Addiction & Health
Volume:12 Issue: 4, Autumn 2020

Waterpipe tobacco smoking (WTS) is an ancient type of smoking that has become a globalphenomenon. This study aimed to identify the prevalence of waterpipe smoking and its relation tosocio-demographic characteristics in Herat University students in western Afghanistan.

In this cross-sectional study, a structured self-administered questionnaire containing 53 items in3 subscales was distributed between July and December 2018, to examine the use of waterpipe among HeratUniversity students. Data were evaluated in SPSS. Chi-square test was used to observe differences betweencategorical variables. All important variables were separately evaluated for men and women in logisticregression models. A P-value less than 0.05 was considered statistically significant.

The prevalence of ever waterpipe use in male and female students was 54.1% and 81.8%,respectively. Parents’ higher education and family economic status were associated with higher rates of everwaterpipe use in both sexes. On the other hand, marital status and parents’ employment were not associatedwith waterpipe use. Ever waterpipe use was associated with having smoking friends or family members inboth sexes. Male and female waterpipe users believed that cigarette smoke had more nicotine thanwaterpipe. While more male waterpipe users believed that cigarette was more addictive than waterpipe, morefemale users believed otherwise.

The prevalence of ever waterpipe use is higher in male students at Herat University. Having asmoking friend and family member positively influences waterpipe use among both sexes. Most usersbelieved that waterpipe smoking was less hazardous than cigarette smoking.

The cigarette compounds are associated with the increase in the incidence of oral cancer andprecancerous lesions. Salivary antioxidant system plays an important role in anti-carcinogenic capacity ofsaliva. Cotinine, a nicotine metabolite, has a longer half-life in comparison with nicotine and is a suitablemarker for exposure to cigarette smoke. This study aims to measure total antioxidant capacity (TAC) andcotinine level in saliva of smokers and non-smokers and compare salivary cotinine level and TAC in each grou.

In this cross-sectional study, 32 smokers and 34 non-smokers were recruited by consecutivesampling from Department of Oral Medicine, School of Dentistry, Mashhad University of Medical Sciences,Mashhad, Iran. Salivary cotinine and TAC concentrations were determined using the enzyme-linkedimmunosorbent assay (ELISA) technique. For data analysis, correlation tests of Spearman, Mann-WhitneyU, and independent samples t-test were used.

A significant difference was observed between the two groups in the mean cotinine level and in themean TAC (P = 0.015, P = 0.027, respectively). TAC showed a weak negative correlation with the cotininelevel, but the difference was not significant (P = 0.651).

Antioxidants are of great importance to smokers because antioxidants are able to scavenge freeradicals found in cigarette smoke. According to the results of present study, the salivary TAC in smokers waslower than that of non-smokers, and the salivary cotinine level in smokers was higher than non-smokers.Therefore, smoking endangers the oral cavity health by reducing the salivary TAC. Further studies with ahigher sample size and other factors affecting the salivary TAC are needed for definitive comment.

Empathy is the capability to represent the mental and emotional states of other subjects.Previous studies have demonstrated a possible correlation between morphine addiction and altered empathyresponse in morphine-addicted subjects. This study was performed to evaluate the effect of chronic morphineexposure as an animal model of morphine addiction on empathic changes in affective and sensory pain.

Adult male Wistar rats (3 months old) were used for the current study. Animals were grouped incages of two (n = 8 for each group) and one animal was selected as the pain observer group. Pain observeranimals received either saline or morphine (10 mg/kg, twice daily for 8 days). At ninth day, formalin [50 µg,5%, subcutaneous (SC)] was injected into the hindpaw of the cagemate and placed inside the cage. Elevatedplus maze (EPM) and open field test (OFT) were recruited to evaluate anxiety; hot plate and tail flick testswere used to assay sensory pain. Conditioned place aversion (CPA) was also measured as indicator ofaffective pain component.

Chronic morphine exposure led to a reduced level of anxiety in EPM and OFT assays. An opioidinduced hyperalgesia was observed in the sensory pain assays, while there was a reduced affective pain in theCPA paradigm in morphine-treated animals.

It might be plausible that chronic morphine exposure might alter empathy for pain throughaffective and not sensory pain pathways.

Adding magnesium sulfate (MgSO4) to opioid receptor agonists increases the opioid analgesiceffects via blocking this receptor. The current study aimed to evaluate the effectiveness of adding MgSO4 totincture of opium (TOP) and buprenorphine (BUP) on pain and quality of life (QOL).

In prospective, randomized, double-blind, placebo-controlled clinical trial, one hundred andsixty-three women with secondary dysmenorrhea caused by endometriosis were selected using a respondentdriven sampling (RDS) and assigned into six groups using block randomization. Patients received 50 mg/kgMgSO4 in 100 ml saline by micro set in six monthly menstrual periods and completed the visual analoguescale (VAS) and QOL Questionnaire (QOLQ). Data were analyzed by repeated measures analysis of variance(ANOVA) and hierarchical regression.

The primary outcomes showed that pain scores in magnesium (MAG) + opium tincture (OT)[F = 5.7(1,162), P = 0.004] and MAG+ BUP [F = 4.5(1,162), P = 0.006] groups showed a significant decreasecompared with control group. Also, QOL scores in MAG + OT [F = 4.8(1,162), P = 0.005] and MAG + BUP[F = 5.9(1,162), P = 0.003] showed a significant increase. However, there was no significant differencebetween the two groups (P = 0.140) and the changes did not persist until follow-up (P = 0.810). Secondaryoutcomes indicated that the low scores of the two components of QOL including physical and psychologicalcomponents were predictors of pain (P = 0.011, Beta > 3.09).

Simultaneous use of MAG with opioids is associated with pain reduction and the improvement ofQOL. However, this hypothesis requires careful handling in a randomized controlled trial.

This study was carried out to reveal the effect of individual and group education done by a nurseon smoking dependency and smoking cessation motivation in patients with coronary artery disease (CAD).

The present randomized controlled trial study was conducted in Iran. A total of 255 patients wererandomly divided into three groups: 1) individual education, 2) group education, and 3) control. Data werecollected using the Fagerstrom Test of Nicotine Dependence (FTND) and Smoking Cessation MotivationQuestionnaire (Q-MAT) one time before the intervention and two times after intervention (1st and 3rd months).

The mean scores of motivation for smoking cessation and smoking dependency in patients in theindividual and group education were significantly better than the control group after the intervention (1st and3rd months) (P < 0.05). Although there was no significant difference in the mean scores of smoking cessationmotivation and smoking dependency in patients in the individual education and group education groupsafter education, the status of the patients in the group education was slightly better.

Education by nurses might have a significant impact on smoking cessation motivation andsmoking dependency in patients with CAD. Further studies are recommended.

Methamphetamine use has been associated with higher rates of depression and anxiety. Themesocorticolimbic dopaminergic reward system seems to play a crucial role in inducing depression andanxiety in methamphetamine users. High-frequency repetitive transcranial magnetic stimulation (rTMS) hasbeen shown to alter dopaminergic neurotransmission considering the acute rewarding and reinforcing effectsin the subcortical structure. The aim of this study was to investigate the efficacy of rTMS in reducingdepression and anxiety symptoms in methamphetamine users.

In a single-subject method with concurrent multiple baseline designs, in 2017, in Iran, eightmethamphetamine users were included, which compared 15 days of active versus placebo stimulation andcontrol group. Two subjects received rTMS on the right dorsolateral prefrontal cortex (DLPFC) and twosubjects received rTMS on the left DLPFC. We carried out the measurement using the Beck Anxiety Inventory(BAI) and Beck Depression Inventory (BDI) before, during, and after 15 and 30 days of the procedure.

Right and left DLPFC stimulation significantly reduced depression and anxiety, but the reductionof depression and anxiety by the right DLPFC stimulation was noticeable in this study.

High-frequency rTMS is useful for the treatment of depression and anxiety in methamphetamineusers.

Waterpipe tobacco smoking (WTS) has recently increased in Iran. There is no valid instrumentto measure the level of nicotine dependence among its consumers. This study was aimed to investigate thevalidity and reliability of the Lebanon Waterpipe Dependence Scale-11 (LWDS-11).

A cross-sectional study was conducted in the year 2017 whereby 367 waterpipe smokers wererecruited from Golestan Province of Iran. LWDS-11 scale is composed of 4 subscales: 1) nicotine dependence,2) negative reinforcement, 3) psychological craving, and 4) positive reinforcement. The validity of thequestionnaire was examined using construct validity. Reliability of this scale was examined using test-retestreliability and internal consistency.

The four-factor model for LWDS [comparative fit index (CFI) = 0.985, Tucker-Lewis index(TLI) = 0.979, standardised root mean residual (SRMR) = 0.059, root mean square error of approximation(RMSEA) = 0.049 (0.031, 0.061)] demonstrated good fit to this data. Cronbach’s α was 0.825 for totalscale and it was 0.818, 0.746, 0.624, and 0.670 for each individual subscale. The test-retest reliability of thescale was 0.925.

All goodness of fit indices (GFIs) represented a good fit of model. The LWDS-11 scale had anappropriate remarkable validity and reliability for waterpipe consumers to measure the level of nicotinedependence and it appeared to be likely useful for utilizing in the clinical and epidemiological studies.