Desire thinking across the continuum of nicotine dependence

Introduction: Desire thinking is a voluntary cognitive process involving verbal and imaginal elaboration of a desired target. Recent research has highlighted the role of desire thinking in the maintenance of addictive disorders over and above that of other psychological antecedents including negative affect and urges. The goal of this research project was to explore the role of desire thinking across the continuum of nicotine dependence.

Method: A sample of 156 smokers recruited from the general population completed measures of negative affect, smoking urges, desire thinking and nicotine dependence.

Results: Individuals high on nicotine dependence reported significantly higher scores on desire thinking dimensions controlling for age, gender, negative affect and smoking urges. In addition, the verbal perseveration component of desire thinking was the strongest predictor of nicotine dependence independently of negative affect and smoking urges across the nicotine dependence spectrum.

Conclusions: Findings suggest that desire thinking may be a risk factor for nicotine dependence and that cognitive-behavioural interventions for treating nicotine dependence may benefit from targeting specifically desire thinking.     

Assessment of nicotine dependence among adolescent and young adult smokers: A comparison of measures

Introduction

Tobacco use often starts in adolescence, yet assessment of dependence among adolescent smokers remains a challenge, particularly given the potential discord between self-reports of smoking behavior and actual use. We could find no prior study, among adolescents, that directly compares the association between objective biomarkers of tobacco exposure (e.g., cotinine) and multiple measures of dependence. This study examined the concurrent validity of two common dependence measures: the Fagerström Test for Nicotine Dependence (FTND) and the Hooked on Nicotine Checklist (HONC). We further examined the FTND by removing the one item on cigarettes smoked per day.

Methods

Based within a parent clinical trial for adolescent smoking cessation, eligible participants were 12–21 years old, smoking ≥ 5 cigarettes per day on average, and with urine cotinine > 100 ng/ml at baseline. Results are based on participants who completed each measure and who provided a urine cotinine sample at baseline (N = 73).

Results

Results showed that the FTND was associated with cotinine (p < 0.001; R² = 0.25), and that this relationship held true for the revised FTND as well (p < 0.001; R² = 0.18). However, the HONC was only marginally associated with cotinine (p = 0.06; R² = 0.09).

Discussion

Our results suggest that the FTND may be better associated with actual smoking behavior in adolescents as compared to the HONC. Pending replication, our data provide caution with regard to assessment of nicotine dependence at least among established adolescent smokers who have more entrenched smoking behavior.     

The retest reliability of nicotine dependence measures

Four variables potentially indicative of different aspects of drug problems have been selected for study in a community sample of young people aged 16–20 who use drugs; Severity of Dependence Score; Whether or not interactional problems caused by own drug use were experienced; Number of college or work days missed specifically as a result of drug use; and 12-item General Health Questionnaire Score. The study population comprised 200 young cannabis users, approximately one-third of whom were also stimulant drug users. Substantial levels of these problems were observed.

A range of predictors of these problems were identified in regression models. Lifetime stimulant drug use emerges as a principal indicator of risk. In addition, age, ongoing drug consumption variables and satisfaction with personal drug use emerge are recurrent predictors. An indicator of deprivation is identified as being associated with interactional problems. The need for development of the study of drug problems in the context of the normalisation of recreational drug use within British youth culture is discussed. More elaborate and sophisticated studies of problems will be required to identify significant harms as consequences of teenage patterns of non-opiate drug use.     

Predictive validity of four nicotine dependence measures in a college sample

BACKGROUND: The present study compared the predictive and incremental validity of four commonly used dependence measures (Diagnostic and Statistical Manual-IV [DSM-IV] nicotine dependence criteria, Fagerstrom Test for Nicotine Dependence [FTND], Hooked On Nicotine Checklist [HONC], Nicotine Dependence Syndrome Scale [NDSS]) in a first year college sample reporting light smoking patterns. METHODS: Nicotine dependence measures were administered at the end of the first semester and follow-up smoking behavior (i.e. continued smoking, quantity, frequency, and length of abstinence) was assessed at the end of the first and second academic years. RESULTS: Higher levels of dependence as measured by the HONC and DSM-IV predicted smoking behavior at both follow-up assessments. While higher scores on some of the NDSS factors predicted heavier smoking behavior during follow-up assessments, higher scores on other NDSS factors predicted lighter smoking behavior. The DSM-IV, NDSS-priority, and HONC measures provided some evidence for incremental validity. Higher dependence scores on all four measures were related to shorter lengths of smoking abstinence. CONCLUSIONS: The four dependence measures were differentially related to smoking behavior outcomes in a light smoking sample. These findings suggest that nicotine dependence can predict a variety of smoking behaviors in light smokers.     

Exploring brief measures of nicotine dependence for epidemiological surveys

A score > or = 6 in the Fagerstr?m Test for Nicotine Dependence (FTND), identifying high nicotine dependence, was compared with three briefer classifications: (1) Item 4: heavy smoking (more than 30 cigarettes per day); (2) Item 1: high early smoking (smoking within 30 min of waking up); and (3) a score > or = 4 by combining Items 1 and 4. The FTND scores from 1642 smokers from five samples in the US and Spain were analyzed. Heavy smoking had low sensitivity. High early smoking had low specificity. A score > or = 4 by combining Items 1 and 4 had relatively good sensitivity (94%) and specificity (88%). Researchers needing definition of nicotine dependence briefer than FTND may want to only use Items 1 and 4 of FTND with a cutting score > or = 4.     

Major depression among adolescent smokers undergoing treatment for nicotine dependence

This is the first study to examine the prevalence and effects of major depression (MDD) in a sample of adolescent smokers (N = 211) undergoing treatment for nicotine dependence. We assessed MDD at baseline and end of treatment with the mood disorders portion of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). Eleven percent of participants reported a history of MDD (6% of males and 21% of females). Study variables did not distinguish those with and without a history of MDD. End of treatment abstinence rates and relapse rates were similar in both groups. Two participants (1%), both female, experienced onset of MDD during the treatment. The findings provide further evidence that MDD is a comparatively common disorder among children and adolescents and that clinicians should monitor and be prepared to respond to depression that may emerge during the treatment of nicotine-dependent adolescents.     

尼古丁依赖的药物治疗

烟草是世界上使用最普遍的精神活性物质。烟草中的成分复杂 ,其种类高达２０００多［１］，但只有尼古丁象其它依赖性药物如海洛因、可卡因等一样，可以在人和动物中引起耐受、依赖及戒断综合征［２］，象其它精神活性物质一样，尼古丁依赖的核心特征也是难以克制的觅药和用药     

Concordance of different measures of nicotine dependence: two pilot studies

Two samples of adult daily smokers completed a structured interview to determine nicotine dependence according to generic (DSM-IV/ICD-10), Fagerstr?m [Fagerstr?m Tolerance Questionnaire (FTQ), Fagerstr?m Test for Nicotine Dependence (FTND), Heavy Smoking Index (HSI), and time to first cigarette after awakening (TFC)], consumption [e.g., cigarettes/day (CPD)], and self-rating (e.g., "how addicted are you") measures. One sample was a population-based sample of 43 smokers from the Vermont site of the DSM-IV field trial for substance use disorders. The other sample consisted of 50 smokers evenly distributed across a wide range of CPD to study biochemical markers of smokers. In the first study, DSM/ICD criteria were only slightly correlated with Fagerstr?m (r =.24-.35) and consumption (r =.06-0.33) criteria. Self-rating criteria were correlated moderately with most other criteria (r =.24-.60). In the second study, generic, Fagerstr?m, and self-rating criteria increased with increasing CPD up to 30 CPD but not thereafter. One interpretation of these results is that generic, Fagerstr?m, consumption, and self-rating criteria each tap different aspects of nicotine dependence.     

Time-varying effects of smoking quantity and nicotine dependence on adolescent smoking regularity

Background

Little is known about time-varying effects of smoking quantity and nicotine dependence on the regularity of adolescent smoking behavior.

Methods

The sample was drawn from the Social and Emotional Contexts of Adolescent Smoking Patterns Study which followed adolescent smokers over 5 assessment waves spanning 48 months. Participants included former experimenters (smoked <100 cigarettes/lifetime but did not smoke in past 90 days), recent experimenters (smoked <100 cigarettes/lifetime and smoked in past 90 days), and current smokers (smoked >100 cigarettes/lifetime and smoked in past 30 days). Mixed-effects regression models were run to examine the time-varying effects of smoking quantity and nicotine dependence on regularity of smoking behavior, as measured by number of days smoked.

Results

Smoking quantity and nicotine dependence were each found to be significantly associated with regularity of adolescent smoking and the size of each effect exhibited significant variation over time. The effect of smoking quantity decreased across time for each smoking group, while the effect of nicotine dependence increased across time for former and recent experimenters. By the 48-month follow-up, the effects of smoking quantity and nicotine dependence had each stabilized across groups.

Conclusions

This study reveals that smoking quantity and nicotine dependence are not static risk factors for the development of more regular smoking patterns. At low levels of smoking when nicotine dependence symptoms are less common, smoking quantity is a stronger predictor of increased regularity of smoking, while for more experienced smokers, nicotine dependence predicts further increases in regularity.     

Exposure to chronic intermittent nicotine vapor induces nicotine dependence

Animal models of drug exposure are important tools for the study of the neurobiological mechanisms of nicotine dependence and as preclinical models for medication development. There are few non-invasive animal models of nicotine exposure and currently there is no known animal model of second-hand exposure to nicotine. We hypothesized that chronic administration of nicotine vapors would produce blood levels of nicotine in rodents that are clinically relevant to those observed in human smoking and that rodents exposed to nicotine vapors would develop dependence to nicotine. We developed a system that vaporizes nicotine in the air in a stable, reliable and consistent manner. Intermittent exposure to nicotine vapor (0.2 mg/m³) for 8 or 14 h per day for 7 days produced a concentration of nicotine in the blood of 22 ng/mL. Sixteen hours after removal from nicotine vapors, rats showed significant somatic withdrawal signs precipitated by mecamylamine (1.5 mg/kg). These results provide a new rodent model of nicotine dependence using vapor administration that produces consistent levels of nicotine in the blood that are relevant for both heavy smoking and second-hand smoking, using a non-invasive technique that mimics the intermittent aspect and route of administration in humans.     

Effect of fenfluramine and nicotine upon a stimulant-depressant continuum

Rats were rapidly trained to discriminate between 0.8 mg/kg d-amphetamine and 6 mg/kg pentobarbital in a two-lever food-motivated operant task by imposing the drug states from the earliest stage of training. Once trained, rats were administered lower doses of each of the training drugs and both d-amphetamine and pentobarbital were observed to produce dose-responsive effects upon discriminative performance. When graphically represented, the dose-response curves were shown to be parallel suggesting a common site and/or mechanism of action. Administration of fenfluramine (1.5 and 2.25 mg/kg) produced pentobarbital-appropriate responding, whereas the injection of three doses of nicotine (0.1–0.4 mg/kg) resulted in amphetamine-like discriminative responding. Inspection of dose-response curves suggested that fenfluramine produces its pentobarbital-like effects by acting differently than does pentobarbital and, although nicotine produces amphetamine-like effects, it acts by a different mechanism than does amphetamine.     

Psychosocial factors in adolescent nicotine dependence symptoms: a sample of high school juniors who smoke daily

Cross-sectionally examined seven theory-guided psychosocial factors associated with nicotine dependence symptoms in a representative self-report survey of 794 Washington State high school junior daily smokers (93% participation). Outcomes were four nicotine dependence symptoms. Results showed that low self-efficacy for quitting smoking and being around adults who smoke were associated with a 3.48-10.35 and a 1.47-1.77 times higher odds, respectively, of each of the four nicotine dependence symptoms. These results, needing replication in a longitudinal study, suggest that interventions designed to enhance self-efficacy to quit smoking and counter adult smoking influences might reduce adolescent nicotine dependence.     

The relationship between the nicotine metabolite ratio and three self-report measures of nicotine dependence across sex and race

Rationale

Variability in the rate of nicotine metabolism, measured by the nicotine metabolite ratio (NMR), is associated with smoking behavior. However, data linking the NMR with nicotine dependence measured by the Fagerström test for nicotine dependence (FTND) are mixed. Few past studies have examined alternative measures of nicotine dependence and how this relationship may vary by sex and race.

Objective

Using data from smokers undergoing eligibility evaluation for a smoking cessation clinical trial (n?=?833), this study examined variability in the relationship between NMR and nicotine dependence across sex and race and using three measures of nicotine dependence: FTND, time-to-first-cigarette (TTFC), and the heaviness of smoking index (HSI).

Results

Controlling for sex and race, nicotine metabolism was associated with nicotine dependence only when using the HSI (p?<?0.05). Male normal metabolizers of nicotine were more likely to have high nicotine dependence based on the FTND and HSI (p?<?0.05), but NMR was not related to measures of nicotine dependence in women. For African Americans, the NMR was associated with nicotine dependence only for the TTFC (p?<?0.05), but NMR was not associated with nicotine dependence among Caucasians. Post hoc analyses indicated that the NMR was associated with cigarettes per day, overall, and among men and Caucasians (p?<?0.05).

Conclusions

While there was some variation in the relationship between nicotine metabolism and nicotine dependence across measures and sex and race, the results indicate that this relationship may be more attributable to the association between NMR and cigarettes per day.     

Pharmacotherapy of nicotine dependence

Withdrawal treatment of cigarette smokers is a task of the utmost urgency in view of the consequences for national health programs and legislative policies of the high morbidity and mortality rates caused by smoking. Smokers need medical consultation in addition to drug-based treatment, but this results in self-willed quitting of the smoking habit in a limited number of smokers only. From the point of view of the criteria of "evidence-based medicine", non-drug methods such as hypnosis therapy and acupuncture are not effective (odds ratio = 1.22). Among the drug-based methods, treatment with nicotine substitution preparations has shown confirmed efficacy in numerous studies (odds ratio 1.63 to 2.67, depending on the application form used) and results in successful withdrawal from the smoking habit in 30-40% of cases. A decisive problem in the initial therapeutic phase appears to be the amount of the applied nicotine dose, but beyond that can be mastered above all by combining 2 or 3 application forms (patchs, chewing gum, nasal spray). Treatment is then continued for 4-12 weeks, depending on the degree of dependence, with successively reduced nicotine dosage. Two controlled studies with disparate designs have been done on bupropion (odds ratio 2.3/3.0). However, further studies are desirable due to concern about undesirable effects of bupropion described recently. Other substances subjected to trials in years past, such as clonidine, lobeline, mecamylamine and antidepressants including buspirone cannot be recommended on the basis of current data for treatment of smokers seeking a withdrawal cure.     

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.     

Prolonged nicotine dependence associated with extended access to nicotine self-administration in rats

Rationale Most nicotine self-administration (NSA) studies in rats are performed under limited-access conditions. Few studies have examined the relationship between nicotine dependence and NSA.Objectives To determine how NSA access conditions affect NSA and the duration of nicotine dependence during abstinence, as reflected in somatic signs of withdrawal precipitated by administration of the nicotinic receptor antagonist mecamylamine.Methods The effects of different NSA access conditions (zero, 1 h/5 days, 1 h/7 days and 6 h/7 days per week) and non-contingent nicotine administration on NSA and somatic signs were examined.Results Daily NSA access (30 days) resulted in spontaneous and mecamylamine-induced somatic signs. Both daily access groups (1 h/day and 6 h/day, 7 days/week) exhibited spontaneous somatic signs on day 25 of NSA (17 h post-NSA) and sensitivity to mecamylamine up to 2 and 4 weeks of abstinence, respectively. In contrast, the 1 h/day, 5 days/week access group exhibited mecamylamine-induced somatic signs only up to 1 week of abstinence. NSA behavior was stable in rats with 1 h/day 5 days/week and 1 h/day 7 days/week access, but decreased from initially high rates in the 6 h/day 7 days/week access group, and decreased in rats receiving non-contingent nicotine. In contrast, extended cocaine self-administration access resulted in a gradual escalation in cocaine intake.Conclusion There was no escalation in nicotine intake with extended access conditions, unlike cocaine self-administration. Nevertheless, daily nicotine self-administration seven days per week, for either 1 or 6 h per day, was sufficient to induce long-lasting adaptations in nicotinic acetylcholine receptor activity reflected in spontaneous and antagonist-precipitated somatic signs of withdrawal, possibly reflecting aspects of nicotine dependence.     

Risk factors for adolescent smoking: parental smoking and the mediating role of nicotine dependence

Background

Parental smoking and early-emerging nicotine dependence symptoms are well-documented risk factors for adolescent smoking. However, very little is known about the mediating pathways through which these risk factors may act, or whether parental smoking may cause or signal early-emerging nicotine dependence symptoms.

Methods

Data were drawn from the longitudinal Social and Emotional Contexts of Adolescent Smoking Patterns Study. Adolescents who had smoked under 100 cigarettes in their lifetime (n = 594; low-exposure group) and adolescents who had smoked over 100 cigarettes, but fewer than 5 cigarettes per day (n = 152) were included in the analyses. Path analysis was performed on longitudinal data to investigate the association between parental smoking and smoking frequency at the 48 months follow-up, both directly and through mediating variables of smoking frequency, smoking quantity, and nicotine dependence.

Results

Father's smoking was associated with higher adolescent nicotine dependence scores at the baseline assessment wave. Structural equation modeling revealed that mother's smoking at baseline was associated with adolescent's smoking frequency at the 48-month follow-up, and its effect was partially mediated by both smoking frequency and nicotine dependence among low-exposure adolescent smokers.

Conclusions

Parental smoking is a risk factor for future smoking in low-exposure adolescent smokers, above and beyond the risks posed by smoking behavior and nicotine dependence. Moreover, parental smoking is associated with early-onset nicotine dependence in low-exposure adolescent smokers. As an easily measureable risk factor, parent smoking status can be used to identify and intervene with novice adolescent smokers who are at high risk for chronic smoking behavior.