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PubMed1994

Transdermal nicotine: reduction of smoking with minimal abuse liability.

Cigarette consumption as well as the physiologic, performance and subjective effects of the nicotine patch were evaluated in ten subjects who smoked ad libitum while residing on a residential research ward for 30 days. Nicotine transdermal systems ("patches") delivering a total of 0, 22 or 44 mg per 24 h were applied daily at a constant dose during each 7-day condition; the order of dosing conditions was varied according to a randomized, double-blind, crossover design. Nicotine patches significantly but modestly reduced spontaneous smoking and significantly increased venous plasma nicotine levels. Self ratings of patch liking, satisfaction with cigarettes and the ability to identify the patch condition did not change as a function of the nicotine dose, indicating minimal abuse liability. There were no consistent changes in the puffing pattern measures; however, in all patch conditions, subjects with extensive histories of illicit drug use smoked cigarettes faster than subjects with histories of occasional drug use. Small changes in resting heart rate, pulse and blood pressure occurred when the nicotine patch was worn. Thus large changes in venous plasma nicotine levels engender only modest changes in ad libitum cigarette consumption, measures of abuse liability and cardiovascular effects. These findings are consistent with the notion that the addictive and toxic effects of nicotine are partially determined by the rate of drug administration.

Administration, Cutaneous↗
PubMed1986

Children's sore throats related to parental smoking.

There has been concern that the smoking of tobacco can adversely affect the health of non-smokers. This is most cogent in children who are subject to smoke at home. The aim of this study is to relate children's sore throats to the smoking habits of their parents. The parents of 154 children were asked about the age, sex, birthweight, method of postnatal feeding and age at starting school or day nursery of the child, the frequency of sore throats, smoking habits and history of tonsillectomy of all members of the household, the size of family, the dwelling size, and the occupation of the father. Analysis by multiple regression showed a significant association between children's sore throats and maternal smoking. Reduction in domestic cigarette smoke exposure should benefit the child by reducing the number of sore throats he or she suffers.

Adolescent↗
PubMed2001

Smoking cessation or reduction in women attempting to conceive after ectopic pregnancy.

The relationship between smoking cessation or reduction and attempt to conceive was studied in 646 women treated for ectopic pregnancy (EP) (Auvergne register of EP, France). Women were prospectively followed. Tobacco consumption was recorded as the mean number of cigarettes smoked per day at the time of interview. Smoking reduction was defined as stopping smoking or decreasing tobacco consumption by at least 3 cigarettes per day. Statistical analysis was performed using conditional logistic regression. The results confirmed that women reduced tobacco consumption when they became pregnant. However, no association was found between smoking reduction and attempting to conceive again. These results suggest that both women and physicians need to be informed about the possible tobacco consumption effects of smoking on fertility.

Adolescent↗
PubMedDate not supplied

Effects of acupuncture on smoking cessation or reduction for motivated smokers.

BACKGROUND: This study was undertaken to examine the effects of acupuncture on smoking reduction and possibly also cessation and to examine whether some acupoints are more effective than others for smoking cessation. METHODS: A total of 46 healthy men and women, 39 +/- 9 years of age (mean +/- SD), who smoked 20 +/- 6 cigarettes per day and had smoked for 23 +/- 8 years, and who wanted to quit smoking, volunteered to participate. The subjects were randomly assigned to two groups. One group was given acupuncture treatment at points previously used for anti-smoking (test group, TG). The other group was given acupuncture treatment at points assumed to have no effect for smoking cessation (control group, CG). Before each treatment and after the last treatment each subject answered questionnaires about his or her smoking habits and attitudes. In addition the concentrations of serum cotinine, serum thiocyanate, serum peroxides, and plasma fibrinogen were measured before the first and after the last acupuncture treatment. RESULTS: The daily cigarette consumption fell during the treatment period in both groups, but the reduction was larger for TG than for CG (P < 0.002). Altogether 31% of subjects in TG had quit smoking completely at the end of the treatment, compared with none in CG. For TG the concentrations of cotinine and thiocyanate were reduced significantly after the treatment period (P < 0.001), but no significant reductions were observed for CG. For both groups the taste of tobacco worsened during the treatment period, but the effect was more pronounced for TG than for CG (P < 0.05). The desire to smoke fell significantly in both groups after treatment, and the reduction was larger for TG than for CG (P < 0.001). No significant changes in serum peroxides and plasma fibrinogen concentrations were observed during the treatment period for either group. CONCLUSIONS: This study suggests that acupuncture may help motivated smokers to reduce their smoking or even quit smoking completely. Different acupoints appear to have different effects for smoking cessation and reduction.

Acupuncture Therapy↗
PubMed1998

Depression and self-medication with nicotine: the modifying influence of the dopamine D4 receptor gene.

This study evaluated whether there are genetic subgroups of depressed individuals who are more or less predisposed to engage in self-medication smoking practices. Smokers (N = 231) completed self-report questionnaires of depression and smoking practices and were genotyped for the dopamine D4 receptor (DRD4) gene. A significant interaction (DRD4 Genotype x Depression) was found for stimulation smoking and negative-affect reduction smoking. Specifically, these smoking practices were significantly heightened in depressed smokers homozygous for the short alleles of DRD4 but not in those heterozygous or homozygous for the long alleles of DRD4. These preliminary results suggest that the rewarding effects of smoking and the beneficial effects of nicotine replacement therapy for depressed smokers may depend, in part, on genetic factors involved in dopamine transmission.

Adult↗
PubMed2003

Role of nicotine pharmacokinetics in nicotine addiction and nicotine replacement therapy: a review.

Smoking is a complex behaviour involving both pharmacological and psychological components. Nicotine is the main alkaloid found in tobacco, and is responsible for its addictive potential. Nicotine-positive effects on mood and cognition are strong reinforcements for smokers that contribute to their addiction, and cigarette smoking is particularly addictive because inhaled nicotine is absorbed through the pulmonary venous rather than the systemic venous system, and thus reaches the brain in 10-20 seconds. As the likelihood that a substance will be abused depends on the time between administration and central reinforcement, tobacco smoking can easily become addictive. Nicotine replacement therapy (NRT) is available in different forms (gum, transdermal patch, nasal spray, inhaler, sublingual tablet and lozenge), and has been shown to relieve withdrawal symptoms and to double abstinence rates compared to placebo. Most NRT forms deliver nicotine more slowly than smoking, and the increase in nicotine blood levels is more gradual. Compared to tobacco smoking or even tobacco chewing, few positive (reinforcing) effects are obtained from NRT use. Nasal spray provides faster withdrawal relief than other NRT, but compared to smoking absorption is slower and nicotine blood levels obtained are lower than with smoking. These differences in pharmacokinetic profiles compared with smoking may explain that some smokers still have difficulties quitting smoking even when using NRT (apart from psychological and/or social factors). Combination therapy (e.g., patch+gum, patch+inhaler), higher dosage, temporary abstinence or smoking reduction (using NRT to reduce smoke intake) may be needed to help more smokers to quit.

Affect↗
PubMed1996

Efficacy of dental health advice as an aid to reducing cigarette smoking.

Ninety-eight cigarette smokers attending the Newcastle upon Tyne Dental Hospital, wishing to reduce their tobacco consumption, received smoking reduction advice in combination with dental health instruction and periodontal care. Those advised against smoking showed a greater reduction (P < 0.001) in reported cigarette consumption during treatment and follow-up, compared with 38 control subjects who received dental health instruction but no advice against smoking. Fifty percent of intervention subjects reported reducing to half or less than half of their initial cigarette consumption, compared with 24% for controls. Eighty percent of those advised against smoking reported some reduction, against 29% for controls. The reported smoking cessation rate in the intervention group was 13.3%, compared with 5.3% in the control subjects. The results indicate that advice against smoking combined with dental health instruction and periodontal care can be an effective aid to reducing tobacco consumption.

Adolescent↗
PubMed1995

The relative effectiveness of a peer-led and adult-led smoking intervention program.

This study compared a six-session peer-led smoking intervention program for high school-age youth to the same program led by adults. Ninety-three students participated in the study and were divided into peer-led, adult-led, and control groups. Number of cigarettes smoked was assessed by self-report through pretest, posttest and one-month follow-up measures. Self-efficacy was measured post-and follow-up. Student feedback regarding the helpfulness of program components was also assessed. There was a significant difference in the number of cigarettes smoked by students in both peer-led and adult-led groups when compared to the control group (p = .0001). Smoking reduction continued to take place in both treatment groups at the one-month follow-up measure. Those students who were exposed to fewer smoking individuals in their daily lives were able to maintain a reduction in smoking when measured one month after completion of the program.

Adolescent↗
PubMed2003

The effects of peer counseling on smoking cessation and reduction.

OBJECTIVE: To evaluate a peer counseling intervention for pregnant smokers. METHODS: One hundred forty-two pregnant, predominantly Hispanic women were assigned to a peer-led smoking cessation program or to usual care. RESULTS: Compared with usual care, peer counseling reduced smoking (-9.1 versus -4.5 cigarettes daily, P =.03), but did not affect absolute quit rates (24% versus 21%) at 36 weeks' gestation. Infant birth weight negatively correlated with cigarettes smoked per day (r = -0.29, P <.01) and expired carbon monoxide (r = -0.39, (P <.001) at delivery. Birth weight for infants born to women who quit smoking averaged 7.2 lb versus 6.8 and 6.3 lb for mothers smoking one to six and more than six cigarettes per day at delivery (P <.01). CONCLUSION: Peer counseling reduced the number of cigarettes smoked daily but did not increase cigarette abstinence rates. Infant birth weight increases with both smoking cessation and smoking reduction, suggesting that peer counseling intervention programs may improve newborn health despite their failure to affect smoking cessation.

Adult↗
PubMed2006

Toxicant exposure in cigarette reducers versus light smokers.

BACKGROUND: The extent of exposure to tobacco toxicants in smokers who have reduced their cigarette intake compared with smokers who are light smokers is relatively unknown. The goal of this study is to investigate the occurrence of compensatory smoking in reducers compared with light smokers by measuring toxicant exposure. METHODS: Participants in two smoking reduction intervention studies (N = 64) were selected for comparison with a group of light smokers (N = 62) who smoked the same number of cigarettes as the reducers. A compensatory smoking score was defined (biomarker level for reducer/biomarker level for light smoker) and calculated for urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and its glucuronides (total NNAL), metabolites of the tobacco-specific lung carcinogen 4-(methylnitrosamino)-I-(3-pyridyl)-1-butanone, to measure the degree of smoking compensation in reducers when compared with the light smokers. RESULTS: The mean level of creatinine-adjusted total NNAL for reducers was over twice that of light smokers even when they smoked about the same number of cigarettes per day. The difference of the mean total NNAL concentrations between light smokers and reducers was highly significant (P < 0.0001). Wide variability in total NNAL concentrations was also observed in reducers, with the extent of this variability between light smokers and reducers being significantly different (P = 0.0005). The level of individual reduction was shown to be a consistent predictor of compensatory smoking (r = 0.50; adjusted Ps = 0.002), with greater cigarette reduction associated with more compensation. CONCLUSIONS: Compensatory smoking limits the harm reduction value of decreased smoking of cigarettes.

Administration, Cutaneous↗
PubMed1992

Smoking cessation in women: effects of the menstrual cycle.

Ten females in the midcycle phase of the menstrual cycle, 10 females in the premenstrual phase of the menstrual cycle, and 10 males agreed to try and stop smoking for two consecutive days. The Smoking Motivation Questionnaire and Profile of Mood States Questionnaire (POMS) were completed by all subjects beforehand. On each "no smoking" day, the POMS and a Smoking Withdrawal Questionnaire were completed. Males and midcycle females achieved significantly greater smoking reduction than premenstrual females during the "no smoking" days. Premenstrual females reported becoming significantly more tired, confused, depressed, anxious, and irritable than midcycle females. Midcycle females reported only slight changes in feeling state during cigarette withdrawal. The position of the males was broadly intermediate between the two female groups.

Adaptation, Psychological↗
PubMed1998

Cigarette smoking by New Zealand doctors and nurses: results from the 1996 population census.

AIM: To determine the prevalence of cigarette smoking among New Zealand doctors and nurses and to examine intercensal trends in smoking behaviour. METHODS: The 1996 New Zealand population census included two questions on cigarette smoking. The data for doctors and nurses have been analysed and compared with results from the 1976 and 1981 censuses. RESULTS: There were 7335 doctor respondents and 30,507 nurses. Five percent of male and female doctors smoke cigarettes regularly compared with 15% in 1981, 20% in 1976 and 35% in 1963. Almost 90% of doctors aged less than 30 years have never smoked and reductions in smoking have occurred in all specialties. Eighteen percent of nurses (18% females, 27% males) are smokers compared with 31% of females and 39% of males in 1981. The highest prevalence is among psychiatric nurses (31%) while only 10% of midwives and Plunket nurses are smokers. CONCLUSIONS: Doctors continue to lead the New Zealand community in non-smoking and the goal of a smokefree medical profession by the year 2000 may be achievable. In contrast to 1981, the prevalence of smoking by female nurses (18%) is now less than women in the general New Zealand population (23%). Substantial reductions in smoking have occurred in all categories of the nursing profession.

Adult↗
PubMed2004

Characteristics of cigarette smokers seeking treatment for cessation versus reduction.

Comparisons were made between cigarette smokers seeking treatment to quit smoking and cigarette smokers seeking treatment to reduce the number of cigarettes they smoke. Potential subjects were recruited from the local metropolitan area by advertisement in the local media. A total of 665 cigarette smokers telephoned our clinic to seek treatment for smoking cessation and 565 cigarette smokers telephoned to seek treatment to gradually reduce the number of cigarettes they smoke but not quit smoking. Potential subjects were instructed to call the clinic to find out additional information about the studies, and while on the telephone they were asked questions pertaining to tobacco use and health status. The results show that the two populations are similar in many respects with the following exceptions: smokers seeking treatment to reduce cigarette use tend to smoke more cigarettes per day, are less motivated to quit, make fewer quit attempts, drink more alcoholic beverages per day, and have more health problems (Ps<.05). These results indicate that cigarette smokers seeking treatment for smoking reduction but not cessation may be more dependent smokers who experience more medical disorders.

Adult↗