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Biomedical subjects

L T Kozlowski

Publications and source records attributed to L T Kozlowski.

At least 55 records · Page 3Linked to original sources
PubMed1990

Alcohol or tobacco research versus alcohol and tobacco research.

Despite the frequent co-occurrence of tobacco and alcohol use, little is known about relationships between alcohol and nicotine. This paper reviews similarities and differences between tobacco and alcohol use, offers speculation about why a marriage of the two fields has been so long in coming, and discusses the multiple scientific and therapeutic benefits that could derive from the study of individuals who use both drugs.

Alcoholism↗
PubMed1990

Statistical control in research on alcohol and tobacco: an example from research on alcohol and mortality.

Many of the major studies of deaths related to alcohol use report evidence for a U-shaped relationship between mortality and consumption, with abstainers having higher mortality than moderate drinkers. Some have suggested that this indicates a protective effect of moderate drinking; others have argued that pre-existing health problems and demographic and lifestyle differences explain the finding. In this report, we present evidence that the U-shaped function is largely an artefact of inadequate controls for smoking and drinking intake and history. Never smoking abstainers die at about the same rate as never smoking moderate drinkers. We stress the importance of using precise measures of drug use history and drug use status and make the point that, given the strong interaction between smoking and drinking, controlling for smoking may produce misleading results.

Alcoholism↗
PubMed1989

Comparing tobacco cigarette dependence with other drug dependencies. Greater or equal 'difficulty quitting' and 'urges to use,' but less 'pleasure' from cigarettes.

About 1000 persons seeking treatment for alcohol or drug dependence were asked, relative to cigarettes, about the difficulty of quitting the use of the substance for which they were seeking treatment, the strength of their strongest urges to use, and the pleasure they derived from use. Fifty-seven percent said that cigarettes would be harder to quit using than their problem substance. These ratings were related to the level of cigarette dependence and the perceived difficulty of quitting the use of the problem substance. The alcohol-dependent persons were about four times more likely than the drug-dependent persons to say that their strongest urges for cigarettes were at least as great as their strongest urges for their problem substance. Cigarettes were generally rated as less pleasurable than alcohol or other drugs. Thus, experiential experts on dependence judge cigarette dependence as at least as "addictive" as other drug use, but not as pleasurable, indicating important similarities and differences between cigarette dependence and other forms of dependence on psychoactive substances.

Adult↗
PubMed1989

Self-selected blocking of vents on low-yield cigarettes.

Blockers of vents in ultra-low-yield cigarettes had higher levels of carbon monoxide (CO) and salivary cotinine than did nonblockers. None of the blockers reported that they blocked vents. Exposure differences seemed not to be due simply to vent blocking, but also to be the result of syndromes of heavier (blocking, more cigarettes per day, and starting earlier in the morning) or lighter smoking (not blocking, fewer cigarettes per day, and starting later in the morning). The results are interpreted in light of the boundary model. Cigarette smoking and brand selection should be studied as they occur naturally, as well as in experimentally contrived studies.

Adult↗
PubMed1989

"Cravings" are ambiguous: ask about urges or desires.

Despite the dictionary definition of "craving" (a strong desire), two studies indicate that a substantial percentage of persons with alcohol and drug problems use the word "craving" to mean any desire or urge, even a weak one, to use substances. Researchers and clinicians are advised to beware of this ambiguity of "craving" and to consider the conceptual status of "craving" in their work.

Adult↗
PubMed1989

Prospects for smoking treatment in individuals seeking treatment for alcohol and other drug problems.

Alcohol and drug using clients of the Addiction Research Foundation were asked about their interest in receiving treatment for cigarette smoking. Forty-six percent said that they were "moderately" to "very much" interested in attending a treatment program if it were available. Despite a consistent preference for receiving smoking treatment after their alcohol or drug problem was treated, there was moderate interest in receiving smoking treatment during the alcohol or drug treatment among those who were very interested in receiving smoking treatment in general. Seventy-one percent reported that it would be "as difficult" or "more difficult" to give up cigarettes than the drug or alcohol which brought them to the hospital for treatment. The importance of treating smoking in alcohol and drug using clients is discussed.

Adolescent↗
PubMed1989

Measuring the heaviness of smoking: using self-reported time to the first cigarette of the day and number of cigarettes smoked per day.

Two simple self-report measures have been used to assess the heaviness of smoking, 'number of cigarettes per day' (CPD) and 'time to the first cigarette of the day' (TTF). Little attention, however, has been given to the precise method of scoring this information. Using biochemical indicators of heaviness of smoking (alveolar carbon monoxide and cotinine), we explore the optimum data transformations for regression analysis and categorical analysis. We suggest a four category scoring scheme for both time to the first cigarette of the day (less than or equal to 5, 6-30, 31-60 and 61+ min) and average daily consumption of cigarettes (1-10, 11-20, 21-30, 31+ cigarettes) as the most powerful and practical categorical scoring of these variables. Due to possible ceiling effects on biochemical measures, we suggest using logarithmic transformations of CPD or TTF for regression or correlation analyses.

Adolescent↗
PubMed1989

Evidence for limits on the acceptability of lowest-tar cigarettes.

The sales of the lowest yield cigarettes (1-3 mg tar) seem to have been particularly resistant to the effects of promotion and advertising, while the sales of other low-yield cigarettes (4-9 mg tar) seem to have been increased by promotional efforts. This finding is consistent with the existence of a boundary of tar and nicotine acceptability below which consumers in general are not prepared to go. Use of lower tar cigarettes may be helpful for those who cannot stop smoking, but, since 1979, the percentage of cigarettes under 16 mg tar has changed little.

Advertising↗
PubMed1989

Reduction of tobacco health hazards in continuing users: individual behavioral and public health approaches.

For those smokers who will not stop using tobacco, methods are discussed for reducing the risks to health of continued tobacco use. Overall, tobacco users are encouraged to reduce their exposure to tobacco toxins as much as they can tolerate. The boundary model of nicotine regulation implies that it is practical to prevent so-called "needless" excesses of nicotine intake. For continuing smokers of cigarettes, fewer cigarettes per day and very-low-tar cigarettes are encouraged, provided filter-vents are not blocked by the smoker. Better yet would be a switch to smoking one or two non-inhaled pipes or cigars each day. Even better would be a switch to use of the minimum acceptable amount of smokeless tobacco or nicotine-containing gum. Of course, the best course would be abstinence from any form of tobacco or nicotine use. Since relatively few tobacco users voluntarily engage in substantially less hazardous ways of using tobacco, public health measures (e.g., social restrictions, differential taxation, changes in package size) may be the most important means of bringing about less hazardous tobacco use among continuing users.

Attitude to Health↗
PubMed1988

The importance of direct questions about inhalation and daily intake in the evaluation of pipe and cigar smokers.

Pipe and cigar smokers traditionally have been subdivided into primary (never regular cigarette) and secondary (ex-cigarette) smokers. This distinction is considered important because it is believed that former cigarette smokers who switch to pipes or cigars inhale their pipe or cigar smoke, whereas primary pipe and cigar smokers do not. In this study, it was found that self-reported inhalation more accurately predicted expired-air carbon monoxide levels than cigarette smoking history and, combined with self-reported per day consumption, could account for most instances of carbon monoxide levels above the non-smoker cut-off level of 8 parts per million. Thus, it is concluded that a primary/secondary distinction is less useful than a noninhaling/inhaling distinction in attempting to assess health risks associated with pipe and cigar smoking, and health-care providers and researchers should focus their attention on the more direct questions of inhalation and daily intake.

Breath Tests↗
PubMed1988

Prevalence of the misuse of ultra-low-tar cigarettes by blocking filter vents.

Evidence from tar-stain patterns in 135 cigarette filters discarded in ashtrays in public areas of shopping malls was used to estimate the prevalence of behaviorally blocked air dilution vents in ultra-low-yield cigarettes. Nineteen per cent (+/- 4, standard errors of the mean) of the filters had been blocked extremely, 39 per cent (+/- 5 SEM) had been blocked to some degree, and 42 per cent (+/- 5 SEM) had not been blocked at all. Smokers, health practitioners, and researchers need to be warned of the risks of vent blocking.

Behavior↗
PubMed1987

A second look at the effects of supportive follow-up on smoking cessation.

In 1982 a report in CMAJ (1982; 126: 127-129) indicated that the addition of supportive follow-up appointments in a family practice increased the 6-month cigarette abstinence rate from 12% to 23%. We reanalysed the data by means of recognized standards for treatment success and found little evidence that the treatment had any reliable effect on attempts to quit that lasted at least 3 months: 8.5% and 4.8% of the groups with and without supportive follow-up respectively abstained for more than 3 months. We discuss a problem of the experimental design (longer evaluative follow-up for the control group than for the treatment group) and cost-benefit issues.

Costs and Cost Analysis↗
PubMed1986

Influence of smoking fewer cigarettes on exposure to tar, nicotine, and carbon monoxide.

In the hope of reducing the adverse health consequences of smoking, physicians frequently advise their patients who cannot quit to smoke fewer cigarettes. Habitual smokers may compensate for the reduced number of cigarettes, however, by taking in more smoke per cigarette. We measured the intake of tar (estimated as mutagenic activity of the urine), nicotine, and carbon monoxide during short-term cigarette restriction. With a reduction from an average of 37 cigarettes to an average of 5 cigarettes per day, the intake of tobacco toxins per cigarette increased roughly threefold and daily exposure to tar and carbon monoxide declined only 50 percent. We conclude that smoking fewer cigarettes may reduce exposure to toxins and related adverse health consequences. However, consistent with a tendency to maintain intake of nicotine, the magnitude of the benefit is much less than expected. Whether "oversmoking" persists during long-term restriction of cigarettes requires further investigation.

Adult↗