scholarly journals Withdrawal Symptoms From E-Cigarette Abstinence Among Former Smokers: A Pre–Post Clinical Trial

2019 ◽  
Vol 22 (5) ◽  
pp. 734-739 ◽  
Author(s):  
John R Hughes ◽  
Erica N Peters ◽  
Peter W Callas ◽  
Catherine Peasley-Miklus ◽  
Emmanuel Oga ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Physical Dependence ◽  
Interactive Voice Response ◽  
Withdrawal Symptoms ◽  
Time Pattern ◽  
Diagnostic And Statistical Manual ◽  
Severe Withdrawal ◽  
Tobacco Cigarette ◽  
Former Smokers ◽  
Never Smokers

Abstract Introduction The major aim of this study was to test whether abstinence from e-cigarettes causes withdrawal symptoms in former smokers. Methods We conducted an unblinded, within-participants, pre–post clinical trial in which 109 former smokers who were current daily electronic cigarette (e-cigarette) users used their own e-cigarette for 7 days followed by 6 days of biologically confirmed abstinence engendered via an escalating contingency payment system. Participants monitored symptoms of nicotine withdrawal daily via an Interactive Voice Response system. They also attended three laboratory visits per week for carbon monoxide and cotinine testing to verify abstinence. Results Half of participants completely abstained for a week. All the Diagnostic and Statistical Manual, Fifth Edition (DSM-5) tobacco withdrawal symptoms, craving for e-cigarettes, craving for tobacco cigarettes, and the four possible new withdrawal symptoms (anhedonia, impulsivity, mood swings, and positive affect) increased during abstinence. Weight increased and heart rate decreased with abstinence. Symptoms showed the prototypical inverted U time pattern of a withdrawal state. The magnitude of withdrawal appeared to be somewhat less than that in a prior study of abstinent daily tobacco cigarette smokers. More severe withdrawal on the first 2 days of abstinence did not predict abstinence on the last day of the study. Conclusions Former smokers who are daily e-cigarette users transfer physical dependence on tobacco cigarettes to dependence on e-cigarettes. The severity of withdrawal from e-cigarettes appears to be only somewhat less than that from daily tobacco cigarette use. Replication tests that include placebo controls, testing for pharmacological specificity, and including never-smokers, non-daily e-cigarette users and dual users are indicated. Implications Our results indicate e-cigarettes can maintain physical dependence. This adverse effect should be included in any risk vs. benefit calculation. Also, potential and current e-cigarette users should be informed that abrupt cessation of e-cigarettes can cause withdrawal symptoms. Trial registration NCT02825459.

scholarly journals Withdrawal Symptoms From E-Cigarette Abstinence Among Adult Never-Smokers: A Pilot Experimental Study

2019 ◽  
Vol 22 (5) ◽  
pp. 740-746 ◽  
Author(s):  
John R Hughes ◽  
Erica N Peters ◽  
Peter W Callas ◽  
Catherine Peasley-Miklus ◽  
Emmanuel Oga ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Sample Size ◽  
Interactive Voice Response ◽  
Small Sample Size ◽  
Small Sample ◽  
Withdrawal Symptoms ◽  
Clinical Trial Registration ◽  
Response System ◽  
Never Smokers ◽  
Regulatory Significance

Abstract Introduction Use of e-cigarettes among never-smokers has substantially increased; yet there are few descriptions of the consequences of such use. We assessed whether adult never-smokers can have withdrawal from cessation of e-cigarettes. Methods In an un-blinded pre-post clinical trial, 30 never-smoker daily e-cigarette users used their own nicotine-containing e-cigarette for 7 days followed by 6 days of biologically confirmed abstinence. Participants monitored symptoms of nicotine withdrawal nightly via an Interactive Voice Response system. They attended three lab visits/week to provide expired carbon monoxide and urine samples to determine compliance. Findings Abstinence increased all the DSM5 symptoms of tobacco withdrawal and this occurred in the majority of participants. The increase in severity of withdrawal was small and rarely impaired functioning. Conclusions Our finding suggests that withdrawal symptoms can occur in never-smokers who stop e-cigarettes abruptly. However, the severity of withdrawal appears to be small and may not be of clinical or regulatory significance. Although our sample size was small and thus replication tests of our results are indicated, it may be prudent to warn never-smokers that withdrawal symptoms may occur. Implications This study indicates that withdrawal symptoms can occur in never-smokers who are daily e-cigarette users. However, the severity of withdrawal from e-cigarette abstinence in never-smokers appears to be small and may not be of clinical or regulatory significance. Given our small sample size, replication of our results is warranted. Nevertheless, it might be prudent to warn never-smokers of addiction to e-cigarettes. Clinical Trial Registration = NCT02825459

“Withdrawal symptoms” in adolescents: A comparison of former smokers and never‐smokers

2005 ◽  
Vol 7 (6) ◽  
pp. 909-913 ◽  
Author(s):  
Alexander Prokhorov ◽  
Karen Suchanek Hudmon ◽  
Paul Cinciripini ◽  
Salma Marani
Keyword(s):  
Withdrawal Symptoms ◽  
Former Smokers ◽  
Never Smokers

Cancer of the Lung, Larynx, and Pleura

2018 ◽  
Author(s):  
Jyoti Malhotra ◽  
Paolo Boffetta ◽  
Lorelei Mucci
Keyword(s):  
Lung Cancer ◽  
Secondhand Smoke ◽  
Lung Cancer Risk ◽  
Occupational Exposures ◽  
Men And Women ◽  
Established Risk Factor ◽  
Former Smokers ◽  
Never Smokers ◽  
Exposure To Secondhand Smoke ◽  
Cancer Of The Lung

Lung cancer is the most commonly diagnosed cancer among men in most countries, and is the primary cause of cancer death in men and women. Its epidemic increase in incidence began in the first half of the twentieth century, paralleling the uptake of cigarette smoking that occurred 20 years before. A series of landmark studies beginning in 1950 established tobacco as the primary cause of lung cancer. Current smokers have a 10- to 20-fold higher lung cancer risk compared to never smokers. Important for prevention, former smokers substantially reduce this excess risk 5 years after smoking cessation. Exposure to secondhand smoke, a well-established risk factor for lung cancer, has a 20%–25% higher risk for those exposed. There are several occupational exposures associated with lung cancer, including asbestos. Despite the success in defining lung cancer’s etiology, this highly preventable disease remains among the most common and most lethal cancers globally.

scholarly journals Tobacco use in the Myeloproliferative neoplasms: symptom burden, patient opinions, and care

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sarah F. Christensen ◽  
Robyn M. Scherber ◽  
Gina L. Mazza ◽  
Amylou C. Dueck ◽  
Nana Brochmann ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Tobacco Use ◽  
Myeloproliferative Neoplasms ◽  
Myeloproliferative Neoplasm ◽  
Symptom Burden ◽  
Symptom Assessment ◽  
Cross Sectional ◽  
Former Smokers ◽  
Never Smokers

Abstract Background Patients with Philadelphia-negative Myeloproliferative Neoplasms (MPN) suffer from numerous symptoms and decreased quality of life. Smoking is associated with an increased symptom burden in several malignancies. The aim of this study was to analyze the association between smoking and MPN-related symptom burden and explore MPN patients’ opinions on smoking. Methods A total of 435 patients with MPN participated in a cross-sectional internet-based survey developed by the Mayo Clinic and the Myeloproliferative Neoplasm Quality of Life Group. Patients reported their demographics, disease characteristics, tobacco use, and opinions on tobacco use. In addition, MPN-related symptoms were reported via the validated 10-item version of the Myeloproliferative Neoplasms Symptom Assessment Form. Results Current/former smokers reported worse fatigue (mean severity 5.6 vs. 5.0, p = 0.02) and inactivity (mean severity 4.0 vs. 3.4, p = 0.03) than never smokers. Moreover, current/former smokers more frequently experienced early satiety (68.5% vs. 58.3%, p = 0.03), inactivity (79.9% vs. 71.1%, p = 0.04), and concentration difficulties (82.1% vs. 73.1%, p = 0.04). Although not significant, a higher total symptom burden was observed for current/former smokers (mean 30.4 vs. 27.0, p = 0.07). Accordingly, overall quality of life was significantly better among never smokers than current/former smokers (mean 3.5 vs. 3.9, p = 0.03). Only 43.2% of the current/former smokers reported having discussed tobacco use with their physician, and 17.5% did not believe smoking increased the risk of thrombosis. Conclusion The current study suggests that smoking may be associated with increased prevalence and severity of MPN symptoms and underscores the need to enhance patient education and address tobacco use in the care of MPN patients.

Alprazolam and Exposure for Panic Disorder with Agoraphobia

1994 ◽  
Vol 164 (5) ◽  
pp. 652-659 ◽  
Author(s):  
Metin Başoglu ◽  
Isaac M. Marks ◽  
Cengiz Kiliç ◽  
Richard P. Swinson ◽  
Homa Noshirvani ◽  
...  
Keyword(s):  
Side Effects ◽  
Panic Disorder ◽  
Drug Treatment ◽  
Psychological Treatment ◽  
Illness Severity ◽  
Withdrawal Symptoms ◽  
Severe Withdrawal ◽  
End Of Treatment

Patients with panic disorder plus agoraphobia had 8 weeks of drug treatment (alprazolam or placebo) plus psychological treatment (exposure or relaxation). At the end of treatment at week 8, 40 patients who had become much/very much improved rated how much their gains were attributable to medication or to their own efforts. During the tapering-off to week 16, and treatment-free follow-up to week 43, patients who at week 8 had attributed their gains to medication and felt less confident in coping without tablets had more severe withdrawal symptoms and greater loss of gains than did patients who at week 8 had attributed their gains to their own efforts during treatment. Baseline illness severity, greater age, higher expectations from drug treatment, and more side-effects of drugs during treatment all predicted more external attributions (i.e. to the effect of drugs) but did not independently predict relapse. Patients on alprazolam compared with placebo had more drug attributions. Though drug attributions predicted relapse in both alprazolam and placebo groups, predictions were stronger in the alprazolam group.

scholarly journals Self-reported and cotinine-verified smoking and increased risk of incident hearing loss

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Woncheol Lee ◽  
Yoosoo Chang ◽  
Hocheol Shin ◽  
Seungho Ryu
Keyword(s):  
Smoking Status ◽  
Objective Measure ◽  
Self Report ◽  
Urinary Cotinine ◽  
Increased Risk ◽  
Former Smokers ◽  
Never Smokers ◽  
Time Varying Covariates ◽  
New Onset

AbstractWe examined the associations of smoking status and urinary cotinine levels, an objective measure of smoking, with the development of new-onset HL. This cohort study was performed in 293,991 Korean adults free of HL who underwent a comprehensive screening examination and were followed for up to 8.8 years. HL was defined as a pure-tone average of thresholds at 0.5, 1.0, and 2.0 kHz ≥ 25 dB in both ears. During a median follow-up of 4.9 years, 2286 participants developed new-onset bilateral HL. Self-reported smoking status was associated with an increased risk of new-onset bilateral HL. Multivariable-adjusted HRs (95% CIs) for incident HL comparing former smokers and current smokers to never-smokers were 1.14 (1.004–1.30) and 1.40 (1.21–1.61), respectively. Number of cigarettes, pack-years, and urinary cotinine levels were consistently associated with incident HL. These associations were similarly observed when introducing changes in smoking status, urinary cotinine, and other confounders during follow-up as time-varying covariates. In this large cohort of young and middle-aged men and women, smoking status based on both self-report and urinary cotinine level were independently associated with an increased incidence of bilateral HL. Our findings indicate smoking is an independent risk factor for HL.

Differences in Awareness and Perceptions of Smokers' Behaviors

1992 ◽  
Vol 71 (1) ◽  
pp. 225-226 ◽  
Author(s):  
Rory Remer
Keyword(s):  
Shopping Malls ◽  
Negative Behaviors ◽  
Former Smokers ◽  
Never Smokers

Information regarding smokers' ( n = 74), never-smokers' ( n = 56), and former smokers' ( n = 13) relative awareness of and reaction to a sample of 17 negative behaviors of smokers was elicited and examined. Over-all ratings of irritation and of awareness were also analyzed for the 143 participants solicited in shopping malls in Lexington, KY. Former smokers were significantly, both statistically and practically, more aware and less tolerant of smokers' negative behaviors than either never-smokers or smokers, while never-smokers were more aware and bothered than were smokers, in all but one instance where all three groups responded similarly.

scholarly journals Clinicopathologic correlates of pembrolizumab efficacy in patients with advanced NSCLC and a PD-L1 expression of ≥ 50%

2020 ◽  
Author(s):  
Alessio Cortellini ◽  
Marcello Tiseo ◽  
Giuseppe L Banna ◽  
Federico Cappuzzo ◽  
Joachim GJV Aerts ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Bone Metastases ◽  
Recursive Partitioning ◽  
Single Agent ◽  
Multivariable Analysis ◽  
Tobacco Exposure ◽  
Former Smokers ◽  
Never Smokers ◽  
Ecog Ps ◽  
Nsclc Patients

AbstractBackgroundSingle agent pembrolizumab represents the standard first line option for metastatic non-small-cell-lung-cancer (NSCLC) patients with a PD-L1 (programmed death-ligand 1) expression of ≥ 50%.MethodsWe conducted a multicenter study aimed at evaluating the clinicopathologic correlates of pembrolizumab efficacy in patients with treatment-naïve NSCLC and a PD-L1 TPS ≥ 50%.Results1026 consecutive patients were included. ECOG-PS ≥ 2 (p < 0.0001) and bone metastases (p = 0.0003) were confirmed to be independent predictors of a worse ORR. Former smokers (p = 0.0002), but not current smokers (p = 0.0532) were confirmed to have a significantly prolonged PFS compared to never smokers at multivariate analysis. ECOG-PS (p < 0.0001), bone metastases (p < 0.0001) and liver metastases (p < 0.0001) were also confirmed to be independent predictors of a worse PFS. Previous palliative RT was significantly related to a shortened OS (p = 0.0104), while previous non-palliative RT was significantly related to a prolonged OS (p = 0.0033). Former smokers (p = 0.0131), but not current smokers (p = 0.3433) were confirmed to have a significantly prolonged OS compared to never smokers. ECOG-PS (p < 0.0001), bone metastases (p < 0.0001) and liver metastases (p < 0.0001) were also confirmed to be independent predictors of a shortened OS. A PD-L1 expression of ≥ 90%, as assessed by recursive partitioning, was associated with significantly higher ORR (p = 0.0204), and longer and OS (p = 0.0346) at multivariable analysis.Conclusionspembrolizumab was effective in a large cohort of NSCLC patients treated outside of clinical trials. We confirmed that the absence of tobacco exposure, and the presence of bone and liver metastasis are associated with worse clinical outcomes to pembrolizumab. Increasing levels of PD-L1 expression may help identifying a subset of patients who derive a greater benefit from pembrolizumab monotherapy.

scholarly journals REPEATABILITY OF A CALIBRATED DIGITAL SPECTROPHOTOMETER FOR DENTAL SHADE EVALUATION IN CURRENT, FORMER AND NEVER SMOKERS – STUDY PROTOCOL

2021 ◽  
Author(s):  
Gianluca Conte ◽  
Sebastiano Antonio Pacino ◽  
Salvatore Urso ◽  
Rosalia Emma ◽  
Fabio Cibella ◽  
...  
Keyword(s):  
Negative Impact ◽  
Good Reproducibility ◽  
Tobacco Products ◽  
Quit Smoking ◽  
Dental Aesthetics ◽  
Research Findings ◽  
Former Smokers ◽  
Never Smokers ◽  
Clear Objective

ABSTRACTDespite the negative impact of cigarette smoking on oral health and teeth appearance, there is no data available on dental shade changes in smokers who quit smoking. Dental discoloration caused by smoking may be permanent, with minimal restoration after stopping smoking. If this is valid, former smokers can show dental shade values equivalent to those of current smokers.The aim of this study is to compare the dental shade assessment by digital spectrophotometry (VITA Easyshade V) in current, former and never smokers and to verify the short (7 days) and long-term (30 days) repeatability of these measurements.Confirmation of good reproducibility of VITA Easyshade V with clear objective discrimination of dental shade measurements among current, former, and never smokers will improve the power of this measurement giving more confidence in clinical research findings of dental shades in these populations.It is also anticipated that results from the study will expand the application of this measurements to include medical and regulatory research applied to combustion-free tobacco products (e.g. e-cigarettes, heated tobacco products, oral tobacco/nicotine products, etc.), smoking cessation medications, and to consumer care product for oral hygiene and dental aesthetics.

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