Higher nicotine and carbon monoxide levels in menthol cigarette smokers with and without schizophrenia.

UMDNJ-Robert Wood Johnson Medical School and UMDNJ-School of Public Health Tobacco Dependence Program, New Brunswick, NJ 08901, USA.
Nicotine & Tobacco Research (Impact Factor: 2.81). 08/2007; 9(8):873-81. DOI: 10.1080/14622200701484995
Source: PubMed

ABSTRACT This study examined whether smoking menthol cigarettes was associated with increased biochemical measures of smoke intake. Expired carbon monoxide (CO) and serum nicotine and cotinine were measured in 89 smokers with schizophrenia and 53 control smokers immediately after smoking an afternoon cigarette. Serum nicotine levels (27 vs. 22 ng/ml, p = .010), serum cotinine levels (294 vs. 240 ng/ml, p = .041), and expired CO (25 vs. 21 ppm, p = .029) were higher in smokers of menthol compared with nonmenthol cigarettes, with no differences in 3-hydroxycotinine/cotinine ratios between groups when controlling for race. Backward stepwise linear regression models showed that, in addition to having a diagnosis of schizophrenia, smoking menthol cigarettes was a significant predictor of nicotine and cotinine levels. Individuals with schizophrenia or schizoaffective disorder smoked more generic or discount value brands (Basic, Doral, Monarch, USA, Wave, others) compared with control smokers (28% vs. 6%, p = .002) but did not smoke more brands with high nicotine delivery as estimated by the U.S. Federal Trade Commission method. Although rates of mentholated cigarette smoking were not higher in smokers with schizophrenia overall, they were significantly higher in non-Hispanic White people with schizophrenia compared with controls of the same ethnic/racial subgroup (51% vs. 28%, p<.0001). The higher exhaled CO in menthol smokers suggests that the higher nicotine levels are at least partly related to increased intake of smoke from menthol cigarettes, although menthol-mediated inhibition of nicotine metabolism also may be a factor. Menthol is an important cigarette additive that may help explain why some groups have lower quit rates and more smoking-caused disease.

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    • "Individuals with schizophrenia have a high risk for tobacco dependence. Epidemiological studies estimate that as many as 80% of individuals diagnosed with schizophrenia smoke cigarettes and clinical reports indicate that those with schizophrenia are particularly heavy smokers (Hughes et al, 1986; Glassman, 1993; Olincy et al, 1997; Kalman et al, 2005; Tidey et al, 2005; Williams et al, 2005, 2007; McKee et al, 2009). In support of a self-medication hypothesis, some studies have shown that smoking enhances cognition, improves sensory-gating deficits, and relieves side effects of neuroleptic therapeutics (Leonard et al, 1998, 2007; Sacco et al, 2005; Levin and Rezvani, 2007; D'Souza and Markou, 2011). "
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    ABSTRACT: Individuals diagnosed with schizophrenia have an exceptionally high risk for tobacco dependence. Postmortem studies show that these individuals have significant reductions in α7 nicotinic acetylcholine receptors (nAChRs) in several brain areas. Decreased α7-mediated function might not only be linked to schizophrenia but also to increased tobacco consumption. The purpose of this study was to determine whether pharmacological blockade of α7 nAChRs would increase motivation of rats to intravenously self-administer nicotine (NIC) during a progressive ratio schedule of reinforcement (PR). Before PR, rats received local infusions of 0, 10, or 20 pmol of a selective α7 nAChR antagonist, α-conotoxin ArIB [V11L,V16D] (ArIB) into the nucleus accumbens (NAc) shell or the anterior cingulate cortex, brain areas that contribute to motivation for drug reward. We additionally sought to determine whether local infusion of 0, 10, or 40 nmol of a selective α7 nAChR agonist, PNU 282987, into these brain areas would decrease motivation for NIC use. Infusion of ArIB into the NAc shell and anterior cingulate cortex resulted in a significant increase in active lever pressing, breakpoints, and NIC intake, suggesting that a decrease in α7 nAChR function increases motivation to work for NIC. In contrast, PNU 282987 infusion resulted in reductions in these measures when administered into the NAc shell, but had no effect after administration into the anterior cingulate cortex. These data identify reduction of α7 nAChR function as a potential mechanism for elevated tobacco use in schizophrenia and also identify activation of α7 nAChRs as a potential strategy for tobacco cessation therapy.
    Neuropsychopharmacology: official publication of the American College of Neuropsychopharmacology 12/2011; 37(5):1134-43. DOI:10.1038/npp.2011.299 · 7.83 Impact Factor
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    • "However, expired carbon monoxide (CO) breath levels were higher in schizophrenia versus control smokers (p=0.02), consistent with previous studies (Williams et al., 2007). Amongst the non-smokers, the proportion of former versus never smokers was significantly different (p<0.05) in the schizophrenia and control nonsmoker groups (Table 1). "
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    ABSTRACT: In schizophrenia, neurocognitive deficits associated with the illness are modulated by tobacco smoking. However, little is known about how smoking status modulates the relationships between neurocognitive measures in schizophrenia and healthy control subjects. The goal of this study was to evaluate the relationship between sensorimotor gating assessed by prepulse inhibition (PPI) and executive cognitive function using the Wisconsin Card Sorting Test (WCST) in schizophrenia and controls as a function of smoking status. We studied PPI and neuropsychological function in four groups (N=50); smokers with schizophrenia (SS; n=15), control smokers (CS; n=13), non-smokers with schizophrenia (SNS; n=11) and control non-smokers (CNS; n=11). SNS demonstrated the poorest PPI, while SS showed comparably high levels of PPI to CNS. Non-psychiatric controls outperformed patients on WCST outcomes irrespective of smoking status. Several prefrontal outcome measures on the WCST (categories completed, percentage perseverative and non-perseverative errors) correlated significantly with PPI at the 60 and 120 ms prepulse intervals. In contrast, there were no significant correlations between PPI and any WCST outcomes in SNS, CS or CNS, and few significant correlations between PPI and other neuropsychological measures. Our preliminary data suggests that the correlation between sensorimotor gating (PPI) and prefrontal executive cognitive functioning (WCST) is enhanced by acute cigarette smoking in schizophrenia.
    Schizophrenia Research 09/2009; 114(1-3):91-7. DOI:10.1016/j.schres.2009.07.006 · 4.43 Impact Factor
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    ABSTRACT: Nimpitakpong P. and Dhippayom T. Menthol cigarettes: Tobacco control policy in Thailand. J Pub. Health Dev. 2012; 10(2): 72-85 Thailand has more than 12.5 million smokers (8 million smoke cigarettes). About 19% of cigarette smokers smoke menthol cigarettes. This article reviews previous research related to menthol cigarettes in order to improve public health policy regarding tobacco control. The review shows that menthol cigarette smokers' risk of developing diseases was equivalent to that of those who smoke non-menthol cigarettes. However, menthol cigarette smokers believe that menthol had medicinal benefits and therefore were less harmful than normal cigarettes. The tobacco industry uses menthol cigarettes to target young and new smokers as well as those who intend to quit smoking. This strategy will either increase the number of smokers or not reduce the number of smokers as much as expected. The challenge for tobacco control policy in Thailand is to comply with the WHO Framework Convention for Tobacco Control by prohibiting the use on cigarette packs of the word "menthol" or other terms which could imply as a cooling property and to ban menthol cigarettes in Thailand.
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