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At least 19 recordsLinked to original sources
PubMed2024

Multi-ancestry meta-analysis of tobacco use disorder identifies 461 potential risk genes and reveals associations with multiple health outcomes.

Tobacco use disorder (TUD) is the most prevalent substance use disorder in the world. Genetic factors influence smoking behaviours and although strides have been made using genome-wide association studies to identify risk variants, most variants identified have been for nicotine consumption, rather than TUD. Here we leveraged four US biobanks to perform a multi-ancestral meta-analysis of TUD (derived via electronic health records) in 653,790 individuals (495,005 European, 114,420 African American and 44,365 Latin American) and data from UK Biobank (ncombined = 898,680). We identified 88 independent risk loci; integration with functional genomic tools uncovered 461 potential risk genes, primarily expressed in the brain. TUD was genetically correlated with smoking and psychiatric traits from traditionally ascertained cohorts, externalizing behaviours in children and hundreds of medical outcomes, including HIV infection, heart disease and pain. This work furthers our biological understanding of TUD and establishes electronic health records as a source of phenotypic information for studying the genetics of TUD.

Humans↗
PubMedDate not supplied

[Tobacco and tobacco use disorder in the history of Mexico and Europe].

The tobacco used for a long time by American and Caribbean natives was introduced into Europe at the end of XV century, and essentially during the XVI century, by travelers returning to their Fatherlands. After the tobacco industry was organized, several concerns arose regarding medical and social care for the workers in the tobacco factories. Medical and hygienic aspects were reflected in a whole chapter (the XVII) of the Ramazzini's Treatise on Medicine of Work, published in 1700. Concerning social care for the workers' families, the creation, April 1796, of nursery schools for the children of working women in tobacco factories of the New Spain must be recalled. In opposition to the predictions of some natives and visitors during the last centuries, with the passage of time, the tobacco habit instead of decreasing, became progressively more accentuated in all social classes. To aggravate conditions, at present, the noxious effects of the tobacco smoke are combined with those of environmental contamination. Recent epidemiological reports on the number and health conditions of smokers, as well as the National Antitobacco Program in Mexico, are mentioned.

Adult↗
PubMed2003

Alcohol and tobacco use disorders in a general population: short-term and long-term associations from the St. Louis epidemiological catchment area study.

BACKGROUND: Although research using clinical and convenience samples has shown alcohol use disorders (AUD) to be highly comorbid with tobacco dependence (TD), little work has examined this association prospectively using population-based data. The AUD-TD association was prospectively examined using data from the St. Louis Epidemiological Catchment Area (ECA) Study and its 1-year follow-up as well as from a 16-year follow-up on a subsample of ECA data. METHOD: Respondents were 3004 (2564, 85%, at Wave 2) participants in the St. Louis household ECA sample, including 444 participants at Year 16 follow-up. At baseline, the sample was predominately White (58%; 38% Black), female (60%), and 44.3 years. Past-year AUD and TD were diagnosed at all waves according to DSM-III criteria. RESULTS: AUDs and TDs were cross-sectionally associated at Years 1, 2, and 16. Controlling for demographics, Year 1 TD prospectively predicted Year 2 AUD, and Year 1 AUD prospectively predicted Year 16 TD. We found evidence for prediction of onset and persistence of both AUD and TD at short-term but not long-term follow-up. Prospective findings were reduced and no longer reached significance when concurrent diagnoses at follow-up were included in the regression models. CONCLUSIONS: We observed short-term and long-term associations between AUD and TD. These associations were mediated through concurrent diagnoses with the other substance use disorder.

Adult↗
PubMedDate not supplied

[Design and implementation of evidence-based measures for the prevention and treatment of tobacco use disorder: the experience of the Public Health Department of the Cesena Local Health Authority].

Tobacco smoke is the main cause of preventable death in Italy. It is important therefore to develop evidence-based measures aimed at preventing and treating tobacco addiction. This article describes the "Smoke-free" community project, implemented in the territory of the Cesena Local Health Authority. The success of the project shows that it is possible to carry out inter-sectorial and evidence-based prevention. It also leads to considerations about the role of Prevention Services in the fight against tobacco smoke.

Evidence-Based Medicine↗
PubMedDate not supplied

[Tobacco use disorder prevalence among hospital workers].

BACKGROUND: In Spain, as in other countries, numerous studies on tobaccoism have been carried out. The purpose of this survey was to evaluate the prevalence of tobaccoism in a representative sample of hospital employees and its association with age, sex, profession level and attitudes. METHODS: Following a pilot study, a survey was carried out amongst a representative and random sample (n = 360) of hospital personnel, who were asked about their attitudes towards smoking, classified according to age, sex and professional level. RESULTS: The total percentage of smokers was 36.4%, but no significant statistical differences were found between sex or age group. The professional levels with the highest percentage of smokers are ATS/DUE and clerks. 42.8% of non-smokers declared having smoked in the past. ATS/DUE, clerks and doctors showed the highest percentage. 40.5% of smokers declare that they were willing to give up smoking, whereas people over 50 were the most reluctant. The majority of cigarette smokers admitted that they smoke in the hospital. Most of them are intermediate smokers (10-20 cigarettes per day) and have been so for many years. The majority of former smokers gave up smoking in recent years. CONCLUSIONS: These results prove that a large number of hospital employees are smokers. However, many are willing to give up the habit. We should therefore encourage these people to give up smoking and help them by different means such as: anti-smoking advice, medical advice and health education. We propose to declare hospitals as "Non-Smoking Area" as of the year 2000 which includes employees, patients and visitors, according to the WHO "Health for All." program.

Adult↗
PubMedDate not supplied

Hepatitis C in patients with co-occurring mental disorders and substance use disorders: is tobacco use a possible risk factor?

This study of a dually diagnosed population in Colorado estimated the prevalence of hepatitis C to be 29.7%, or sixteen times higher than that in the general population. In attempts to determine possible risk factors, a surprisingly high correlation was found between the use of tobacco and HCV infection. This appears to be beyond the risk factor conveyed by IV drug use. Of the patients whose primary diagnoses were cocaine, opiate, amphetamine, or poly-substance dependence (drugs often used intravenously), 42% of the tobacco users were HCV positive, while only 20% of the non-tobacco using patients with similar primary diagnoses were HCV positive. The association of tobacco use with HCV was found to be even more striking for females with alcohol, sedative/hypnotic, inhalant, or cannabis dependence, as none of the seventeen non-tobacco using female patients with these diagnoses were HCV positive, while fourteen of the 45 (31%) tobacco-using females with these diagnoses did test positive for HCV. Results of this study suggest that tobacco use may in some way influence the susceptibility to infection with hepatitis C virus.

Adult↗
PubMed1998

Cigarette smoking is associated with unhealthy patterns of nutrient intake: a meta-analysis.

The aim of this investigation was to assess the relationship between smoking status and nutrient intakes using a meta-analysis. Publications in English were sought through a Medline search using the following key words: food habits, eating, feeding behavior, diet, food, nutrition, nutritional status or assessment, tobacco use disorder, tobacco, nicotine and smoking. Scanning relevant reference lists of articles and hand searching completed the data collection. No attempt was made to search for unpublished results. Paper selection was based on nutritional surveys including comparisons of smokers with nonsmokers. Fifty-one published nutritional surveys from 15 different countries with 47,250 nonsmokers and 35,870 smokers were used in the analysis. The estimates of size effects were calculated with the mean and variance values of each nutrient intake and the size of the sample. Smokers declared significantly (all P < 10(-5)) higher intakes of energy (+4.9%), total fat (+3.5%), saturated fat (+8.9%), cholesterol (+10.8%) and alcohol (+77.5%) and lower intakes of polyunsaturated fat (-6.5%), fiber (-12.4%), vitamin C (-16.5%), vitamin E (-10.8%) and beta-carotene (-11.8%) than nonsmokers. Protein and carbohydrate intakes did not differ between smokers and nonsmokers. There was no evidence of heterogeneity among studies. In conclusion, the nutrient intakes of smokers differ substantially from those of nonsmokers. Some of these differences may exacerbate the deleterious effects of smoke components on cancer and coronary heart disease risk.

Adolescent↗
PubMed2006

Help seeking for substance use problems in two American Indian reservation populations.

OBJECTIVES: This study examined the extent and types of help seeking (biomedical, traditional, and 12-step groups) for substance use problems in two American Indian reservation populations by using data from the American Indian Service Utilization, Psychiatric Epidemiology, Risk, and Protective Factors Project (AI-SUPERPFP). This study also sought to understand the correlates of such help seeking, including measures of need, demographic characteristics, spirituality, and ethnic identity. METHODS: AI-SUPERPFP, completed between 1997 and 2000, was a cross-sectional probability sample survey. Altogether 2,825 tribal members, aged 18 to 54 years, representing two tribal groups living on or near their home reservations, were randomly sampled from the tribal rolls. Response rates averaged 75.3 percent. The primary outcome measure was help seeking in the past year for substance use problems, which was further divided into help seeking from biomedical services, traditional healing sources, and 12-step programs. RESULTS: Help-seeking rates were high, with 13 percent of the population and 38 percent of those with diagnoses of substance use disorders in the past year having sought services for alcohol or drug problems in the preceding 12 months. Correlates of help seeking included variables related to need for services (substance use disorders, tobacco use, and mental and physical health problems), marital status, and spirituality. Slightly more than half of service users sought help from formal biomedical providers; use of traditional healing and 12-step programs was also common. Need and spirituality variables best differentiated among the users of the three modalities. CONCLUSIONS: Help seeking for alcohol and drug problems was common in these communities, with traditional healing and 12-step resources as essential components of the local service ecologies.

Adolescent↗
PubMed2005

Patterns and predictors of substance use disorders and daily tobacco use in first-episode psychosis.

OBJECTIVE: To investigate the patterns and predictors of substance use disorders (SUD) and daily tobacco use in first-episode psychosis (FEP). METHOD: In this study, consecutive admissions of 126 patients with an initial presentation for FEP were recruited from three psychiatric services. Each patient was assessed with a comprehensive assessment package in order to collect demographic information, to diagnose psychotic disorders and SUD, to estimate the duration of untreated psychosis and to assess premorbid functioning and the severity of psychiatric symptoms. RESULTS: The rates of lifetime SUD and daily tobacco use were 71% and 77%, respectively. The onset of SUD pre-dated the onset of positive psychotic symptoms in 91% of relevant cases. In multivariate analyses, male gender, younger age, Australian birth and unemployed status were the most consistent demographic predictors of SUD and daily tobacco use. There were no associations found between SUD and symptom severity, premorbid adjustment, psychotic disorder diagnosis or hospitalization. CONCLUSIONS: Male gender and younger age are reliable predictors of SUD in FEP. Patients with and without SUD appear to have similar clinical characteristics at initial presentation.

Adolescent↗
PubMed2000

Trajectories of concurrent substance use disorders: a developmental, typological approach to comorbidity.

BACKGROUND: Although alcohol and tobacco use disorders are highly comorbid, little is known regarding the combined course of these disorders. METHODS: The current study utilized latent class analysis to examine longitudinal patterns of alcohol-tobacco use disorder comorbidity. Participants were 449 young adults (baseline age, 18.5 years; 48% male; 51% with paternal history of alcoholism) assessed five times over 7 years. RESULTS: Five longitudinal types of alcohol or tobacco use disorder over time were identified: nondiagnosing; developmentally limited alcohol use disorder; chronic alcohol use disorder; chronic tobacco use disorder; and comorbid alcohol and tobacco use disorder. These typologies were distinguishable on the basis of family history of alcoholism status and sex. Etiologically important third variables (alcohol expectancies, behavioral undercontrol, childhood stressors) mediated the relation between family history and the latent classes. CONCLUSIONS: Characterizations of alcohol use disorders typically fail to consider important sources of heterogeneity such as course or comorbidity. By simultaneously modeling developmental course and comorbidity with tobacco dependence, we were able to identify distinct trajectories of single and concurrent substance use disorders. Such multi-substance trajectories represent meaningful subtypes that, although sharing substantial common influences, have unique etiologic correlates. Additionally, these subtypes might represent distinct groups from the perspective of intervention strategies.

Adolescent↗
PubMed2006

Mental health and alcohol, drugs and tobacco: a review of the comorbidity between mental disorders and the use of alcohol, tobacco and illicit drugs.

This paper reviews some major epidemiological studies undertaken in high-income countries during the last 15 years which have reported the prevalence of mental disorders and substance use disorders and their relationship. Comorbidity between mental and substance use disorders is highly prevalent across countries. In general, people with a substance use disorder had higher comorbid rates of mental disorders than vice versa, and people with illicit drug disorders had the highest rates of comorbid mental disorders. There is a strong direct association between the magnitude of comorbidity and the severity of substance use disorders. While causal pathways differ across substances and disorders, there is evidence that alcohol is a casual factor for depression, in some European countries up to 10% of male depression. Policies that reduce the use of substances are likely to reduce the prevalence of mental disorders. Treatment should be available in an integrated fashion for both mental and substance use disorders. There is a need to expand the evidence base on comorbidity, particularly in low-income countries.

Alcohol Drinking↗
PubMed2000

Prospective analysis of comorbidity: tobacco and alcohol use disorders.

Alcohol use disorders (AUD) and tobacco use disorders (TD) frequently co-occur. The authors examined AUD-TD comorbidity over time using a state-trait (ST) model. The ST model represents variance in AUD/TD as a traitlike factor that spans measurement occasion and identifies distinct sources of variance in AUD-TD comorbidity. The ST model was evaluated on 450 young adults (baseline age = 18.5 years; 51% with family history of alcoholism) assessed 5 times over 7 years. The ST model demonstrated superior fit over a first-order autoregressive model. The tendency to diagnose with AUD and TD was partially explained by family history of alcoholism; this relationship was mediated by childhood stressors, alcohol expectancies, and behavioral undercontrol. Results supported a common third-variable influence (vs. directional) model of comorbidity. The ST model is an important conceptual and methodological approach to the prospective study of comorbidity in general.

Adolescent↗
PubMed2005

Anticraving medications for relapse prevention: a possible new class of psychoactive medications.

Psychiatrists have gradually developed a list of medications that are effective in the treatment of addictive disorders. Although alcoholism has received the most attention, nicotine, heroin, and cocaine have all been shown to be influenced by heredity. Of course, the immediate goal is the reduction of drug craving and the prevention of relapse to compulsive drug taking. A medication that can aid in the maintenance of the opiate-free state is naltrexone, a specific opiate antagonist. Naltrexone is also a good example of an anticraving medication used in the treatment of alcoholism. Clinicians currently have two types of medication to aid in the treatment of tobacco use disorder, arguably the most important addiction. Bupropion and nicotine replacement can be given in a coordinated fashion to provide the best available results. At present, no medication is approved by the Food and Drug Administration for the indication of cocaine addiction. Recently, however, five different medications, already approved for other purposes, have been found to be effective among cocaine addicts. Despite clinical trials that show benefit, anticraving medications are not well known and are underused by clinicians. Addiction is a heterogeneous condition, with variability in reactivity to the drug of abuse and to the medications available to treat it. Recent developments in pharmacogenetics may result in improved selection of medications based on genotype.

Alcoholism↗