SLC6A4 STin2 VNTR genetic polymorphism is associated with tobacco use disorder, but not with successful smoking cessation or smoking characteristics: a case control study.

The aim of this study was to determine if variable number of tandem repeats (VNTR) in the second intron (STin2) of the serotonin transporter (SLC6A4) gene was associated with tobacco use disorder, successful smoking cessation, or smoking characteristics. In this case-control study, patients with current tobacco use disorder, diagnosed according to DSM IV criteria (n = 185), and never-smokers, diagnosed according to CDC criteria (n = 175), were recruited and received 52 weeks of combined pharmacotherapy and cognitive therapy. Successful smoking cessation was defined as exhaled carbon monoxide < 6 ppm. SLC6A4 gene STin2 VNTR polymorphism was assessed using a Multiplex-PCR-based method. At baseline, participants were evaluated using the Fagerström Test for Nicotine Dependence (FTND) and the ASSIST scale

Características clínicas e qualidade de vida de fumantes em um centro de referência de abordagem e tratamento do tabagismo Clinical characteristics and quality of life of smokers at a referral center for smoking cessation

OBJETIVO: Comparar, entre fumantes e nunca fumantes, os seguintes aspectos: qualidade de vida, IMC, hospitalizações, incapacidades, história familiar de transtorno mental, doenças relacionadas ao uso de tabaco, depressão e uso de substâncias psicoativas. MÉTODOS: Um total de 167 fumantes inscritos em um programa de cessação do tabagismo no Centro de Referência de Abordagem e Tratamento do Tabagismo da Universidade Estadual de Londrina e 272 nunca fumantes doadores de sangue foram incluídos no estudo. Foram utilizados um questionário estruturado para a coleta de dados sociodemográficos, Alcohol, Smoking and Substance Involvement Screening Test, World Health Organization Quality of Life Instrument, brief version (WHOQoL-BREF) e Fagerström Test for Nicotine Dependence, todos validados para uso no Brasil, assim como critérios diagnósticos para a pesquisa de transtornos depressivos. RESULTADOS: A média de idade para fumantes e nunca fumantes foi, respectivamente, de 45 e 44 anos. As mulheres predominaram nos dois grupos. Fumantes mais frequentemente apresentaram incapacidades laborais e domésticas, presença de fumantes em casa, hospitalizações, transtorno depressivo, uso de sedativos, história de transtorno mental na família e piores escores em todos os domínios do WHOQoL-BREF. A média de idade do início do tabagismo em fumantes com depressão ou em uso de substâncias psicoativas foi mais baixa do que os sem essas comorbidades. Fumantes apresentaram mais frequentemente diabetes, hipertensão arterial, doenças cardíacas, doenças respiratórias e úlcera péptica do que os que nunca fumaram. O IMC médio foi menor entre fumantes do que nos que nunca fumaram. CONCLUSÕES: Este estudo sugere que, no tratamento do tabagismo, deveriam ser identificados subgrupos de fumantes com características específicas: início precoce do tabagismo, doenças que sofrem agravos pelo tabaco, depressão e uso de substâncias psicoativas.<br>OBJECTIVE: To compare smokers and never smokers in terms of the following: quality of life; BMI; hospitalizations; functionality; family history of mental disorder; tobacco-related diseases; depression; and psychoactive substance use. METHODS: We evaluated 167 smokers enrolled in a smoking cessation program at the Londrina State University Referral Center for Understanding and Treating Smoking, together with 272 never-smoking blood donors. We employed the following instruments, all validated for use in Brazil: a structured questionnaire for the collection of sociodemographic data; the Alcohol, Smoking and Substance Involvement Screening Test; the World Health Organization Quality of Life Instrument, brief version (WHOQoL-BREF); and the Fagerström Test for Nicotine Dependence. We also applied diagnostic criteria for the investigation of depressive disorders. RESULTS: The mean age of the smokers and never smokers was, respectively, 45 and 44 years. Females predominated in both groups. Smokers more often presented with impaired work/domestic functionality, hospitalizations, depressive disorders, smoking in the household, sedative use and a family history of mental disorders, as well as scoring lower in all domains of the WHOQoL-BREF. The mean age at smoking onset was lower for smokers with depression or using psychoactive substances than for smokers without such comorbidities. Diabetes, arterial hypertension, heart disease, respiratory disease and peptic ulcer were more common in smokers than in never smokers. The mean BMI was lower in the smokers than in the never smokers. CONCLUSIONS: This study suggests that, for smoking cessation programs, subgroups of smokers with specific characteristics (early age at smoking onset, tobacco-related diseases, depressive disorders and use of psychoactive substances) should be identified

The nicotine dependence associated with alcohol use and other psychoactive substance <br> A dependência da nicotina associada ao uso de álcool e outras substâncias psicoativas

To examine an association between nicotine dependence with alcohol, other psychoactive use, and depressive disorder. Smokers were recruited from Centro de Referência de Abordagem e Tratamento do Tabagismo at the Hospital das Clínicas da Universidade Estadual de Londrina (AHC/ UEL). All subjects were informed and gave then written consent for the research as approved by the Ethics Research Committee of Universidade Estadual de Londrina. The measures used were: structured questionnaire, alcohol, smoking, and psychoactive substance involvement screening test (ASSIST v 3.0), the Fagerström test for Nicotine Dependence (FTND), and the Diagnostic Interview for Research on Depressive disorder of the World Health Organization. Smokers presented the following socio-demographic characteristics: prevalence of the female sex and mean age of 47 years old with capacity for domestic activities and work. The mean age of onset of cigarette use for smokers was 16 years old. Fagerström’s test presented a medium punctuation of 6, so much for users of substances psicoativas, as for the ones that they don’t use them. Relationship between serious depression and the of psychoactive substances use was relevant for the research. This study evidenced an association among the use of the tobacco and other psychoactive substances, and depressive disorder. The health professional in smoking cessation intervention would be to identify subgroups of adult smokers, associated with depression, psychoactive substance use, and promote an intervention in both comorbidities and larger effectiveness of the smoking cessation. Analisar a associação entre a dependência de nicotina com o uso de álcool, outras substâncias psicoativas e transtorno depressivo. Os tabagistas foram recrutados a partir do Centro de Referência de Abordagem e Tratamento do Tabagismo no Hospital de Clínicas da Universidade Estadual de Londrina (AHC/UEL). Todos os participantes foram informados e assinaram o termo de consentimento livre e esclarecido aprovado pelo Comitê de Ética em Pesquisa da Universidade Estadual de Londrina. Os instrumentos foram: questionário estruturado, teste de triagem do envolvimento com álcool, tabaco e outras substâncias (ASSIST v 3.0), teste de Fargerström de Dependência de Nicotina (FTND) e critérios diagnósticos para pesquisa de transtorno depressivo, da Organização Mundial da Saúde. Os tabagistas apresentaram as seguintes características sócio-demográficas: predomínio do sexo feminino, e média de idade de 47 anos, com capacidade para atividades domésticas e trabalho. A média de idade de início do uso do tabaco foi de 16 anos. O teste de Fagerström apresentou uma pontuação média de seis, tanto para tabagistas com e sem uso de substâncias psicoativas, A relação encontrada entre a depressão grave e o uso de substâncias psicoativas foi significativa. Este estudo evidenciou uma associação entre o uso do tabaco, de outras substâncias psicoativas e transtorno depressivo. Os profissionais da saúde deveriam identificar subgrupos de fumantes adultos com associação de depressão e uso de substâncias psicoativas, e promover uma intervenção em ambas as comorbidades para maior efetividade do abandono do tabaco

Factors influencing insulin resistance in relation to atherogenicity in mood disorders, the metabolic syndrome and tobacco use disorder

OBJECTIVE: This study examines the effects of malondialdehyde (MDA) and uric acid on insulin resistance and atherogenicity in subjects with and without mood disorders, the metabolic syndrome (MetS) and tobacco use disorder (TUD). METHODS: We included 314 subjects with depression and bipolar depression, with and without the MetS and TUD and computed insulin resistance using the updated homeostasis model assessment (HOMA2IR) and atherogenicity using the atherogenic index of plasma (AIP), that is log10 (triglycerides/high density lipoprotein (HDL) cholesterol. RESULTS: HOMA2IR is correlated with body mass index (BMI) and uric acid levels, but not with mood disorders and TUD, while the AIP is positively associated with BMI, mood disorders, TUD, uric acid, MDA and male sex. Uric acid is positively associated with insulin and triglycerides and negatively with HDL cholesterol. MDA is positively associated with triglyceride levels. Comorbid mood disorders and TUD further increase AIP but not insulin resistance. Glucose is positively associated with increasing age, male gender and BMI. DISCUSSION: The results show that mood disorders, TUD and BMI together with elevated levels of uric acid and MDA independently contribute to increased atherogenic potential, while BMI and uric acid are risk factors for insulin resistance. The findings show that mood disorders and TUD are closely related to an increased atherogenic potential but not to insulin resistance or the MetS. Increased uric acid is a highly significant risk factor for insulin resistance and increased atherogenic potential. MDA, a marker of lipid peroxidation, further contributes to different aspects of the atherogenic potential. Mood disorders and TUD increase triglyceride levels, lower HDL cholesterol and are strongly associated with the atherogenic, but not insulin resistance, component of the MetS