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ABSTRACT: Asthma and suicide attempts are leading causes of morbidity and mortality among adults in the United States. The objective of this study was to investigate the relationship between asthma and suicidal ideation and suicide attempt among adults in the United States, and to examine whether timing of asthma, mood disorders, poverty, allergies, cigarette smoking and sex differences confound these relationships. Data were drawn from the Third National Health and Nutrition Examination Survey (NHANES III), a representative sample of adults (N = 6584) in the United States. Logistic regression analyses were used to examine the relationships between current and former asthma and suicidal ideation and suicide attempt, adjusting for demographics, poverty, smoking, allergies and mood disorders. Current asthma is significantly associated with an increased likelihood of suicidal ideation (OR: 1.77, CI: 1.11, 2.84) and suicide attempt (OR: 3.26, CI: 1.97, 5.39), after adjusting for mood disorders, smoking, poverty and demographics. There does not appear to be a significant relationship between former asthma and suicidal ideation or suicide attempt. These findings confirm and extend previous evidence by showing that the link between asthma and suicide-related outcomes is evident among adults in a representative sample and that this relationship persists after adjusting for a range of variables. This study may provide an empiric foundation for including asthma in the clinical assessment of suicide risk.
Journal of psychiatric research 06/2012; 46(8):1002-7. · 3.72 Impact Factor
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ABSTRACT: Previous studies have shown links between anxiety and depression and chronic obstructive pulmonary disease (COPD), but little is known about possible mechanisms of this association. The current study examined whether the observed relationship between anxiety and depression and COPD is explained by confounding due to cigarette smoking and lifetime nicotine dependence.
Data were drawn from the National Comorbidity Survey Replication, a community-based representative sample of adults in the United States.
Analyses suggest that the association between anxiety disorders and COPD appears to be largely explained by confounding by former cigarette smoking and lifetime nicotine dependence. The association between mood disorders and COPD appears to be largely explained by confounding by lifetime nicotine dependence.
These findings provide initial evidence suggesting that the association between anxiety, depression, and COPD may be at least partly attributable to confounding by cigarette smoking and nicotine dependence. Efforts toward prevention of chronic lung disease may be more effective if treatment and prevention efforts aimed at smoking cessation address mental health problems.
Nicotine & Tobacco Research 02/2012; 14(2):176-83. · 2.58 Impact Factor
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ABSTRACT: Although pregnancy is often viewed as a unique opportunity to engage women in positive health changes, including smoking cessation, it is not clear whether, or to what extent, smoking cessation initiated during pregnancy persists long term after pregnancy. The purpose of the present study was to investigate the relation between smoking cessation during pregnancy and smoking status three years later.
Data were drawn from the National Epidemiologic Survey of Alcohol and Relation Conditions (NESARC), a nationally representative sample of over 40,000 adults in the United States. Multiple logistic regression analyses were conducted to examine the relation between smoking cessation during pregnancy and odds of smoking three years later. Smoking status at follow-up of women who continued smoking during pregnancy and women who never smoked was also examined. Analyses controlled for demographic differences.
Smoking cessation during pregnancy was not significantly related to smoking status three years later. However, continued smoking during pregnancy was associated with significantly increased odds of smoking three years later, compared to smokers who were not pregnant at baseline. Among non-smokers, pregnancy at baseline was associated with a significantly decreased likelihood of smoking three years later, compared to women who were not pregnant at baseline.
The present study uniquely extends previous research on smoking cessation during and following pregnancy. The results call for increased efforts to develop interventions that help new mothers develop and maintain abstinence from smoking.
Drug and alcohol dependence 11/2011; 123(1-3):110-4. · 3.60 Impact Factor
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ABSTRACT: Evidence suggests that nicotine dependence is the key barrier to successful smoking cessation. No previous study has documented predictors of persistent nicotine dependence among adults in the community. The goal of this study is to prospectively identify predictors of continued nicotine dependence over a 3-year period among adults.
Data were drawn from Waves I and II of the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), a nationally representative sample of 34,653 adults in the United States. Logistic regression analyses were used to estimate the odds of persistent nicotine dependence at Wave 2 given the presence of various sociodemographic and psychiatric predictors at Wave 1.
Mood, anxiety, personality and illicit substance use disorders were associated with significantly increased risk of persistent nicotine dependence. The strength of these relationships was attenuated slightly after adjusting for demographic differences, but remained statistically significant. Persistent nicotine dependence was more common among unmarried, younger females with lower income levels and lower educational attainment.
To our knowledge, this study is the first to prospectively identify predictors of persistent nicotine dependence among adults. Our results suggest that the incorporation of mental health treatment into alternative smoking cessation approaches may help to increase the effectiveness of these programs and that a greater focus of these services on vulnerable segments of the population is needed in order to reduce continued disparities in smoking in the general population.
Drug and alcohol dependence 04/2011; 118(2-3):127-33. · 3.60 Impact Factor
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ABSTRACT: To determine whether subjective social standing in school predicts a change in body mass index (BMI) in adolescent girls during a 2-year period.
Prospective cohort study.
Self-report questionnaires from a community-based population of adolescent girls living across the United States from 1999 to 2001.
Of 5723 girls aged 12 to 18 years participating in the Growing Up Today Study (GUTS), adequate information was available for 4446 (78%), who provided the analytic sample.
Low subjective social status in the school.
Change in BMI between 1999 and 2001 and multivariable odds ratio for a 2-U increase in BMI in girls with low subjective social status in the school compared with girls with higher subjective social status in the school.
After adjusting for age, race/ethnicity, baseline BMI, diet, television viewing, depression, global and social self-esteem, menarche, height growth, mother's BMI, and pretax household income, adolescent girls who placed themselves on the low end of the school subjective social status scale had a 69% increased odds of having a 2-unit increase in BMI (odds ratio, 1.69; 95% confidence interval, 1.10-2.60) during the next 2 years compared with other girls.
Higher subjective social standing in school may protect against gains in adiposity in adolescent girls.
Archives of pediatrics & adolescent medicine 02/2008; 162(1):23-8. · 3.73 Impact Factor
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ABSTRACT: To address methodologic issues in searching for observational studies by presenting database search methods and results.
Results of two literature searches for publications reporting on observational studies of alcohol consumption and the risk of breast cancer and large bowel cancer were compared, to evaluate the sensitivity of various bibliographic databases and search strategies, including hand-searching reviews and meta-analyses.
The target sensitivity of 90% of publications in the breast cancer search was achieved by starting with Medline, then adding Biosis, Embase, and SCI EXPANDED-SSCI, which provided a total of 72 (91%) of the 79 relevant publications. To reach a similar 89% sensitivity for large bowel cancer, at least Biosis, Dissertation Abstracts Online, Embase, ETOH, and Medline had to be searched, with the addition of hand search of reviews and meta-analyses.
Limiting a search to one or two databases when conducting meta-analyses of observational studies will not provide a thorough summary of the existing literature. The findings support recommendations to implement a comprehensive search of electronic databases and the reference lists of recent review articles and meta-analyses.
Journal of Clinical Epidemiology 10/2005; 58(9):867-73. · 4.27 Impact Factor
