Biomedical subjects
Publications and source records attributed to R E Bliss.
In conclusion, we found no evidence of any reduction in blood pressure with greater smoking exposure. For smokers allowed to smoke in a natural manner before blood pressure assessment, greater smoking exposure indexed by saliva cotinine concentration is associated with higher systolic blood pressure levels.
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Heart rate slows immediately after smoking cessation but it is unclear whether this is a permanent or transient effect. Examining this issue may improve our understanding of nicotine withdrawal effects. A transient heart rate pattern would suggest that the cardiovascular system adapts chronically to nicotine and requires a period of adjustment to achieve a new homeostasis after cessation. Heart rate was assessed on 110 smokers prior to quitting and at 1, 3, 8, 15, 30, 45, and 60 days post-cessation. For 12 subjects abstinent 60 days, heart rate slowed at day 1 by 8.1 bpm. Heart rate remained below baseline from days 1 through 45, although exhibiting partial recovery, and returned fully to baseline at day 60. The results indicate that heart rate exhibits a pattern of transient change after smoking cessation which seems to be a physiological effect of nicotine withdrawal.
We followed 235 adults for one year after a self-initiated attempt to stop smoking cigarettes. Relapse rates were much larger than expected in the early days and weeks after the quit attempt. Approximately 62% had relapsed by 2 weeks after their quit dates. Those who smoked any cigarettes at all in the post-cessation period (i.e., lapsed) had a 95% probability of resuming their regular pattern of smoking subsequently. Shorter periods of abstinence on prior quit attempts, greater pre-cessation consumption of alcoholic beverages, and lower pre-cessation levels of confidence in quitting were related to relapse. In addition, abstainers who reported decreased confidence after cessation concerning their ability to maintain abstinence were more likely to relapse thereafter. The presence of a greater proportion of smokers in the subjects' environment also increased the likelihood of relapse. Demographic variables such as age, gender, and education level did not predict relapse. Likewise, neither baseline psychosocial stress levels, nor post-cessation increases in stress were related prospectively to relapse. Clinical implications of finding are discussed.
Excretion levels of norepinephrine, epinephrine, and dopamine were assessed in 17 habitual cigarette smokers while smoking and periodically during 30 days of abstinence to determine whether a pattern of transient change existed, suggestive of sympathetic nervous system (SNS) involvement in tobacco withdrawal. Excretion of all three catecholamines declined 1 day after abstinence but did not return to precessation levels during the rest of the follow-up period. The results suggest that postcessation declines in excretion may be permanent changes caused by loss of tobacco's agonist effects, rather than transient withdrawal phenomena resulting from SNS adaptation to the stimulatory effects of tobacco.
Examines the influence of situational characteristics and coping on the outcome of a relapse crisis for 232 Ss followed for 1 month after a self-initiated smoking cessation attempt. Survival of a relapse crisis was most strongly related to the number of coping strategies used. All coping strategies were equally effective; furthermore, combining cognitive and behavioral coping strategies was not more effective than using multiple cognitive or multiple behavioral strategies. During the second half of the follow-up period (Weeks 3 and 4 postcessation), the presence of smokers resulted in a decreased likelihood of coping and an increased likelihood of smoking. In addition, active coping was marginally related to higher baseline levels of motivation to quit. When motivation and the presence of smokers were controlled, however, coping still significantly predicted outcome. Results are discussed with reference to previous relapse studies.
The purpose of this paper is to present a comprehensive review of the literature on SCN in order to illustrate the methodological issues involved in using biochemical indices of behavior. We discuss issues related to the sensitivity, specificity, predictive value, and reportedly long half-life of SCN. We also briefly discuss how these issues relate to other biochemical indices of smoking. We conclude with suggestions for improving the measurement of smoking status.
There is conflicting evidence concerning gender differences in success at quitting smoking. Information is especially lacking regarding gender differences among unaided quitters who make up the vast majority of those attempting to quit. One hundred thirty-five smokers who made an unaided attempt at quitting were interviewed before quitting and were followed for 1 year after cessation. Relapse rates were extremely high both for men and women, with 62% of participants returning to regular smoking within 15 days after cessation. Women and men were equally likely to maintain short-term abstinence (through 15 days), but women were more than three times as likely to relapse subsequently. Nine percent of men, but no women, had biochemically verified sustained abstinence throughout the 1-year follow-up period. For both men and women, any smoking after the quit attempt inevitably led to full-blown relapse. Most participants resumed regular smoking within 24 hours after the first episode of smoking. Gender differences were observed for several variables related to smoking history, demographics, social support, perceived stress, and motivational factors, but these differences did not explain the increased risk of relapse for women. Our results clearly indicate that women are less likely than men to maintain long-term smoking abstinence following an unaided quit attempt, but reasons for this gender difference need further exploration.