Cigarette Smoking Among Adolescent Psychiatric Inpatients: Prevalence and Correlates

The aim of this study was to ascertain the rate of smoking among adolescent (13–17 years old) psychiatric inpatients and to examine factors related to smoking status in this population. The medical records of all adolescents admitted to a private psychiatric hospital during a 1-year period were reviewed. The rate of current smoking was 59.8%. Of the adolescents who reported smoking, 40% smoked at least 140 cigarettes per week, and 44.7% smoked 7 days a week. Smokers were more likely to be Caucasian, fall within the 13-year age group, and meet criteria for substance abuse/dependence. Adolescents who used no alcohol or illicit substances were least likely to report current smoking, followed by those who used alcohol only, followed by those who used illicit substances. Results of the current study suggest the need for both thorough assessment of smoking and specialized smoking interventions in this population, who are likely to mature into heavily dependent, recalcitrant adult smokers in the absence of intervention.     

Pathways Linking Adverse Childhood Experiences to Cigarette Smoking Among Young Black Men: a Prospective Analysis of the Role of Sleep Problems and Delayed Reward Discounting

Background

African American men experience increases in smoking during the young adult transition. Exposure to childhood adversity, a risk factor which disproportionately affects African American men, has been identified as a robust precursor to health risk behavior in general and cigarette smoking in particular. The intermediate mechanisms that transmit the influence of early adversity to smoking behavior are not well understood.

Purpose

We tested a model of the escalation of smoking behaviors among young adult African American men, investigating sleep disturbance and delayed reward discounting as intermediate factors linking adverse childhood experiences with smoking.

Methods

Hypotheses were tested with three waves of data (M _age-T1 = 20.34, M _age-T2 = 21.92, M _age-T3 = 23.02) from 505 African American men living in rural counties in South Georgia. Men provided self-report data on their adverse childhood experiences, sleep problems, and smoking behavior using audio-assisted computer self-interviews. Men also completed a computer-based delayed reward discounting task.

Results

Structural equation modeling analyses supported our hypotheses: Adverse childhood experiences predicted poor sleep adequacy, which forecast increases in delayed reward discounting; discounting, in turn, predicted increased smoking. Significant indirect pathways were detected linking adversity to discounting via sleep adequacy and linking sleep adequacy to smoking via discounting.

Conclusions

Prevention and intervention researchers can draw on these findings to develop programs that focus on sleep adequacy to reduce smoking in African American men exposed to childhood adversity.

     

Structural Stigma and Cigarette Smoking in a Prospective Cohort Study of Sexual Minority and Heterosexual Youth

Background

Sexual minority youth are more likely to smoke cigarettes than heterosexuals, but research into the determinants of these disparities is lacking.

Purpose

This study aimed to examine whether exposure to structural stigma predicts cigarette smoking in sexual minority youth.

Methods

Prospective data from adolescents participating in the Growing Up Today Study (2000–2005) were utilized.

Results

Among sexual minority youth, living in low structural stigma states (e.g., states with non-discrimination policies inclusive of sexual orientation) was associated with a lower risk of cigarette smoking after adjustment for individual-level risk factors (relative risk [RR]?=?0.97; 95 % confidence interval [CI], 0.96, 0.99; p?=?0.02). This association was marginally significant after additional controls for potential state-level confounders (RR?=?0.97; 95 % CI, 0.93, 1.00; p?=?0.06). In contrast, among heterosexual youth, structural stigma was not associated with past-year smoking rates, documenting specificity of these effects to sexual minority youth.

Conclusions

Structural stigma represents a potential risk factor for cigarette smoking among sexual minority adolescents.     

Homecoming of Citizen Soldiers: Postdeployment Problems and Service Use Among Army National Guard Soldiers

The present study described the types and amount of problems and services sought among returned deployed Army National Guard soldiers (4568 soldiers in 50 units). The study responds to gaps in the research literature to better understand community intervention needs of reservists. About half (48%) of the soldiers reported one or two problems, mostly those of psychological well-being, such as feelings of anger and frustration, upsetting memories, and troubled sleep (34% of the study sample), followed by problems of social support (18%), alcohol use (17%), feelings of isolation including suicidal thoughts (13%), and financial difficulties (11%). Having engaged in direct combat and having wounded or killed someone showed positive relationships with reported problems. One-third (35%) of soldiers who reported having used services went to one service and, generally, soldiers went to services related to their expressed problems. Variance in self-reported problems explained by service use was low, suggesting unsought postdeployment services.     

I (should) Need a Cigarette: Adolescent Social Anxiety and Cigarette Smoking

Background

Approximately half of high school students in the USA have used tobacco. Social anxiety can put adolescents at increased risk for smoking.

Purpose

This study aims to determine whether adolescents high in trait social anxiety report more cigarette use and greater urge to smoke before, during, and after friend interactions than do teens low in trait social anxiety.

Methods

Four hundred two students who reported smoking more than once during high school were assessed approximately every 30?min during up to 84-day monitoring sessions.

Results

Controlling for momentary anxiety, high socially anxious teens were equally or less likely to smoke, but more likely to report urge to smoke, surrounding friend interactions than low socially anxious teens.

Conclusions

Although high socially anxious adolescents do not smoke more than low socially anxious peers, they may believe that they should need a cigarette in anxiety-provoking situations. Such urges may later develop into smoking behaviors.     

Cigarette Smoking is Negatively Associated with Family Average Income Among Urban and Rural Men in Regional Mainland China

Socio-economic status (SES) has a strong influence on cigarette smoking behaviour. However, as a more sensitive and realistic index of SES, family average income (FAI) has little studied regarding its association with smoking. With a response rate of 90.1%, a cross-sectional study was conducted among randomly selected urban-rural participants (n = 29,353) between October of 2000 and March of 2001 in Nanjing, China. The proportion of male participants who were current smokers was 54.7%; for females it was 2.2%. After adjustment for possible confounding variables (area of residence, age, education, occupation) males in the middle (OR 0.76; 95% CI 0.69–0.84) and higher (OR 0.64; 95% CI 0.57–0.71) FAI tertiles had lower odds of being smokers than did males in the lower FAI tertile. There were no differences by FAI category in the odds of being an ex-smoker. Therefore, current smoking among adult males is inversely associated with family average income in a regional Chinese population. FAI may inform the targeting of campaigns or other initiatives, particularly in populations where material prosperity is low in some social groups.     

Cigarette Smoking and Psychiatric Disorder in a Community Sample

We examined the lifetime prevalence of psychiatric disorders in cigarette smokers and nonsmokers in a non-patient sample. First-degree relatives of psychiatric patients (n = 697) and normal controls (n = 360) were interviewed with the Diagnostic Interview Schedule and the Structured Interview for DSM-III Personality Disorders. Using these interviews we diagnosed the major mental (Axis I) disorders and personality (Axis II) disorders. A cigarette smoker was defined as someone who smoked daily for a month or more at some time in their lives. We found that smokers more frequently had a lifetime history of major depression, alcohol and drug abuse/dependence, agoraphobia, unstable/acting out and anxious/fearful personality disorders. In a logistic regression analysis, the only significant variables independently associated with smoking status were the alcohol and drug use disorders. Age was an important modifying variable—the smoking-illness relationship was robust in the youngest age cohort and negligible in the oldest cohort. We conclude that cigarette smokers have increased rates of mood, anxiety, substance use, and personality disorders. However, after controlling for the comorbidity among the disorders only alcohol and drug abuse/dependence were independently associated with smoking. Young smokers had particularly high rates of substance use disorders. This age effect may reflect the impact of a quarter century of health education.     

Effects of Social Network Characteristics on Mental Health Outcomes Among United States Army Reserve and National Guard Soldiers

Community Mental Health Journal - We sought to examine the relative salience of multiple social network structural characteristics (e.g., size, composition, quality, substance use) for...     

Persistent Disparity in Prevalence of Current Cigarette Smoking Between US Adolescents With vs. Without a Past-Year Major Depressive Episode

Using data from annual (2004–2010) cross-sectional surveys of nationally representative samples, the prevalence rate of current (i.e., past 30 days) cigarette smoking among US adolescents age 12–17 years was twice as high for those with vs. without a past-year major depressive episode (PYMDE) (22 vs. 11 % in the 2004 survey and 16 vs. 8 % in the 2010 survey). The proportion of all US adolescent current smokers who had a PYMDE was about 24 % for females; 70–80 % of all smokers with PYMDE were females. The persistently higher smoking rates in US adolescents with vs. without PYMDE emphasizes the need for interventions.     

Validation Study of Kim's Smoking Cessation Motivation Scale and Its Predictive Implications for Smoking Cessation

Objective

The purpose of this study was to develop a scale to measure motivation for smoking cessation. Motivation is known to be important for success of smoking cessation. The reliability of the scale was assessed and its predictive validity for smoking cessation was evaluated.

Methods

We recruited 333 men aged 20 to 70 that visited smoking cessation clinics at seven public health centers. The demographic characteristics were recorded and the Korean version of Stages of Readiness for Change and Eagerness for Treatment Scale for Smoking (K-SO-CRATES-S) performed. A smoking cessation motivation scale was developed with 10 questions based on the theory of motivation enhancement therapy.

Results

The motivation scale was composed of four subscales based on the factor analysis; each subscale had an adequate degree of internal consistency. In addition, the newly developed scale had a high degree of validity based on its significant correlation with the smoking version of SOCRATES. Moreover, the precontemplation level of motivation was found to significantly predict the success of smoking cessation. And one of the subscales of the Korean Nicotine Dependence Syndrome Scale (K-NDSS), stereotypy which also significantly predicted the success of smoking cessation, significantly correlated with the preparation 1 and 2 level of motivation.

Conclusion

The smoking cessation motivation scale with 10 questions that was developed in this study was a highly reliable and valid scale for the prediction of success for smoking cessation for those who wanted to stop smoking.     

The Effect of Cigarette Smoking on Chemosensory Perceptionof Common Beverages

Introduction

This study aimed to determine whether a smoking restriction prior to sensory evaluation affects sensory perception and liking of beverages that represent sweetness (sweetened cocoa), saltiness (vegetable juice), sourness (orange juice), and bitterness (black coffee).

Methods

Smokers were asked to either abstain from smoking for 2 h or to smoke a cigarette 5 min prior to sensory evaluation of beverages. As a control, non-smokers participated in this study.

Results

Smokers who smoked 5 min prior to tasting beverages rated black coffee as significantly more bitter than did those who either abstained from smoking for 2 h or non-smokers. No effect of cigarette smoking was found either in intensity of other taste qualities and flavor or in the liking of the four types of beverages.

Conclusion

This study provides empirical evidence that cigarette smokers should abstain from smoking for 2 h prior to sensory evaluation of bitter-tasting beverages such as black coffee.

     

Mental Health Correlates of Post Disaster Increases in Alcohol and Cigarette Smoking: A Vietnamese Study

Previous research in US populations has found associations between disaster-related variables, psychological variables, and post-disaster increases in smoking and alcohol use. To date, no research has examined this association in an international population of disaster exposed individuals. Data used in this study were drawn from a larger study involving a two-wave assessment of a disaster-affected sample of Vietnamese citizens (N?=?798). Interviews were conducted to assess the effects of mental health variables and typhoon related variables on reported increases in alcohol use and cigarette smoking. Results indicate that post-disaster increases in smoking were associated with post-disaster diagnosis of generalized anxiety disorder. Post-disaster increases in alcohol use were associated with posttraumatic stress disorder and panic disorder. None of the typhoon-characteristics were significantly associated with increases in substance use. Implications for mental health providers and future research directions are discussed.     

Bullying Among Adolescents With Autism Spectrum Disorders: Prevalence and Perception

This study examined: (a) the prevalence of bullying and victimization among adolescents with ASD, (b) whether they correctly perceived bullying and victimization, and (c) whether Theory of Mind (ToM) and bullying involvement were related to this perception. Data were collected among 230 adolescents with ASD attending special education schools. We found prevalence rates of bullying and victimization between 6 and 46%, with teachers reporting significantly higher rates than peers. Furthermore, adolescents who scored high on teacher- and self-reported victimization were more likely to misinterpret non-bullying situations as bullying. The more often adolescents bullied, according to teachers and peers, and the less developed their ToM, the more they misinterpreted bullying situations as non-bullying. Implications for clinical practice are discussed.     

缺血性卒中后痉挛发生情况及预测因素分析

目的 了解国人缺血性卒中6个月后肢体痉挛的发生情况与危险因素。 方法 连续选取2013年4月1日-7月31日在我院神经内科住院的新发缺血性卒中患者,在缺血性卒中 后6个月时评估其痉挛情况。痉挛评定采用改良Ashworth痉挛量表（modified Ashworth Scale,MAS）,所 有患者的痉挛评定均由同一人进行。 结果 纳入患者185例,完成随访114例,32例发生痉挛,上下肢均发生痉挛的有22例。最易受累的是 肘关节（26例）,其次为踝关节（22例）、指关节（20例）、腕关节（19例）、膝关节（18例）、肩关节（15 例）和髋关节（7例）。统计分析发现,入院时美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale,NIHSS）痉挛组（4.64,0～23分）显著高于无痉挛组（2.41,0～7分,P =0.001）;入 院时NIHSS评分中瘫痪评分（3,2～6分）痉挛组明显高于无痉挛组（1,0～2分,P <0.001）;出院时 日常生活活动能力评分（Barthel Index,BI）痉挛组（71.2分,5～100分）明显低于无痉挛组（91.7分, 45～100分,P <0.001)。多因素回归分析后,发现入院时NIHSS评分中瘫痪评分及出院时BI评分与痉挛的 发生存在相关性。 结论 缺血性卒中后,痉挛在上下肢同时发生最常见,上肢较下肢更易发生痉挛,其中肘关节最易受 累,入院时NIHSS评分中瘫痪评分与出院时BI评分有助于预测痉挛的发生。     

Effect of Cigarette Smoking on Functional Outcomes in Patients with Spontaneous Intracerebral Hemorrhage

Background: Nicotine may have neuroprotective effects on the injured brain through modulation of the cholinergic anti-inflammatory pathway. Aims: This study aimed to evaluate the relationship between cigarette smoking and outcomes in patients with spontaneous intracerebral hemorrhage (ICH). Methods: This was a retrospective review of consecutive ICH patients enrolled in the ICH Outcomes Project from 2009 to 2017. Patients with age ≥18 years and baseline modified Rankin Scale (mRS) score 0-2 were included. Smoking patterns were categorized as recent smoker (≤30 days prior to ICH) and not recent smoker (>30 days prior to ICH). Not recent smokers were further categorized into former smokers and nonsmokers. The primary outcome was good outcome (90-day mRS ≤ 2). Secondary outcomes were excellent outcome (90-day mRS 0-1), 90-day Barthel Index, and in-hospital and 90-day mortality. Results: The study cohort comprised 545 patients, including 60 recent smokers and 485 not recent smokers. Recent smokers had higher rates of good (35% versus 23%; odds ratio [OR] = 1.787, P = .047) and excellent (25% versus 13%; OR = 2.220, P = .015) outcomes compared to not recent smokers. These differences were not significant after baseline adjustments. Recent smokers had higher rates of good (36% versus 24%; OR = 1.732, P = .063) and excellent (25% versus 13%; OR = 2.203, P = .018) outcomes compared to nonsmokers. These differences were not significant after baseline adjustments. A 90-day Barthel Index, in-hospital, and 90-day mortality were comparable between recent and not recent smokers, recent and nonsmokers, and former and nonsmokers. Conclusions: Despite potential neuroprotective effects of nicotine found in cigarettes, these may be outweighed by the detrimental effects of cigarette smoking on health outcomes.     

Posttraumatic Stress Disorder Post Iraq and Afghanistan: Prevalence Among Military Subgroups

A large body of research has been produced in recent years investigating posttraumatic stress disorder (PTSD) among military personnel following deployment to Iraq and Afghanistan, resulting in apparent differences in PTSD prevalence. We compare prevalence estimates for current PTSD between military subgroups, providing insight into how groups may be differentially affected by deployment. Systematic literature searches using the terms PTSD, stress disorder, and acute stress, combined with terms relating to military personnel, identified 49 relevant papers. Studies with a sample size of less than 100 and studies based on data for treatment seeking or injured populations were excluded. Studies were categorized according to theatre of deployment (Iraq or Afghanistan), combat and noncombat deployed samples, sex, enlistment type (regular or reserve and [or] National Guard), and service branch (for example, army, navy, and air force). Meta-analysis was used to assess PTSD prevalence across subgroups. There was large variability in PTSD prevalence between studies, but, regardless of heterogeneity, prevalence rates of PTSD were higher among studies of Iraq-deployed personnel (12.9%; 95% CI 11.3% to 14.4%), compared with personnel deployed to Afghanistan (7.1%; 95% CI 4.6% to 9.6%), combat deployed personnel, and personnel serving in the Canadian, US, or UK army or the navy or marines (12.4%; 95% CI 10.9% to 13.4%), compared with the other services (4.9%; 95% CI 1.4% to 8.4%). Contrary to findings from within-study comparisons, we did not find a difference in PTSD prevalence for regular active-duty and reserve or National Guard personnel. Categorizing studies according to deployment location and branch of service identified differences among subgroups that provide further support for factors underlying the development of PTSD.     

Cigarette Smoking and Tryptophan Hydroxylase 2 mRNA in the Dorsal Raphe Nucleus in Suicides

Cigarette smoking is associated with suicide and mood disorders and stimulates serotonin release. Tryptophan hydroxylase (TPH2) synthesizes serotonin and is over-expressed in suicides. We determined whether smoking is associated with TPH2 mRNA in suicides and controls. TPH2 mRNA was measured postmortem in the dorsal raphe nucleus (DRN) of controls (N = 26, 17 nonsmokers and nine smokers) and suicides (N = 23, 5 nonsmokers and 18 smokers). Psychiatric history was obtained by psychological autopsy. TPH2 mRNA was greater in suicide nonsmokers than suicide smokers, control smokers and control nonsmokers (p = 0.006). There was more TPH2 mRNA throughout the DRN. Smoking interferes with the TPH2 mRNA increase observed in suicide nonsmokers. The absence of altered TPH2 expression in non-suicide smokers suggests no pharmacological effect of smoking.