A systematic review of anxiety across smoking stages in adolescents and young adults

Background: In adolescence and young adults, inconsistence of the association between anxiety and smoking remains to be investigated and clarified. The aim of this study is investigated and clarified the association between anxiety and smoking stages in adolescence and young adults. Methods: The data on the causal influence of anxiety on smoking in adolescents and young adults aged 14 to 25 years old was retrieved from electronic databases. Results: Nineteen of 668 articles were subjected to a systematic review. Definitional differences with respect to smoking stages constrained homogeneity across the nineteen analyzed reports. Anxiety appears to play a more consistent risk role for nicotine dependent (ND) smokers than for non-nicotine dependent (non-ND) regular or daily smokers. Anxious non-ND smokers are at higher risk to become nicotine dependent. Conclusions: A ununified definition of smoking stages is responsible for the production of inconsistent results. The analysis reinforced anxiety as a significant risk factor for smoking in one’s lifetime. Anxious non-ND smokers are the key target for interventions aimed at preventing nicotine dependence and smoking-related health problems.     

抽烟对异丙酚有效靶浓度的影响

目的:观察抽烟对异丙酚有效靶浓度的影响。方法:选择择期在全麻下行上腹部手术的男患者50例,其中抽烟患者24例为A组,非抽烟患者26例为B组,在BIS监测下观察两组患者在插管前、插管后、切皮前、切皮后、术中探查、术毕时的异丙酚效应靶浓度、心率和平均动脉压。结果:两组患者的一般情况比较差异无显著性(P>0.05)。除切皮前,抽烟患者的异丙酚有效靶浓度均较非抽烟患者高(P<0.01或P<0.05),而其它各时间点的血流动力学指标无差异(P>0.05)。结论:长期抽烟使患者手术时对异丙酚的反应性降低,效应室有效靶浓度明显高于非抽烟患者,而对手术期间血流动力学无明显影响。     

Tobacco policies and on-premise smoking in bars and clubs that cater to young African Americans following the Maryland Clean Indoor Air Act of 2007

African American young adults ages 18–25 smoke less than their Caucasian peers, yet the burden of tobacco-related illness is significantly higher in African Americans than in Caucasians across the lifespan. Little is known about how clean indoor air laws affect tobacco smoking among African American young adults. We conducted a systematic observation of bars and clubs with events targeted to African American adults 18–25 in Baltimore City at two timepoints (October and November of 2008 and 2010) after enforcement of the Maryland Clean Indoor Air Act (CIAA). Twenty venues—selected on the basis of youth reports of popular venues—were rated during peak hours. All surveillance checklist items were restricted to what was observable in the public domain. There was a significant decrease in observed indoor smoking after CIAA enforcement. Observed outdoor smoking also decreased, but this change was not significant. Facilities for smoking outdoors increased significantly. The statewide smoking ban became effective February 1, 2008, yet measurable changes in smoking behavior in bars were not evident until the City engaged in stringent enforcement of the ban several months later.     

Effect of impulsivity on cardiovascular and subjective reactivity to smoking cues

Individuals with high levels of impulsivity are more likely to smoke and may have greater difficulty quitting than other smokers. Although the specific mechanisms mediating this relationship are not explicitly known, one candidate is disproportionate cigarette craving in response to environmental smoking cues. We assessed the effect of impulsivity on three measures of cue reactivity. Regular smokers (n=75) were exposed to a smoking cue and a neutral cue in 2 counterbalanced experimental sessions. Cigarette craving, heart rate (HR), and mean arterial pressure (MAP) were used to index cue reactivity. More impulsive smokers exhibited a disproportionate response to the smoking cue in terms of MAP (p=.009) but not HR or craving. Impulsive smokers may experience disproportionate cigarette craving in response to environmental smoking cues that are not reflected in self-report measures due to a relative lack of conscious awareness of the urge to smoke.     

青年缺血性卒中病因学分型特点分析

目的探讨青年缺血性卒中的病因学分型特点。方法回顾性分析2010年9月至2013年9月本院收治的青年缺血性卒中患者（18~45岁）247例,总结颅脑影像学特点,并根据影像学及其他病因学检查,进行缺血性卒中的改良TOAST病因分型。结果影像学单发病灶、前循环供血区病灶为著。改良TOAST分型中,大动脉粥样硬化型占25.9%,心源性栓塞型占16.6%,小动脉闭塞型占21.6%,其他病因型占11.3%,不明病因型占24.7%。结论青年缺血性卒中主要病因分型是大动脉粥样硬化型、小动脉闭塞型、不明病因型。18~35岁以其他病因型、不明病因型为著;36~45岁以大动脉粥样硬化、小动脉闭塞型为著。     

Fruit and vegetable intake as a moderator of the association between depressive symptoms and cigarette smoking

ABSTRACT

Background: Studies have consistently reported associations among depression, cigarette smoking, and fruit and vegetable intake (FVI). This study evaluated FVI as a moderator of the association between depressive symptoms and smoking. Methods: The authors analyzed data from the National Longitudinal Survey of Youth 1979: Child and Young Adult. The study sample was adults aged 19–33 years at baseline in the year 2004 from the Young Adult Survey portion. Moderation analyses were performed using the Johnson-Neyman technique to assess whether baseline FVI moderated the association between depressive symptoms and smoking status cross-sectionally and as a predictor of smoking cessation longitudinally at 4-year follow-up. Results: Cross-sectionally, at lower levels of FVI (<4.9 times/day), there was a significant association between smoking and depressive symptoms (P < .05), but not at higher levels of FVI (≥4.9 times/day; P > .05). Longitudinally, there was an inverse association between depressive symptoms and quitting smoking at FVI <1.2 times/day (P < .05), but there was not a significant association at FVI ≥1.2 times/day (P ≥ .05). Conclusions: FVI moderated the association between depressive symptoms and cigarette smoking cross-sectionally and longitudinally. The cross-sectional findings might be partially explained by the longitudinal findings paired with prior research; there might be fewer smokers with high FVI because depressive symptoms are removed as an impediment to cessation. Further experimental research is warranted to test the efficacy of increased FVI as an adjunct to smoking cessation, with a possible mechanism of action being reduced depressive symptoms during quit attempts.     

Effects of cigarette smoking on priapism induced by quetiapine: a case report

Priapism is defined as an unwanted, prolonged, and painful erection which is unrelated to sexual stimulation. Some case studies suggest that priapism is an adverse effect of antipsychotic medications. In our case study a 30 year-old Iranian male with schizophrenia was experiencing recurrent priapism associated with quetiapine use. There are three interesting facts about this case: Firstly, the patient suffered priapism after even low dose consumption of quetiapine. Secondly, this case had experienced priapism with risperidone, olanzapine, and even clozapine in the past, suggesting a possible pharmacodynamic interaction of antipsychotics and inner biological traits in this particular case. Thirdly, priapism induced by low dose quetiapine was resolved after cigarette smoking.     

Dysmenorrhea in adolescents and young adults: an update on pharmacological treatments and management strategies

Introduction: Dysmenorrhea is the most common gynecologic complaint among adolescents/young adults. Dysmenorrhea is usually primary and is associated with normal ovulatory cycles and with no pelvic pathology. Potent prostaglandins and potent leukotrienes play an important role in generating primary dysmenorrhea symptoms. Adolescents/young adults with severe dysmenorrhea symptoms may have pelvic abnormalities, such as endometriosis or uterine anomalies (secondary dysmenorrhea).

Areas covered: This review provides an update on treatments and management strategies of dysmenorrhea in adolescents/young adults. Medical literature articles were retrieved using a Medline search on primary and secondary dysmenorrhea. Original articles from peer-reviewed journals were selected based on relevance.

Expert opinion: Treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) is the preferred initial treatment for dysmenorrhea in nonsexually active adolescents/young adults. Adolescents/young adults with symptoms that do not respond to NSAIDs for three menstrual periods should be offered hormonal treatment, such as combined estrogen and progestin oral contraceptive pills (OCPs), for three menstrual cycles. If dysmenorrhea does not improve within 6 months of NSAIDs and OCPs, a laparoscopy is indicated to look for endometriosis, which is the most common reason for secondary dysmenorrhea.     

Ginkgo biloba: no robust effect on cognitive abilities or mood in healthy young or older adults

Ginkgo biloba extracts are commonly used to prevent or treat memory problems but evidence on the efficacy of ginkgo is equivocal. In any case, the psychological locus of ginkgo's effects is unknown. A 12-week, double-blind, placebo-controlled study assessed effects of ginkgo (120 mg per day) on a wide range of cognitive abilities, executive function, attention and mood in 93 healthy older adults (55-79 years) and in 104 young adults (18-43 years). For the older adult sample, longer-term memory assessed by associational learning tasks showed improvement with ginkgo (d = 0.52, p = 0.04). There was no statistically significant difference on any other measure. For the young adult group no measure showed statistically significant effects of ginkgo enhancement. There were no side effects unequivocally attributable to treatment with ginkgo and those reported by participants in the ginkgo groups were mild and similar to those reported elsewhere.     

Interactive effects of chronic cigarette smoking and age on hippocampal volumes

Background

Previous cross-sectional MRI studies with healthy, young-to-middle-aged adults reported no significant differences between smokers and non-smokers on total hippocampal volume. However, these studies did not specifically test for greater age-related volume loss in the total hippocampus or hippocampal subregions in smokers, and did they did not examine relationships between hippocampal and subfield volumes and episodic learning and memory performance.

Methods

Healthy, young-to-middle-aged (45 ± 12 years of age) smokers (n = 39) and non-smokers (n = 43) were compared on total hippocampal and subfield volumes derived from high-resolution 4 Tesla MRI, emphasizing testing for greater age-related volume losses in smokers. Associations between hippocampal volumes and measures of episodic learning and memory were examined.

Results

Smokers showed significantly smaller volumes, as well as greater volume loss with increasing age than non-smokers in the bilateral total hippocampus and multiple subfields. In smokers, greater pack-years were associated with smaller volumes of the total hippocampus, presubiculum, and subiculum. In the entire cohort, performance on measures of learning and memory was related to larger total hippocampal and several subfield volumes, predominately in the left hemisphere.

Conclusions

Chronic cigarette smoking in this young-to-middle aged cohort was associated with smaller total hippocampal and subfield volumes, which were exacerbated by advancing age. Findings also indicated an adverse smoking dose/duration response (i.e., pack-years) with total hippocampal and select subfield volumes. These hippocampal volume abnormalities in smokers may be related to the deficiencies in episodic learning and memory in young-to-middle-aged smokers reported in previous studies.     

Effect of cigarette smoking on prepulse inhibition of the acoustic startle reflex in healthy male smokers

The present study investigated the effects of cigarette smoking on prepulse inhibition (PPI) of the acoustic startle reflex in healthy men. Cigarette smoking in a group of overnight smoking-deprived smokers increased PPI as compared to the smoking-deprived condition. This finding is consistent with previous animal studies showing that nicotine increases PPI of the acoustic startle reflex. In addition, cigarette smoking also reduced startle amplitude during the first 6–7 min of the post-smoking session. Received: 4 March 1996 / Final version: 17 June 1996     

The co-occurrence of smoking and drinking among young adults in college: national survey results from the United States

BACKGROUND: In US colleges, alcohol and tobacco pose substantial health risks but little is known about their co-occurrence, limiting development and use of appropriately targeted prevention efforts. METHODS: Data from the 2001 HSPH College Alcohol Study (student n = 10,924; college n = 120) were analyzed using multivariate logistic regression. Co-occurring smoking/drinking risks were examined in aggregate, by gender, and by age of onset of regular drinking and smoking across 10 measures of drinking style, three categories of transitional drinking behavior, and by treatment behavior. RESULTS: Over 98% of current smokers drink; a fraction (<1%) of lifetime and 7% of past year alcohol abstainers smoke. Across drinking pattern measures, 44-59% of drinkers smoke. Co-occurrence risks are greatest among youth reporting high total alcohol consumption (adjusted OR 4.21, p < 0.0001), drinking problems (adjusted OR 3.31, p < 0.0001) or symptoms of diagnosable alcohol abuse (adjusted OR 3.02, p < 0.0001). Risks are sharply elevated among students who self-medicate for drinking problems and do not seek/receive help (adjusted OR 1.87, p < 0.0001), and those reporting symptoms of diagnosable alcohol abuse who may or may not seek/receive help (adjusted OR 2.67, p < 0.01 and 2.96, p < 0.01, respectively). Females and students reporting early adolescent onset of regular smoking are at greatest risk. CONCLUSIONS: Virtually all college smokers drink, and smoking and drinking are powerfully interrelated across drinking measures. Efficiency argues for jointly targeting both behaviors and developing interventions tailored to the special vulnerabilities of young women, students experiencing difficulties adjusting to college, and students reporting early onset of regular smoking.     

Relationship between smoking status and body weight in a military population of young adults

The purpose of the present study was to determine the association between smoking and body weight in a cohort of young U.S. Air Force recruits (mean age = 20 years) enrolled in basic military training (N = 35 986). Twenty-two percent of recruits smoked daily prior to basic military training (n = 8087) and were compared to never smokers, former smokers, and experimental or nondaily smokers. A three-way interaction among smoking status, gender and ethnicity suggested a small effect for daily smoking among White male recruits only and no significant differences for female recruits or members of any other ethnic group. Although there was a statistically significant relationship between smoking and body weight in White males, the effect size was ~ 1 kg. These results suggest that the energy balance differences in body weight between young smokers and nonsmokers are minimal and that it would take decades to accrue the differences typically seen in adult smokers.     

Effect of tryptophan depletion on the attentional salience of smoking cues

Rationale There is increasing evidence linking cigarette craving and smoking behavior to serotonergic neurotransmission. Objectives The purpose of the current study was to examine the effects of a serotonergic challenge on the attentional salience of various cues associated with cigarettes. We hypothesized that cigarette-related word cues would be more distracting after acute tryptophan depletion than after a placebo challenge. We also hypothesized that smokers vulnerable to recurrent depression would show greater attentional bias towards these cues than smokers without a history of depression. Methods Thirty-four smokers diagnosed as having (n = 15) or lacking (n = 19) a history of DSM-IV major depressive disorder (MDD) underwent acute tryptophan depletion (ATD) and placebo challenges in double-blind and counterbalanced order 1 week apart. Five hours after consumption of each mixture, subjects completed a modified Stroop task to measure attentional bias to smoking-related, positive affect, and negative affect word cues. Stroop interference was calculated as a difference score between latencies for the motivationally salient and the neutral (furniture) word lists. Results Controlling for change in dysphoric mood from baseline to 5 h, repeated measures MANOVAs showed that ATD, as compared to placebo challenge, produced greater interference for smoking word cues [F(1,29)=4.15, p = 0.05], but not for negative [F(1,29)=2.78, p = 0.11] or positive [F(1,29)=1.60, p = 0.22] affect word cues. Conclusions Acutely compromising central serotonergic neurotransmission via ATD heightens the attentional salience of cigarette-related cues, perhaps by triggering reward and motivational deficits underlying nicotine dependence.     

Differences by gender at twelve months in a brief intervention trial among Mexican-origin young adults in the emergency department

In this study, we investigate the role of gender in prevalence and consequences of binge drinking and brief intervention outcomes among Mexican-origin young adults aged 18–30 years at the U.S.-Mexico border. We conducted a secondary analysis, stratified by gender, from a randomized controlled trial of a brief motivational intervention in a hospital emergency department. Intervention effects for males included reductions in drinking frequency, binge drinking, and alcohol-related consequences. For females the intervention was associated with reduction in drinking frequency and binge drinking but did not have a significant effect on alcohol-related consequences. Results suggest a new direction for tailoring interventions to gender.     

Nicotine from cigarette smoking increases circulating levels of cortisol,growth hormone,and prolactin in male chronic smokers

Results of this study indicate that nicotine from cigarette smoking increases circulating levels of cortisol, growth hormone, and prolactin in male chronic smokers. Previous studies have not addressed the question of whether the stimulus for smoking-related hormone release is the stress of smoking or a pharmacologic action of nicotine and other tobacco substrates. Nicotine exposure is controlled in this study by allowing each subject to smoke only two 2.0 mg nicotine cigarettes during one experimental session and two 0.2 mg nicotine cigarettes in another session. Plasma levels of cortisol, growth hormone, and prolactin for the higher nicotine session were found to be significantly elevated over those for the low-nicotine session, indicating that nicotine itself plays a predominate role in smoking-induced hormone increases. All hormone levels for the 2.0 mg nicotine session had not returned to baseline 60 min after smoking.     

The effects of smoking on dry eye parameters in healthy women

Aim: To investigate the effects of chronic smoking on dry eye parameters.

Methods: Ocular surface disease index (OSDI) and tear function tests such as Schirmer’s test, tear break-up-time (TBUT) test and impression cytology of 63 female chronic smokers and 40 age-matched female non-smokers were analyzed statistically.

Results: The mean OSDI scores, Schirmer test results and TBUT levels were 35.85?±?24.01 point, 14.25?±?5.94?mm and 5.17?±?2.85?s in chronic smokers and 15.20?±?12.93 point, 15.48?±?7.01?mm and 10.03?±?3.44?s in non-smokers, respectively. Differences in OSDI scores, TBUT levels and impression cytology grades among the chronic smokers and non-smokers were statistically significant.

Conclusion: Smoking behavior seems to affect the dry eye parameters negatively.     

Changes in the relative reinforcing effects of cigarette smoking as a function of initial abstinence

Rationale  Experimental research is needed in investigating how early smoking abstinence affects relapse risk. Objective  The present study assessed the feasibility of promoting smoking abstinence using once- rather than thrice-daily abstinence monitoring and the relationship between different durations of initial abstinence and changes in smoking preference. Methods  Participants were 34 adult smokers randomized into one of two conditions: 14-day (14C) and 1-day (1C) contingent payment for smoking abstinence. Smoking status and participant ratings were assessed daily; a delay discounting task involving hypothetical money and an inter-temporal choice task involving hypothetical money and cigarettes were administered at baseline and days 7 and 14; a direct test of preference for smoking versus money was assessed on day 14. Results  Once-daily monitoring gained robust experimental control over smoking abstinence. No differences in delay discounting for hypothetical money were observed between the two conditions. Compared to the 1C condition, participants in the 14C condition (1) showed significant increases in the mean percent of delayed hypothetical money over cigarettes choices in the inter-temporal choice task, (2) were significantly less likely to ever choose the smoking option in the direct test of preference for smoking versus money, and (3) reported greater ease of abstaining from smoking and lower nicotine withdrawal and craving. Conclusions  These results offer a more efficient procedure for experimentally promoting smoking abstinence, while providing further evidence that an initial period of sustained abstinence produces a profile of changes consistent with an overall lowering of relapse risk.     

Effects of exercise on craving and cigarette smoking in the human laboratory

Exercise is increasingly being pursued as a treatment to reduce cigarette smoking. The efficacy of clinical, exercise-based cessation interventions may be enhanced by conducting laboratory studies to determine maximally effective conditions for reducing smoking, and the mechanisms through which the effects on smoking are achieved. The main purpose of this study was to assess whether the effects of exercise on two components of craving (anticipated reward from smoking, anticipated relief from withdrawal) mediated the relationship between exercise and delay (in min) to ad libitum smoking. Experiment 1 (N = 21) assessed the effects of exercise intensity (inactivity, low, moderate) on craving components up to 60 min post-exercise. Because moderate-intensity exercise most effectively reduced craving on the reward component, all participants exercised at a moderate intensity in Experiment 2. Using an ABAB within-subjects design, Experiment 2 (N = 20) evaluated whether the effects of moderate-intensity exercise on reward and relief components of craving mediated the relationship between exercise and participants' delays (in min) to ad libitum smoking. Delays were significantly longer after exercise (M = 21 min) versus inactivity (M = 4 min), and the effects of exercise on delay were mediated through the reward component of craving. Future research should continue to explore the mechanisms through which exercise influences behavioral indices of smoking in the human laboratory. Additionally, given the benefits uniquely afforded by exercise-based cessation interventions (e.g., improving mood and other health outcomes), implementing these interventions in clinical settings may contribute substantially to improving public health.