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.     

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.     

Tobacco consumption and spontaneous quitting at the first trimester of pregnancy

IntroductionThe purpose of this study was to examine the association between pregnant women's socio-demographic characteristics, smoking-related variables and psychological symptoms (anxiety and depression) and both tobacco consumption and spontaneous quitting at the first trimester of pregnancy. In particular, we wished to examine the contribution of depressive symptoms to tobacco consumption and spontaneous quitting, while controlling for anxiety symptoms, socio-demographic and smoking-related variables.MethodsThe sample was comprised of 901 Spanish pregnant women. Assessment included an ad hoc questionnaire with socio-demographic and tobacco consumption information, the Edinburg Postnatal Depression Scale (EPDS), and The State-Anxiety Inventory (STAI-S). Two multiple logistic regression analyses were performed, respectively to predict tobacco consumption and to predict spontaneous quitting.ResultsHaving a partner who smokes (OR = 5.578), not having a college education (OR = 2.803), higher scores on the EPDS (OR = 1.073) and higher scores on the STAI-S (OR = 1.027) increase the probability of continuing smoking. Being primiparous (OR = 2.463), having a college education (OR = 2.141), smoking fewer cigarettes before pregnancy (OR = 1.175), and lower scores on the STAI-S (OR = 1.045) increase the probability of spontaneously quitting smoking at the first trimester of pregnancy.ConclusionsDepressive symptoms were a predictor of tobacco consumption but not of spontaneous quitting; spontaneous quitting was better predicted by anxiety symptoms. These findings support recommendations that women with depressive symptoms are at risk for smoking during pregnancy and highlight that anxious symptoms should be targeted in interventions for smoking cessation during pregnancy.     

Increased self-efficacy to quit and perceived control over withdrawal symptoms predict smoking cessation following nicotine dependence treatment

AimTo examine changes in nicotine withdrawal, nicotine craving, self-efficacy to quit smoking, and perceived control over withdrawal symptoms as predictors of smoking cessation following behavioral counseling and nicotine replacement therapy in a sample of smokers.Design and settingThe data were ascertained from a randomized effectiveness trial comparing nicotine patch to nicotine lozenge. Predictors of smoking cessation were assessed at baseline and 5 weeks post-baseline, and 24-hour point prevalence abstinence, biochemically confirmed, was assessed at the end-of-treatment (week 15) and 6 months after a target quit date (week 27).Participants642 treatment-seeking smokers randomized to 12 weeks of nicotine patch or nicotine lozenge.FindingsParticipants who showed a greater increase in self-efficacy to quit smoking (OR = 1.09, 95% CI: 1.02–1.16, p = .01) and perceived control over withdrawal symptoms (OR = 1.02, 95% CI: 1.00–1.04, p = .05) were significantly more likely to have quit smoking at week 15. Participants who showed a greater increase in self-efficacy to quit smoking (OR = 1.04, 95% CI: 1.01–1.06, p = .01) were significantly more likely to have quit smoking at week 27. Changes in withdrawal symptoms and craving were not related to week 15 or week 27 abstinence rates.ConclusionsThe results highlight two relatively under-studied potential psychological predictors of abstinence following treatment for nicotine dependence. Behavioral counseling interventions to promote smoking cessation should help smokers develop confidence in their ability to quit smoking and increase their sense of control over withdrawal symptoms to increase their chances for cessation.     

Correspondence between adolescent and informant reports of substance use: Findings from the Philadelphia Neurodevelopmental Cohort

Inclusion of collateral informant reports is common in adolescent psychopathology research and clinical assessment, yet few studies have examined agreement on ratings of adolescent substance use or factors that may be associated with reporter agreement. The present study aimed to extend prior work on the correspondence between adolescent and informant reports of adolescent substance use with data from a large (n = 5214), diverse, community-based sample of youth aged 11–17 (mean age = 14.53, SD = 1.98; 52% female). Specifically, we examined: (a) agreement between adolescent and collateral informant reports of adolescent use of alcohol, marijuana, cocaine, inhalants, and stimulants and (b) potential correlates of reporter agreement. Agreement ranged from low (κ = 0.007, p = 0.053) for inhalant use to moderate (κ = 0.414, p < 0.001) for marijuana use. Disagreements were mainly driven by collateral underestimation of adolescent substance use. Older adolescent age was associated with poorer agreement across all substances (Odds Ratios [ORs] ≤ 0.80, ps < 0.05) except inhalants (OR = 1.28, p < 0.001). Reporter agreement on alcohol and marijuana use was lower for male than female adolescents (ORs ≤ 0.85, ps < 0.05). Adolescent psychopathology was associated with poorer agreement on all substances (ORs ≤ 0.62, ps < 0.01). For alcohol and marijuana, past year frequency of use was associated with better reporter agreement (ORs ≥ 1.54, ps < 0.001). For marijuana, older age at first use was related to poorer agreement (OR = 0.81, p = 0.01). Our results suggest that collateral reports of adolescent substance use may be ineffective proxies for adolescent self-reports in community samples, particularly for low base rate substances. Findings also highlight important factors to consider when collecting substance use information from multiple informants.     

Nicotine withdrawal and craving in adolescents: Effects of sex and hormonal contraceptive use

While sex differences in the nicotine withdrawal (NW) symptoms and craving (NC) have been extensively described in adult cigarette smokers, few studies have investigated these phenomena in adolescents. We investigated the effect of gender and hormonal contraception (HC) on NW and NC during the first 14 days of cessation in adolescent smokers using data from a randomized, placebo-controlled, double-blind trial of the transdermal nicotine replacement therapy for smoking cessation.Analyses showed similar levels of NW severity in males and females, regardless of HC use. However, significantly higher NC was observed in females compared to males, (2.22 ± 0.12 vs. 1.65 ± 1.14; p = 0.003). Further, females not using HC reported the highest level of NC (2.38 ± 0.16) followed by females using HC (2.08 ± 0.25) and males (1.71 ± 0.16; p = 0.007).The current findings suggest that adolescent females experience similar NW severity to males, but have stronger NC. Further, the use of hormonal contraceptives may impact the severity of craving. Addressing these different symptoms in adolescents may be useful in increasing smoking cessation rates in this special population of smokers.     

Psychiatric disorders,suicidal ideation,and sexually transmitted infections among post-deployment veterans who utilize digital social media for sexual partner seeking

IntroductionDigital social media platforms represent outlets through which individuals may find partners for sexual encounters. Using a sample of US post-deployment military veterans, the current study evaluated the prevalence of digital sex seeking as well as clinical correlates of psychopathology, suicidal ideation, and sexually transmitted infections (STIs).MethodsUsing data from a baseline telephone interview and follow-up internet-based survey, we examined the prevalence of sexual partnering via digital social media platforms in a national sample of 283 US combat veterans.ResultsAmong veterans, 35.5% of men and 8.5% of women reported having used digital social media to meet someone for sex. Individuals who reported having used digital social media to find sexual partners (DSMSP+) as compared to those who did not (DSMSP-) were more likely to be young, male, and in the Marine Corps. After adjusting for sociodemographic variables, DSMSP+ status was associated with post-traumatic stress disorder (OR = 2.26, p = 0.01), insomnia (OR = 1.99, p = 0.02), depression (OR = 1.95, p = 0.03), hypersexuality (OR = 6.16, p < 0.001), suicidal ideation (OR = 3.24, p = 0.04), and treatment for an STI (OR = 1.98, p = 0.04).ConclusionAmong US post-deployment military veterans, DSMSP+ behaviors were prevalent, particularly among men. The association between DSMSP+ behaviors and PTSD, insomnia, depression, hypersexuality, suicidal ideation, and STIs suggest that veterans who engage in DSMSP+ behaviors should be particularly thoroughly screened and evaluated for these psychiatric concerns and counseled on the benefits of safe sexual practices.     

Nicotine dependence and self-esteem in adolescents with mental disorders

Recent studies in adolescents have found a weak association between lower self-esteem and smoking. However, this association has not been investigated in a psychiatric setting.In 223 inpatient adolescents [140 girls (16.5 years) and 83 boys (16.4 years)], self-esteem was measured with Coopersmith's self-esteem inventory (SEI), and smoking dependence with the Fagerström Test for Nicotine Dependence (FTND). DSM-IV categories included major depression (n = 35), anxiety disorders (n = 35), psychotic disorders (n = 31), eating disorders (n = 9), and conduct disorders (n = 113). There were 101 smokers and 122 nonsmokers.Self-esteem scores were lower in smokers than in nonsmokers (p = 0.039). Self-esteem scores were very significantly lower in smokers showing moderate or high nicotine dependence (i.e., FTND score ≥ 4) when compared with nonsmokers (p = 0.002). Smoking with moderate or high nicotine dependence was associated with lower self-esteem in both girls and boys, whereas smoking with no or low nicotine dependence was associated with lower self-esteem only in girls. Smoking was associated with lower self-esteem in all diagnostic categories, except in eating disorders.Interventions targeted on self-esteem might be used to prevent smoking in adolescents with mental disorders.     

Development and initial testing of the brief adolescent smoking curiosity scale (ASCOS)

BackgroundAlthough the reasons behind tobacco smoking at young age are complex, research has identified curiosity as a potent driver of smoking among adolescents.ObjectiveThe objective of the current study is to develop and provide initial evidence of reliability and validity of a short scale assessing smoking curiosity among adolescents (first measure of its kind). In particular, we developed and tested the adolescent smoking curiosity scale (ASCOS).MethodsAfter scale development, 101 adolescents completed a survey on smoking-related measures, including ASCOS (June to August 2014). We conducted exploratory factor analysis and Cronbach's alpha calculation to inspect factor-structure and reliability. We conducted multiple linear regression models to examine the scale's capacity to predict antecedents of smoking initiation.ResultsFactor analysis supported a single-factor structure of smoking curiosity. ASCOS was internally reliable (Cronbach's alpha = 0.83). Controlling for demographics, the measure correlated significantly with temptation to try smoking (β = 0.41, p < 0.01), number of friends who smoke (β = 0.27, p < 0.01), agreeing with the pros of smoking (β = 0.41, p < 0.001), sensation seeking (β = 0.21, p < 0.05), and depression (β = 0.23, p < 0.01). When controlling for a single-item measure for smoking curiosity, ASCOS significantly predicted susceptibility to smoke cigarettes (OR = 3.40, p < 0.05) and cigars (OR = 6.66, p < 0.01).ConclusionsASCOS presented good psychometric properties and passed initial validity-testing through associations with antecedents of smoking. ASCOS was a better predictor of susceptibility to smoke than did a traditional single-item measure used by previous research. As an implication, ASCOS can be crucial to the development of tailored interventions for smoking prevention that can reduce smoking curiosity.     

Is smokeless tobacco use becoming more common among U.S. male smokers? Trends in Alaska

IntroductionThe tobacco industry has promoted the use of smokeless tobacco (SLT) to smokers as a substitution for cigarettes when smoking is not possible, and some smokers are using SLT this way. However, few publications have examined recent trends in dual cigarette and SLT use (dual use) over time in the U.S.Materials and methodsWe examined trends in the use of SLT among current, former and never cigarette smokers using data on adult (aged 18+ years) males (n = 16,590) from the 1996–2008 Alaska Behavioral Risk Factor Surveillance System (BRFSS). We also examined trends from 2004 to 2008 in cigarette consumption among dual users.ResultsBetween 1996 and 2008, the overall prevalence of current SLT use and prevalence of current smoking among Alaskan men did not significantly change over time (p-value from age-adjusted models p = .63, p = .09, respectively). When we examined trends in SLT use by smoking status, we found that the prevalence of current SLT use remained unchanged between 1996 and 2008 among former and never smokers, but almost doubled among current smokers (age-adjusted p = .004). Between 2004 and 2008, cigarette consumption remained steady among current smokers who did not use SLT, but significantly decreased among dual users (age-adjusted p < .001).ConclusionsOur findings suggest that male smokers in Alaska are increasingly likely to use SLT, but do not appear to be switching to SLT use exclusively. We recommend that other state tobacco control programs examine trends in dual use to confirm our findings, and for programs to continue encouraging cessation of all tobacco products.     

Get with the program: Adherence to a smartphone app for smoking cessation

IntroductionAlthough engagement is generally predictive of positive outcomes in technology-based behavioral change interventions, engagement measures remain largely atheoretical and lack treatment-specificity. This study examines the extent to which adherence measures based on the underlying behavioral change theory of an Acceptance and Commitment Therapy (ACT) app for smoking cessation predict smoking outcomes, and user characteristics associated with adherence.MethodsStudy sample was adult daily smokers in a single arm pilot study (n = 84). Using the app's log file data, we examined measures of adherence to four key components of the ACT behavior change model as predictors of smoking cessation and reduction. We also examined baseline user characteristics associated with adherence measures that predict smoking cessation.ResultsFully adherent users (24%) were over four times more likely to quit smoking (OR = 4.45; 95% CI = 1.13, 17.45; p = 0.032). Both an increase in tracking the number of urges passed (OR = 1.02; 95% CI = 1.00, 1.03; p = 0.043) and ACT modules completed (OR = 1.27; 95% CI = 1.01, 1.60; p = 0.042) predicted cessation. Lower baseline acceptance of cravings was associated with over four times higher odds of full adherence (OR = 4.59; 95% CI = 1.35, 15.54; p = 0.014).ConclusionsFull adherence and use of specific ACT theory-based components of the app predicted quitting. Consistent with ACT theory, users with low acceptance were most likely to adhere to the app. Further research is needed on ways to promote app engagement.     

Awareness of legal blood alcohol concentration limits amongst respondents of a national roadside survey for alcohol and traffic behaviours in Brazil

BackgroundIn Brazil the legal blood alcohol content (BAC) allowed for driving was changed to zero in 2008. If the BAC found is above 0.6 g/L, drivers may be arrested. However, there are limited data on drivers’ awareness of such limits.MethodsDrivers from 27 major metropolitan areas (n = 3397) were randomly asked to participate in roadside survey from 12 a.m. to 12 p.m. on Fridays and Saturdays. They were breathalized by highway patrol officers, and after consent interviewers collected data on drinking behaviours, knowledge about the law, and breath tests results.ResultsThe mean age was 37.3 ± 11.3 years; 94.3% were male and 26.5% had some college education. When asked about the BAC that could result in arrest, 34.5% of the subjects claimed to know it. However, only 23.5% (8.1% of the total sample) provided correct answers. Factors associated with the right answers were: male gender (p = 0.04; OR = 2.08; CI = 1.01–4.27); higher education (p < 0.0001); negative BAC or self-report of driving under the influence (DUI) (p = 0.02); higher family income (p = 0.01) and non-professional driving (p = 0.041). Age was not statistically different between groups. After multivariate analysis, male gender (p = 0.002), higher education (p < 0.0001) and negative BAC or DUI (p = 0.046) remained in the model.ConclusionsThe knowledge that BAC levels over 0.6 g/L may result in arrest is sparse amongst Brazilian drivers, notably amongst women, the less educated and those who drink and drive. Educational programmes targeted at those specific groups may be necessary in order to increase awareness about the legal BAC limit and its consequences.     

Impact of self-initiated pre-quit smoking reduction on cessation rates: results of a clinical trial of smoking cessation among female prisoners

ObjectivesThis study examined differences in cessation success based on smokers' self-initiated pre-quit reductions in cigarettes per day (cpd).MethodsThe study utilized data from a nicotine replacement + behavioral therapy smoking cessation intervention conducted in a female prison facility with 179 participants who were wait-listed for 6 months prior to intervention. We compared two groups of smokers based on whether they self-selected to reduce smoking prior to their cessation attempt (n = 77) or whether they increased smoking or did not reduce (n = 102). General Estimating Equations (GEE) were used to model smoking cessation through 12-month follow-up.ResultsExamination of pre-cessation cpd showed that those who reduced were heavier smokers at baseline, relative to those who did not reduce (p < 0.001). By the week prior to the quit attempt (week 3) heavier smokers at baseline smoked significantly fewer cigarettes (p < 0.001) and had lower CO levels (p < 0.05) compared to baseline lighter smokers. GEE analyses showed that individuals who reduced prior to their quit attempt had significantly higher quit rates during early treatment but these gains were not sustained by follow-up points.ConclusionsParticipant-initiated pre-cessation smoking reduction may be initially helpful in preparing to quit smoking, or may serve as a marker for participant motivation to quit smoking, but these differences do not sustain over time. More intensive interventions are still needed for successful cessation.     

Effects of alcohol and cigarette use on the initiation,reinitiation, and persistence of cannabis use from adolescence to emerging adulthood

ObjectiveAdolescent cannabis use has been associated with several negative outcomes. A previous study on an adult sample found alcohol and cigarette use to be associated with three cannabis use stages: initiation, reinitiation, and persistence, which represent distinct periods of use regarding progression and severity. Yet, the risk factors associated with these important stages have never been examined in a longitudinal study spanning adolescence to emerging adulthood.MethodsUsing longitudinal data from Add Health Waves 1–3, 1775 nonusers, 200 prior users, and 384 current users of cannabis were identified who were at risk of cannabis use initiation, reinitiation, and persistence, respectively. Three logistic regressions were conducted to examine the effects of prior cigarette and alcohol use on the three cannabis use stages, controlling for sociodemographic factors.ResultsEarly onset of cigarette use (OR = 2.04, p = 0.006) and higher alcohol use frequency (OR = 1.40, p < 0.001) were associated with cannabis use initiation. Greater cigarette use quantity was associated with a lower likelihood of reinitiation of cannabis use (OR = 0.58, p = 0.02). Increased cannabis use frequency (OR = 1.72, p = 0.006) and higher alcohol use frequency (OR = 1.32, p = 0.048) were associated with persistence of cannabis use. Sociodemographic factors such as household income, sex, and being older adolescents were associated with different cannabis use stages.ConclusionsPrior cigarette and alcohol use affect the risk of initiation, reinitiation, and persistence of cannabis use. The specific risk factors vary across different cannabis use stages. Interventions to prevent adolescent cannabis use should recognize these different risk factors and tailor to the stages of cannabis use.     

Peer drug use and adolescent polysubstance use: Do parenting and school factors moderate this association?

AimsThis study examined the association between peer drug use and adolescent polysubstance use, and investigated if this association was moderated by parenting and/or school factors.MethodsThe sample consisted of 9966 participants (mean age = 14.3; 49.34% males) randomly selected from secondary schools in Victoria, Australia. Three 30-day polysubstance use profiles were derived from latent class analysis – no drug use (47.7%), mainly alcohol use (44.1%) and polysubstance use (8.2%). These profiles were then regressed on peer's drug use, family conflict, parental monitoring, parental disapproval of drug use, school commitment, reward for prosocial involvement in school and academic failure, and the interactions between peer's drug use and each of the parenting and school variables.ResultsRelative to non-users, peer's drug use was strongly associated with polysubstance use (OR = 30.91, p < 0.001), and this association was moderated by parental disapproval of drug use (OR = 0.46, p < 0.001). This indicated that high level of parental disapproval may mitigate the negative influence of drug using peers. School commitment and parental monitoring were significantly associated with reduced likelihood of polysubstance use (p < 0.05), but they did not moderate the relationship between peer drug use and adolescent polysubstance use. All analyses were adjusted for key demographic factors such as age, gender, areas of residence, birth place and family affluence.ConclusionReinforcing parent disapproval of drug use may be an important strategy in reducing adolescent substance use. Parents may need to be more integrated into mainstream prevention programs.     

Pulmonary function in cannabis users: Support for a clinical trial of the vaporizer

BackgroundDebates about cannabis policy often mention respiratory symptoms as a negative consequence of use. The cannabis vaporizer, a machine that heats the plant to release cannabinoids in a mist without smoke and other respiratory irritants, appears to have the potential to minimize respiratory complaints.MethodsTwenty frequent cannabis users (uninterested in treatment) reporting at least two respiratory symptoms completed subjective ratings of respiratory symptoms and spirometry measures prior to and following 1 month's use of a cannabis vaporizer in a pre/post-design. Outcome measures included self-reported severity of nine respiratory symptoms as well as spirometry measures, including the maximum amount of air exhaled in 1 s (forced expiratory volume; FEV1) and maximum total lung volume (forced vital capacity; FVC).ResultsThe 12 participants who did not develop a respiratory illness during the trial significantly improved respiratory symptoms (t(11) = 6.22, p = 0.000065, d = 3.75) and FVC, t(11) = 2.90, p = 0.007, d = 1.75. FEV1 improved but not significantly t(11) = 1.77, p = 0.053, d = 1.07.ConclusionsThese preliminary data reveal meaningful improvements in respiratory function, suggesting that a randomized clinical trial of the cannabis vaporizer is warranted. The vaporizer has potential for the administration of medical cannabis and as a harm reduction technique.     

Prevalence and correlates of a lifetime cannabis use disorder among pregnant former tobacco smokers

BackgroundFollowing tobacco and alcohol, cannabis is the most commonly used substance during pregnancy. Given the high prevalence of concurrent cannabis and tobacco use as well as the health consequences associated with prenatal substance use, we sought to document the relative contributions of psychosocial and psychiatric factors commonly associated with cannabis use in predicting a lifetime cannabis use disorder (CUD) among women who had quit smoking tobacco as a result of pregnancy.MethodsPregnant former tobacco smokers (n = 273) enrolled in a larger randomized controlled trial for postpartum tobacco relapse prevention completed semi-structured psychiatric interviews and self-reported demographic, pregnancy, health, psychosocial, and tobacco use factors during their third trimester of pregnancy.ResultsIn total, 14% (n = 38) of women met criteria for a lifetime CUD. The strongest predictors of a lifetime CUD were a history of having multiple psychiatric disorders (OR = 36.44; 95% CI = 5.03–264.27; p < 0.001) followed by a lifetime alcohol use disorder (OR = 3.54; 95% CI = 1.27–9.87; p < 0.05). In addition, more frequent attempts to quit smoking tobacco (OR = 1.12; 95% CI = 1.01–1.25; p < 0.05) and lower self-efficacy about weight management after quitting smoking tobacco (OR = 0.78; 95% CI = 0.62–0.97; p < 0.05) also were significantly associated with a lifetime CUD.ConclusionsWomen with a history of both cannabis and tobacco dependence may represent a subset of women who need more specialized treatment during the perinatal period to improve substance use outcomes.     

Significance of genetic polymorphism of CYP2D6 in the pathogenesis of systemic sclerosis

BackgroundSystemic sclerosis (SSc) belongs to the group of systemic diseases of the connective tissue, which are characterized by a chronic autoimmune inflammatory process. The studies on etiopathogenesis of autoimmune diseases focus on the impact the genetically conditioned impairment of xenobiotic metabolism may exert. The genetically polymorphic CYP2D6 is one of the most important phase I drug metabolizing enzymes. The knowledge of oxidation polymorphism in the course of SSc may be helpful in choosing more efficient and safer therapy, particularly in the case of a disease involving various organs and treated with drugs belonging to diverse therapeutic groups. The aim of the study was to evaluate the CYP2D6 polymorphism in the SSc patients and to investigate a possible correlation with disease susceptibility.MethodsThe study was carried out in 77 patients with SSc and 129 healthy volunteers. The CYP2D6 genotypes were analyzed by polymerase chain reaction fragment length polymorphism (PCR-RFLP) method.ResultsRisk of SSc development for particular genotype carriers expressed by the odds ratio (OR) was statistically significantly higher for subjects with CYP2D6*1/CYP2D6*4 (OR = 3.2; p = 0.001). A statistically significant correlation between the CYP2D6*4 allele prevalence and the risk for developing SSc was found (OR = 1.6; p = 0.029).ConclusionsThe obtained results may suggest the influence of CYP2D6*4 gene mutated alleles on increased incidence of systemic sclerosis.     

Participants' sports characteristics related to heavy episodic drinking among French students

BackgroundThe relationships between involvement in sports and alcohol consumption appear to be complex in the alcohol literature. In this study we aimed to examine this link among French students, taking into account their sports characteristics. We also examined variations in alcohol use among sport sciences students between 2002 and 2006, and the difference in alcohol use and heavy episodic drinking among sport sciences, law and pharmacy students.MethodDesign: repeated survey; cross-sectional study; Setting: self-questionnaire survey; Participants: French (south-east France) sport sciences (n = 693), law (n = 325) and pharmacy (n = 338) students (females = 58%).ResultsIn 2002, 38% of the male sport sciences students reported repeated heavy episodic drinking, and this proportion has risen to 48% in 2006 (p < 0.05). When compared to law and pharmacy students, female and male sport sciences students were less likely to report repeated heavy episodic drinking (p < 0.05). Engaging in physical activity (whether or not it takes place within an institution) and practising martial art were negatively related to heavy episodic drinking (p < 0.05). Other factors related to heavy episodic drinking were gender-specific: among males, practising sport in a formal context, team sports, and competitive participation at a departmental or regional level represented risk factors (p < 0.05), while practising an individual sport was a protective factor among females (p < 0.05).ConclusionThis study corroborated the importance to take into account the context of practice and the type of sport practised to examine the link between sport participation and alcohol consumption. The normative context of peer socialization among competitive and team sports participants seemed to play a role in alcohol use. Further studies are needed to confirm the role of this putative factor.     

Prevalence of long QTc interval in methadone maintenance patients

BackgroundThere is a concern about cardiac rhythm disorders related to QTc interval prolongation induced by methadone. A cross-sectional study was designed to evaluate the prevalence of long QTc (LQTc) interval in patients in methadone maintenance treatment (MMT) and risk factors for LQTc.MethodsThe study population included 109 subjects (74 males, median age 43 years). Socio-demographic and toxicological variables were recorded, as well as concomitant use of drugs related with QT prolongation, history of heart diseases, and corrected QT interval by heart rate (QTc) in the ECG. Plasma concentrations of (R)-methadone and (S)-methadone enantiomers were determined in 69 subjects.ResultsTen patients (9.2%) presented a QTc above 440 ms but a QTc above 500 ms was observed in only 2 (1.8%). Patients with QTc above 440 ms compared with the remaining subjects were older (median [25th–75th percentile range]: 49 [39–56] years vs. 37 [33–43]; Wilcoxon's W = 217.5, p = 0.002) and took a higher daily dose of methadone (median [25th–75th percentile range]: 120 [66–228] mg/day vs. 60 [40–110] mg/day; W = 298.5, p = 0.037). Methadone dose correlated with QTc interval (Pearson's r² = 0.291, p = 0.002). Patients with and without long QTc showed no differences in plasma concentrations of (R)-methadone and (S)-methadone enantiomers.ConclusionsThe prevalence of LQTc was 9.2%. An association between LQTc and methadone doses was observed but the relationship with plasma concentrations of methadone enantiomers is unclear.