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Arch Gen Psychiatry. 2003 Jul;60(7):692-700.
Smoking increases the risk of panic: findings from a prospective community study.

Isensee B, Wittchen HU, Stein MB, Hofler M, Lieb R.

Clinical Psychology and Epidemiology Unit, Max-Planck-Institute of Psychiatry, Munich, Germany.

BACKGROUND: We examined prospectively determined bidirectional associations between smoking and panic and other anxiety disorders and their temporal ordering of onset in a representative community sample of adolescents and young adults. METHODS: Baseline and 4-year follow-up data were used from the Early Developmental Stages of Psychopathology Study, a prospective longitudinal study of adolescents and young adults in Munich, Germany. We assessed smoking (occasional and regular), nicotine dependence, panic attacks, panic disorder, other anxiety disorders, and other mental disorders using the Munich-Composite International Diagnostic Interview. RESULTS: At baseline, panic attacks and panic disorder were strongly associated with occasional and regular smoking and nicotine dependence (odds ratio [OR] range, 3.0-28.0). In the prospective analyses, we found increased risk for new onset of panic attacks with prior regular smoking (OR, 2.9; 95% confidence interval [CI], 1.0-8.4) and nicotine dependence (OR, 3.6; 95% CI, 1.2-10.5). Prior nicotine dependence increased also the risk for onset of panic disorder (OR, 3.3; 95% CI, 1.0-10.5), whereas preexisting panic was not associated with subsequent smoking or nicotine dependence. When using Cox regression with time-dependent covariates, prior nicotine dependence was confirmed to be related to subsequent panic attacks (hazard ratio, 2.7; 95% CI, 1.7-4.2), but not panic disorder (hazard ratio, 1.7; 95% CI, 0.7-3.9). Rather, we found indications that prior panic attacks/disorder might also have an effect on secondary development of nicotine dependence. CONCLUSIONS: In young adults, prospective analyses revealed a fairly unique and specific, unidirectional relationship between prior smoking and increased risk for subsequent panic attacks/disorder. However, we could not exclude the existence of a second, less frequent, reverse pathway of prior panic and secondary nicotine dependence.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12860773&dopt=Abstract [PubMed - in process]

J Subst Abuse Treat. 2003 Jun;24(4):357-61.
Nicotine and drug interaction expectancies among methadone maintained cigarette smokers.

Stein MD, Anderson BJ.

Brown University and Division of General Internal Medicine, Rhode Island Hospital, 593 Eddy Street, 02903, Providence, RI, USA. msteiifespan.org

Smoking rates among persons being treated with methadone for opiate dependence are exceptionally high. Nevertheless, there is debate about whether smoking cessation has a negative effect on substance abuse treatment outcomes. To understand patient perceptions of the interaction between smoking and illicit drug use, we administered the Nicotine and Other Substances Interaction Expectancies questionnaire (NOSIE) to 168 smokers-79% Caucasian and 48% female-at two methadone programs in Providence, Rhode Island. The four summed-rating scales of this 20-item instrument exhibited good to excellent internal-consistency reliabilities. The scales measured the effect of drug use on smoking (5 items, alpha =.84), the effect of smoking on drug use (3 items, alpha =.73), smoking to cope with drug urges (9 items, alpha =.91), and the difficulty of concomitantly quitting smoking and drugs (3 items, alpha =.72).Most subjects believed drug use increased smoking, but that smoking did not trigger drug use. Relatively few reported smoking to cope with drug urges and most did not consider quitting smoking and quitting drug use to be incompatible goals. NOSIE was a reliable instrument that offers insight into patient expectations of the interaction of smoking and drug use.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12867210&dopt=Abstract [PubMed - in process]

J Neurosci. 2003 Jul 16;23(15):6200-8.
Muscarine-induced increase in frequency of spontaneous EPSCs in Purkinje cells in the vestibulo-cerebellum of the rat.

Takayasu Y, Iino M, Furuya N, Ozawa S.

Department of Physiology, Gunma University School of Medicine, Maebashi, Gunma, 371-8511, Japan.

Cholinergic projections are relatively sparse in the cerebellum compared with other parts of the brain. However, some mossy fibers in the vestibulo-cerebellum are known to be cholinergic. To clarify the functional roles of cholinergic mossy fibers in the vestibulo-cerebellum, we investigated the effects of acetylcholine (ACh) on the membrane electrical properties of both granule cells and Purkinje cells in slices of the cerebellar vermis of the rat using whole-cell patch-clamp techniques. The bath application of ACh induced a marked increase in the frequency of spontaneous EPSCs (sEPSCs) in Purkinje cells specifically in the vestibulo-cerebellum. This effect of ACh was mimicked by muscarine but not by nicotine. It was abolished by application of either tetrodotoxin or the antagonist of AMPA receptors, indicating that the ACh-induced enhancement of sEPSCs occurred indirectly via the activation of neurons sending glutamatergic projections to Purkinje cells. In approximately 15% of granule cells tested in the vestibulo-cerebellum, muscarine elicited membrane depolarization accompanied by a decrease in membrane conductance and increased the neuronal excitability. The muscarine-induced depolarization of granule cells in the vestibulo-cerebellum was attributable to the inhibition of standing-outward K+ currents (IKSO) most likely via the activation of muscarinic M3 receptors. Taken together, these results indicate that ACh increases the firing frequency of granule cells by inhibiting IKSO, which in turn increases the frequency of sEPSCs in Purkinje cells in the rat vestibulo-cerebellum.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12867503&dopt=Abstract

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