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Biomedical subjects

Christi A Patten

Publications and source records attributed to Christi A Patten.

At least 19 recordsLinked to original sources
PubMed2006

Randomized clinical trial of an Internet-based versus brief office intervention for adolescent smoking cessation.

OBJECTIVE: Evaluation of novel treatment delivery methods, such as the Internet are notably absent from the adolescent smoking treatment literature. METHODS: Adolescent smokers ages 11-18 years were randomized to a clinic-based, brief office intervention (BOI; N=69) consisting of four individual counseling sessions; or to Stomp Out Smokes (SOS), an Internet, home-based intervention (N=70). Adolescents in SOS had access to the SOS site for 24 weeks. RESULTS: The 30-day, point-prevalence smoking abstinence rates for BOI and SOS were 12% versus 6% at week 24 and 13% versus 6% at week 36, with no significant treatment differences. Among participants who continued to smoke, SOS was associated with a significantly greater reduction in average number of days smoked than BOI (P=0.006). The BOI was found to be feasible with high session attendance rates. SOS participants accessed the site a mean+/-S.D. of 6.8+/-7.1 days. SOS use dropped to less than one-third of participants by week 3. CONCLUSION: Additional research is needed to tap the potential capabilities of the Internet for adolescent smoking cessation using proactive, personalized, patient-education components. PRACTICE IMPLICATIONS: Augmenting the SOS type of intervention with more structured, personal and proactive patient-education components delivered in-person or by telephone or electronic mail is recommended.

Adolescent↗
PubMed2006

Reported distress associated with concern about a cigarette smoker.

It is well documented that concerned others of alcohol abusers report distress associated with the substance user's behavior. No previous study has examined distress associated with concern for someone who smokes cigarettes. To investigate this association, college students, ages 18-24 (N=1719), completed a survey assessing whether or not they were close to someone who smokes whom they thought should quit and the level of distress they experienced regarding this person's smoking. 827 (48.1%) respondents endorsed knowing a smoker whom they thought should quit and 60% reported experiencing at least some distress regarding this person's smoking. From multivariate analysis, the presence of distress (any vs. none) was associated with female gender (OR=1.8, 95% C.I. 1.2, 2.5, p=0.001), never tobacco user (OR=2.0, 95% C.I. 1.4, 2.9, p<0.001), and elevated Perceived Stress Scale score (OR=1.05, 95% C.I. 1.02, 1.08, p<0.001, per 1 unit increase in PSS score). These findings contribute to our understanding of how smoking impacts the psychological well being of another and is intended to stimulate future research investigating the potential for distressed individuals to serve as change agents in tobacco control efforts.

Adolescent↗
PubMed2006

The Fagerström Test for Nicotine Dependence-Smokeless Tobacco (FTND-ST).

Few nicotine dependence measures have been developed for smokeless tobacco (ST) users. Existing measures are limited by the requirement to rate the nicotine content of ST brands for which data is scarce or non-existent. We modified the Fagerström Test for Nicotine Dependence (FTND) for ST users, referred to this scale as the FTND-ST, and evaluated its characteristics in a population of 42 ST users. The correlation between the FTND-ST total score and the serum cotinine concentrations was 0.53 (p<0.001). Internal consistency reliability assessed using the coefficient alpha was 0.47. Correlations and the coefficient alpha are similar to those reported for commonly used nicotine dependence measures. Development and refinement of nicotine dependence measures for ST users are essential steps in order to advance the field of ST research.

Adult↗
PubMed2006

Measuring nicotine dependence among smokeless tobacco users.

The objective of this study was to assess the concurrent validity of the FTQ-ST and the DIS-IV diagnosis of nicotine dependence among 68 adult ST users enrolled in a randomized, controlled clinical trial of bupropion SR. FTQ-ST scores were not found to differ between those with and without a current DIS-IV diagnosis of nicotine dependence (7.4+/-2.1 vs. 6.8+/-2.8, P=0.325). For all possible FTQ-ST cutoff scores, the observed agreement between the FTQ-ST and the DIS-IV was not found to be different from that expected due to chance. FTQ-ST total scores were positively correlated with serum cotinine (Spearman's r=0.40, P<0.001), amount of tobacco used (r=0.51 and r=0.41 for average dips/chews per day; average tins/pouches per week, respectively, P<0.001), and a reduced likelihood of abstinence at 3 months (OR=0.76, 95% C.I. 0.61-0.96; P=0.019). Participants meeting DIS-IV criteria had lower cotinine concentrations than those without this diagnosis (411+/-263 ng/ml vs. 493+/-246 ng/ml; P=0.042). Poor concordance was observed between the FTQ-ST and the DIS-IV in the assessment of nicotine dependence in ST users.

Adult↗
PubMed2006

Characteristics of six-month tobacco use outcomes of Black patients seeking smoking cessation intervention.

Although Blacks experience disproportionately greater morbidity and mortality attributable to smoking than other racially-classified social groups, few studies have examined the impact of clinical interventions for nicotine dependence within this population. The main objective of this study was to examine 6-month outcomes among 146 self-identified adult Black patients who received an individually-tailored nicotine dependence intervention in an academic medical setting. Measures included a baseline demographic questionnaire and telephone follow-up to obtain self-reported 6-month tobacco use status. Univariate analysis was performed to assess the association of baseline patient characteristics with tobacco abstinence at 6 months following the clinic intervention. Of the 146 patients, 83% were seen in an outpatient clinic setting, while 17% were seen as inpatients in the hospital. At baseline, 53% reported smoking an average of 20 or more cigarettes per day, 32% were highly nicotine dependent, and 53% were in the preparation or action stage of change. Six months following the intervention, the 7-day point-prevalence tobacco abstinence rate was 43/146 (29%; 95% C.I. 22% to 37%). An individualized nicotine dependence intervention conducted in an academic medical setting yielded encouraging abstinence rates for Black smokers.

Academic Medical Centers↗
PubMed2005

The prevalence of weight concerns in a smoking abstinence clinical trial.

Recent research has demonstrated there is a high prevalence of weight concerns in smokers and that smokers with weight concerns may respond poorly to treatment for tobacco dependence. Most studies have focused only on females or have consisted of small samples. In this study of a 12-week randomized trial of nicotine inhaler, bupropion or both for smoking cessation, 50% of the 1012 female smokers and 26% of the 680 male smokers, at study entry, were weight concerned. In examining the impact of weight concerns on the 12-week point-prevalence smoking abstinence, 26% of non-weight-concerned smokers quit smoking compared to 22% of weight-concerned smokers (p=0.06). This study, which includes a large sample of both genders, provides further evidence that approximately half of females who are seeking smoking cessation treatment are weight concerned and that one quarter of male smokers are weight concerned. Additionally, being weight concerned may impact the short-term success rates of stopping smoking using pharmacotherapy.

Adult↗
PubMed2005

Nicotine dependence treatment: perceived health status improvement with 1-year continuous smoking abstinence.

BACKGROUND: This study evaluated change in health status as a function of change in smoking status among patients treated clinically for nicotine dependence by comparing overall perceived health status of patients who abstained from cigarettes for 1 year versus those who smoked continuously for 1 year. METHODS: Patients from the Mayo Clinic Nicotine Dependence Center completed a quality-of-life questionnaire (SF-36) following their consultation for nicotine dependence (baseline). At 1 year post-intervention, patients were mailed a follow-up survey that included the SF-36 and items assessing interval smoking history. Study patients included those who self-reported continuous smoking (n=60) and those reporting continuous smoking abstinence for the entire follow-up year (n=146). Data from SF-36 scales at 1 year were analysed using analysis of covariance with baseline scale scores serving as covariates along with baseline characteristics that differed significantly between groups. RESULTS: Compared with those who continued to smoke, patients who were continuously abstinent from smoking for the entire year had more improvement in perceived health status for the SF-36 mental composite scale (P=0.009) and for the SF-36 subscales for role limitations (P<0.001 and P=0.017 for emotional and physical role limitations, respectively), social functioning (P=0.010) and general health (P=0.013). CONCLUSIONS: Smokers treated for nicotine dependence who stop smoking for a year report more improvement in-quality-of-life compared with those who continue to smoke.

Adult↗
PubMed2005

Relation between smoking cessation and receiving results from three annual spiral chest computed tomography scans for lung carcinoma screening.

BACKGROUND: The relation between undergoing a single computed tomography (CT) screening for lung carcinoma and the potential long-term impact on smoking status has been equivocal. Perhaps, recommendations from multiple cancer screenings may promote smoking abstinence among individuals at high risk for lung carcinoma. METHODS: The current longitudinal study comprised 926 current smokers and 594 former smokers who participated in 3 annual follow-up low-dose, fast spiral chest CT scan screenings for lung carcinoma. Baseline demographic, pulmonary function, smoking history variables, and previous abnormal findings were evaluated as predictors of self-reported point prevalence smoking abstinence. RESULTS: Among current smokers at baseline, abstinence from smoking during the 3-year follow-up was associated with older age, worse baseline pulmonary function, and abnormal CT finding the previous year requiring interim follow-up. Of participants who received abnormal screens each of the previous 3 years, 41.9% reported smoking abstinence compared with 28.0% with 2 abnormal screens, 24.2% with 1 abnormal screen, and 19.8% with no abnormal screens. Among former smokers, abstinence from smoking was associated with a longer duration of abstinence before the baseline visit. CONCLUSIONS: Smokers with abnormal CT findings from multiple CT screens were more likely to be abstinent from smoking at the 3-year follow-up. Multiple low-dose, fast spiral chest CT scan screenings for lung carcinoma may represent teachable moments and opportunities to enhance motivation for smoking abstinence. Further research is needed to continue to investigate how annual screening may enhance motivation for health behavior change.

Age Factors↗
PubMed2005

Expressive writing intervention for young adult cigarette smokers.

This investigation examined the feasibility and magnitude of the effect of a stress management intervention involving expressive writing as an adjunct to brief office smoking cessation intervention for young adults. Participants aged 18-21 years were randomized to brief office intervention (N=30) or expressive writing plus brief office intervention (N=30). Biochemically confirmed 30-day point-prevalence tobacco abstinence, smoking reduction, perceived stress, negative affect, and treatment compliance were assessed at 4, 12, and 24 weeks post randomization. The expressive writing adjunct was not found to be effective. The 30-day smoking abstinence rates were 0% versus 0% ( p=1.000) at week 4, 20% versus 3% ( p=0.103) at week 12, and 20% versus 10% ( p=0.472) at week 24 for the brief office intervention only versus expressive writing plus brief office intervention groups, respectively. Participants stated they benefited most from the support and structure associated with the brief office intervention. Enthusiasm was lacking for the expressive writing treatment adjunct.

Adolescent↗
PubMed2005

Development and preliminary evaluation of a measure of support provided to a smoker among young adults.

Most studies indicate a positive association between social support and smoking cessation. However, clinic-based interventions to increase support for stopping smoking have had limited success. Prior research has emphasized the smoker's perceptions of support received for smoking cessation while less attention has focused on support persons' reports of supportive behaviors provided to a smoker. This study examined select psychometric properties of the Support Provided Measure (SPM), a self-report questionnaire designed by the investigative team to assess supportive behaviors provided to a smoker. The SPM was administered to a college sample (N=771; 67% female) of young adults, aged 18 to 24 years, who reported knowing a smoker whom they thought should quit smoking. Results indicate that, in this sample, the SPM has a two-factor structure with good internal consistency reliability (Cronbach's alpha=0.77) and appears to assess a wide range of individual differences in the provision of support. Demographic correlates associated with SPM scores are described and suggestions for future research are offered.

Adolescent↗
PubMed2005

Exploring the association of John Henry active coping and education on smoking behavior and nicotine dependence among Blacks in the USA.

Although smoking is used as a coping tool in response to stress and Blacks have been found to report smoking more in response to stress than Whites, little research exists that has examined ethno-culturally specific constructs of stress and coping as they relate to smoking behavior and nicotine dependence among Blacks in the USA. This study explored the association between the ethno-culturally interactively defined construct of John Henryism, as well as the individual contributions of John Henry active coping and education on smoking behavior and nicotine dependence in a relatively urban-Midwestern Black population. Self-identified Black patients (n = 146) who had previously received a clinical intervention for nicotine dependence were followed to assess smoking status and John Henry active coping. Results revealed that patients with low levels of education who had low levels of John Henry active coping reported higher nicotine dependence scores than any other education by John Henry active coping group. Furthermore, low levels of John Henry active coping were associated with the use of menthol cigarettes and lower-educational level was associated with smoking greater than 20 cigarettes per day. Further community-based studies examining this construct among Black smokers in various socio-cultural contexts are needed to clarify the association between John Henry active coping and socioeconomic status on smoking behavior and nicotine dependence among Blacks.

Adaptation, Psychological↗
PubMed2005

Iqmik--a form of smokeless tobacco used by pregnant Alaska natives: nicotine exposure in their neonates.

OBJECTIVE: To determine the concentration of nicotine and cotinine in maternal blood and neonatal cord blood among pregnant Alaska Native women and to assess the neonates for neurobehavioral effects. METHODS: In a nonrandomized, clinical observational pilot trial, 60 pregnant Alaska Native women were enrolled for assessment of Iqmik (a mixture of leaf tobacco and ash) and other tobacco use during pregnancy and at delivery. Neonatal cord blood, nicotine and cotinine concentrations were obtained, and neonatal neurobehavioral effects were assessed using the Lipsitz scale. RESULTS: At delivery, there were 22 subjects who reported using only Iqmik, and 10 who used other tobacco products. Subjects who reported using only Iqmik prior to delivery had higher concentrations of cotinine (167+/-116 vs. 81+/-100) in maternal blood (rank sum test, p=0.036) and higher concentrations of nicotine (8.4+/-7.3 vs. 4.4+/-5.1, p=0.048) and cotinine (153+/-115 vs. 70+/-95, p=0.048) in cord blood compared to subjects who reported using other tobacco products. Neurobehavioral signs as assessed by the Lipsitz score were increased in neonates born to mothers using only Iqmik (3.7+/-1.8, p=0.011), or to mothers using other tobacco products (3.4+/-1.4, p=0.034) compared to neonates born to women who reported no tobacco use (1.8+/-1.4). CONCLUSIONS: Mothers who use Iqmik and their neonates have higher cotinine concentrations compared to mothers who use cigarettes and/or other forms of tobacco. Neurobehavioral signs occur in neonates born to women who use Iqmik but also in neonates born to mothers who use other forms of tobacco during pregnancy.

Adult↗
PubMed2005

Revision of the Self-Administered Alcoholism Screening Test (SAAST-R): a pilot study.

The original Self-Administered Alcoholism Screening Test (SAAST; Swenson and Morse, 1975) is a self-report alcoholism screening measure intended for use with adult medical patients. However, the SAAST does not indicate the recency of alcohol use-related problems, not all items use the appropriate verb tense for assessing lifetime experience of alcohol use-related problems, many of the items contain out-dated language, and the diagnostic criteria for alcohol dependence and alcohol abuse are not fully represented. The SAAST was revised to address these issues. This paper describes the rationale for revision and the process through which the SAAST was revised. Preliminary information about comparability of the original SAAST and the revised version (SAAST-R) was obtained. Data are presented from two intervention trials for smokers in which both the SAAST and SAAST-R were administered. One sample was comprised of participants in recovery from alcoholism (N = 60; 82% male) and the other sample consisted of participants not meeting criteria for alcohol abuse or dependence within the previous year (N = 98; 45% male). The results suggest that the SAAST-R is highly correlated with the original SAAST, has a similar factor structure, good internal consistency, and correctly identifies those in recovery from alcoholism. Areas for refinement in the format and items of the SAAST-R were identified and suggestions for further validation studies are presented.

Adult↗
PubMed2005

Effect of nicotine replacement therapy on stress and smoking behavior in surgical patients.

BACKGROUND: Many surgical patients are dependent on nicotine. Smoke-free policies in healthcare facilities mandate abstinence from smoking, which could contribute to psychological stress in the perioperative period. The authors tested the hypothesis that nicotine replacement therapy decreases psychological stress in cigarette smokers scheduled to undergo elective surgery and determined whether nicotine replacement therapy affects postoperative smoking behavior, even when not specifically prescribed to promote abstinence. METHODS: In this double-blind, placebo-controlled trial, 121 smokers, of whom 116 received a study intervention, were randomly assigned to receive either active (nicotine-containing) or placebo patches, beginning on the morning of surgery and continuing for up to 30 days after discharge from the hospital. Outcomes included the Perceived Stress Score, the Nicotine Withdrawal Score, and subject self-report of smoking behavior. RESULTS: The Perceived Stress Score and the Nicotine Withdrawal Score did not change significantly from baseline over the immediate perioperative period and did not differ between active or placebo patch groups (all P > 0.19). The percentage of placebo versus active patch subjects reporting 7-day abstinence at 30 days postoperatively (30% vs. 39%; P = 0.29) did not differ significantly between groups. At 30 days postoperatively, subjects in both groups significantly reduced their cigarettes smoked per day from baseline, but those receiving active patches reported a greater decrease (a mean decrease of 11 +/- 11 vs. 15 +/- 7 cigarettes/day in placebo and active groups; P = 0.045). CONCLUSION: Routine nicotine replacement therapy is not indicated in smokers undergoing surgery for the purposes of managing nicotine withdrawal and stress but can modify some aspects of postoperative smoking behavior.

Adolescent↗
PubMed2005

Motivation for stopping tobacco use among emergency department patients.

OBJECTIVES: To determine the feasibility of new models for reinforcing tobacco-use-cessation interventions initiated in the emergency department (ED). The authors assessed the level of motivation to quit tobacco use among a general population of ED patients; the proportion who receive tobacco-use assessments, information, and interventions from ED providers; and the desired timing of tobacco-use interventions. METHODS: Face-to-face interviews with a convenience sample of 376 adult patients receiving care in the ED at the Mayo Clinic in Rochester, Minnesota. RESULTS: Of the 376 participants, 27% (100/376; 95% CI = 22% to 31%) currently used one or more forms of tobacco. Thirty percent (30/100; 95% CI = 21% to 40%) of tobacco users were in the preparation stage of change for tobacco cessation. The median score on the Contemplation Ladder was 6 (range: 0-10). Twenty-seven percent (27/100; 95% CI = 19% to 37%) of all tobacco users would have been interested in a tobacco-use treatment after the ED visit, such as telephone-based counseling. Of the current tobacco users either receiving or desiring a tobacco-use intervention, 74% (25/34; 95% CI = 56% to 87%) would be interested in receiving an intervention component after the ED visit. CONCLUSIONS: ED patients who use tobacco demonstrate motivation to quit and express interest in receiving interventions to assist them after the ED visit. Previous investigations have observed that ED patients do not attend interventions prescribed after the initial ED encounter. These findings suggest that the development of new models for reinforcing tobacco-use interventions initiated in the ED deserve exploration, such as linking them to a tobacco quitline.

Adult↗
PubMed2005

Treating nondepressed smokers with alcohol dependence in sustained full remission: nicotine patch therapy tailored to baseline serum cotinine.

OBJECTIVE: Studies of the efficacy of nicotine replacement therapy among alcoholic smokers have produced mixed findings. Our objective was to examine the smoking abstinence rate in smokers in sustained full remission from alcoholism (as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) who are receiving nicotine patch therapy with the dose tailored to the baseline serum cotinine concentration. METHOD: In this pharmacological relapse prevention study for 195 smokers with alcohol dependence in sustained full remission, the primary aim was to determine the 7-day point prevalence smoking abstinence rate at the end of 8 weeks of nicotine patch therapy in doses projected to achieve 100% venous replacement. Nicotine patch dose was based on the baseline serum venous cotinine as follows: (1) participants with < or = 200 ng/ml received a patch dose of 22 mg per day; (2) those with 201-300 ng/ml received a 33-mg dose per day, and (3) those with > 300 ng/ml received a 44-mg dose per day. A second (steady-state) serum cotinine concentration was obtained between weeks 2 and 7 to determine the percentage replacement. RESULTS: The point prevalence smoking abstinence rate at the end of the 8 weeks of nicotine patch treatment was 51% (95% confidence interval [CI]: 45%-58%) which is higher than would be expected, and percent replacement of > 80% was achieved in 49 of 85 (58%) tobacco-abstinent subjects. Higher cigarettes per day (odds ratio [OR] = 1.030, 95% CI: 1.004-1.057, p = .023) and a history of depressed mood on the Diagnostic Interview Schedule (OR = 1.940, 95% CI: 1.044-3.605, p = .036) were found to be multivariate independent predictors of smoking at week 8. However, percentage replacement did not predict smoking abstinence. CONCLUSION: We achieved > 80% replacement in most subjects, and there was no evidence of severe nicotine toxicity associated with the tailored dose of nicotine patch therapy.

Administration, Cutaneous↗
PubMed2004

Beliefs and attitudes regarding smoking among young adult Latinos: a pilot study.

BACKGROUND: Tobacco use interventions for young adult Latinos have not yet been developed. This qualitative pilot study employed semistructured interviews to assess beliefs and attitudes regarding tobacco use interventions among young adult Latinos. METHODS: The size of the individual or group interviews ranged from one to four participants each. Participants were 19 Latino adults (37% female), 18-24 years of age. The interviews were videotaped and transcribed for analysis of common themes. RESULTS: Use of tobacco in Latino cultures is most common among men, and most prevalent in social situations. Tobacco use is discouraged by and often hidden from elder family members. Participants acknowledged adverse health effects of tobacco use. Barriers to preventing and stopping tobacco use are its acceptance among peers and its use during social situations. Although some Latinos would like to quit, cultural barriers included lack of knowledge, unwillingness to ask for help, and perceived deficiency of Spanish language resources regarding tobacco dependence interventions. Participants lacked understanding of how research might benefit their cultural community. CONCLUSION: Cultural attitudes toward tobacco and perceived barriers to quitting will be useful in developing tobacco use interventions for Latinos.

Adolescent↗