Un
gene della serotonina associato all’iniziazione al fumo
Sullivan
PF. Jiang YX.
Neale
MC. Kendler KS.
Straub
RE. (2001) Association of the tryptophan hydroxylase gene with smoking
initiation but not
progression to nicotine dependence.
American Journal of Medical Genetics. 105(5):479-484.
Correlazione
tra un gene legato al triptofano e l’insorgenza del fumare. E’
stata studiata l’associazione tra due marker genetici della
triptofano-idrossilasi, nei confronti di tratti come l’iniziazione
al fumo e la progressione della dipendenza da nicotina. Il primo
fattore risulta significativamente correlato ai marker genetici.
Considerando che la triptofano-idrossilasi è l’enzima che regola la
sintesi del neurotrasmettitore serotonina, questi dati suggeriscono un
ruolo della serotonina nell’eziologia del fumo.
Vaccinarsi contro la nicotina?
Isomura
S. Wirsching P.
Janda
KD. (2001) An
immunotherapeutic program for the treatment of nicotine addiction:
Hapten design and synthesis. Journal of Organic Chemistry. 66(12):4115-4121.
Immunizzazione
contro nicotina come promettente associazione
alle terapie attuali. Sono stati sintetizzati e saggiati degli
anticorpi specifici contro la nicotina per il riconoscimento specifico
di questa in modo da bloccarne il trasporto dal plasma al
sistema nervoso centrale. Apteni ad alta purezza sono stati
prodotti in modo da garantire una potenziale
immunofarmacologia efficace e sicura.
Cessazione dal fumo on-line
Etter
J.F. Perneger T.V. (2001) Effectiveness of a Computer-Tailored Smoking
Cessation Program A Randomized Trial. Arch
Intern Med. 2001;161:2596-2601
L’informatica
in aiuto della cessazione del fumo. L’uso di materiale sperimentale
computerizzato ha permesso di applicare un protocollo di cessazione da
fumo di tipo cognitivo-comportamentale, in circa 3000 pazienti. I dati
di efficacia, significativi verso placebo, suggeriscono che le
metodologie informatiche possono incrementare la penetrazione ed il
beneficio dell’intervento terapeutico.
Il ragazzo non sta bene: fuma…
Tomori
M. Zalar B.
Plesnicar BK. Ziherl
S. Stergar E. (2001)
Smoking in relation to psychosocial risk factors in adolescents.
European
Child & Adolescent Psychiatry. 10(2):143-150.
Evidenziati
i fattori che caratterizzano e distinguono gli adolescenti fumatori da
quelli non. L’indagine è stata effettuata su 2111 studenti delle
scuole superiori somministrando questionari riguardanti fattori
familiari, scolastici, abitudini di salute, abuso di sostanze,
ideazione suicidaria oltre ad una scala di depressione ed autostima.
Si sono dimostrati discriminanti tra fumatori e non, fattori come
l’ideazione suicidaria, l’abuso di sostanze ed il fallimento
scolastico. Il fumo tra adolescenti risulta
quindi far parte di un quadro problematico di varie
psicopatologie e disturbi del comportamento.
Ragazzo, non vedi che rischio corri?
Romer
D. Jamieson P. (2001)
Do adolescents appreciate the risks of smoking? Evidence from a
national
survey.
Journal of Adolescent Health.
29(1):12-21.
Gli
adolescenti sottostimano la pericolosità del fumo. La presente
indagine telefonica ha verificato quanto, in base a criteri oggettivi
e personali, giovani adolescenti stimano il danno da fumo e la loro
possibilità di smettere. Lo studio ha confermato un’alta
percentuale di sottostima del rischio di morte, degli anni di vita
persi, del rischio di tumori. Tuttavia, è anche emerso che i giovani
ritengono ottimisticamente che la loro stima del rischio sia in ogni
caso sufficiente per pianificare la decisione di smettere.
Infermieri esperti per smettere di fumare
Cataldo
JK. (2001) The role of advanced practice psychiatric nurses in
treating tobacco use and dependence. Archives of Psychiatric Nursing. 15(3):107-119.
La
presente rassegna rimarca il ruolo fondamentale del personale
infermieristico psichiatrico nel trattamento del tabagismo.
I
testi dei sommari...
Sullivan PF. Jiang YX.
Neale
MC. Kendler KS.
Straub
RE. (2001) Association of the tryptophan hydroxylase gene with smoking
initiation but not
progression to nicotine dependence.
American Journal of Medical Genetics. 105(5):479-484.
We
investigated the association between two markers in the seventh intron
of the tryptophan hydroxylase gene (TPH C218A and C779A) in a
population-based case control study of 780 genotyped subjects.
As in prior studies, the
two markers were in strong linkage disequilibrium, The
phenotypes we studied were smoking initiation and progression
to nicotine dependence. Allele, genotype, and estimated haplotype
frequencies for each marker were highly significantly different for
smoking initiation (P<0.0004 for each comparison) and were
nonsignificant for progression to nicotine dependence. An empirical
test suggested that the positive results
were unlikely to have resulted from population stratification.
Our results are similar to those of Lerman et al, [2001: Am J Med
Genet (Neuropsychiatr
Genet) 105:000-000] in associating these TPH markers with
a construct related to smoking initiation but dissimilar in the
variable implicated. If
these results replicate in other samples, the serotonergic
system may be involved in the etiology of smoking initiation
given the rate-limiting
role of TPH in the biosynthesis of serotonin.
Isomura
S. Wirsching P.
Janda
KD. (2001) An
immunotherapeutic program for the treatment of nicotine addiction:
Hapten design and synthesis. Journal of Organic Chemistry.
66(12):4115-4121.
People
continue to smoke and use tobacco products despite well-established
hazardous consequences. The most contributing factor is the
addictive nature of nicotine. There is no highly effective treatment
for the problem of nicotine dependence. Immunotherapy offers an
alternative to conventional approaches. The chemistry necessary for a
comprehensive immunopharmacological program is presented. Haptens for
the generation of antibodies
specific for naturally occurring (S)-nicotine, (S)- and
(R)-nornicotine,
and the metabolite (S)-cotinine were prepared with high optical purity.
Preliminary data for antinicotine antibodies are reported.
Etter J.F. Perneger T.V. (2001) Effectiveness of a Computer-Tailored
Smoking Cessation Program A Randomized Trial. Arch
Intern Med. 2001;161:2596-2601
Background:
From a public health perspective, prevention of cancer and
cardiovascular diseases requires effective smoking cessation programs
that can be used on a large scale.
Objective
To test the effectiveness of a new computer-tailored smoking
cessation program vs no intervention.
Methods:
Randomized controlled trial, in the French-speaking part of
Switzerland, September 20, 1998, to December 31, 1999. Potential
participants were randomly selected from a general population register
and recruited by mail. Daily cigarette smokers who wished to
participate (N = 2934) were randomized to either the program or no
intervention. A mean of 1.5 times per 6 months, participants in the
active arm received by mail a computer-tailored counseling letter
based on their answers to a questionnaire and stage-matched booklets.
The counseling letters were tailored to the participants' stage of
change (categorized as precontemplation [no intention of quitting
smoking in the next 6 months], contemplation [seriously considers
quitting in the next 6 months], or preparation [has decided to quit in
the next 30 days]), level of tobacco dependence, self-efficacy, and
personal characteristics. The outcome measure was self-reported
abstinence (no puff of tobacco smoke in the past 4 weeks) 7 months
after entry into the program.
Results:
Abstinence was 2.6 times greater in the intervention group than in
the control group (5.8% vs 2.2%, P<.001).
The program was effective in "precontemplators" who were not
motivated to quit smoking at baseline (intervention vs control, 3.8%
vs 0.8%; P = .001) and was
effective regardless of perceived difficulty in quitting smoking at
baseline.
Conclusions:
The program was effective in increasing smoking cessation rates.
Because it can reach a large number of smokers, this program can
substantially contribute to disease prevention at a population level.
Tomori M. Zalar B.
Plesnicar BK. Ziherl
S. Stergar E. (2001)
Smoking in relation to psychosocial risk factors in adolescents.
European Child & Adolescent Psychiatry. 10(2):143-150.
Objective.
The study investigated which psychosocial factors distinguish
adolescent smokers from non-smokers, and examined the most important
factors correlated with smoking. Method. A cross-sectional
survey carried out by means of a questionnaire which, in addition to
items on family, school,
healthy habits, drug abuse and suicidal behaviour, also included a
scale of depression (Zung's SDS) and of self-esteem (Rosenberg's SES).
Sample. Two thousand one hundred and eleven high school
students aged from 17.0 to 18.11 (1083 girls and 1028 boys), of whom
221 girls and 239 boys were smokers. Results. The smokers of both
sexes differed significantly from
the non-smokers in frequency of substance abuse, family dysfunction,
suicidal ideation and suicide attempts, attitude towards the
harmful effects of smoking, truancy from school, and lesser
involvement in sports. With
regard to smoking behaviour, the most important predictive factors for
adolescents of both sexes proved to be substance abuse, truancy,
suicide attempts, a lower estimate of the harmfulness of smoking, and
infrequent engagement in sports. Among the girls, predictive
factors were also sexual
and physical abuse, and binge eating. Conclusions. Smoking
behaviour in adolescence may be part of a pattern of
problematic behaviour and
may be linked to various psychopathological disturbances.
Romer D. Jamieson P.
(2001) Do adolescents
appreciate the risks of smoking? Evidence from a national
survey. Journal of Adolescent Health. 29(1):12-21.
Purpose:
To evaluate whether adolescents understand the risks of smoking
when they decide to start. Estimates of objective risks that
can be compared with
epidemiologic evidence suggest that adolescents overstate
the risks. Ratings of personal risk suggest the opposite.
Methods:
A nationally representative telephone survey of 300 14- to
22-year-old nonsmokers and 300 14- to 22-year-old smokers was
conducted. Respondents
estimated both objective and personal risks of smoking, and smokers
reported their plans to quit. Objective estimates were compared
with both epidemiologic evidence and personal ratings of risk.
Regression procedures
were used to assess relationships between different estimates of risk
and between risk estimates and plans to quit.
Results:
Two of the three objective estimates of risk revealed high
proportions of misunderstanding. Over 40% of smokers and 25% of
nonsmokers underestimated,
or did not know, the likelihood of smoking-related death, and over 40%
did not know, or underestimated, the number of years of life
lost owing to smoking. Although young people overestimated lung
cancer risk relative to
objective data, these estimates are inflated by
underestimation of the fatality of lung cancer and by overlap
with other illnesses not included in objective risk measures. Young
smokers exhibited optimism
about personal risks of smoking regardless of their perceptions
of objective risk. Both objective and personal measures of risk
predicted plans to quit.
Conclusions:
Because perceptions of both personal and objective risks are
related to plans to quit, antismoking messages should include
evidence about risk,
particularly to the individual smoker.
Cataldo JK. (2001) The role of advanced practice psychiatric nurses in
treating tobacco use and dependence. Archives of Psychiatric Nursing.
15(3):107-119.
Tobacco
use is treatable and the benefits of smoking cessation are impressive,
yet like other health care providers, psychiatric nurses have failed
to consistently assess and treat tobacco use effectively, Tobacco use
continues to cause illness, disability, and death at unprecedented
rates. Nicotine addiction is drug abuse and it is a chronic disease
and needs to be treated
as such. There are clear health benefits to smoking cessation
regardless of the age of smoking initiation or the age of
smoking cessation, Advanced practice psychiatric nurses (APPNs)
are in a unique position
to make an impact on a smoker's risk of suffering from tobacco-related
diseases: the treatment of choice is the combination of
pharmacotherapy and psychosocial interventions, both within the
realm of APPN practice;
psychiatric and substance abusing patients consistently demonstrate
increased rates of cigarette smoking compared with healthy
controls; and tobacco use is drug abuse, a treatable chronic
disease, The ability of APPNs to deliver psychotherapeutic and
pharmacologic care secures
a position in the forefront of treating tobacco use. In addition to
intervention, psychiatric nurses need to step up and take an active
role in initiating and supporting tobacco control policy and
legislation.
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