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Biobehavioral nicotine dependence in persons with schizophrenia

Yerardi, Ruth S.

Abstract Details

2007, Doctor of Philosophy, Ohio State University, Nursing.
Tobacco use is the leading cause of preventable death in the United States with an adult smoking prevalence less than 21%. Yet, those with schizophrenia approach smoking prevalence as high as 83%. Studying tobacco use in this population has been challenged by their decision making capabilities. Their ability to recall, understand, and provide informed consent can be enhanced with educational interventions. An electronic version informed consent, with highlighted key points was read aloud by research assistant with the subject following along, resulted in 78% of 49 subjects achieving 100% on a comprehension informed consent questionnaire at trial one; after remediation, the remaining achieved 100%. Past studies found those on atypical antipsychotic medications smoked less than those on typical antipsychotics. This study examined if there were any differences in smoking topography, smoke constituent exposure, and levels of nicotine dependence between persons with schizophrenia on atypical and typical antipsychotics at baseline and at two, four, and eight weeks with bupropion therapy. Results found no significant differences at baseline between the subjects. At the end of study with eight weeks of bupropion, 25 remained enrolled. They had significant within subject differences with shortened interpuff interval in atypical category; mean flow rate and mean peak flow increased in both. Mean carbon monoxide boost decreased in atypicals, but was unchanged in typicals. There was significant within group changes from visits one to four using paired samples Wilcoxon test for post-cigarette nicotine, decreasing approximately 22% in atypicals and 11% in typicals. Similarly, post-cigarette cotinine decreased approximately 23% in atypicals and 9% in typicals. Findings suggest smoking behavior changed as a compensatory mechanism as they smoked fewer cigarettes per day and for a shorter period of time. Possible predictors of exposure using regression analysis found 40% of post-cigarette carbon monoxide levels explained by cotinine of visit one and typical medication category. Eight weeks of bupropion was found to be effective in decreasing amount of nicotine and cotinine exposure whether on atypical or typical antipsychotics. For the severely dependent who are unable or unwilling to quit smoking, a program of harm reduction may be a second best alternative.
Karen Ahijevych (Advisor)
135 p.

Recommended Citations

Citations

  • Yerardi, R. S. (2007). Biobehavioral nicotine dependence in persons with schizophrenia [Doctoral dissertation, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1172512647

    APA Style (7th edition)

  • Yerardi, Ruth. Biobehavioral nicotine dependence in persons with schizophrenia. 2007. Ohio State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1172512647.

    MLA Style (8th edition)

  • Yerardi, Ruth. "Biobehavioral nicotine dependence in persons with schizophrenia." Doctoral dissertation, Ohio State University, 2007. http://rave.ohiolink.edu/etdc/view?acc_num=osu1172512647

    Chicago Manual of Style (17th edition)