Publications by authors named "Joseph Difranza"

Objective: Identifying the factors associated with nicotine dependence (ND) is essential to prevent initiation and continued use, and to promote cessation among youth. This study aims to document the predictors of the appearance of initial ND symptoms and full ND syndrome among adolescent waterpipe (WP) and cigarette smokers.

Methods: A 6-year longitudinal study was conducted among 8th and 9th graders from 38 schools in Lebanon.

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Purpose: Electronic cigarette (e-cigarette) use has increased exponentially among the youth in the United States and may increase the incidence of substance use.

Methods: Youth participants (12-17 years) were surveyed through the Population Assessment of Tobacco and Health study over a three-year time period. Youth with any baseline substance use or diagnosis of an attention deficit disorder were excluded from the analysis.

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Purpose: Waterpipe (WP) smoking patterns and setting can result in a unique trajectory of nicotine dependence (ND) compared with cigarette smoking. This longitudinal study compared the development of ND symptoms among adolescent WP and cigarette smokers.

Methods: A cohort of 647 eighth and ninth graders in Lebanon were followed over 5 years.

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Background And Objectives: A previous single-county study found that retail stores usually asked young-looking tobacco customers to show proof-of-age identification, but a large proportion of illegal tobacco sales to minors occurred after the customers had shown identification proving they were too young to purchase tobacco. We sought to investigate these findings on a larger scale.

Methods: We obtained state reports for federal fiscal years 2017 and 2018 from a federal agency that tracks tobacco sales to supervised minors conducting compliance checks in retail stores.

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Importance: Despite progress against tobacco sales to minors, retailers continue to violate state and federal laws and supply adolescent smokers with tobacco products. Government-sanctioned surveys underestimate the extent of the problem, and retailer associations use these data to block stricter enforcement policies.

Objectives: To assess the validity of the US federal retailer violation rate (RVR) as an estimate of the proportion of retailers that sell tobacco to minors and to investigate what proportion always or almost always sells vs refuses to sell cigarettes to minors.

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Introduction: Waterpipe smoking continues to pose significant challenges to tobacco control efforts and many adolescent waterpipe smokers experience symptoms of nicotine dependence (ND). This study examined the predictors of progression of ND symptoms in adolescent waterpipe smokers.

Methods: We assembled a cohort of Lebanese adolescents enrolled in eighth and ninth grades at baseline, and surveyed them every 6 months over the next 24 months.

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Background: Korean Americans are known for a high smoking prevalence within the Asian American population. This study examined the effects of acculturation and depression on Korean Americans' smoking cessation and abstinence.

Methods: This is a secondary data analysis of a smoking cessation study that implemented eight weekly individualized counseling sessions of a culturally adapted cessation intervention for the treatment arm and a standard cognitive behavioral therapy for the comparison arm.

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Mentholated cigarettes capture a quarter of the US market, and are disproportionately smoked by adolescents. Menthol allosterically modulates nicotinic acetylcholine receptor function, but its effects on the brain and nicotine addiction are unclear. To determine if menthol is psychoactive, we assessed locomotor sensitization and brain functional connectivity.

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Introduction: Waterpipe typically is smoked intermittently over long smoking sessions. Waterpipe is addictive and its users show symptoms of nicotine dependence (ND). This study examined the risk of developing ND symptoms across waterpipe use patterns among Lebanese youth.

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Introduction: Individuals with attention deficit/hyperactivity disorder (ADHD) are susceptible to earlier and more severe nicotine addiction. To shed light on the relationship between nicotine and ADHD, we examined nicotine's effects on functional brain networks in an animal model of ADHD.

Methods: Awake magnetic resonance imaging was used to compare functional connectivity in adolescent (post-natal day 44 ± 2) males of the spontaneously hypertensive rat (SHR) strain and two control strains, Wistar-Kyoto and Sprague-Dawley (n = 16 each).

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Introduction: Waterpipe smoking is addictive and its use is increasing globally among youth, yet little is known about the factors associated with nicotine dependence (ND) among waterpipe smokers. We investigated the factors associated with ND symptoms among a sample of Lebanese adolescents who smoke a waterpipe.

Methods: We collected data on factors potentially associated with ND (individual, socio-demographic, environmental, smoking patterns) among 160 current (past 30days) waterpipe smokers recruited from 8th and 9th school grades in Lebanon.

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Within the field of addiction research, individuals tend to operate within silos of knowledge focused on specific drug classes. The discovery that tobacco dependence develops in a progression of stages and that the latency to the onset of withdrawal symptoms after the last use of tobacco changes over time have provided insights into how tobacco dependence develops that might be applied to the study of other drugs.As physical dependence on tobacco develops, it progresses through previously unrecognized clinical stages of wanting, craving and needing.

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Background: Physically dependent smokers experience symptoms of wanting, craving or needing to smoke when too much time has passed since the last cigarette. There is interest in whether wanting, craving and needing represent variations in the intensity of a single physiological parameter or whether multiple physiological processes may be involved in the developmental progression of physical dependence.

Aim: Our aim was to determine how a population of cigarette smokers is distributed across the wanting, craving and needing stages of physical dependence.

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Purpose: The purpose of this study is to assess tobacco dependence among Cypriot adolescents and examine its association to cigarette consumption and attitudes towards smoking.

Methods: The current study used cross-sectional data from the 2011 Cyprus Global Youth Tobacco Survey which adopted multistage cluster sampling methods to select adolescents registered in middle and high schools in Cyprus. Tobacco use, physical dependence on tobacco, and attitudes towards tobacco use were measured in 187 adolescents aged 13-18years old who reported that they had smoked at least once in the preceding 30days.

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Background: Although waterpipe smoking is increasingly popular among youth and can lead to nicotine dependence (ND), no studies have documented how ND develops in waterpipe smokers. We examined the emerging symptoms of ND among adolescent waterpipe smokers in Lebanon.

Methods: Individual confidential interviews were used to evaluate ND in 160 waterpipe smokers and 24 cigarette smokers from a sample of 498 students enrolled in 8th and 9th grades in Lebanon.

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This clinical case presentation discusses a family in which 3 generations are affected by tobacco. The discussants discuss approaches to be taken to minimize the exposure of an infant to tobacco smoke from older relatives, behavioral and pharmacological approaches to assist smoking cessation, and concerns regarding electronic cigarettes.

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Background: The first self-reported symptoms of nicotine dependence (e.g., as craving) can appear within days to weeks of the onset of occasional use, and the appearance of symptoms predicts future consumption and dependence.

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Background: Among adolescent novice smokers, craving is often the first, and is the most reported, symptom of nicotine dependence. Until now, little has been known about the development of craving symptoms in novice smokers. The aim of this study was to identify specific genetic (i.

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The 2013 U.S. Preventive Services Task Force (USPSTF) concluded that behavioral interventions are effective in reducing initiation of smoking in youth, recommending primary care clinicians provide education or brief counseling to prevent initiation, and that there are promising trends toward behavioral interventions improving cessation in this population.

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Smoking Cessation in adolescents can be considered in a developmental context to enable the clinician to individualise the appropriate assessment and management of the young person they are seeing whether it is in a primary or tertiary care setting. Adolescence is a time of rapid neurocognitive and hormonal change with these factors affected by personality and behavioural factors as well as family, cultural and psychosocial context. Adolescents are uniquely vulnerable to smoking initiation and nicotine addiction throughout these years.

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Introduction: The Autonomy over Tobacco Scale (AUTOS), a 12-item self-administered questionnaire, was designed to measure autonomy in three correlated lower-order symptom domains: withdrawal, psychological dependence, and cue-induced craving. The factor structure of the AUTOS remains an open question; confirmatory analyses in adolescents supported the hierarchical structure, while exploratory analyses in adolescents and adults yield single-factor solutions. Here we seek to determine whether the hypothesized hierarchical structure is valid in adult smokers.

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This review will describe the biological and behavioral aspects of nicotine addiction as it develops during adolescence and advances over a lifetime. Symptoms of physical nicotine dependence typically appear when adolescents are smoking only a few cigarettes each month. Physical dependence develops through a set sequence of symptoms that correlate with changes in brain structure in addiction circuits.

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Introduction: The Autonomy over Tobacco Scale (AUTOS) is composed of 12-symptoms of nicotine dependence. While it has demonstrated excellent reliability and validity, several psychometric properties have yet to be investigated. We aimed to determine (1) whether items functioned differently across demographic groups, (2) the likelihood that individual symptoms would be endorsed by smokers at different levels of diminished autonomy, and (3) the degree of information provided by each item and the reliability of the full AUTOS across the range of diminished autonomy.

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Introduction: It is unknown how the timing between doses might affect nicotine's impact on neural activity. Our objective was to examine how the interdose interval affects nicotine's impact on resting-state functional connectivity (rsFC).

Materials And Methods: Adult male Sprague-Dawley rats were administered nicotine daily (0.

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