Expired carbon monoxide levels in self-reported smokers and nonsmokers in prison.

Breath carbon monoxide (CO) is a convenient, widely used method for abstinence validation, with cutoffs of 8-10 ppm commonly employed. The goal of the present study was to determine an appropriate CO cutoff to differentiate nonsmokers and smokers within a large sample (N = 374) of female prisoners incarcerated at a correctional facility in Virginia. Mean age of the population was 34.5 years, 49.2% were White, and 29% had less than a high school education. Smoking prevalence was 74.1% within the prison population. Examination of CO levels versus smoking self-report using a receiver operator characteristic (ROC) analysis revealed that a CO cutoff of 3 ppm resulted in the best sensitivity (98.1%) and specificity (95.8%). Overall ROC area under the curve was 99% (95% CI = 98.2%-99.9%). This same cutoff was optimal for smoking subgroups including Black and light (<10 cigarettes/day) smokers. Results suggest that CO cutoffs higher than 3 ppm may misclassify some smokers as nonsmokers and underestimate the prevalence of smoking.     

Prevalence and correlates of internet cigarette purchasing among adult smokers in New Jersey

Objective: To examine the prevalence and correlates of internet cigarette purchasing among adult smokers.

Design: Analysis of internet purchasing in data from a population based telephone survey of New Jersey households. Logistic regression was used to determine factors associated with internet cigarette purchasing, adjusting for year, demographic, and smoking behaviour variables.

Participants: 3447 current cigarette smokers pooled from three cross sectional surveys conducted in 2000, 2001, and 2002.

Main outcome measures: Ever purchasing tobacco and usually buying cigarettes via the internet.

Results: Among all current cigarette smokers, ever having purchased tobacco via the internet increased from 1.1% in 2000 to 6.7% in 2002 and usually buying cigarettes via the internet increased from 0.8% in 2000 to 3.1% in 2002. Among current cigarette smokers with internet access, ever having purchased tobacco via the internet was higher among those who reported smoking 31 or more cigarettes per day (adjusted odds ratio (OR) 3.9, 95% confidence interval (CI) 1.5 to 10.2) and those without a past year quit attempt (adjusted OR 1.8, 95% CI 1.1 to 3.0). Usually purchasing cigarettes via the internet was higher among those aged 45–64 years (adjusted OR 4.4, 95% CI 1.1 to 17.1) and who reported having their first cigarette 30 minutes after waking (adjusted OR 3.3, 95% CI 1.2 to 9.2).

Conclusions: Although higher prices are known to reduce the demand for cigarettes, internet cigarette purchasing is likely to weaken this effect, particularly among heavy, more dependent smokers who are less interested in quitting.

     

Smoke constituent exposure and smoking topography of adolescent daily cigarette smokers.

Adolescent smoking prevalence is a major health concern, with 24.4% reporting smoking in the past 30 days and 15.8% considered daily smokers. The purpose of this study was to characterize biobehavioral nicotine dependence, smoke constituent exposure and smoking topography in adolescent daily smokers. Relationships among biological markers of nicotine dependence (nicotine boost, carbon monoxide [CO] boost and cotinine levels) with existing self-report measures (modified Fagerstr?m Tolerance Questionnaire [mFTQ] and the motivations for smoking scale) were examined. Gender differences were characterized. Fifty adolescents 13-18 years old were recruited for the study, 50% female. CO, plasma nicotine levels pre- and postcigarette, cotinine, and smoking topography were measured during a smoking bout with participant's usual cigarette. Average CO boost, pre- to postcigarette was 7.2 + 3.6 ppm, baseline cotinine level averaged 224.0 +/- 169.6 ng/ml and nicotine boost averaged 23.4 +/- 21.7 ng/ml. Mean puffs per cigarette was 14.2 +/- 6.3. Males had significantly higher total puff volumes, but similar smoke constituent exposure to females, and higher handling of cigarettes as smoking motive. In regression analysis, 35% of variance in tobacco use, as indicated by baseline cotinine concentration, was explained by maximum puff duration, postcigarette CO level, and nicotine dependence, as measured by the mFTQ. Results indicated adolescents had considerable smoke constituent exposure and nicotine dependence suggesting the importance of appropriate smoking cessation treatment.     

Psychiatric disorders, familial factors, and cigarette smoking: III. Associations with cessation by young adulthood among daily smokers.

The present study examined whether lifetime psychopathology, regular smoking and psychopathology in family members, and smoking characteristics were associated with successful cessation among daily smokers. A sample of 941 young adults was interviewed for lifetime psychopathology and smoking at three time points; biological parents and siblings were interviewed once for lifetime psychopathology and regular smoking. Within the subset of 242 daily smokers with complete data, most (83%) had tried to quit at least once, although only 22% met our definition of successful cessation (no smoking during the 12 months prior to turning age 25 years). Successful cessation was positively associated with being married and having a higher household income in young adulthood, and negatively associated with lifetime major depressive disorder, elevated antisocial personality disorder symptoms, a family history of drug and alcohol use disorder, and nicotine dependence (for women but not men). Marital status, nicotine dependence (for women but not men), and male gender were significant in multivariate analyses; the effect for major depressive disorder approached significance (p=.052). None of the measures of familial smoking were associated with successful smoking cessation. In conclusion, whereas almost all Axis I disorders in our two previous papers were associated with smoking initiation and progression to daily smoking, major depressive disorder and antisocial personality disorder symptoms were the only psychiatric conditions negatively associated with successful cessation. The causal nature of the significant associations and the degree to which modification of these factors increases the probability of future smoking cessation deserve further attention.     

Higher nicotine and carbon monoxide levels in menthol cigarette smokers with and without schizophrenia.

This study examined whether smoking menthol cigarettes was associated with increased biochemical measures of smoke intake. Expired carbon monoxide (CO) and serum nicotine and cotinine were measured in 89 smokers with schizophrenia and 53 control smokers immediately after smoking an afternoon cigarette. Serum nicotine levels (27 vs. 22 ng/ml, p = .010), serum cotinine levels (294 vs. 240 ng/ml, p = .041), and expired CO (25 vs. 21 ppm, p = .029) were higher in smokers of menthol compared with nonmenthol cigarettes, with no differences in 3-hydroxycotinine/cotinine ratios between groups when controlling for race. Backward stepwise linear regression models showed that, in addition to having a diagnosis of schizophrenia, smoking menthol cigarettes was a significant predictor of nicotine and cotinine levels. Individuals with schizophrenia or schizoaffective disorder smoked more generic or discount value brands (Basic, Doral, Monarch, USA, Wave, others) compared with control smokers (28% vs. 6%, p = .002) but did not smoke more brands with high nicotine delivery as estimated by the U.S. Federal Trade Commission method. Although rates of mentholated cigarette smoking were not higher in smokers with schizophrenia overall, they were significantly higher in non-Hispanic White people with schizophrenia compared with controls of the same ethnic/racial subgroup (51% vs. 28%, p<.0001). The higher exhaled CO in menthol smokers suggests that the higher nicotine levels are at least partly related to increased intake of smoke from menthol cigarettes, although menthol-mediated inhibition of nicotine metabolism also may be a factor. Menthol is an important cigarette additive that may help explain why some groups have lower quit rates and more smoking-caused disease.     

Contribution of occupational factors to current smoking among active-duty U.S. Navy careerists.

Rates of cigarette smoking among active-duty U.S. military personnel remain elevated, ranging from 23% among Air Force personnel to 38% among Army personnel. The purpose of this study was to estimate the contribution of occupational factors to current smoking and heavy smoking among a sample of Navy careerists (those with at least 7 years of military service), and to determine if gender moderates these associations. Participants in the study (n = 2,922) were randomly recruited within over-sampled strata of women and racial/ethnic minorities, and voluntarily completed confidential self-administered questionnaires on drinking, smoking, demographic, and occupational factors during 2001-2002. Approximately 23% of study participants reported current smoking; 9% reported heavy smoking. Multivariate logistic regression models were developed to estimate the contribution of occupational factors to current smoking and heavy smoking. The results indicated that careerists in the enlisted ranks were significantly more likely to be current smokers and heavy smokers compared with careerist officers. In addition, those who were deployed at sea were significantly more likely to report current smoking compared with those not currently deployed at sea. Mean daily ounces of alcohol were also significantly associated with likelihood of current and heavy smoking. Gender did not modify the association between occupational factors and smoking. Because aspects of the work environment are potentially modifiable, understanding the role of occupational factors vis-à-vis smoking can aid in smoking prevention and cessation efforts within the military.     

Correlates of home smoking restrictions among rural smokers.

The prevalence of smoking is greater and smoking restrictions are less common in rural areas in comparison to urban areas. Consequently, rural smokers and their families are at increased risk for adverse health consequences from smoking. The presence of home smoking restrictions (i.e., limiting or banning cigarette smoking in the home) can be a mediator for smoking cessation and can reduce health risks for those who live with smokers. The purpose of the present study was to identify correlates of home smoking restrictions among rural smokers. We surveyed 472 smokers from 40 rural Kansas primary care practices who were enrolled in a smoking cessation intervention study. We assessed the prevalence of home smoking restrictions and examined the relationship between such restrictions, demographic variables, comorbid diagnoses, and psychosocial measures of smoking abstinence self-efficacy and motivation to quit. Complete home smoking restrictions were found among 25.4% of rural smokers with an additional 28.3% reporting some restrictions. Restrictions were associated with younger age, higher controlled motivation to quit (i.e., motivation from external pressure), the presence of children under age 6 years living in the home, fewer friends who smoke, and a partner who does not smoke. Smokers with a comorbid diagnosis of high cholesterol, chronic lung disease, or heart disease were less likely to have restrictions. Most smokers in rural primary care practices do not have home smoking restrictions, particularly those without children or a nonsmoking partner and those with significant risk factors for smoking-related illnesses. These patients may be critical targets for broaching issues of home smoking restrictions.     

轻质面板在美国的应用

轻质面板是一种采用较少木料，辅以填充轻质的蜂窝状材料组成的新型板材。 其制作时，通常会先将蜂窝状材料放平．拉伸到适当的形状，并加热干燥处理，排除蜂窝材料中的水分．以确保其保持蜂窝的形状，然后辅以面板、底板、四周支撑，组合成轻质面板。     

The immunogenicity and safety of a nicotine vaccine in smokers and nonsmokers: results of a randomized, placebo-controlled phase 1/2 trial.

This randomized, placebo-controlled phase 1/2 trial evaluated the safety and immunogenicity of four doses of a nicotine vaccine in smokers and nonsmokers. Subjects were 21 smokers and 9 nonsmokers in good physical and mental health. They were aged 24-60 years, were recruited from the general public using newspaper advertisements, and were evaluated at University Hospital Maastricht. Each volunteer received four spaced intramuscular injections of 100 microg of purified 3'-aminomethylnicotine conjugated to detoxified Pseudomonas aeruginosa r-exoprotein A or placebo both adsorbed to 800 microg aluminum into the deltoid muscle of alternating arms. Clinical safety was determined by vital signs, reactogenicity, and adverse events, and immunogenicity was measured by enzyme-linked immunosorbent assay. Intensive follow-up for 266 days revealed the vaccine to be well tolerated. We found no significant differences in adverse events between the vaccine and placebo groups. Significant increases in the geometric mean titer (GMT) levels of nicotine-specific antibodies were observed from 7 days after the second vaccination (day 21), reaching nicotine-specific antibody levels of at least 8 microg/ml in half of the subjects (50%) at day 49. A fourth dose administered at day 182 significantly boosted waning antibody levels to a GMT of 10.8 microg/ml at day 217 (95% CI 6.0-19.3). Results showed that the immunogenicity of the vaccine was not impeded by the presence of nicotine. These observations provide evidence in humans that the vaccine we used may represent a feasible strategy for evoking type-specific antibodies against nicotine.