Net Effect of Short-Term Smoking Cessation on Mental Health Changes:Inverse Probability of Treatment Weighting and Difference-in-Differences Method

Background:In response to the need for research clearly demonstrating the net effect of smoking cessation on mental health status,considering the causal relationship between smoking cessation and changes in mental health status,this study was undertaken.Thus,this study aimed to examine the net effect of short-term smoking cessation on five specific mental health metrics and the overall mental health status score.Methods:We used data from the first wave of the Korean Health Panel(KHP)Survey(2011–2013,2016–2018)and focused on men aged 19 years and older,to explore the effects of smoking cessation.We compared mental health status before and after cessation among current non-smokers who had quit smoking and continuous smokers.We ensured homogeneity between the two groups via inverse probability of treatment weighting(IPTW)and employed a difference-in-differences(DID)analysis to assess changes in mental health status.This study controlled for factors that could influence mental health and explored the net effect of short-term smoking cessation through difference-in-differences model using multiple regression analysis.Results:The results showed that short-term smoking cessation significantly alleviated mental and physical stress(p<0.1),reduced experiences of frustration(p<0.01),and improved the overall mental health status score(p<0.1).Conclusion:Thus,these results highlight a meaningful link between positive health behavior changes,such as smoking cessation,and enhanced mental health.Moreover,the application of temporal variables further improved the understanding of the causal relationship between health behaviors and mental health.

Smoking cessation prior to elective total joint arthroplasty results in sustained abstinence postoperatively

BACKGROUND Tobacco use is a well-documented modifiable risk factor for perioperative complications.AIM To determine the tobacco abstinence rates of patients who made cessation efforts prior to a total joint arthroplasty(TJA)procedure.METHODS A retrospective evaluation was performed on 88 self-reported tobacco users who underwent TJA between 2014-2022 and had tobacco cessation dates within 3 mo of surgery.Eligible patients were contacted via phone survey to understand their tobacco use pattern,and patient reported outcomes.A total of 37 TJA patients participated.RESULTS Our cohort was on average 61-years-old,60%(n=22)women,with an average body mass index of 30 kg/m^(2).The average follow-up time was 2.9±1.9 years.A total of 73.0%(n=27)of patients endorsed complete abstinence from tobacco use prior to surgery.Various cessation methods were used perioperatively including prescription therapy(13.5%),over the counter nicotine replacement(18.9%),cessation programs(5.4%).At final follow up,43.2%(n=16)of prior tobacco smokers reported complete abstinence.Patients who were able to maintain cessation postoperatively had improved Patient-Reported Outcomes Measurement Information System(PROMIS)-10 mental health scores(49 vs 58;P=0.01),and hip dysfunction and osteoarthritis outcome score for joint replacement(HOOS.JR)scores(63 vs 82;P=0.02).No patients in this cohort had a prosthetic joint infection or required revision surgery.CONCLUSION We report a tobacco cessation rate of 43.2%in patients undergoing elective TJA nearly 3 years postoperatively.Patients undergoing TJA who were able to remain abstinent had improved PROMIS-10 mental health scores and HOOS.JR scores.The perioperative period provides clinicians a unique opportunity to assist active tobacco smokers with cessation efforts and improve postoperative outcomes.

Persuasive Technology for the Future of Smoking Cessation*

This paper explores the integration of persuasive technology into smoking cessation efforts through the development and evaluation of a mobile app, “No-Smoke.” Leveraging compelling features like social support, tracking, planning, and motivation, the app aims to augment user engagement and support the process of quitting smoking. The efficacy of these features has been substantiated through both automated testing and user feedback, highlighting their potential to enhance awareness, motivation, and behavior modification. Despite notable successes, limitations, including a limited user base and uncertainties regarding long-term efficacy, have been acknowledged, stemming from the inherent complexities of smoking cessation. Nevertheless, based on user experiences and feedback, “No-Smoke” represents a promising advancement in the use of technology for public health interventions, particularly in the realm of smoking cessation. To address existing challenges, future research is recommended to encompass a comprehensive, long-term study involving a larger and more diverse user base. Additionally, further investigation should focus on personalization enhancements and the integration of machine learning algorithms to better understand and respond to user behavior.

CD8＋ Tc-lymphocytes immunodeviation in peripheral blood and airway from patients of chronic obstructive pulmonary disease and changes after short-term smoking cessation

Background Cigarette smoke induces an acute but persisting inflammation in peripheral blood and airway in chronic obstructive pulmonary disease （COPD）,and CD8＋ Tc-lymphocytes are considered as a key role in this process.We aimed to investigate the Tc-lymphocytes immunodeviation in system and local airway of COPD patients and changes of the immunodeviation after short-term smoking cessation.Methods Peripheral blood （PB） and bronchoalveolar lavage fluid （BALF） were collected from 42 patients （14 COPD patients,16 smokers with normal lung function and 12 nonsmokers）,while PB and induced sputum （IS） were obtained from other 19 patients （10 quitting smokers and 9 continuing smokers） at baseline and follow-up respectively of 4-week smoking cessation.Percentages of CD8＋ Tc-lymphocytes （%CD3＋） and Tc1/Tc2 ratios were measured by flow cytometry.Results Percentages of CD8＋ Tc-lymphocytes were higher in COPD patients than those in smokers and nonsmokers in both PB and BALF.Tc1/Tc2 ratio in PB and in BALF from COPD patients was greater than that from smokers and nonsmokers and negatively correlated with FEV1%pre.When comparing the ratios between PB and BALF,significantly positive correlation was found in COPD patients.Furthermore,after 4-week smoking cessation,percentages of CD8＋ Tc-lymphocytes in PB and IS in quitting smokers were decreased compared to that in baseline and continuing smokers,whereas Tc1/Tc2 ratios were not influenced.Conclusions CD8＋ Tc1-trend immunodeviation profiles occurred in both system and local airway of COPD patients.This exceptional immunodeviation could not be relieved by short-term smoking cessation.

Smoking Cessation with E-Cigarettes in Smokers with a Documented History of Depression and Recurring Relapses

The association between nicotine dependence and affective disorders, particularly major depressive disorder (MDD), is well known with high prevalence rates being reported for smokers. The reason for this association is not clear, but, it has been argued that smoking may help individuals to cope with stress or medicate depressed mood. Smoking cessation programs are useful in helping smokers to quit, but smoking is a very difficult addiction to break, especially for people suffering from depression, and the need for novel and effective approaches to smoking cessation interventions for this special population is unquestionable. The e-cigarette is a battery-powered electronic nicotine delivery device (ENDD), which may help smokers to remain abstinent during their quit attempt. Here, we report for the first time objective measures of smoking cessation in two heavy smokers, suffering from depression, who experimented the e-cigarette.

Motivations, Challenges and Coping Strategies for Smoking Cessation: Based on Multi-ethnic Pregnant Couples in Far Western China

The present study aimed to clarify the smoking cessation motivations, challenges and coping strategies among pregnant couples. A qualitative design using a grounded theory approach was applied. Data were collected by individual semi-structured interviews with 39 married individuals(21 non-smoking pregnant women and 18 smoking or ever-smoking men with a pregnant wife) and 3 imams in an ethnically diverse region of far western China. The most common theme for smoking cessation motivation was 'embryo quality'(i.e., a healthier baby), followed by family's health. Most interviewees reported that husband's withdrawal symptoms were the greatest challenge to smoking cessation, followed by the Chinese tobacco culture. Coping strategies given by the pregnant women typically involved combining emotional, behavioral and social interventions. Social interventions showed advantages in helping to quit smoking. Pregnancy appears to be a positive stimulus for pregnant couples' smoking cessation. Our results suggest that pregnancy, a highly important life event, may help to reduce barriers to smoking cessation at the social level(e.g., limiting access to cigarettes, avoiding temptation to smoke), but does little to help with the withdrawal symptoms. Professional guidance for smoking cessation is still necessary.

Family History of Cancer and Smoking Cessation, Is There a Role for Physicians?

Aim: This study aims to investigate the relationships among family history of cancer, physician’s advice on quitting, and motivation to quit among smokers in the United State. Method: This study using data collected by the 2010 National Health Interview Survey. Five separate sets of multivariate logistic regression models were used to investigate the three-direction relationships among: 1) effect of family cancer history on medical doctors’ advice on quitting, 2) effect of family cancer history on motivation to quit smoking, 3) effect of doctor’s advice on smokers’ motivation to quit. Results: Smoking cessation advice given by physicians has a significant effect on both smoker’s motivation and action taken to quit smoking, but a large proportion of the smokers with family cancer history did not receive doctor’s advice on quitting. Conclusion: Family history of lung cancer or other cancer types was not found to be associated with increased motivation to quit smoking. This is at least partly due to poor collection of family cancer history by physicians. This may be ameliorated by promoting the use of a recently developed self-administered tool for the collection of patient data on family cancer history in primary care settings.

Impacts of Preoperative Smoking and Smoking Cessation Time on Preoperative Peripheral Blood Inflammatory Indexes and Postoperative Hospitalization Outcome in Male Patients with Lung Cancer and Surgery Treatment

Objectives To investigate the effects of preoperative smoking and smoking cessation time on preoperative peripheral blood inflammatory indexes and postoperative hospitalization outcomes in male patients with lung cancer and surgery therapy.Methods We retrospectively enrolled 637 male patients who underwent curative-intent lung cancer resection between January 2014 and December 2016.Patients were classified as the current smokers,the never smokers,and the ex-smokers based on their smoking history,and the ex-smokers were allocated into five subgroups according to their smoking cessation times(CeT):CeT W6 weeks,6weeks<CeT W lyear,lyear<CeT<5years,5years<CeT<lOyears,CeT>10years.The preoperative peripheral blood white blood cells(WBCs),albumin,neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),intraoperative blood loss,30-day mortality,in-hospital days,hospitalization costs,intensive care un辻(ICU),admission days and placement time of closed thoracic drainage tube were compared among difTerent groups.Results There were significant differences in WBC(F=S.275,P<0.001)and albumin(F=2,470,P<0.05)among patients of current smokers,ex-smokers with different smoking cessation time,and never-smokers.The blood WBC count in current smokers(7.7 X 109/L)was significantly higher than that in ex・smokers(7.0 X 109/L)and never-smokers(5.9 X 109/L)(t=-2.145,P<0.05;t=-6.073,P<0.01,respectively).The level of peripheral blood albumin in current smokers(41.1 g/L)was lower than that in ex・smokers(42.1 g/L)and neve—smokers(43.2 g/L)(t=2.323,P<0.05;t=3.995,P<0.01,respectively).The level of peripheral blood NLR in current smokers(3.7)was higher than that in ex-smokers(3.1)and never smokers(2.8)(t—-1.836,P<0.05;t=-2.889,P<0.01,respectively).There was no significant difference in WBC,albumin and NLR among five subgroups of different smoking cessation time.No significant difference was observed in intraoperative blood loss,30-day mortality,hospitalization costs,hospital stay,ICU stay and placement time of closed thoracic drainage tube among groups either.Conclusion Smoking increases the preoperative inflammatory indexes in peripheral blood of lung cancer patients.Smoking cessation has beneficial effect on reducing levels of these inflammatory indexes,which may be not impacted by the time length of smoking cessation.Therefore,lung cancer patients should be encouraged to quit smoking at any time.

Supporting smoking cessation in healthcare: obstacles in scientific understanding and tobacco addiction management

Despite ongoing efforts to reduce tobacco smoking, the smoking prevalence in many countries has remained stable for years. This may be a consequence of either lack of knowledge about effective ways to reduce smoking, or failing treatment of tobacco addiction in healthcare. This study explored gaps in the current understanding of smoking cessation and the challenges facing tobacco addiction management in order to formulate recommendations for future research and healthcare practice. A narrative review was written to determine areas in which more research is needed as well as areas in which sufficient knowledge is already available. Recommendations for future research were prioritised using a Delphi-procedure. Recommendations for healthcare practice were confirmed by expert’s assessment. Smoking is not widely acknowledged as an addiction and a relatively small number of smokers ask help from a healthcare professional when trying to stop smoking. Most healthcare professionals recognise the importance of advising patients to stop smoking, but experience certain barriers to actually do this. Overall, healthcare professionals need to be convinced that tobacco smoking is an addiction and should be treated likewise. If all healthcare professionals systematically advise their patients to give up smoking, eventually more smokers will successfully stop smoking.

Comparison of characteristics among Korean American male smokers between survey and cessation studies

This study compared characteristics of Korean American men in two studies: a telephone survey with a random sample of Korean American men who reported daily smoking versus a smoking cessation clinical trial with a convenience sample of Korean American men who reported smoking at least 10 cigarettes a day. Guided by the Theory of Planned Behavior (TPB), both studies attempted to explain how much its theoretical variables (attitudes, perceived social norms, and self-efficacy) would explain quit intentions in Korean American men. Participants in the cessation study were less likely to have health insurance coverage (χ2 [2, 271] = 138.31, p = 0.001) than those in the survey study. The cessation group was more likely to smoke in indoor offices (χ2 [1, 231] = 18.09, p = 0.003) and had higher nicotine dependence than the survey group (t269 = 3.32, p = 0.001) but these differences became insignificant when only those who smoked 10 or more cigarettes were compared. Participants in the cessation study had more positive attitudes towards quitting (t267 = 4.99, p < 0.001), stronger perceived social norms favoring quitting (t269 = 5.63, p t268 = 9.86, p < 0.001) at baseline than those in the survey study. Korean American men are more likely to have a quit intention and make a quit attempt when they have more positive and fewer negative attitudes towards quitting and perceive stronger social norms favoring quitting. To motivate Korean American men to quit smoking, clinicians should underscore the immediate health benefits of quitting, promote quitting with cessation aids to reduce perceived risks of quitting in anticipation of withdrawal symptoms, and encourage family members to relate firm anti-smoking messages.

Mining twitter to understand the smoking cessation barriers

Smoking cessation is challenging and lack of positive support is a known major barrier to quitting cigarettes.Previous studies have suggested that social influences might increase smokers' awareness of social norms for appropriate behavior,which might lead to smoking cessation.Although social media use is increasing among young adults in the United States,research on the relationship between social media use and smoking cessation is lacking.Twitter has provided a rich source of information for researchers,but no overview exists as to how the field uses Twitter in smoking cessation research.To the best of our knowledge,this study conducted a data mining analysis of Twitter to assess barriers to smoking cessation.In conclusion,Twitter is a cost-effective tool with the potential to disseminate information on the benefits of smoking cessation and updated research to the Twitter community on a global scale.

Plain cigarette packaging: A policy analysis of Australia’s integrated “whole-of-system” model for smoking cessation

Introduction: Plain cigarette packaging as a tobacco control measure is to be implemented in Australia on December 1st 2012. There is mounting evidence for its likely impact on smokers and potential smokers. Yet Australia’s integrated model of smoking cessation and the particular role and opportunities it has created for primary healthcare have not yet been subject to policy analysis in leading international journals. This policy analysis paper explores these new Australian policy developments and debates in ways that identify their international relevance to primary healthcare. Policy analysis: There are 57 studies about plain cigarette packaging published since 2002. Of these, 27 looked at the impact of health warnings. These studies support the introduction of plain packaging as a tobacco control measure, by increasing the efficacy of health warnings and reducing misconceptions about cigarettes. However, the Australian tobacco control reforms are not limited to plain cigarette packaging. They include other evidence-based tobacco control measures as part of its primary health care strategy: for example, increasing tobacco excises, a mass media campaign focusing on high-risk and hard-to-reach groups, and a national summit on smoking in prisons. The Australian government has acknowledged the key role of primary health care in health promotion activities, establishing a network of regional primary health care organisations (“medicare locals”) in 2011-2012, and expanding the role of nurses in general practice. These initiatives offer general practice a chance to seize “golden opportunities to intervene with smoking patients”. Conclusions: Whether the combined impact of the Australian government’s recent tobacco control reforms and its previous measures will be sufficient to reduce daily smoking prevalence to 10% or less by 2020, only time will tell. What is more certain is that the Australian experience of plain packaging offers international colleagues in general practice key lessons about the importance of “whole-of-system” approaches, integrating efforts at the local to national levels, to tackle smoking cessation. The achievement of Australia’s political leaders in plain cigarette packaging is an extraordinary testament to political will but there is no room for complacency. Primary healthcare sectors must continue to lobby political leaders around the world to tackle smoking at the system level where the motivations and beliefs about smoking are being shaped, especially among disadvantaged groups with lower health literacy.

Frequency of smoking cessation interventions from health care providers in Minnesota

Objective: There is strong evidence supporting the impact of health care provider advice on patients’ smoking behavior. This paper examines adult smoker reports of health care provider smoking cessation interventions. Design: The 2010 Minnesota Adult Tobacco Survey (MATS) is a random digit dial telephone survey with 7057 Minnesota adults. Both landline and mobile telephone samples were included. These samples were combined and weighted to represent the population of adults in Minnesota. Results: Among adult Minnesotans, 16.1% were current smokers, 80.9% reported seeing a health care provider in the past 12 months and 80.2% of those adults were asked if they smoke. Among smokers who saw any provider in the past 12 months, 94.4% reported they were asked about smoking and 71.8% were advised not to smoke. In contrast, 43.9% of smokers received referrals from a health care provider and among those, 37.5% were recommended medications and 24.8% were referred to a quit smoking program. Conclusion: Given the large body of evidence supporting cessation interventions by health care providers, the increase in use of electronic medical records and the availability and success of evidence-based cessation programs, efforts to improve rates of identifying and treating each tobacco user are needed. Further research is needed to explore how cessation intervention responsibilities can be shared among the clinical team and integrated into ongoing clinical care.

Enhanced physician prompts in prenatal electronic medical records impact documentation on smoking cessation

Objective: Smoking cessation during pregnancy is a modifiable intervention that can improve maternal and neonatal outcomes. Encouraging smoking cessation is an assessed measure of the Meaningful Use incentives to ensure best practices with the increased use of the electronic medical record (EMR). Physician EMR prompts have been used shown to be successful with preventive care but there is a paucity of data evaluating prompts within obstetrics. The objective of this study is to determine the effectiveness of enhanced smoking cessation prompts in a prenatal EMR. Methods: A retrospective cohort study of an enhanced smoking cessation prompting system within our prenatal EMR was performed. Pregnant women who reported tobacco use at first prenatal visit were included. The number of times a smoking cessation method was offered and documented, the number of documented attempts at smoking cessation, and the final number of cigarettes smoked were compared pre and post the enhancement of the smoking cessation prompting system. Results: 95 patients were included (48 pre-enhancement;47 post-enhancement). Post-enhancement, the documentation of smoking cessation method offered increased (0 vs. 1, p = 0.03) and documentation of smoking cessation attempts increased (1 vs. 2, p = 0.006). There was no change in the final number of cigarettes smoked (p = 0.9). Conclusions: Enhanced prompting systems increase documentation related to smoking cessation with no change in number of cigarettes smoked. In the era of Meaningful Use guidelines which focus on documentation in the EMR, continued research must be done to assure that software enhancements and improved documentation truly result in improved patient care.

Geographical Analysis of Smoking in Leeds: A GIS-Based Location-Allocation Technique for the Optimal Location of Smoking Cessation Services

Smoking is associated with several illnesses in the UK. Smoking rate in Leeds is higher than the national average. Finding optimal locations for stop-smoking services will be a good place to start in reducing smoking rates. The study utilizes a GIS-Based location-allocation method for the optimal distribution of smoking cessation centres in relation to the spatial distribution of the smoking population in Leeds. The demand for the smoking cessation clinics was estimated based on the 2009 General Life Style (GLS) statistics on age and social class stratification of smoking rates for the UK. Leeds specific rates were then obtained from the 2001 census key statistics data on socioeconomic status and age structure for output areas via Census Area Statistics Website (CASWEB). The research findings show that spatial inequalities in smoking rate exist in output areas of Leeds. Poorer and non-skilled populations are demonstrated to have higher smoking rates compared with wealthier neighbourhoods. The study confirms the capability of GIS-Based location-allocation techniques to be useful modelling tools for determining the best locations for health facilities. The model allocates services in relation to the spatial patterns of demand in a fashion that minimises average travel distance.

Effects Assessment of Auricular Acupuncture and Group Counseling for Smoking Cessation in Senior High School Students

Smoking is a serious public health problem since it harms not only the smokers but also other people in touch with the smokers.Many obstinate illnesses such as cancer,chronic obstructive pulmonary disease,cardiovascular disease are now be proven to be related to smoking itself.To help young smokers,particularly adolescent,quitting smoking can prevent more tobacco use.Some studies showed auricular acupuncture(AA)is increasingly used to treat chemical dependency and withdrawal symptoms based as it’s safe and effective.Moreover,group counseling can motivate young adults to set a quit date and strengthen their belief in quitting smoking via peer effects.The present study evaluates the effects of a 8-week smoking cessation courses consisting of AA and group counseling once per week on senior high school students aged from 15 to 18.The AA treatment was administrated at both side of ears on a weekly basis for six weeks.Clinicians gave an intensive counseling session assessing the readiness to quit,exploring smoking habits,and identifying barriers to smoking cessation and relapsing factors.Before each intervention,the 23 participants completed questionnaires and offered levels of carbon monoxide exhalation.The participants showed significant differences in levels of carbon monoxide exhalation,daily tobacco consumptions,reduction in the taste of tobacco and intensity of the desire to smoke after 6-week consecutive sessions.However,the smoking cessation success was only three cases(13%).Given limited and uncertain efficacy of AA for smoking cessation,though it’s non-invasive and safe,it’s better to combine AA with other methods not only for synergistic effects but also better smoking cessation success rate.

A Comparative Study for Successful Treatment per Gender in a Specialized Smoking Cessation Unit in the Albacete University Hospital during Two Years

Objective： Analysis of abstinence rates of smokers per gender at 3, 6, 9 and 12 months in a Smoking Cessation Unit from January 2008 to December 2009. Methods： Descriptive retrospective study. Analysis of socio-demographic variables, smoking patterns, associated comorbidities, continuous abstinence rates, success, relapses, failure and dropping out. Results： 278 smokers started treatment （33%）; 55.4% males and 44.6% females （mean age of 48.3 and 44.06 years, respectively）. The main associated comorbidities were： psychiatric （38.7%）, cardiovascular （dyslipemia 25%） and respiratory （COPD （chronic obstructive pulmonary disease） 9.7%） in females; cardiovascular （dyslipemia 34.4%）, psychiatric （34.4%） and respiratory （COPD 19.5%） in males. VRN （Varenicline） was prescribed in 40.2% males and 32.2% females; NRT （nicotine replacement therapy） was used in 46.6% and 38.7%, respectively; bupropion was employed in 6.5% and 21.8%, respectively. Psychological counseling was offered only to 7.8% males and 8.1% females. The continuous abstinence rates in males at 3, 6, 9 and 12 months were 51.3%, 37.7%, 32.5% and 30.5%, respectively, and were 45.2%, 29.8%, 25.0% and 24.2% for females. Failure was 9.7% for females and 18.8% for males. Success was more frequent for those on VRN （n = 41 males; n = 12 females）. No relapses were indicated for 42 females and 71 males. The percentage of relapses was higher at 3 months （29.0% females, 19.5% males）. Conclusions： The study observed differences in treating abstinence between genders （in the abstinence rates and failure index）. This implies having to consider incorporating the gender variable into the diagnosis, treatment and prevention of smoking.

Identifying Distinct Quitting Trajectories after an Unassisted Smoking Cessation Attempt: An Ecological Momentary Assessment Study

Objectives: This study aimed at identifying distinct quitting trajectories over 29 days after an unassisted smoking ces- sation attempt by ecological momentary assessment (EMA). In order to validate these trajectories we tested if they predict smoking frequency up to six months later. Methods: EMA via mobile phones was used to collect real time data on smoking (yes/no) after an unassisted quit attempt over 29 days. Smoking frequency one, three and six months after the quit attempt was assessed with online questionnaires. Latent class growth modeling was used to analyze the data of 230 self-quitters. Results: Four different quitting trajectories emerged: quitter (43.9%), late quitter (11.3%), returner (17%) and persistent smoker (27.8%). The quitting trajectories predicted smoking frequency one, three and six months after the quit attempt (all p < 0.001). Conclusions: Outcome after a smoking cessation attempt is better described by four distinct trajectories instead of a binary variable for abstinence or relapse. In line with the relapse model by Marlatt and Gordon, late quitter may have learned how to cope with lapses during one month after the quitting attempt. This group would have been allocated to the relapse group in traditional outcome studies.

Impact of smoking cessation counseling among acute myocardial infarction patients on post-hospitalization mortality rates:a systematic review

Objective:The current systematic review aimed to assess the impact of smoking cessation counseling(SCC)on patients’short-and long-term mor tality after acute myocardial infarction(AMI).Methods:The Cochrane guidelines were used to conduct a systematic review of Medline(Pub Med),Science Direct,CINAHL Cochrane database,and Google Scholar for studies on the impact of SCC on AMI patients’mor tality.Results:Five studies were found to meet the predefined inclusion criteria.Smoker patients were not routinely counseled to quit smoking during their post-AMI hospital stay.Studies showed a reduction in mor tality among AMI patients’who received SCC compared with patients who did not receive it.Conclusions:SCC during hospitalization and after discharge is a simple and cost-effective intervention that improves AMI patients’survival.

Characterization of α-conotoxin TxIB and TxID for smoking cessation and drug rehabilitation

Nicotinic acetylcholine receptors(nAChRs) are widely distributed ligand gated ion channels throughout the peripheral and central nervous systems of mammals.There are 16 different n AChR subunits,α1-α7,α9,α10 and β1-β4,as well as γ,δ,and ε,which assemble into pentamers to form different nAChR subtypes with distinct pharmacological properties in mammals.Among them α6β2*(*designates other possible subunit),α3β4 and α4β2 nAChR subtypes are potential therapeutic targets for the treatment of addiction.However,various n AChR subtypes are very difficult to pharmacologically distinguish from each other.The α6* n AChRs are expressed by dopaminergic neurons in the central nervous system,which modulate the release of dopamine and are believed to be important in mediating tobacco,morphine,cocaine and ethanol addiction.The α3β4 nAChRs present in the medial habenula with important role in influencing nicotine addiction.Blockage of α3β4 nAChRs in the medial habenula decreased the dose of nicotine that rodents would self-administer.Thus,new antagonists of α6β2* or α3β4 nA ChR subtypes are of considerable interest,which would give strategies to selectively modulate α6β2* or α3β4 nA ChR function.We characterized an α-conotoxin(α-CTx)TxIB with 16 amino acids and an α-CTx TxID with 15 amino acids from Conus textile.The sequence of TxIB is GCCSDPPCRNKHPDLCamide.The sequence of TxID is GCCSHPVCSAMSPIC with C-terminal amidation too.Both peptides with a Ⅰ-Ⅲ and Ⅱ-Ⅳ disulfide con-nectivity were chemically synthesized.The residues between Cys-Ⅱ and Cys-Ⅲ and Cys-Ⅲand Cys-Ⅳ of α-CTx are commonly referred to as loops 1 and 2,respectively.The number of residues in each of these loops is used to further classify the α-CTx.So TxIB is classified as a 4/7α-CTx,whereas the α-CTx TxIB has a 4/6 spacing.Both peptides were tested on rat nAChRs heterologously expressed in Xenopus laevis oocytes.The α-CTx TxIB blocked α6/α3β2β3 nAChR with an IC50 of 28 nmol·L^(-1),which showed little or no block of all the other tested subtypes at concentrations up to 10 μmol·L^(-1).TxIB blocking α6/α3β2β3 nAChR is rapidly reversed after toxin washout.The ability ofα-CTx TxIB to discriminate between α6/α3β2β3 and the other nAChR receptors is unique.There are no small molecules have this selectivity profile.Previously described α-CTx that potently blockα6/α3β2β3 nA ChR s also block either α6/α3β4 nAChRs,α3β2 nAChRs and(or) other nAChRs subtypes.TxID was the very potent α3β4 nAChR antagonists blocking rat α3β4 n AChRs with an IC-50 of 12.5 nmol·L1.However,TxID also blocked the closely related α6/α3β4 with an IC50 of 94 nmol·L^(-1).In fact,the expression profile ofα3β4 nAChRs and α6/α3β4 nAChRs overlap in a variety of tissues.So TxI D can′t differentiate α3β4 nA ChR from α6/α3β4 nA ChR effectively.To distinguish between these two close subtypes,positional-scanning mutagenesis of TxID was performed to identify critical residues that confer potency for α3β4 nAChRs,and hope to obtain more selective mutant to discriminate between these two close subtypes.The effects of 15 analogues and TxID were tested on both α3β4 and α6/α3β4 nAChRs.An analogue,ie [S9 A]TxID had46-fold greater potency for α3β4 versus α6/α3β4 nAChRs,which showed significantly improved selectivity for α3β4 versus α6/α3β4 nAChRs.Both TxI D and [S9 A]TxI D had little activity on other nA ChR subtypes.The three-dimensional solution structures of TxIB,TxID and [S9 A]TxID were determined using NMR spectroscopy.α-CTx TxI B,TxID and [S9 A]TxID represent uniquely selective ligand for probing the structure and function of α6β2*and α3β4 nA ChR s respectively.It is known about20% people have used drugs recreationally resulting in a substance use disorder finally.Therefore,structural insights derived from these ligands may facilitate the development of novel therapeutics for addiction involving α6β2* and α3β4 nA ChR s.