The Diversity of Nicotine and Tobacco Research

The Diversity of Nicotine and Tobacco Research The articles in this issue of NTR reflect the current major areas of nicotine/tobacco research: efficacy of treatment, special populations, and harm reduction. In terms of efficacy, most treatments that have focused on extinguishing smoking cues have not been effective; however, Brandon and colleagues1 used an innovative program to assist varenicline in disrupting cues and found that it reduced both craving and satisfaction from smoking. Ignacio and colleagues2 found that smokers with psychiatric or smoking-related illnesses were more likely to be offered pharmacotherapy for smoking cessation. Koslovsky and colleagues3 used a sophisticated statistical produce to replicate prior work4 that which variables predict relapse varies over time. Pacek and colleagues5 reviewed the literature on factors that influenced adherence to treatment and did not any factor that did so consistently; however, they also suggest several methodological changes that might reveal such factors. Prior research found that smokers with strokes in the insular region had higher short-term abstinence. Suner-Soler and colleagues6 replicated that result and found its effect appeared to be due to its influence on “disruption of addiction,” defined as smoking cessation from the moment of the stroke, the absence of relapses, and having stopped smoking without difficulties. In terms of special populations, pregnant smokers metabolize nicotine faster than nonpregnant smokers7; thus, one would expect pregnant smokers to smoke cigarettes more intensely than nonpregnant smokers. Bergeria and colleagues8 did not find this was the case, but interestingly they did find that pregnant smokers reported less pleasure from smoking, perhaps due to nausea associated with pregnancy. Web-based treatments are popular but most have poor compliance. Brunette and colleagues9 designed an app that, even among those with severe mental illnesses, had very high compliance and a large cessation effect. Negative affect is consistently found to undermine smoking cessation. Recent data also suggest that positive affect may reduce relapse. Liautaud and colleagues10 found that, among African-Americans, subjective happiness reduced the effect of increased dependence to increase withdrawal symptoms. O’Toole and colleagues11 found that simply being in combat (and not necessarily posttraumatic stress disorder) predicted smoking. This result is similar to findings that depressed mood (not necessarily major depression) is associated with smoking. Most mental health workers focus on helping with disruptive or painful behaviors, not on improving medical problems. Consistent with this, Rogers and colleagues12 found that mental health workers have mixed opinions on whether increasing smoking cessation is their responsibility, and many do not have the training to intervene with smokers. Perkins and colleagues have done a series of studies showing female smokers are less influenced by nicotine levels than male smokers. The current study13 found that, when given a variety of nicotine doses, female smokers were less sensitive to increasing doses than male smokers. In terms of harm reduction, nicotine absorption from cigars has been thought to be less than that from cigarettes because the formal is via buccal rather than lung absorption. Goel and colleagues14 found that nicotine absorption from small cigars is similar to that for cigarettes. They argue small cigars should be regulated more similar to cigarettes than large cigars. Lee and colleagues15 found that never-smokers (≤100 cigarettes in lifetime) had less intensive e-cigarette vaping topographies than established smokers and suggested the latter group may have more harm from use of e-cigarettes. Ventilated (“low tar”) cigarettes appear to be more harmful because smokers smoke them more intensely. Selya and colleagues16 found that when high-dependent smokers began using e-cigarettes, they decreased their use of tobacco cigarettes. When low-dependent smokers began using e-cigarettes they smoke more, not fewer, cigarettes. It may be that e-cigarettes are being used as substitutes in high-dependent smokers, but allowing low-dependent smokers to take in more nicotine, thereby fostering more use of tobacco cigarettes. Tests of products to replace cigarettes typically provide the replacement products and usual cigarettes free of charge. Shiffman and Scholl17 found the number of cigarettes smoked per day was 66% higher when they were free versus non-free. This suggests that results in settings with free replacement product may not generalize to settings when product must be purchased. Stein and colleagues18 had smokers use both ventilated and unventilated cigarettes. They found smokers liked and preferred unventilated cigarettes. This suggests that unventilated cigarettes are acceptable and may be less dependence-producing. The ability of e-cigarettes to reduce smoking has been thought to be due to its delivery of nicotine; however, several prior studies have failed to find differences in high versus low nicotine dose e-cigarettes. Tucker and colleagues19 compared the effect of three active doses and a placebo e-cigarette among less moderately dependent smokers. They found no differences in the four conditions in amount of reduction in cigarette smoking. The results of many of the above studies remind me of the quip by Robert Pirsig that one should not be a scientist because scientific studies usually raise more questions than they answer and, thus, increase, not decrease, knowledge. But, an analogy attributed to Pascal may be a better explanation. He said to think of knowledge as a sphere, all matter outside the sphere as ignorance, and the surface of the sphere (i.e. the interaction of knowledge and ignorance) as questions. So, as the volume of the sphere increases, questions increase but ignorance still decreases. References 1. Brandon TH, Unrod M, Drobes DJet al.   facilitated extinction training to improve pharmacotherapy for smoking cessation: A pilot feasibility trial. Nicotine Tob Res . 2017. 2. Ignacio RV, Barnett PG, Kim HMet al.   Trends and patient characteristics associated with tobacco pharmacotherapy dispensed in the veterans health administration. Nicotine Tob Res . 2017. 3. Koslovsky MD, Hébert ET, Swartz MDet al.   The time-varying relations between risk factors and smoking before and after a quit attempt. Nicotine Tob Res . 2017. 4. Yong HH, Borland R, Cummings KM, Partos T. Do predictors of smoking relapse change as a function of duration of abstinence? Findings from the United States, Canada, United Kingdom and Australia. Addiction . 2018. 5. Pacek LR, McClernon FJ, Bosworth HB. Adherence to pharmacological smoking cessation interventions: A literature review and synthesis of correlates and barriers. Nicotine Tob Res . 2017. 6. Suñer-Soler R, Grau-Martín A, Terceno Met al.   Biological and psychological factors associated with smoking abstinence six years post-stroke. Nicotine Tob Res . 2017. 7. Bowker K, Lewis S, Coleman T, Cooper S. Changes in the rate of nicotine metabolism across pregnancy: A longitudinal study. Addiction . 2015; 110( 11): 1827– 1832. Google Scholar CrossRef Search ADS PubMed  8. Bergeria CL, Heil SH, Bunn JY, Sigmon SC, Higgins ST. Comparing smoking topography and subjective measures of usual brand cigarettes between pregnant and non-pregnant smokers. Nicotine Tob Res . 2017. 9. Brunette MF, Ferron JC, Robinson Det al.   Brief web-based interventions for young adult smokers with severe mental illnesses: A randomized, controlled pilot study. Nicotine Tob Res . 2017. 10. Liautaud MM, Leventhal AM, Pang RD. Happiness as a buffer of the association between dependence and acute tobacco abstinence effects in African American smokers. Nicotine Tob Res . 2017. 11. O’Toole BI, Kirk R, Bittoun R, Catts SV. Combat, posttraumatic stress disorder, and smoking trajectory in a cohort of male Australian army Vietnam veterans. Nicotine Tob Res . 2017. 12. Rogers ES, Gillespie C, Smelson D, Sherman SE. A qualitative evaluation of mental health clinic staff perceptions of barriers and facilitators to treating tobacco use. Nicotine Tob Res . 2017. 13. Perkins KA, Karelitz JL, Kunkle N. Sex differences in subjective responses to moderate versus very low nicotine content cigarettes. Nicotine Tob Res . 2017. 14. Goel R, Trushin N, Reilly SMet al.   A survey of nicotine yields in small cigar smoke: Influence of cigar design and smoking regimens. Nicotine Tob Res . 2017. 15. Lee YO, Nonnemaker JM, Bradfield B, Hensel EC, Robinson RJ. Examining daily electronic cigarette puff topography among established and nonestablished cigarette smokers in their natural environment. Nicotine Tob Res . 2017. 16. Selya AS, Dierker L, Rose JS, Hedeker D, Mermelstein RJ. The role of nicotine dependence in e-cigarettes’ potential for smoking reduction. Nicotine Tob Res . 2017. 17. Shiffman S, Scholl S. Increases in cigarette consumption and decreases in smoking intensity when nondaily smokers are provided with free cigarettes. Nicotine Tob Res . 2017. 18. Stein JS, Koffarnus MN, O’Connor RJ, Hatsukami DK, Bickel WK. Effects of filter ventilation on behavioral economic demand for cigarettes: A preliminary investigation. Nicotine Tob Res . 2017. 19. Tucker MR, Laugesen M, Bullen C, Grace RC. Predicting short-term uptake of electronic cigarettes: Effects of nicotine, subjective effects and simulated demand. Nicotine Tob Res . 2017. © The Author(s) 2018. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/about_us/legal/notices) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Nicotine and Tobacco Research Oxford University Press

The Diversity of Nicotine and Tobacco Research

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Oxford University Press
Copyright
© The Author(s) 2018. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
ISSN
1462-2203
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1469-994X
D.O.I.
10.1093/ntr/nty100
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Abstract

The articles in this issue of NTR reflect the current major areas of nicotine/tobacco research: efficacy of treatment, special populations, and harm reduction. In terms of efficacy, most treatments that have focused on extinguishing smoking cues have not been effective; however, Brandon and colleagues1 used an innovative program to assist varenicline in disrupting cues and found that it reduced both craving and satisfaction from smoking. Ignacio and colleagues2 found that smokers with psychiatric or smoking-related illnesses were more likely to be offered pharmacotherapy for smoking cessation. Koslovsky and colleagues3 used a sophisticated statistical produce to replicate prior work4 that which variables predict relapse varies over time. Pacek and colleagues5 reviewed the literature on factors that influenced adherence to treatment and did not any factor that did so consistently; however, they also suggest several methodological changes that might reveal such factors. Prior research found that smokers with strokes in the insular region had higher short-term abstinence. Suner-Soler and colleagues6 replicated that result and found its effect appeared to be due to its influence on “disruption of addiction,” defined as smoking cessation from the moment of the stroke, the absence of relapses, and having stopped smoking without difficulties. In terms of special populations, pregnant smokers metabolize nicotine faster than nonpregnant smokers7; thus, one would expect pregnant smokers to smoke cigarettes more intensely than nonpregnant smokers. Bergeria and colleagues8 did not find this was the case, but interestingly they did find that pregnant smokers reported less pleasure from smoking, perhaps due to nausea associated with pregnancy. Web-based treatments are popular but most have poor compliance. Brunette and colleagues9 designed an app that, even among those with severe mental illnesses, had very high compliance and a large cessation effect. Negative affect is consistently found to undermine smoking cessation. Recent data also suggest that positive affect may reduce relapse. Liautaud and colleagues10 found that, among African-Americans, subjective happiness reduced the effect of increased dependence to increase withdrawal symptoms. O’Toole and colleagues11 found that simply being in combat (and not necessarily posttraumatic stress disorder) predicted smoking. This result is similar to findings that depressed mood (not necessarily major depression) is associated with smoking. Most mental health workers focus on helping with disruptive or painful behaviors, not on improving medical problems. Consistent with this, Rogers and colleagues12 found that mental health workers have mixed opinions on whether increasing smoking cessation is their responsibility, and many do not have the training to intervene with smokers. Perkins and colleagues have done a series of studies showing female smokers are less influenced by nicotine levels than male smokers. The current study13 found that, when given a variety of nicotine doses, female smokers were less sensitive to increasing doses than male smokers. In terms of harm reduction, nicotine absorption from cigars has been thought to be less than that from cigarettes because the formal is via buccal rather than lung absorption. Goel and colleagues14 found that nicotine absorption from small cigars is similar to that for cigarettes. They argue small cigars should be regulated more similar to cigarettes than large cigars. Lee and colleagues15 found that never-smokers (≤100 cigarettes in lifetime) had less intensive e-cigarette vaping topographies than established smokers and suggested the latter group may have more harm from use of e-cigarettes. Ventilated (“low tar”) cigarettes appear to be more harmful because smokers smoke them more intensely. Selya and colleagues16 found that when high-dependent smokers began using e-cigarettes, they decreased their use of tobacco cigarettes. When low-dependent smokers began using e-cigarettes they smoke more, not fewer, cigarettes. It may be that e-cigarettes are being used as substitutes in high-dependent smokers, but allowing low-dependent smokers to take in more nicotine, thereby fostering more use of tobacco cigarettes. Tests of products to replace cigarettes typically provide the replacement products and usual cigarettes free of charge. Shiffman and Scholl17 found the number of cigarettes smoked per day was 66% higher when they were free versus non-free. This suggests that results in settings with free replacement product may not generalize to settings when product must be purchased. Stein and colleagues18 had smokers use both ventilated and unventilated cigarettes. They found smokers liked and preferred unventilated cigarettes. This suggests that unventilated cigarettes are acceptable and may be less dependence-producing. The ability of e-cigarettes to reduce smoking has been thought to be due to its delivery of nicotine; however, several prior studies have failed to find differences in high versus low nicotine dose e-cigarettes. Tucker and colleagues19 compared the effect of three active doses and a placebo e-cigarette among less moderately dependent smokers. They found no differences in the four conditions in amount of reduction in cigarette smoking. The results of many of the above studies remind me of the quip by Robert Pirsig that one should not be a scientist because scientific studies usually raise more questions than they answer and, thus, increase, not decrease, knowledge. But, an analogy attributed to Pascal may be a better explanation. He said to think of knowledge as a sphere, all matter outside the sphere as ignorance, and the surface of the sphere (i.e. the interaction of knowledge and ignorance) as questions. So, as the volume of the sphere increases, questions increase but ignorance still decreases. References 1. Brandon TH, Unrod M, Drobes DJet al.   facilitated extinction training to improve pharmacotherapy for smoking cessation: A pilot feasibility trial. Nicotine Tob Res . 2017. 2. Ignacio RV, Barnett PG, Kim HMet al.   Trends and patient characteristics associated with tobacco pharmacotherapy dispensed in the veterans health administration. Nicotine Tob Res . 2017. 3. Koslovsky MD, Hébert ET, Swartz MDet al.   The time-varying relations between risk factors and smoking before and after a quit attempt. Nicotine Tob Res . 2017. 4. Yong HH, Borland R, Cummings KM, Partos T. Do predictors of smoking relapse change as a function of duration of abstinence? Findings from the United States, Canada, United Kingdom and Australia. Addiction . 2018. 5. Pacek LR, McClernon FJ, Bosworth HB. Adherence to pharmacological smoking cessation interventions: A literature review and synthesis of correlates and barriers. Nicotine Tob Res . 2017. 6. Suñer-Soler R, Grau-Martín A, Terceno Met al.   Biological and psychological factors associated with smoking abstinence six years post-stroke. Nicotine Tob Res . 2017. 7. Bowker K, Lewis S, Coleman T, Cooper S. Changes in the rate of nicotine metabolism across pregnancy: A longitudinal study. Addiction . 2015; 110( 11): 1827– 1832. Google Scholar CrossRef Search ADS PubMed  8. Bergeria CL, Heil SH, Bunn JY, Sigmon SC, Higgins ST. Comparing smoking topography and subjective measures of usual brand cigarettes between pregnant and non-pregnant smokers. Nicotine Tob Res . 2017. 9. Brunette MF, Ferron JC, Robinson Det al.   Brief web-based interventions for young adult smokers with severe mental illnesses: A randomized, controlled pilot study. Nicotine Tob Res . 2017. 10. Liautaud MM, Leventhal AM, Pang RD. Happiness as a buffer of the association between dependence and acute tobacco abstinence effects in African American smokers. Nicotine Tob Res . 2017. 11. O’Toole BI, Kirk R, Bittoun R, Catts SV. Combat, posttraumatic stress disorder, and smoking trajectory in a cohort of male Australian army Vietnam veterans. Nicotine Tob Res . 2017. 12. Rogers ES, Gillespie C, Smelson D, Sherman SE. A qualitative evaluation of mental health clinic staff perceptions of barriers and facilitators to treating tobacco use. Nicotine Tob Res . 2017. 13. Perkins KA, Karelitz JL, Kunkle N. Sex differences in subjective responses to moderate versus very low nicotine content cigarettes. Nicotine Tob Res . 2017. 14. Goel R, Trushin N, Reilly SMet al.   A survey of nicotine yields in small cigar smoke: Influence of cigar design and smoking regimens. Nicotine Tob Res . 2017. 15. Lee YO, Nonnemaker JM, Bradfield B, Hensel EC, Robinson RJ. Examining daily electronic cigarette puff topography among established and nonestablished cigarette smokers in their natural environment. Nicotine Tob Res . 2017. 16. Selya AS, Dierker L, Rose JS, Hedeker D, Mermelstein RJ. The role of nicotine dependence in e-cigarettes’ potential for smoking reduction. Nicotine Tob Res . 2017. 17. Shiffman S, Scholl S. Increases in cigarette consumption and decreases in smoking intensity when nondaily smokers are provided with free cigarettes. Nicotine Tob Res . 2017. 18. Stein JS, Koffarnus MN, O’Connor RJ, Hatsukami DK, Bickel WK. Effects of filter ventilation on behavioral economic demand for cigarettes: A preliminary investigation. Nicotine Tob Res . 2017. 19. Tucker MR, Laugesen M, Bullen C, Grace RC. Predicting short-term uptake of electronic cigarettes: Effects of nicotine, subjective effects and simulated demand. Nicotine Tob Res . 2017. © The Author(s) 2018. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/about_us/legal/notices)

Journal

Nicotine and Tobacco ResearchOxford University Press

Published: Jun 7, 2018

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