@article{4ae888d829614c508d65de5bca0c65b1,
title = "Comparing the Rate of Nicotine Metabolism Among Smokers With Current or Past Major Depressive Disorder",
abstract = "Background and Objectives: Persons with current or past major depressive disorder (MDD) vs those without have higher smoking rates. The nicotine metabolite ratio (NMR) represents variation in the rate of nicotine metabolism and has been associated with smoking behaviors and response to tobacco treatments. We compared NMR between smokers with current or past MDD (MDD+) vs smokers without MDD (MDD−). We also assessed correlates of NMR and compared withdrawal and craving between MDD+ and MDD− smokers. Methods: Using baseline data from two clinical trials and propensity score weighting based on sex, race, body mass index, and smoking rate, we compared NMR between MDD+ (N = 279) and MDD− (N = 1575) smokers. We also compared groups on and nicotine withdrawal and craving. Results: Mean NMR (β = −.02, 95% confidence interval [CI]: −0.05 to 0.01, P =.13) and the distribution of smokers across NMR quartiles (odds ratio [OR] = 0.76, 95% CI: 0.50 to 1.16, P =.21) were similar between MDD+ and MDD− samples. This relationship was not affected by antidepressant medication. In the MDD+ sample, African Americans had significantly lower mean NMR, while older smokers and smokers with lower education had higher mean NMR (Ps <.05). MDD+ smokers had significantly higher withdrawal and craving than MDD− smokers (Ps <.05). Discussion and Conclusions: While variability in NMR may not explain differences in smoking rates between MDD+ and MDD− smokers, MDD+ smokers report increased withdrawal and craving. Scientific Significance: In this first study to assess NMR among MDD+ smokers, the findings underscore the need to address withdrawal and craving within smoking cessation treatments for those with MDD. (Am J Addict 2021;00:00–00).",
author = "Robert Schnoll and {Paul Wileyto}, E. and Bauer, {Anna Marika} and Erica Fox and Frank Leone and Caryn Lerman and Tyndale, {Rachel F.} and George, {Tony P.} and Larry Hawk and Paul Cinciripini and Mackenzie Quinn and Janelle Purnell and Jane Hatzell and Brian Hitsman",
note = "Funding Information: . This research was supported by grants from the National Institutes of Health (R01 CA184211, K24 DA045244, R35 CA197461, and U01 DA020830), by grants from the Canadian Institutes of Health Research (FDN‐154294) and a Canada Research Chair in Pharmacogenomics, and by the Department of Preventive Medicine at Northwestern University Feinberg School of Medicine Funding Information: This research was supported by grants from the National Institutes of Health (R01 CA184211, K24 DA045244, R35 CA197461, and U01 DA020830), by grants from the Canadian Institutes of Health Research (FDN-154294) and a Canada Research Chair in Pharmacogenomics, and by the Department of Preventive Medicine at Northwestern University Feinberg School of Medicine. Data for this sample came from a randomized controlled trial testing varenicline plus behavioral activation therapy for smokers with current or past MDD. The study was approved by the Northwestern University and University of Pennsylvania IRBs (ClinicalTrials.gov ID: NCT02378714). Participants were recruited through media advertisements. To be eligible, participants had to be more than 18 years of age, report daily smoking, have a current or past DSM-5 diagnosis of MDD without psychotic features, able to communicate in English, and able to provide informed consent. Key exclusion criteria included daily use of e-cigarettes or another nicotine/tobacco product, use of mood stabilizers, self-reported suicide attempt in the last 12 months, self-reported current or planned pregnancy, self-reported current use of smoking cessation medication, heavy alcohol consumption defined as more than 28 drinks per week, lifetime bipolar or psychotic disorder as determined by either self-report or the Mini-International?Neuropsychiatric Interview (MINI-7), 16 and uncontrolled hypertension (systolic > 185 or diastolic > 110). Of the 300 participants enrolled in this trial, 279 provided a sample for NMR and were included in this study. Data for this sample came from a randomized controlled trial testing varenicline plus behavioral activation therapy for smokers with current or past MDD. The study was approved by the Northwestern University and University of Pennsylvania IRBs (ClinicalTrials.gov ID: NCT02378714). Participants were recruited through media advertisements. To be eligible, participants had to be more than 18 years of age, report daily smoking, have a current or past DSM-5 diagnosis of MDD without psychotic features, able to communicate in English, and able to provide informed consent. Key exclusion criteria included daily use of e-cigarettes or another nicotine/tobacco product, use of mood stabilizers, self-reported suicide attempt in the last 12 months, self-reported current or planned pregnancy, self-reported current use of smoking cessation medication, heavy alcohol consumption defined as more than 28 drinks per week, lifetime bipolar or psychotic disorder as determined by either self-report or the Mini-International?Neuropsychiatric Interview (MINI-7), 16 and uncontrolled hypertension (systolic > 185 or diastolic > 110). Of the 300 participants enrolled in this trial, 279 provided a sample for NMR and were included in this study. Data for this sample came from a multisite NMR-stratified (slow vs?fast) randomized controlled trial testing varenicline, vs transdermal nicotine, vs placebo approved by all site IRBs (ClinicalTrials.gov ID: NCT01314001). Participants were aged 18 to 65, reported smoking more than 10 cigarettes per day for the past 6 months, and provided written informed consent. Exclusion criteria included the use of noncigarette tobacco products, e-cigarettes, or current smoking treatment; history of substance abuse treatment, current use of cocaine or methamphetamine, or more than 25 alcoholic drinks per week; medical contraindications (eg, pregnancy, uncontrolled hypertension); history of DSM-IV psychiatric disorder or suicide risk score greater than 1 on the MINI, or current major depression assessed by the MINI; current use of mood stabilizers, antipsychotics, stimulants, metformin, or medications altering CYP2A6 activity (eg, tricyclic antidepressants). Publisher Copyright: {\textcopyright} 2021 American Academy of Addiction Psychiatry",
year = "2021",
month = jul,
doi = "10.1111/ajad.13155",
language = "English (US)",
volume = "30",
pages = "382--388",
journal = "American Journal on Addictions",
issn = "1055-0496",
publisher = "Wiley-Blackwell",
number = "4",
}
