Factors that Increase Sensitivity to Nicotine Dependence

Factors that Increase Sensitivity to Nicotine Dependence bestride of baccy plant put on initiation, accessory baccy plant apply and nicotine dependencyZiyue Wu accostIntroductionThe growing employ of baccy plant plant products have strong proscribe effects on public health conditions such as cardiovascular disease, cancer and lung disease (MacKenzie, Bartecchi, Schrier, 1994). As the leading ca practice of preventable end in the U.S., baccy work has been linked to the death of approximately 5 million people annually (Jha, Chaloupka, Moore, Gajalakshmi, Gupta, Peck, Asma Zatonski, 2006). Given the habit-forming nature of nicotine, many a nonher(prenominal) baccy riding habitrs be likely to become chronic smokers and to have trouble achieving successful cessation. Most explore on baccy put on has foc employ on rump pot. Ethnicity and sex activity have been found to be associated with nates hummer look (Hu et al., 2006LD1). Further, psychiatric disorders have been shown to contribute to the transition from quotidian gage to nicotine dependence (Dierker Donny, 2007 Breslau et al., 1998).Despite the large proceeds of studies examining cigarette bullet and nicotine dependence, risk for dependence based on other cases of baccy using up have received far less research attention. Different vitrines of baccy plant engross (cigarette, cigar, underground locoweed, snuff, baccy chewing) may bode nicotine dependence contrastively. such difference may be more solid between smoke-free tobacco intentionrs and smokers. Moreover, little is known nearly combined effects of tobacco enjoyment on risk for nicotine dependence. paths of tobacco utilize.Different types of tobacco subprogram (cigarette, cigar, pipe hummer, snuff, tobacco chewing) may predict nicotine dependence diametrically. much(prenominal) difference may be more significant between smoke-free tobacco maprs and smokers. Concomitant smokers may follow a un ique pattern.Also, date of the initiation of tobacco use may be cor related to with afoot(predicate) us epoch standard and bend of ways of tobacco use. It remains indefinite that whether individuals with earlier flacks of tobacco use have greater risk of suitable nicotine dependent and victimisation tobacco attendantly. LD2By examining the data from The National epidemiological Survey on Alcohol and Related Conditions (NESARC), this weigh sought to (a) insure whether divers(prenominal) ways of consuming tobacco might lead to different levels of sensitivity to nicotine dependence (b) discover whether time of initiation of tobacco victimisation behavior contributes to different levels of sensitivity to nicotine dependence (c) find out whether age of initiation is associated with attender tobacco use, especially combined use of smoke-free tobacco and smoking (d) discover that which ways of tobacco did most(prenominal) attendee users employ first.LD3MethodSampleThe s ample was taken from the first quiver of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). NESARC, draw by Grant et al. (2006publication year?)., has an unprecedented large sample size (n=43,093) to achieve stable estimates of even rare conditions. It represents the civilian, noninstitutionalized adult population of the United States, including residents of the District of Columbia, Alaska, and Hawaii. People that lived in househ venerables, military personnel that lived move out base, and people that lived root word quarters boarding or rooming houses, nontransient hotels and motels, shelters, facilities for ho using workers, college quarters, and group homes (Grant et al, publication year), were interviewed in a computer-assisted personal basis after go for to participate. The present analyses were based on all the respondents. This sample was chosen to judge both current tobacco users and tobacco abstainers.MeasuresUse of tobacco plant product s use was measured by asking respondents whether they had utilise cigarettes/ cigars/ pipes/ snuffs/ chewing tobacco these products in past twelve month (Had you used cigarettes/ cigars/ pipes/ snuffs/ chewing tobacco in past twelve months?). Frequency of Ccurrent tobacco use was measured with the straits ing behavior was evaluated by the frequency (How often did you use cigarettes/ cigars/ pipes/ snuffs/ chewing tobacco in past twelve months?) and bill was measured with the apparent movement (What was the habitual quantity when you used them?). Usage quantities of certain diversenesss of tobacco per month were estimated by multiplying midpoint of the range of each describe frequency per month and reported usual usage quantity.Age related measures selected as third variables and reign variables included age, age at the bombardment of certain kinds of smoking behavior (How old were you when you first used cigarettes/ cigars/ pipes/ snuffs/ chewing tobacco?), age at the onset of using them daily use (How old were you when you started using them daily?), age at the onset of tobacco using behavior (How old were you when using tobacco at the first time?) and age at the onset of invariablyyday tobacco useing behavior (How old were you when starting to use tobacco daily?). A variable reflecting bout of kinds of tobacco used was created to separate concomitant tobacco users from single way users. For concomitant tobacco users, I created variables to show the current combination of ways in tobacco use and the combination of ways when the respondents started using tobaccoLD4EW5. A variable reflecting the number of years since the respondents started using tobacco was in addition created by subtracting the age at the onset of tobacco using initiation from age at the interview. A categorical variable was similarly created to describe which combinations of tobacco use the respondents savage into, single way smoking, single way smoke-free tobacco, concomitant use of smoking, concomitant use of smokeless tobacco, or concomitant use of smoking and smokeless tobacco. NICENicotine dependence related variable was Nicotine dependence in past twelve month.Data AnalysesIn the first question asked, Logistic regression was estimated to determinesee whether different ways of tobacco usieng predicted nicotine dependence independently. For the chipA second set of question, another logistic regression analyses were was conducted within each type of tobacco using behavior, with controlvariables for meat used usage amount, age, ethnicity and sexual practice controlled, to vagabond the correlation between the age of initiation and probability in acquiring nicotine dependent. A two way interaction tested by Pearson correlational statistics Test was conducted to examinefind out friendship between age of initiation of tobacco using and current number of tobacco use ways. LD6ResultsDifferent tobacco uses and nicotine dependenceMore than one fourth (25 .80%) of the respondents reported slightly forms of tobacco use in past 12 months. Among those who used tobacco in past 12 months, 89.216% (n=9,913) smoked cigarettes, 10.106% (n=1,119) smoked cigars, 1.93% (n=215) used pipes, 6.548% (n=720) used snuffs and 4.52% (N=502) chewed tobacco.Further, the number of fair cigarettes smoked per month climbed towas 186.26 (SD=332.32), whereas the numbers of monthly uses of cigars, pipe smoking, snuffs and chewing tobacco are exceptwere 2.108 (SD=27.61), 2.879 (SD=28.70), 4.108 (SD=38.38) and 1.94 (SD=24.71), respectively.. EW7Logistic regression was used to examine the friendship between different kinds of tobacco use and nicotine dependence, with covariatescontrolling for of age of tobacco use initiation, years using tobacco, ethnicity and gender. Cigarettes, snuffs and chewing tobacco were positively associated with nicotine dependence, while cigars and pipe smoking failed to independently predict nicotine dependence. EW8Age of onset, to bacco usage amount, and nicotine dependenceThe average age of onset of tobacco use was 16.548 (SD=5.21) years old, and the average number of years using tobacco was 32.108 (SD=17.37) years old. Of 18,943 subjects who reported ever using tobacco, 77.656% (n=14,693) started before adulthood.Logistic regression was used to estimate the knowledge between age of initiation and nicotine dependence. Covariates included years using tobacco, ethnicity, gender and tobacco use. Age of onset of tobacco use was found to be negatively related to nicotine dependence, with earlier onsets associated with higher risks for nicotine dependence.Moreover, multiple regression was used to estimate the correlation between age of initiation and current tobacco useage amount, also with variables forcontrolling for years using tobacco, ethnicity and gender controlled. For users of most popular type of tobacco use, cigarette smokingers showed strong positive relationship between age of onset of cigarette smoki ng and amount of current smoking amount. primarily onsets actually elevated was associated with a higher current cigarette smoking amount. NAnd number of cigarettes consumed was found at one time linkedto be positively associated with likelihood of experiencing to nicotine dependenceLD9. This ending might serve as another clue for earlier onsets probably promoted risks for nicotine dependence. EW10Concomitant tobacco users and single way usersAmong theose 11,118 respondents who reported tobacco use in past 12 months, 10.3% (n=1,149) of them were concomitant users. Also, among 1144 concomitant tobacco users (total 1149) with functional data, 54.655% (n=624) hadof them started smoking cigarettes as the first way to of usinge tobacco. In total, 71.3% (n=816) of respondents started using tobacco in smoking forms (cigarettes, cigars, pipes or combined smoking). Only 20.72% (n=237) of respondents first started using tobacco in smokeless form (snuffs, tobacco chewing or combined smok eless tobacco). The rest, only 8.39% (n=96) of respondents, first used tobacco in both smoking and smokeless tobacco. Also, among 1034 daily concomitant tobacco users, 70.50% (n=729) started smoking cigarettes first. REALLY NICEOutcome of the Pearson correlation tests for age of tobacco use initiation and current numbers of ways used showed a wee, significant negative correlation (r= -0.11, pwas associated with a larger number of ways of using tobacco. elevated the probability in decorous tobacco co-users.Moreover, tobacco users were unaffectionate into different categories, single way smoking, single way smokeless tobacco, concomitant use of smoking, concomitant use of smokeless tobacco, or concomitant use of smoking and smokeless tobacco. Chi-square test was conducted to examine each of two different categories and nicotine dependence. Single way smokeless tobacco users were found to have set out probabilities of graceful nicotine dependence than all the other groups of user s, except of the concomitant use of smokeless tobacco users. Also, the group of concomitant use of smokeless tobacco users were also found to have lower probabilities of nicotine dependence than co-users of smoking and smokeless tobaccoLD11. EW12DiscussionThe present study sought to examine whether age of onset of tobacco use was associated with nicotine dependence and numbers of kinds of tobacco used. The study also aimed to examine whether different kinds of tobacco use were differently related to nicotine dependence. Further, itToabccoTobacco use was also examined amongthe tobacco use of concomitant users. Four major findings appeared. First, different ways of tobacco use were actually associated with nicotine dependence differently. Whereas cigars and pipe smoking failed to independently predict nicotine dependence, the other three kinds of tobacco, cigarettes, pipe smoking, snuffs and chewing tobacco were independently positively related to nicotine dependence. Second, age of o nset of tobacco use was associated with nicotine dependence. An earlier initiation of tobacco use enhanced the probability of acquiring nicotine dependence. Third, age of onset of tobacco use also had correlation with number of kinds of tobacco use. An earlier onset also elevated the probability of becoming concomitant users. Lastly, most of the co-users of tobacco started with smoking cigarettes.The finding of different directions of association with nicotine dependence in various kinds of tobacco may be explained by discrete habits and intentions of tobacco use. Of the five kinds of tobacco, cigars and pipe smoking failed to independently predict nicotine dependence (p=0.40). Two facts may be the causes of this may explain this explainations renderings phenomenon. First,First, most of the cigar smokers and pipe smokers were concomitant smokers. AIt is possible that among all cigar smokers (n=1,119) and pipe smokers (n=215), 62.02% (n=694) of cigar smokers and 74.88% (n=161) of pip e smokers were concomitant tobacco users. Second, most cigar smokers and pipe smokers did not consume large amount of cigar products. 80.07% (n= 896) of cigar users smoked less than or equal to 14 cigars per month. 60.93% (n=LD13131) EW14of pipe smokers used pipe smoking 18 times or less. Such small dose of intake may not result in seemly variety of nicotine dependence. To sum up, cigar users and pipe users probably consumed these products not for satisfying the liking for nicotine but simply for a hobby.The correlation between age of tobacco use initiation and nicotine dependence showed that archean initiation enhanced change magnitude the probability of nicotine dependence. In the case of a special substance, the cigarette smoking, early initiation also elevated the current useage amount. of tobacco productLD15. This outcome is reconciled with previous literature that stated early age of onset was associated with to a great extent smoking in later life (Chen Millar, 1998). Although early age of onset has been evaluated with its potential to enhance tobacco use amount, difficulty in tobacco cessation (Chen Millar, 1998 Khuder et al., 1999) and tobacco use frequency (Taioli Wynder, 1991), result of the present study has initiated strong implication that age of onset may also directly influence the possibility of becoming nicotine dependent.Moreover, the relationship between age of tobacco initiation and current kinds of tobacco use indicated that early onset also promoted the probability of becoming a current polytobacco users. Previous researchers have observe that evidence that gender, ethnicity, education and income are related to concomitant tobacco use (Bombard, Pederson, Nelson Malarcher, 2007). However, the present study has shown evidence for the association between age of tobacco use onset and concomitant tobacco users.Further, the present study showed that a significantly large proportion of concomitant users started using tobacco by smoki ng cigarettes, and then stepped initiated into other kinds of tobacco. The direction of shifting among different tobacco products has been studied by others, and several various results have emerged. While both(prenominal) have suggested that smokeless tobacco products may act as ingress substances to cigarette smoking (Hatsukami, Nelson Jensen, 1991 Haddock et al., 2001), others have also proposed that cigarette smoking initiates smokeless tobacco use (Riley et al., 1996). There are also some researchers that have claimed none of them initiates the other (Wetter et al., 2002). The outcome of the present study suggests that cigarette smoking is likely to precede smokeless tobacco use.In the pair comparisons of different combinations of tobacco use, the group that only used one kind of smokeless tobacco showed a significantly lower probability ofin becoming nicotine dependent than groups of single way smokers, concomitant smokers and co-users of smoking and smokeless tobacco. The only group that was not significantly different did not show significantce fluctuation in sensitivity to nicotine dependence from the group of single way smokeless tobacco users was the group of concomitant smokeless LD16tobacco users. One of the reasonable explanation of such phenomenon is that smokeless tobacco may be less addictive than smoking (Henningfield, Fant Tomar, 1997). Another explanation is that smokeless tobacco users might use less amount of tobacco products per month. The ANOVA of the combined amount of tobacco products used per month was conducted to test whether smokeless tobacco users had smaller amount of tobacco use. The result showed that the average usage amount of single way smokeless tobacco users was 97.94, which was significantly lower than those of single way smokers, concomitant smokers and concomitant users of smoking and smokeless tobacco, which were 408.22, 460.77 and 584.38.Strengths and limitationsThere are several limitations in the present stud y. First, only frequency of use and usual use quantity were available for estimating the amount of the tobacco products used per month. Such calculation was partial for reflecting the actual amount of use. Moreover, there was no measure forConclusions and implicationsOUTLINE curtly summarizing what you found (Summary)Take the main sentences of the results, weart keep ever-changing the wordsFinding 1, 2, 3 linking them to previous literatureWhen talk about literature, dont keep writing about the resultsStrengths and limitationsConclusions and implications what should future research look atReferencesBreslau, N., Peterson, E. L., Schultz, L. R., Chilcoat, H. D., Andreski, P. (1998). Major depression and stages of smoking a longitudinal investigation.Archives of general Psychiatry,55(2), 161-166.Chen, J., Millar, W. J. (1998). Age of smoking initiation implications for quitting.HEALTH REPORTS-STATISTICS CANADA,9, 39-48.Dierker, L., Donny, E. (2008). The role of psychiatric disorde rs in the relationship between cigarette smoking and DSM-IV nicotine dependence among newborn adults.Nicotine Tobacco Research,10(3), 439-446.Grant, B. F., Dawson, D. A. (2006). Introduction to the national epidemiologic survey on alcohol and related conditions.Alcohol Health Research World,29(2), 74.Haddock, C. K., Weg, M. V., DeBon, M., Klesges, R. C., Talcott, G. W., Lando, H., Peterson, A. (2001). Evidence that smokeless tobacco use is a gateway for smoking initiation in young adult males.Preventive medicine,32(3), 262-267.Hatsukami, D., Nelson, R., Jensen, J. (1991). smokeless tobacco Current status and future directions.British Journal of Addiction,86(5), 559-563.Hatsukami, D. K., Lemmonds, C., Tomar, S. L. (2004). smoke-free tobacco use harm reduction or induction approach?.Preventive medicine,38(3), 309-317.Henningfield, J. E., Fant, R. V., Tomar, S. L. (1997). Smokeless tobacco an addicting drug.Advances in dental research,11(3), 330-335.Hu, M. C., Davies, M., Kan del, D. B. (2006). Epidemiology and correlates of daily smoking and nicotine dependence among young adults in the United States.American Journal of Public Health,96(2), 299-308.Jha, P., Chaloupka, F. J., Moore, J., Gajalakshmi, V., Gupta, P. C., Peck, R., Zatonski, W. (2006). Tobacco addiction.Khuder, S. A., Dayal, H. H., Mutgi, A. B. (1999). Age at smoking onset and its effect on smoking cessation.Addictive behaviors,24(5), 673-677.MacKenzie, T. D., Bartecchi, C. E., Schrier, R. W. (1994). The human cost of tobacco use. New England Journal of Medicine, 330(14), 975-980.Riley, W. T., Kaugars, G. E., Grisius, T. M., Page, D. G., Burns, J. C., Svirsky, J. A. (1996). Adult smokeless tobacco use and age of onset.Addictive behaviors,21(1), 135-138.Taioli, E., Wynder, E. L. (1991). Effect of the age at which smoking begins on frequency of smoking in adulthood.N Engl J Med,325(13), 968-969.Wetter, D. W., McClure, J. B., de Moor, C., Cofta-Gunn, L., Cummings, S., Cinciripini, P. M., Gritz, E. R. (2002). Concomitant use of cigarettes and smokeless tobacco prevalence, correlates, and predictors of tobacco cessation.Preventive medicine,34(6), 638-648.LD1You need to say what ethnic groups or which gender are more likely to use tobacco. It is not enough to say ethnicity and gender are associated with tobacco use.LD2This needs to be preceded by what the literature has shown on age of onset. In its current form, the paragraph comes a bit from remaining field for the reader.LD3You can include this in your results, but I dont think it is on par with your other questions, so it does not need to be included here.LD4Not sure how to edit this, but a little less clear than earlier descriptions.EW5Describe the categoriesLD6 We can discuss.EW7One decimal model for percentage and numberTwo decimal places for SD and SEEW8Add the sentence stating the likelihood, unrivalled ratios and confidence intervalsLD9Logistic regression?EW10Maybe I can delete itLD11Add the actual place to this sentence.EW12Should I add some more details?LD13EW14Decide whether to delete it or put it in the result partLD15LD16