were, on average (± standard deviation), 20.7 ± 2.7 years old and smoked 7.3 ± 6.7 cigarettes/day. The majority of females reported a history of HC use (85%) and half reported current use (48%). Cyclical HC users (n = 227) scored significantly lower on three SMs compared to naturally-cycling women in the follicular phase (n = 62) and significantly higher on 15 SMs compared to naturally-cycling women in the luteal phase (n = 29). Women on cyclical HCs differed from women on long-acting HCs (n = 128) on two SMs. Further, the naturally-cycling women in the follicular phase scoring significantly higher on 15 SMs compared to those in the luteal phase.DiscussionThese observations indicate that HC use remains prevalent in female smokers and may influence SMs. Additional research should replicate these observations and explore the implications on smoking cessation outcomes.     

Effect of cigarette smoking on vascular flows in pregnancies complicated by intrauterine growth restriction

Exposure to tobacco smoke during pregnancy may result in intrauterine growth restriction (IUGR). In the study, the effect of tobacco smoke on vascular flows in the middle cerebral artery, umbilical artery, ductus venosus in fetuses and uterine artery in pregnancies complicated by IUGR was investigated.The study subjects were divided into three groups: smoking women with IUGR (n = 31), women with idiopathic IUGR (n = 28) and healthy controls (n = 50). Fetal biometry and flow parameters were measured. Concentration of heavy metals and antioxidants was tested in maternal blood and fetal umbilical cord blood. The Student t test and multiple regression analysis were used.Cotinine and cadmium concentrations were significantly higher in smokers (55.23 ± 54.23, 1.52 ± 0.9), while metallothionein was significantly higher (22.94 ± 8.64) in the idiopathic IUGR group. Strong correlations between cotinine and cadmium concentrations and cerebral–umbilical index were found.Long-term exposure to tobacco smoke deteriorates flows in vital fetal vessels.     

Visceral sensitivity,anxiety, and smoking among treatment-seeking smokers

It is widely recognized that smoking is related to abdominal pain and discomfort, as well as gastrointestinal disorders. Research has shown that visceral sensitivity, experiencing anxiety around gastrointestinal sensations, is associated with poorer gastrointestinal health and related health outcomes. Visceral sensitivity also increases anxiety symptoms and mediates the relation with other risk factors, including gastrointestinal distress. No work to date, however, has evaluated visceral sensitivity in the context of smoking despite the strong association between smoking and poor physical and mental health. The current study sought to examine visceral sensitivity as a unique predictor of cigarette dependence, threat-related smoking abstinence expectancies (somatic symptoms and harmful consequences), and perceived barriers for cessation via anxiety symptoms. Eighty-four treatment seeking adult daily smokers (M_age = 45.1 years [SD = 10.4]; 71.6% male) participated in this study. There was a statistically significant indirect effect of visceral sensitivity via general anxiety symptoms on cigarette dependence (b = 0.02, SE = 0.01, Bootstrapped 95% CI [0.006, 0.05]), smoking abstinence somatic expectancies (b = 0.10, SE = 0.03, Bootstrapped 95% CI [0.03, 0.19]), smoking abstinence harmful experiences (b = 0.13, SE = 0.05, Bootstrapped 95% CI [0.03, 0.25]), and barriers to cessation (b = 0.05, SE = 0.06, Bootstrapped 95% CI [0.01, 0.13]). Overall, the present study serves as an initial investigation into the nature of the associations between visceral sensitivity, anxiety symptoms, and clinically significant smoking processes among treatment-seeking smokers. Future work is needed to explore the extent to which anxiety accounts for relations between visceral sensitivity and other smoking processes (e.g., withdrawal, cessation outcome).     

Examining the psychometric properties and predictive validity of a youth-specific version of the Nicotine Dependence Syndrome Scale (NDSS) among teens with varying levels of smoking

Current conceptualizations of nicotine dependence suggest assessing its multidimensional structure, especially for understanding how dependence develops in teen smokers. It is unknown if a multidimensional structure holds for teens with varying levels of smoking. The psychometric properties and predictive validity of the youth-specific, multidimensional Nicotine Dependence Syndrome Scale (NDSS) was assessed among 526 teens (55.5% female; 74.3% Caucasian) who reported smoking in the past 30 days. NDSS and smoking measures were obtained at baseline and six months. Confirmatory factor analysis supported the NDSS-Total (NDSS-T, α = 0.94) and five factors for the sample: Drive (α = 0.92), Tolerance (α = 0.85), Priority (α = 0.83), Stereotypy (α = 0.73), and Continuity (α = 0.64). NDSS-T, Drive, Tolerance, and Priority were predictors of subsequent amount smoked (p < 0.01). Drive, Tolerance, and Continuity predicted subsequent cessation (p < 0.05). Though the youth-specific NDSS has good psychometric properties, tests of predictive validity for subsequent smoking and cessation behavior suggest only certain dimensions of dependence, particularly Drive and Tolerance, appear to be salient in this sample. Further studies should assess the multidimensional nature of nicotine dependence among teens with varying levels of smoking.     

Panic attacks and smoking cessation among cancer patients receiving smoking cessation treatment

ObjectiveLittle is known about factors associated with smoking cessation in cancer patients. This study examined the impact of panic attacks on smoking abstinence likelihood among cancer patients receiving tobacco cessation treatment.MethodThe relationship of panic attacks to 7-day point-prevalence abstinence at mid-treatment, end of treatment, and 6-month post-end of treatment were examined among cancer patients (N = 2255 patients; 50.1% female; M_age = 54.9, SD = 11.0) who received counseling and pharmacotherapy for smoking cessation. Panic attack history indexed by two questions from the Patient Health Questionnaire (PHQ). Point-prevalence abstinence was assessed via the Timeline Follow-Back.ResultsCancer patients with a history of panic attacks, (n = 493, 21.9%) relative to those without, were less likely to be abstinent at mid-treatment (OR = 0.79, CI_95% = 0.64–0.98) and end of treatment (OR = 0.72, CI_95% = 0.58–0.89). After adjusting for significant covariates, panic attack history remained predictive of decreased abstinence likelihood at end of treatment (OR = 0.78, CI_95% = 0.62–0.99).ConclusionsPanic attacks may be related to poorer cessation outcome during smoking treatment among cancer patients, and may be usefully assessed and targeted for intervention.     

Emotion dysregulation and smoking among treatment-seeking smokers

IntroductionThere has been increased scholarly interest in advancing the study of emotion dysregulation and substance use. However, there is limited study of emotion dysregulation in the context of smoking. The current study examined the emotion dysregulation global construct and sub facets in relation to negative affect reduction expectancies, coping motives, perceived barriers for quitting, and the severity of problems experienced during quit attempts.MethodTreatment seeking smokers (n = 469; 48.2% female, M_age = 36.59, SD = 13.58) enrolled in a smoking cessation trial and completed baseline measures of smoking cognitions and emotion dysregulation.ResultsResults indicated that the emotion dysregulation global score was significantly associated with each of the smoking dependent variables. Additionally, difficulty accessing emotion regulation strategies and difficulty engaging in goal-directed behavior were significantly associated with the dependent variables.ConclusionOverall, this is the first study to evaluate relations between multidimensional facets of emotion dysregulation and clinically relevant smoking variables. Emotion dysregulation may be an important treatment target for changing smoking.