Adrienne L Johnson1, Jesse Kaye1, Timothy B Baker2, Michael C Fiore2, Jessica W Cook1, Megan E Piper3. 1. University of Wisconsin School of Medicine and Public Health, Center for Tobacco Research and Intervention, 1930 Monroe St., Ste. 200, Madison, WI, 53711, United States; William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, WI, 53705, United States. 2. University of Wisconsin School of Medicine and Public Health, Center for Tobacco Research and Intervention, 1930 Monroe St., Ste. 200, Madison, WI, 53711, United States; University of Wisconsin School of Medicine and Public Health, Department of Medicine, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI, 53705, United States. 3. University of Wisconsin School of Medicine and Public Health, Center for Tobacco Research and Intervention, 1930 Monroe St., Ste. 200, Madison, WI, 53711, United States; University of Wisconsin School of Medicine and Public Health, Department of Medicine, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI, 53705, United States. Electronic address: mep@ctri.wisc.edu.
Abstract
BACKGROUND: Comorbid psychiatric diagnoses have been shown to predict cessation failure. The relative impact of various diagnoses on cessation and other cessation processes is rarely studied, particularly among a general population. The impact of psychiatric history among primary care patients seeking cessation services on nicotine dependence, cessation outcomes, treatment effects and adherence, and withdrawal symptoms was examined. METHODS: Secondary data analysis of a multi-site comparative effectiveness smoking cessation trial was conducted. Adult smokers (n = 1051; 52.5 % Female, 68.1 % white) completed a structured clinical interview at baseline to assess psychiatric diagnostic history (past-year and lifetime). Nicotine dependence was assessed via self-report measures at baseline. Point-prevalence abstinence was assessed at 8 weeks and 6 months post-quit. Withdrawal symptoms were assessed for one week pre- and post-quit using ecological momentary assessment. Treatment adherence was self-reported at 1, 4, 8, and 12 weeks post-quit. RESULTS: Past-year substance use disorder, lifetime mood disorder, and > one lifetime diagnosis, were related to lower rates of short-term, but not long-term, cessation. Lifetime psychiatric diagnosis was related to elevated nicotine dependence, particularly to secondary dependence motives associated with instrumental tobacco use. History of psychiatric diagnosis was associated with increased withdrawal-related craving. There was little evidence that psychiatric diagnostic status moderated the effects of the tested pharmacotherapies on long-term abstinence. CONCLUSIONS: Psychiatric diagnoses affect risk factors that exert their effects early in the post-quit process and highlight the potential utility of examining transdiagnostic risk factors to better understand the relations between psychiatric vulnerabilities and the smoking cessation process.
BACKGROUND: Comorbid psychiatric diagnoses have been shown to predict cessation failure. The relative impact of various diagnoses on cessation and other cessation processes is rarely studied, particularly among a general population. The impact of psychiatric history among primary care patients seeking cessation services on nicotine dependence, cessation outcomes, treatment effects and adherence, and withdrawal symptoms was examined. METHODS: Secondary data analysis of a multi-site comparative effectiveness smoking cessation trial was conducted. Adult smokers (n = 1051; 52.5 % Female, 68.1 % white) completed a structured clinical interview at baseline to assess psychiatric diagnostic history (past-year and lifetime). Nicotine dependence was assessed via self-report measures at baseline. Point-prevalence abstinence was assessed at 8 weeks and 6 months post-quit. Withdrawal symptoms were assessed for one week pre- and post-quit using ecological momentary assessment. Treatment adherence was self-reported at 1, 4, 8, and 12 weeks post-quit. RESULTS: Past-year substance use disorder, lifetime mood disorder, and > one lifetime diagnosis, were related to lower rates of short-term, but not long-term, cessation. Lifetime psychiatric diagnosis was related to elevated nicotine dependence, particularly to secondary dependence motives associated with instrumental tobacco use. History of psychiatric diagnosis was associated with increased withdrawal-related craving. There was little evidence that psychiatric diagnostic status moderated the effects of the tested pharmacotherapies on long-term abstinence. CONCLUSIONS:Psychiatric diagnoses affect risk factors that exert their effects early in the post-quit process and highlight the potential utility of examining transdiagnostic risk factors to better understand the relations between psychiatric vulnerabilities and the smoking cessation process.
Authors: Ronald C Kessler; Peggy R Barker; Lisa J Colpe; Joan F Epstein; Joseph C Gfroerer; Eva Hiripi; Mary J Howes; Sharon-Lise T Normand; Ronald W Manderscheid; Ellen E Walters; Alan M Zaslavsky Journal: Arch Gen Psychiatry Date: 2003-02
Authors: Megan E Piper; Jessica W Cook; Tanya R Schlam; Douglas E Jorenby; Stevens S Smith; Daniel M Bolt; Wei-Yin Loh Journal: Nicotine Tob Res Date: 2010-05-03 Impact factor: 4.244
Authors: Arnstein Mykletun; Simon Overland; Leif Edvard Aarø; Hanne-Marthe Liabø; Robert Stewart Journal: Eur Psychiatry Date: 2007-12-21 Impact factor: 5.361