Psychedelics as a potential treatment for tobacco use disorder: a systematic review

Real-world comparison of phone versus video consultation in a tobacco treatment program during the COVID-19 pandemic.

Introduction The clinical practice guideline emphasizes that tobacco dependence is a chronic disease. Quitting is a continuous process with time spent in consideration, planning, maintenan...

In the treatment of tobacco use disorder, current approaches focus on pharmacotherapy, nicotine replacement, and psychotherapy. However, traditional treatments have been widely used in societies for the purpose of smoking cessation for years. Although cases using traditional herbs in the self-treatment of addiction have been reported in the literature, studies on this subject are very limited. Research on certain herbs shows that they may be effective in the treatment of tobacco use disorder by different mechanisms, however, there is no evidence that they are safe to consume as cigarettes. This article aims to question the place of traditional herbs in tobacco use disorder treatment through a case who started to smoke Melissa officinalis herb to help his nicotine withdrawal.

Developing Competency-Based Nursing Treatment for Persons With Tobacco Use Disorder.

363 - Nicotine and Tobacco

Because COVID-19 is a respiratory and cardiovascular disease, understanding behaviors that impact cardiopulmonary health, such as tobacco use, is particularly important. While early studies suggested no change in prevalence of tobacco use as COVID-19 emerged, pandemic fatigue, shifting levels of COVID-19 transmission, and vaccine availability have all changed since the start of the pandemic. The current study examined whether time, COVID-19 surges, and/or vaccination status were associated with likelihood of daily and non-daily tobacco use over the first 24 months of the pandemic. Data were obtained from electronic health records of healthcare visits (n = 314,787) to four Southern California VA healthcare systems. Multinomial logistic regression analyses indicated that the likelihood of reporting both daily and non-daily tobacco use (versus non-use) increased over time. Daily and non-daily tobacco use were less common at visits that occurred during COVID-19 surges, as well as among veterans vaccinated against COVID-19. Our findings provide new insight into changes of tobacco use patterns and correlates across the first two years of this pandemic, and understanding these associations may facilitate understanding of health-related behaviors and inform clinical treatment of tobacco use disorder during the COVID-19 pandemic.

Several fungi, including the plant root symbiont and insect pathogen Metarhizium brunneum, produce lysergic acid amides via a branch of the ergot alkaloid pathway. Lysergic acid amides include important pharmaceuticals and pharmaceutical lead compounds and have potential ecological significance, making knowledge of their biosynthesis relevant. Many steps in the biosynthesis of lysergic acid amides have been determined, but terminal steps in the synthesis of lysergic acid α-hydroxyethylamide (LAH)-by far the most abundant lysergic acid amide in M. brunneum-are unknown. Ergot alkaloid synthesis (eas) genes are clustered in the genomes of fungi that produce these compounds, and the eas clusters of LAH producers contain two uncharacterized genes (easO and easP) not found in fungi that do not produce LAH. Knockout of easO via a CRISPR-Cas9 approach eliminated LAH and resulted in accumulation of the alternate lysergic acid amides lysergyl-alanine and ergonovine. Despite the elimination of LAH, the total concentration of lysergic acid derivatives was not affected significantly by the mutation. Complementation with a wild-type allele of easO restored the ability to synthesize LAH. Substrate feeding studies indicated that neither lysergyl-alanine nor ergonovine were substrates for the product of easO (EasO). EasO had structural similarity to Baeyer-Villiger monooxygenases (BVMOs), and labeling studies with deuterated alanine supported a role for a BVMO in LAH biosynthesis. The easO knockout had reduced virulence to larvae of the insect Galleria mellonella, indicating that LAH contributes to virulence of M. brunneum on insects and that LAH has biological activities different from ergonovine and lysergyl-alanine. IMPORTANCE Fungi in the genus Metarhizium are important plant root symbionts and insect pathogens. They are formulated commercially to protect plants from insect pests. Several Metarhizium species, including M. brunneum, were recently shown to produce ergot alkaloids, a class of specialized metabolites studied extensively in other fungi because of their importance in agriculture and medicine. A biological role for ergot alkaloids in Metarhizium species had not been demonstrated previously. Moreover, the types of ergot alkaloids produced by Metarhizium species are lysergic acid amides, which have served directly or indirectly as important pharmaceutical compounds. The terminal steps in the synthesis of the most abundant lysergic acid amide in Metarhizium species and several other fungi (LAH) have not been determined. The results of this study demonstrate the role of a previously unstudied gene in LAH synthesis and indicate that LAH contributes to virulence of M. brunneum on insects.

Background: Advice from health care professionals (HCPs) is critical for tobacco prevention and cessation efforts. The academic curricula for health care professional students (HCS) lack comprehensive training in assisting patients in tobacco cessation. Tobacco use among HCP’s deters them from giving proper tobacco prevention and cessation guidance. The objective of this study was to determine the prevalence and determinants of tobacco consumption in third-year students of four health care disciplines (medical, dental, pharmacy, and nursing) and to assess their undergraduate education on tobacco control and cessation. Methods: A web-based survey (response rate 84.4%) employing the Global Health Professions Student Survey (GHPSS) questionnaire; n= 838; [20.89 (SD± 0.94) years] was conducted in Mysore, India. A descriptive, comparative and multivariate analysis was performed. Results: The number of students who received formal training in smoking cessation approaches was only 14.04%. In total, two-thirds of medical students, compared to 38.9% of dental, 29.7% of pharmacy, and 11.40 % of nursing students, learned “the reasons why people smoke” as a part of their formal training. However, only less than a quarter of the study population were aware of the role of antidepressants in nicotine cessation medications. The total prevalence of tobacco use was 28.9%. A total of 37.72% wanted to quit smoking, while a mere 1.2% had sought any professional help to do so. Conclusions: Tobacco use in HCS, apart from personal health risks to themselves, may potentially affect their future commitment to support patients in tobacco cessation. There is a need for further research into tobacco prevention and cessation programs tailored to the needs of student groups. There is a need for an updated curriculum for tobacco cessation strategies and more research into better cessation strategies.

Objective: Bupropion is one of the few medications with an FDA indication for smoking cessation. This is of particular significance due to the high co-morbidity of tobacco use disorder in patients with schizophrenia spectrum and other psychotic disorders. We sought to determine whether historical suggestions of bupropion’s pro-dopaminergic activity lead prescribers to withhold bupropion in populations receiving antipsychotic medications. Methods: The prevalence in clinical practice of the combination of bupropion and 10 antipsychotic formulations was determined by a computer review of the Genoa Healthcare database for all prescribers at 10 participating community mental health centers. Actual prevalence was compared with expected prevalence using the test of proportions. A Bonferroni correction for multiple comparisons was included. Results: Clozapine, p = 0.0004, and the microsphere formulation of risperidone, p = 0.0045, were prescribed with bupropion significantly less often that chance. None of the other eight antipsychotic formulations were prescribed significantly differently than chance. Conclusions: The co-prescription of bupropion and antipsychotic medication may be affected by historical misconceptions regarding bupropion’s purportedly pro-dopamine properties. Viable options for the treatment of tobacco use disorder should not be discounted prematurely in patients with schizophrenia spectrum and other psychotic disorders. We suggest further study on the safety and efficacy of the combination of bupropion and antipsychotic medication is needed.

Impact of implementing a tobacco and recreational nicotine-free policy and enhanced treatments on programmatic and patient-level outcomes within a residential substance use disorder treatment program

The global burden of tobacco is a significant public health concern, causing millions of deaths, illnesses, and economic losses annually. In Türkiye, tobacco use is deeply ingrained in society, with historical roots dating back to Ottoman times. The nation faces challenges such as high smoking rates, gender disparities, and the popularity of non-cigarette tobacco products. Despite these issues, Türkiye has adhered to the WHO Framework Convention on Tobacco Control (FCTC) and implemented MPOWER strategies to combat tobacco use effectively. This review aims to synthesize Türkiye's comprehensive tobacco control measures, including legislation, smoking cessation initiatives, public awareness campaigns, and taxation policies. The study examines the country's strategic actions against the backdrop of its historical context and current challenges. The review leverages data from various sources, including the Global Burden of Disease, national health surveys, and reports on tobacco control efforts and achievements. Stakeholder activities, such as those by the Turkish Ministry of Health and non-governmental organizations, are also explored. Türkiye has made substantial progress in tobacco control, evidenced by reduced tobacco consumption and addressing key challenges like gender disparities and youth smoking. However, the country continues to face obstacles such as tobacco smuggling, the rise of narghile (hookah) smoking, and ongoing high daily smoking rates. The review highlights the tobacco industry's influence in Türkiye despite strong adherence to FCTC. Türkiye's efforts in tobacco control represent a significant endeavor to mitigate the public health crisis posed by tobacco use. Through adherence to WHO FCTC guidelines and MPOWER strategies, notable progress has been achieved. Yet, challenges persist, requiring continuous, comprehensive strategies and robust enforcement. Future efforts must focus on strengthening tobacco control measures, ensuring accessibility to smoking cessation services, and countering the tobacco industry's influence, to further reduce tobacco use and its health and economic burdens.

Clavines: New antibiotics with cytostatic activity

Tobacco: Science, Policy and Public health is a major reference text that is intended for an international public health audience, including epidemiologists, health economists and those working or interested in global tobacco control. The volume is primarily designed as a comprehensive review of the scientific literature of the health effects of tobacco use. This in itself is an enormous endeavor. This volume also provides information on the policy-relevant approaches undertaken to curb the use of tobacco and the public health lessons learned from the programmatic efforts to end the use of this deadly product. This is an extremely important topic as there are approximately 1.1 billion smokers around the world and the epidemic of tobacco-related disease is increasing. Based on current trends, by 2030 ten million people per year will die from tobacco-related deaths, accounting for one in every six deaths worldwide. Despite the large number of chapter authors, the book flows reasonably well. The writing is clear and concise, making this an excellent resource for researchers as well as practitioners. In addition, the individual chapters are extremely well referenced, providing an appropriate starting place for health science students who wish to learn more about tobacco science and public health. A significant portion of this book contains a detailed synthesis of the literature related to active and passive smoking and health, including chapters on cancer, heart disease, respiratory disease, and other diseases. The book's editors have done a remarkable job of recruiting scientific leaders who have been on the cutting edge of tobacco control research since the 1950s to provide their unique perspectives. Sir Richard Doll, for example, provides rare historical insights into how the evidence linking tobacco and disease evolved during the past 50 years. Other chapters succinctly document the underlying biologic mechanisms that are related to addiction and disease and a detailed description of how cigarettes have been purposely engineered to be a disastrous nicotine delivery device since ‘carcinogens accompany nicotine in every puff'. The book also provides a general history of how the epidemic developed and spread throughout the world. Case studies describing the tobacco epidemic in key countries, including Great Britain, India, and China, add specific details and depth to the global snapshot. Evidence-based tobacco control policies and other legal and advocacy strategies that have been utilised by the public health community to control tobacco promotion and use are also reviewed. As we have indicated, this book does an excellent job in documenting the remarkable history of tobacco control research and the extensive evidence base that has been generated. However, while this evidence is essential, it is not sufficient in and of itself to generate sound public policy. Moreover, much of the evidence has been reviewed previously by the US Surgeon General and other scientific institutions. Unfortunately, despite all the evidence and understanding that has accrued about tobacco and health and the knowledge that has been gained to combat tobacco use around the world, national and international policy responses often fail to reflect this knowledge base. That is why it would have been beneficial for the editors to include a more comprehensive review concerning the development and implementation of strong and effective programmes and policies. The sections on the public health and policy approaches taken to change behaviour of individuals and of populations are given much less coverage when compared with that given to the global health burden. Descriptions of smoking patterns in selected countries are provided, but more information on the historical perspective of national and international tobacco control movements would have been beneficial. As tobacco control evolves in the coming years, it will be increasingly important to understand not just the health effects, the health burden and underlying genetic processes, but the political, social, cultural and economic factors that facilitate or inhibit public health policy. ‘If public health is to be more successful in the 21st century, it must comprehend the magnitude of the forces against it and the strategies used to engineer its defeat' (McKinlay and Marceau, 2000). Nowhere is this more apparent than the field of tobacco use, as a leading cause of preventable death surrounded by a complex web of factors. While it is always important to discuss the negative health consequences caused by smoking, future texts on tobacco should also include a more comprehensive review of the best practices, policies and actions that need to be taken to actually reduce tobacco use in countries around the world.

The news committee for the SRNT Treatment Network would like to welcome you to our inaugural “Treatment Hot Topics” newsletter. The vision of the committee is to summarize and effectively disseminate a quarterly newsletter that will contain breakthrough scientific and sociopolitical hot topics and how these affect treatment of tobacco use disorders. This month’s newsletter focuses on smoking and special populations as well as novel smoking cessation treatments. These two pertinent topics were selected from a pool of topics of interests, which were requested by SRNT members on an online survey carried out by the SRNT Treatment network. Subsequent topics that will be covered in forthcoming newsletters will include e-cigarettes, updates in novel treatments, and policy issues, which affect nicotine/tobacco treatment and research. Although smoking prevalence has declined from a high of 45% in the 1960s to 18% in 2012 among the general population (Centers for Disease Control and Prevention [CDC], 2013b), smoking remains high in certain subpopulations such as people with severe mental illnesses (SMI), individuals in the criminal justice system, and individuals living in poverty. Smoking prevalence has persisted at about 70% (Fiore et al., 2008; Goff et al., 2005) among individuals with SMI (CDC, 2013a), while individuals in the criminal justice system have smoking prevalence rates of up to 80% (Cropsey et al., 2008; Cropsey, Jones-Whaley, Jackson, & Hale, 2010). Individuals who live below the poverty line have smoking prevalence rates of 29%; however, adults who have received their General Equivalency Diploma have smoking rates of 45.3% (CDC, 2013b). Given the high prevalence of smoking in these subpopulations, it is not surprising that individuals with mental illness consume 44% of all cigarettes in the United States even though they represent 22% of the population (Lasser et al., 2000). Similarly, since the United States places the largest percentage of its citizens in the world under criminal justice supervision (1 in every 34U.S. adults or 3% of all adults; Carson & Sabol, 2012), individuals in the criminal justice system now represent more than 12% of all current smokers (Carson & Sabol, 2012; Cropsey et al., 2010).

The study explored nurse faculty beliefs regarding patient tobacco use and the promotion of patient tobacco cessation.The second aim explored perceived barriers and benefits in teaching baccalaureate students about patient tobacco use and cessation. Nurse faculty have a role in ensuring that graduates entering the nursing profession are knowledgeable, skillful, and have the self-efficacy needed to take action regarding patient tobacco use and cessation. Four 90-minute focus group interviews were taped, transcribed, and analyzed. Two major themes were identified: barriers and opportunities. Barriers included a knowledge deficit about patient tobacco use and cessation, which lagged behind published evidence. Opportunities included perceptions that providing patient tobacco cessation should occur throughout the nursing process during nurse-patient interactions. Nursing faculty development regarding patient tobacco use and cessation needs to occur as well as the development and dissemination of curriculum resources.