1
Tobacco Addiction Treatment in Clients with Co-Occurring
Mental Illness
Dr. Peter Selby, MBBS, CCFP, FCFP, MHSc, dipABAM, DFASAM Chief – Primary Care Division, Director of Medical Education and Clinical Scientist – Addictions, CAMH Professor, DFCM, Psychiatry, and the Dalla Lana School of Public Health, University of Toronto @drpselby www.nicotinedependenceclinic.com
Tobacco Control Symposium Nova Scotia
Sept 28th, 2018
2
Disclosures (5years) Grants/Research Support:
• CAMH, Health Canada, OMOH, CTCRI, CIHR, CCSA, PHAC, Alberta Health Services, • Pfizer Inc./Canada, OLA, Medical Psychiatry Alliance, ECHO, NIDA, CCSRI, CCO, OICR, • Ontario Brain Institute, McLaughlin Centre, AHSC/AFP, WSIB, NIH, AFMC, Mt Sinai Hospital,
Shoppers Drug Mart, Bhasin Consulting Fund Inc., Patient-Centered Outcomes Research Institute
Speaking Engagements (Content not subject to sponsors approval)/Honoraria:
• Pfizer Inc. Canada, Pfizer Global, ABBVie, Bristol-Myers Squibb
Consulting Fees:
• Pfizer Inc./Canada, Pfizer Global, NABI Pharmaceuticals, Evidera Inc., • Johnson & Johnson Group of Companies, Medcan Clinic, Inflexxion Inc., V-CC Systems Inc.,
MedPlan Communications, Kataka Medical Communications, Miller Medical Communications, NVision Insight Group, Sun Life Financial
Other: (received drugs free/discounted for study through open tender process) • Johnson & Johnson, Novartis, Pfizer Inc.
NO TOBACCO or ALCOHOL or FOOD INDUSTRY FUNDING
3
Agenda
1. Case study
2. Screening clients with tobacco addiction and co-occurring mental illness
3. Why is it important to treat tobacco addiction in smokers with co-occurring disorders
4. Benefits of cessation in smokers with co-occurring disorders
5. Treatment options for smokers with co-occurring disorders
4
Introducing Laura
5
Introducing Laura
• Laura is a 36 year old single woman
• Works as a financial advisor at a bank, often works 10-12 hours/day
• Laura describes herself as very stressed, but she does not have time for self-care
• Laura has come to see you for help with her tobacco dependence
6
Introducing Laura
• On review of her medical chart you notice the following:
– Laura has been smoking 25 cigarettes/day for 12 years
– Time to first cigarette is 5 minutes
– Longest quit period is 3 months 30 years old
– Tried NRT in the past
7
Case study: Laura
Why can’t Laura quit tobacco smoking?
8
Case study: Laura
• Psychological trauma at the age of 12
• Diagnosed with depression at age 23
• Drinks 3 glasses of wine daily during the week to unwind from work, and 9 drinks on the weekend (wine and liquor)
• Laura smokes cigarettes at work to take a “break”
9
Clustering of mental health + addiction + tobacco
10
Screening clients with tobacco addiction and co-occurring mental illness
11
What can we do to optimize Laura’s outcomes?
• Engagement
• Focus (diagnostic overshadowing)
• Elicit
• Plan
• BioPsychoSocial Intervention
12
Elements of Assessment
• Trauma History (ACE score)
• Stability
• Risk
• Meds
13
Association between Tobacco Use and Co-Occurring Disorders
Drug/Stimuli Vector
Host
Environment
14
Environmental
Social
Psychological
Biological
Biopsychosocial Model
BEHAVIOUR
Single model approach insufficient!!!!!
15
• Mesolimbic Pathway: – Dopamine (DA) released from the VTA travels to the NAc and PFC, resulting
in feelings of reward from substance use (such as cocaine).
– DA can also extend into brain regions, including amygdala, hippocampus and orbitofrontal cortex, which are involved in executive function, emotional memory and motivation.
Pathways involved in Addiction
Volkow et al., 2012
16
Adverse Childhood Experience (ACE) Study
Sample Size (N)
% Prevalence Odds Ratio
(95% CI)
Depression N = 542 50.7% vs. 14.2%1
(N = 3 799) 4.6*
(3.8 – 5.6)
Ever Attempted Suicide
N = 544 18.3% vs. 1.2%1
(N = 3 852) 12.2*
(8.5 – 17.5)
Alcoholism N = 540 16.1% vs 2.9%1
(N = 3841) 7.4 *
(5.4 – 10.2)
Current Smoker N = 544 16.5% vs. 68%1
(N = 3 836) 2.2*
(1.7 – 2.9)
Ever using Illicit Drugs
N = 541 28.4% vs 6.4%1
(N = 3856) 4.7 *
(3.7-6.0)
Injecting Drugs N = 540 3.4% vs 0.3%1
(N = 3855) 10.3 *
(4.9 – 21.4)
1individuals reporting 0 exposures to adverse childhood experience
Adults reporting exposure to 4 or more adverse childhood experiences including abuse (psychological, physical and sexual) and household dysfunction (substance abuse, mental illness, mother treated violently, and criminal behaviour in household) display increased
prevalence of health risk behaviour and disease.
Adults reporting 4 or more adverse childhood exposures vs. 0 exposure
*p < 0.001
Felitti et al., 1998
17 Felitti et al., 1998
18
Adverse Childhood Experience (ACE) Questionnaire
While you were growing up, during your first 18 years of life:
1. Did a parent or other adult in the household often …
Swear at you, insult you, put you down, or humiliate you?
or
Act in a way that made you afraid that you might be physically hurt?
Yes No If yes enter 1 ________
2. Did a parent or other adult in the household often …
Push, grab, slap, or throw something at you?
or
Ever hit you so hard that you had marks or were injured?
Yes No If yes enter 1 ________
3. Did an adult or person at least 5 years older than you ever…
Touch or fondle you or have you touch their body in a sexual way?
or
Try to or actually have oral, anal, or vaginal sex with you?
Yes No If yes enter 1 ________
19
Adverse Childhood Experience (ACE) Questionnaire
While you were growing up, during your first 18 years of life:
4. Did you often feel that …
No one in your family loved you or thought you were important or special?
or
Your family didn’t look out for each other, feel close to each other, or support each other?
Yes No If yes enter 1 ________
5. Did you often feel that …
You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you?
or
Your parents were too drunk or high to take care of you or take you to the doctor if you needed it?
Yes No If yes enter 1 ________
6. Were your parents ever separated or divorced?
Yes No If yes enter 1 ________
20
Adverse Childhood Experience (ACE) Questionnaire
While you were growing up, during your first 18 years of life:
7. Was your mother or stepmother:
Often pushed, grabbed, slapped, or had something thrown at her?
or
Sometimes or often kicked, bitten, hit with a fist, or hit with something hard?
or
Ever repeatedly hit over at least a few minutes or threatened with a gun or knife?
Yes No If yes enter 1 ________
8. Did you live with anyone who was a problem drinker or alcoholic or who used street drugs?
Yes No If yes enter 1 ________
9. Was a household member depressed or mentally ill or did a household member attempt suicide?
Yes No If yes enter 1 ________
10. Did a household member go to prison?
Yes No If yes enter 1 ________
Now add up your “Yes” answers: _______ This is your ACE Score
21
Association between ACEs and Negative Outcomes
https://www.cdc.gov/violenceprevention/acestudy/ace_brfss.html
22
Why is it important to treat tobacco addiction in smokers with co-occurring disorders?
23
The Relationship between Tobacco use and Co-occurring Disorders
Individuals with mental illness are more likely to have:
Earlier age of onset for tobacco use
Greater tobacco use and higher tobacco dependence • Account for 44.3% of cigarettes smoked in North
America
Co-morbid diseases caused or worsened by tobacco use (i.e. COPD, diabetes, cancer etc.)
Lasser et al., 2000; De Leon & Diaz, 2005; Canadian Mental Health Association, 2008; Solty et al., 2009; McClave et al., 2010; Aubin et al., 2012.
24
Tobacco and Depression
• 60% of individuals with history of depression are current/past smokers
• Past history of MDD associated with:
• Higher prevalence of nicotine dependence
• Increased nicotine withdrawal severity
• Greater depressive symptoms during withdrawal
• Negative mood during quit attempt and higher risk of major depressive episode
• Lower long-term cessation
Individuals with MDD are approximately twice as likely to become smokers
Kalman et al. 2005; Ziedonis et al. 2008; Lasser et al. 2009; Bolam et al. 2011; Gierisch et al. 2012; Torres et al. 2010; Weinberger et al. 2013;
25
Depressive Symptoms Worsen, Worsened by Cessation Attempts
Depressive symptoms Smoking cessation
Bakhshaie et al., 2015; Bolam et al., 2011; Cinciripini et al., 2003; Gierisch et al., 2012; Reid et al., 2016; Torres et al., 2010; Weinberger et al., 2013
Individuals with history of depression are current or past smokers 60%
Negative mood
Nicotine dependence
Withdrawal
Reduced likelihood of cessation success
26
Positive Association: Suicide Risk and Nicotine Dependence
Substance-related factors increasing risk of suicidal thoughts or attempts
Nicotine dependence
Multiple substance use
Withdrawal during quit attempt
Intoxication
Smoking Suicide
?
?
Relationship between smoking and suicide
unclear:
Hughes, 2008; Barker et al., 2015
27
Increased rates of tobacco use vs general population
• 1/3 of individuals with social anxiety disorder display ND
• Greater perceived barriers to quit
• Higher rates of relapse
False conception that smoking relieves anxiety
• Nicotine is a stimulant increases anxiety
• Confuse withdrawal with anxiety symptoms
• Quitting tobacco can improve symptoms of anxiety
Anxiety Disorders and Tobacco Use
Moylan et al., 2012; McDermott et al., 2013; Langdon et al., 2016
28
Reasons/ Motivation to Quit
• Smoking cessation can reduce anxiety and depression and increase positive mood
• Depressed smokers may benefit from mood management
• Despite limited literature, treatment with bupropion, varenicline and NRT show efficacy in long-term cessation outcomes for clients with mood disorder
29
Benefits of cessation in smokers with co-occurring disorders
30
Change in mental health after smoking cessation: systematic review and meta-analysis
Follow-up Measure Number of Studies (N)
SMD (95% CI)
7wk – 12 m follow-up
Anxiety N = 4 studies -0.37* (-0.70 to -0.03)
3m – 6 year follow up
Mixed anxiety and depression
N = 5 studies -0.31* (-0.47 to -0.14)
11wk – 5 year follow-up
Depression N = 10 studies -0.25* (-0.37 to -0.12)
6m – 6 year follow-up
Stress N = 3 studies -0.27* (-0.40 to -0.13)
2m – 9 year follow-up
Psychological Quality of Life
N = 8 studies 0.22* (0.09 to 0.36)
3m – 4 year follow-up
Positive Affect N = 3 studies 0.40* (0.09 to 0.71)
Change in mental health from baseline to follow-up in smokers who quit vs continued smokers
*Significant at p < 0.05
Taylor, Gemma et al., 2014
31
Change in mental health after smoking cessation: systematic review and meta-analysis
Smoking cessation is associated with REDUCED anxiety, depression and stress, and IMPROVED psychological quality of
life, and positive affect.
Taylor, Gemma et al., 2014
32
Treatment options for smokers with co-occurring disorders
33
Psychosocial Interventions
Motivational Interviewing (MI) Psychoeducation Cognitive Behavioural Therapy (CBT)
Relaxation and Mindfulness Social Support Group Therapy
34
Pharmacological Interventions
Bupropion
Varenicline
NRT
35
EAGLES: Neuropsychiatric safety and efficacy of varenicline, bupropion, and nicotine patch in
smokers with and without psychiatric disorders
Population
Intervention 12 week
treatment – 12 week non treatment
% Abstinence Rate +
OR (95%CI) (week 9-12)
% Abstinence Rate +
OR (95% CI) (week 9-24)
What does this mean?
- Smokers age 18-75 years - DSM IV criteria for mood disorder - > 10 cpd
Varenicline 1 mg twice/day
(n = 1026) vs Placebo
(n = 1015)
29.2% vs 11.4 % 3.24*
(2.56 – 4.11)
18.3% vs 8.3% 2.50*
(1.90 – 3.29)
Smokers with psychiatric
disorder treated with varenicline, bupropion and
NRT show significantly
greater odds of continuous
smoking abstinence
compared to placebo group.
Bupropion 150 mg twice/day
(n = 1017) vs Placebo
(n = 1015)
19.3% vs 11.4% 1.87*
(1.46 – 2.39)
13.7% vs 8.3% 1.77*
(1.33 – 2.36)
NRT 21 mg per day (n = 1016) vs
Placebo (n = 1015)
20.4% vs 11.4% 2.00*
(1.56 – 2.55)
13.0% vs 8.3% 1.65*
(1.24 – 2.20)
Anthenelli RM, et al., 2016 *Significant at p<0.05
36
Treatment with varenicline showed the greatest efficacy in maintaining continuous abstinence rates in smokers with psychiatric disorders compared to bupropion, NRT
and placebo groups.
Anthenelli RM, et al., 2016
37
Tobacco Interventions and for Individuals with Depression
Meta-analysis: Effectiveness of smoking cessation interventions, with and without specific mood management components, in smokers with current or past depression
Number of trials (N)
Risk Ratio (95% CI) What does this mean?
Psychosocial Mood
Management vs Control
11 Trials (N = 1844)
current depression
1.47* (1.13, 1.92) Adding psychosocial mood
management to standard smoking cessation intervention, compared
to standard intervention alone, had a positive effect on increasing
cessation in smokers with current or past depression.
13 Trials (N = 1496)
past depression
1.41* (1.13, 1.77)
Outcome: Abstinence at 6 month follow up or longer; *significant at p < 0.05
van der Meer et al., 2013
38
Tobacco Interventions and for Smokers with Depression
Meta-analysis: Effectiveness of smoking cessation interventions, with and without specific mood management components, in smokers with current or past depression
Number of Trials (N)
Risk Ratio (95% CI)
What does this mean? Limitation
Bupropion (150 - 300 mg)
vs Placebo
5 Trials (N = 410) current
depression
1.37 (0.83, 2.27)
Treatment with bupropion may have a significant effect
on long-term cessation in smokers with past
depression compared to placebo.
Evidence for significance is weak due to
limited number of
studies
4 Trials (N = 404)
past depression
2.04* (1.31, 3.18)
Outcome: Abstinence at 6 month follow up or longer; *significant at p < 0.05
van der Meer et al., 2013
39
Tobacco Interventions and for Individuals with Depression
Meta-analysis: Effectiveness of smoking cessation interventions, with and without specific mood management components, in smokers with current or past depression
Number of Trials
(N)
Risk Ratio (95% CI)
What does this mean? Limitation
NRT vs Placebo
1 Trial (N = 196) current
depression
2.64 (0.93, 7.45)
Treatment with NRT shows a positive (but not
significant) effect on long-term cessation in smokers
with current and past
depression compared to placebo.
Evidence is weak due to limited
number of studies.
3 Trials (N = 432)
past depressio
n
1.17 (0.85, 1.60)
Outcome: Abstinence at 6 month follow up or longer.
van der Meer et al., 2013
40
Effect of Nicotine Patches on Cessation in Smokers with Self-reported Depression or Anxiety
Life-time diagnostic status of depression/anxiety does not influence quit outcome
when NRT is mass distributed for a 5-week
course
Kushnir et al., 2016
41
Effect of Nicotine Patches on Cessation in Smokers with Self-reported Depression or Anxiety
Life-time diagnostic status of depression/anxiety does not influence quit outcome
when NRT is mass distributed for a 5-week
course
Kushnir et al., 2016
42
Tobacco Interventions for Individuals with Bipolar Disorder
Population Intervention Control Outcome
- Male or female outpatient - 18-65 years - Any race -DSM-IV bipolar disorder - > 10 cpd - No pharmacotherapy
N = 31 12 weeks treatment + 12 weeks follow-up Prescribed varenicline; - 0.5 mg once/day for 1-3 days - 0.5 mg twice/day for 4-7 days - 1mg twice/day for remainder of 12 weeks
N = 29 Placebo – same schedule as varenicline
At the end of 12 week treatment, varenicline
group significantly more likely to achieve 7-day PPA (OR = 8.13; 95% CI: 2.03 – 32.53)
And 4-week continuous abstinence
(OR = 4.77; 95% CI: 1.02 – 25.13)
compared to placebo.
Chengappa et al. 2014
43
Tobacco Interventions for Individuals with PTSD
Population Intervention Control Outcome
- PTSD outpatient treatment program - DSM-IV criteria for PTSD - 15 male combat veterans - 47-58 years old (Mage = 50) - 60% Caucasian, 40% minority
N = 10 12 weeks treatment Prescribed bupropion SR; -150 mg once/day for 3-4 days - 150 mg twice/day remainder - Received individual counselling sessions
N = 5 Received placebo + individual counselling sessions
At the end of week 8, patients receiving bupropion SR more successful at achieving cessation vs placebo group (70% vs 20%) At 6 month follow-up, greater proportion of patients in bupropion SR group maintained cessation vs placebo group (40% vs 20%)
Hertzberg et al. 2001
44
Tobacco Interventions for Individuals with Schizophrenia
Number of Trials (N)
Risk Ratio (95% CI)
What does this Mean?
Bupropion (150 – 300 mg)
vs. Placebo
End of Treatment 7 studies N = 340
3.03* (1.69 – 5.42)
Treatment with bupropion significantly increased smoking cessation rates at the end of
treatment, and at 6 month follow-up, compared to placebo, in patients with
schizophrenia. Treatment with bupropion did not result in adverse events or changes in mental state (including positive, negative or depressive
symptoms).
6 Month Follow-Up 5 studies N = 214
2.78* (1.02 – 7.58)
Varenicline (0.5 – 1 mg) vs. Placebo
2 studies N = 137
4.47* (1.34 – 16.71)
Treatment with varenicline significantly increased smoking cessation rates at the end of
treatment, compared to placebo, in patients with schizophrenia.
However adverse psychiatric events, including suicidal ideation and behaviour, were reported
in 2/144 patients using varenicline .
Tsoi et al., 2013
45
Tobacco Interventions for Individuals with Alcohol Use Disorder (AUD)
Considerations for Prescribers: • Varenicline may reduce alcohol consumption; however more research needed
to verify efficacy
• Combination treatment with NRT and bupropion does not appear to be more effective for individuals with AUD
• Naltrexone may be used to reduce alcohol cravings, and may also reduce weight gain
• Individuals should meet the following criteria before using bupropion
– No current risk of seizures
– In treatment for alcohol use disorder
– Alcohol use is stable
– Should not drink > 2 standard drinks/day
Nicotine patches, bupropion and varenicline appear to be effective treatment options for individuals with concurrent tobacco and alcohol dependence.
Hughes et al., 2003; King et al., 2013; Nocente et al., 2013;
46
Review the Case: Laura
47
Drug Interactions Antidepressant Class Names of Medications Potential Drug Interactions
Selective Serotonin Reuptake Inhibitors (SSRI)
citalopram (Celexa), fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft)
St. John’s Wort, MAOI; alcohol can increase side effects; caffeine can increase anxiety/insomnia
Anxiolytic Class Names of Medications Potential Drug Interactions
Benzodiazepines alprazolam (Xanax), bromazepam (Lectopam), chlordiazepoxide (Librium), Clonazepam (Rivotril), diazepam (Valium), flurazepam (Dalmane), lorazepam (Ativan), nitrazepam (Mogadon), oxazepam (Serax), temazepam (Restoril), triazolam (Halcion)
Alcohol can increase side effects, especially drowsiness; use with caution in combination with other CNS drugs – can cause increased sedation and other side effects
https://www.nicotinedependenceclinic.com/English/teach/SiteAssets/Pages/Special-Populations
48
Drug Interactions Antipsychotics Names of Medications Potential Drug Interactions
First Generation (Typical, Conventional) Antipsychotics
chlorpromazine (Largactil), flupenthixol (Fluanxol), fluphenazine (Modecate), fluspirilene (IMAP), haloperidol (Haldol), loxapine (Loxapac), mesoridazine (Serentil), pericyazine (Neuleptil), perphenazine (Trilafon), pimozide (Orap), pipotiazine (Piportil), prochlorperazine (Stemetil), thioridazine (Mellaril), thiothixene (Navane), trifluoperazine (Stelazine), zuclopenthixol (Clopixol)
alcohol can increase side effects; caffeine can increase anxiety and agitation; use with caution in combination with other CNS drugs, which can increase side effects
Second Generation (Atypical, Novel) Antipsychotics
clozapine (Clozaril), olanzapine (Zyprexa, Zyprexa Zydis), quetiapine (Seroquel), risperidone (Risperdal, Risperdal M-TAB)
alcohol can increase side effects; caffeine can increase anxiety and agitation; use with caution in combination with other CNS drugs, which can increase side effects
https://www.nicotinedependenceclinic.com/English/teach/SiteAssets/Pages/Special-Populations
49
Drug Interactions with Tobacco Smoke
Drug/Class Mechanism of Interaction and Effects
Alprazolam (Xanax) Possible decrease plasma concentrations
Caffeine Increased metabolism (induction of CYP1A2); increased clearance (56%). Caffeine levels likely increase after cessation
Clozapine (Clozaril) Increased metabolism (induction of CYP1A2); decreased plasma concentrations (by 18%). Increased levels upon cessation may occur; closely monitor drug levels and reduce dose as required to avoid toxicity
Benzodiazepines Decreased sedation and drowsiness, possibly caused by nicotine stimulation of CNS
Serotonin 5-HT1 receptor agonists (triptans)
This class of drugs may cause coronary vasospasm; caution for use in smokers due to possible unrecognized CAD
TEACH/MISUD/Drug Interactions with Smoking TABLE.pdf
50
Summary
• Individuals with mental illness and substance use disorder display higher prevalence of nicotine dependence and lower long-term cessation
• Smoking cessation can reduce anxiety and depression and increase positive mood
• Despite limited literature, treatment with bupropion, varenicline and NRT show efficacy in long-term cessation outcomes for clients with co-occurring mental illness and substance use disorder
• Healthcare providers should offer a combination of counselling and pharmacotherapy treatment to individuals with mental illness and/or substance use disorder.
Questions
53
References • American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders. (4th Text
Revision ed.) Washington, DC: American Psychiatric Association.
• Anthenelli, RM., Benowitz, NL., West, R., Aubin. LS., McRae, T., Lawrence, D., Ascher, J., Russ, C., Krishen, A., Evins, AE., 2016. Neuropsychiatric safety and efficacy of varenicline, bupropion, and nicotine patch in smokers with and without psychiatric disorders (EAGLES): a double-blind, randomized, placebo-controlled clinical trial. The Lancet, 387: 2507-2520
• Bolam B, West R, Gunnell D. Does smoking cessation cause depression and anxiety? Findings from the ATTEMPT cohort. Nicotine & Tobacco Research : Official Journal of the Society for Research on Nicotine and Tobacco. 2011;13(3):209-214./
• Chengappa KN, et al. (2014). Varenicline for smoking cessation in bipolar disorder: A randomized, double-blind, placebo-controlled study. The Journal of Clinical Psychiatry, 75(7), 765-772.
• Centers for Disease Control and Prevention. About Behavioural Risk Factor Surveillance System ACE Data. https://www.cdc.gov/violenceprevention/acestudy/ace_brfss.html
• Gierisch JM, Bastian LA, Calhoun PS, et al. Smoking cessation interventions for patients with depression: A systematic review and meta-analysis. Journal of General Internal Medicine. 2012;27(3):351-360.
• Hertzberg MA, et al. (2001). A preliminary study of bupropion sustained-release for smoking cessation in patients with chronic posttraumatic stress disorder. Journal of Clinical Psychopharmacology, 21(1), 94-98.
• Kalman D, Morissette SB, George TP. Co-morbidity of smoking in patients with psychiatric and substance use disorders. The American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions. 2005;14(2):106-123.
• Kushnir, V., Menon, M., Balducci, X.L., Selby, P., Usoa B., Zawertailo, L.(2013). Enhanced smoking cue salience associated with depression severity in nicotine-dependent individuals: a preliminary fMRI study. Int J Neuropsychopharmacol.16 (5): 997-1008. doi: 10.1017/S1461145710000696
54
References (cont’d) • Kushnir V, Sproule BA, Zawertailo L, et al. (2016). Impact of self-reported lifetime depression
or anxiety on effectiveness of mass distribution of nicotine patches. Tob Control. Published Online First: 19 August 2016. doi: 10.1136/tobaccocontrol-2016-052994
• Langdon K.J., Farris S.G., Hogan J.B.D., Grover K.W., Zvolensky M.J. (2016). Anxiety sensitivity in relation to quit day dropout among adult daily smokers recruited to participate in a self-guided cessation attempt. Addict Behav. (58): 12 – 15.
• Lasser K, Boyd JW, Woolhandler S, et al. Smoking and mental illness: A population-based prevalence study. JAMA: the Journal of the American Medical Association. 2000;284(20):2606-2610.
• Moylan, S., Jacka, F. N., Pasco, J. A., & Berk, M. (2012). Cigarette smoking, nicotine dependence and anxiety disorders: A systematic review of population-based, epidemiological studies. BioMed Central (BMC) Medicine, 10(1), 123-137
• McDermott, M. S., Marteau, T. M., Hollands, G. J., Hankins, M., & Aveyard, P. (2013). Change in anxiety following successful and unsuccessful attempts at smoking cessation: Cohort study. The British Journal of Psychiatry, 202(1), 62-67.
• TEACH. (2017). Tobacco Interventions for Clients with Mental Illness and/or Substance Use Disorders. Retrieved from the Centre for Addiction and Mental Health course website: https://courses.camh.net/d2l/le/news/9284/11743/view; https://www.nicotinedependenceclinic.com/English/teach/SiteAssets/Pages/Special-Populations/Psychiatric%20Medication%20Tables.pdf
55
References (cont’d) • Taylor G., McNeil A., Girling A., Farley A., Lindson-Hawley N., Aveyard P. (2014) Change in
mental health after smoking cessation systematic review and meta-analysis. BMJ 348:g1151.
• Torres LD, Barrera AZ, Delucchi K, et al. Quitting smoking does not increase the risk of major depressive episodes among users of Internet smoking cessation interventions. Psychological Medicine. 2010;40(3):441-449
• van der Meer, RM., Willemsen, MC., Smit, F., Cuijpers, P. (2013). Smoking cessation interventions for smokers with current or past depression (Review). The Cochrane Library, 2013 (8), 1-134.
• Weinberger AH, Mazure CM, Morlett A, et al. Two decades of smoking cessation treatment research on smokers with depression: 1990-2010. Nicotine & Tobacco Research : Official Journal of the Society for Research on Nicotine and Tobacco. 2013;15(6):1014-1031.
• Zawertailo, L., Voci, S., Selby, P. (2015). Depression status as a predictor of quit success in a real world effectiveness study of nicotine replacement therapy. Psychiatry Res. 226; 120-127.
• Zawertailo, L., Baliunas, D., Ivanova, A., Selby P.L. (2015). Individualized treatment for tobacco dependence in addictions treatment settings: the role of current depressive symptoms on outcomes at 3 and 6 months.
• Ziedonis D, Hitsman B, Beckham JC, et al. Tobacco use and cessation in psychiatric disorders: National Institute of Mental Health report. Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco. 2008;10(12):1691-1715.
Top Related