Background: To investigate the improvement in quality of life (QoL) of alcohol-dependent patients... more Background: To investigate the improvement in quality of life (QoL) of alcohol-dependent patients during a 3-week inpatient withdrawal programme, and to identify the sociodemographic, clinical and alcohol-related variables associated with baseline QoL on admission and with improvement of QoL during residential treatment. Methods: This prospective, observational study included 414 alcohol-dependent patients, hospitalised for a period of 3 weeks. QoL was measured on admission and at discharge using the French version of the Medical Outcome Study SF-36. The mean scores for each dimension and for the Physical and Mental Component Summary scores were calculated. Results: The mean scores per dimension and the mean Physical and Mental Component Summary scores were significantly lower on admission than at discharge; the lowest scores being observed for social functioning and role limitations due to emotional problems. At discharge, the mean scores per dimension were similar to those observed in the French general population. Female gender, age >45 years, living alone, working as a labourer or employee, somatic comorbidity, and the existence of at least five criteria for alcohol dependence according to the DSM-IV classification were associated with a low Physical Component Summary score on admission; psychiatric comorbidity, the presence of at least five DSM-IV dependence criteria, smoking and suicidality were associated with a low Mental Component Summary score on admission. The increase in Physical and Mental Component Summary scores during hospitalisation was more marked when the initial scores were low. Apart from the initial score, the greatest improvement in Physical Component Summary score was seen in patients with a high alcohol intake and in those without a somatic comorbidity; the increase in Mental Component Summary score was greatest in patients without psychotic symptoms and in those who abused or were dependent on illegal drugs. Conclusion: QoL improvement after a residential treatment was related to low QoL scores at admission. Improvement in physical component of QoL was related to baseline alcohol intake and good somatic status. Improvement in mental component of QoL was related to other drugs abuse/dependence.
properties similar to its parent measure, the CDS-12, but with less comprehensive content in term... more properties similar to its parent measure, the CDS-12, but with less comprehensive content in terms of tapping compulsion, withdrawal symptoms, loss of control, time allocation, neglect of other activities, and persistence in smoking despite harm. Results of direct comparisons between the FTCD and the CDS have been mixed, with the vast majority of studies involving contrasts between the FTCD and CDS-12. In general, the FTCD and CDS-12 are moderately associated with each other and both are correlated positively with cigarettes per day and age at first daily smoking, 6-8 yet neither measure is associated significantly with the
International Journal of Environmental Research and Public Health, Mar 2, 2009
The ATTEMPT cohort study is multinational , longitudinal study of smokers intending to quit recru... more The ATTEMPT cohort study is multinational , longitudinal study of smokers intending to quit recruited in the U.S.A., Canada, U.K. and France. Data on demographics, medical history, body mass index (BMI), weight concerns and smoking status were collected at baseline and after six months. A total of 2,009 subjects provided data at baseline and 1,303 at six months. High baseline BMI was associated with recent quit attempts, high weight concerns and high cigarette consumption. Weight gain was associated with low income, being single and number of cigarette-free days, but not with baseline weight concerns and confidence in preventing weight gain. Quit attempts were more frequent in subjects with a high baseline BMI and low weight concerns.
International Journal of Environmental Research and Public Health, May 20, 2021
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
In their recent analysis of the Nurses' Health Study (NHS), the NHS 2, and the Health Professiona... more In their recent analysis of the Nurses' Health Study (NHS), the NHS 2, and the Health Professionals Follow-up Study (HPFS), Ding et al 1 reported that coffee consumption, either caffeinated or decaffeinated, was nonlinearly associated with mortality. Compared with no consumption, coffee consumption of 1 to 5 cups/d was associated with a lower risk of mortality, whereas coffee consumption of >5 cups/d was not associated with risk of mortality. When the analysis was restricted to never smokers, coffee consumption was associated with lower risk of total mortality and mortality resulting from cardiovascular disease, neurological diseases, and suicide, even if coffee intake exceeded 5 cups/d. The authors suggested several plausible mechanisms that could explain the negative association of coffee consumption with cardiovascular mortality: coffee beverages contain chlorogenic acid, lignans, quinides, trigonelline, and magnesium, which are known to reduce insulin resistance and systematic inflammation. We would like to raise the fact that coffee consumption has been reported to have a hypercholesterolemic effect, leading to adverse cardiovascular outcomes. 2 Cafestol and kahweol occur naturally in coffee beans and have been identified as hypercholesterolemic compounds. 3 The effects of coffee on serum lipoprotein concentrations are largely dependent on the method of its preparation. For example, cafestol and kahweol are not present in regular coffee made with drip coffeemakers because they are largely trapped by the use of a paper filter. Espresso, which is made with high-pressure hot water through a column of coffee in a percolator, has a different composition. In a recent meta-analysis, consumption of unfiltered coffee resulted in mean increases of 11.9 mg/dL for low-density lipoprotein cholesterol and 18.8 mg/dL for triglyceride concentrations. Filtered coffee consumption did not significantly change low-density lipoprotein cholesterol or triglyceride concentrations. 4 The cohorts analyzed by Ding et al 1 began in 1976 (NHS), 1986 (HPFS), and 1989 (NHS 2) and were followed-up for ≈30 years. During this period, coffee was mostly filtered. Inversely, capsule coffee machines have recently become popular. Therefore, an increasing proportion of occidental population is switching its coffee-drinking behavior from filtered to unfiltered coffee. Sales of the leading brand have leapt 30%/y over the last decade. 5 Consequently, because the dramatic cardiovascular protective effect of coffee reported by Ding et al 1 should encourage many individuals to continue or even increase their coffee consumption, their finding might not be applicable to unfiltered coffee drinkers. Further studies should assess the difference in mortality between filtered and unfiltered coffee drinkers.
International Journal of Environmental Research and Public Health, Apr 11, 2021
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Although studies have demonstrated the validity of imagery procedures to elicit tobacco craving r... more Although studies have demonstrated the validity of imagery procedures to elicit tobacco craving responses in single sessions, few studies have examined the consistency of responding in the same individuals over multiple experimental sessions. In this study, nondeprived smokers were presented with a randomized series of imagery scripts that varied in the intensity of smoking urge content. At each of five sessions spaced over several weeks, participants were exposed to six imagery trials (two each of no-, low-, and high-intensity imagery scripts). After each trial, participants completed subjective measures of tobacco craving and mood. Ratings of craving and negative mood significantly increased as a function of smoking-urge intensity, which was consistent across the five sessions. Further, significant intraclass correlations indicated that craving and mood responses were highly reliable over the five sessions, as well as across two, three, and four sessions. These results have practical implications for examining individual differences in sensitivity to smoking cues and for studies involving repeated measurement of elicited craving over time.
The Adjustment of DOses of NIcotine in Smoking Cessation (ADONIS) clinical trial was a nicotine r... more The Adjustment of DOses of NIcotine in Smoking Cessation (ADONIS) clinical trial was a nicotine replacement therapy (NRT) dose optimization study of French smokers with a smokingrelated disease. The goal of the trial was to compare 100%
British Journal of Clinical Pharmacology, Jan 22, 2014
Strategies for assisting smoking cessation include behavioural counselling to enhance motivation ... more Strategies for assisting smoking cessation include behavioural counselling to enhance motivation and to support attempts to quit and pharmacological intervention to reduce nicotine reinforcement and withdrawal from nicotine. Three drugs are currently used as first line pharmacotherapy for smoking cessation, nicotine replacement therapy, bupropion and varenicline. Compared with placebo, the drug effect varies from 2.27 (95% CI 2.02, 2.55) for varenicline, 1.69 (95% CI 1.53, 1.85) for bupropion and 1.60 (95% CI 1.53, 1.68) for any form of nicotine replacement therapy. Despite some controversy regarding the safety of bupropion and varenicline, regulatory agencies consider these drugs as having a favourable benefit/risk profile. However, given the high rate of psychiatric comorbidity in dependent smokers, practitioners should closely monitor patients for neuropsychiatric symptoms. Second-line pharmacotherapies include nortriptyline and clonidine. This review also offers an overview of pipeline developments and issues related to smoking cessation in special populations such as persons with psychiatric comorbidity and pregnant and adolescent smokers.
Background Assessing bene ts and harms of health interventions is resource-intensive and often re... more Background Assessing bene ts and harms of health interventions is resource-intensive and often requires feasibility and pilot trials followed by adequately powered randomised clinical trials. Data from feasibility and pilot trials are used to inform the design and sample size of the adequately powered randomised clinical trials. When a randomised clinical trial is conducted, results from feasibility and pilot trials may be disregarded in terms of bene ts and harms. Methods We describe using feasibility and pilot trial data in the Trial Sequential Analysis program to estimate the required sample size for one or more trials investigating a behavioural smoking cessation intervention. We show how data from a new, planned trial can be combined with data from the earlier trials using Trial Sequential Analysis to assess the intervention's effects. Results We provide a worked example to illustrate how we successfully used Trial Sequential Analysis methods to argue for the research funds needed to undertake a randomised clinical trial. Conclusions Trial Sequential Analysis can utilise data from feasibility and pilot trials as well as other trials, to estimate a sample size for one or more future randomised clinical trials. As this method uses available data, estimated sample sizes may be smaller than they would have been using conventional sample size estimation methods.
Background Smoking in pregnancy is a public health problem. When used by non-pregnant smokers, ph... more Background Smoking in pregnancy is a public health problem. When used by non-pregnant smokers, pharmacotherapies (nicotine replacement therapy (NRT), bupropion and varenicline) are effective for smoking cessation, however, their efficacy and safety in pregnancy remains unknown. Electronic Nicotine Delivery Systems (ENDS), or e-cigarettes, are becoming widely used but their efficacy and safety when used for smoking cessation in pregnancy are also unknown. Objectives To determine the efficacy and safety of smoking cessation pharmacotherapies (including NRT, varenicline and bupropion), other medications, or ENDS when used for smoking cessation in pregnancy. Search methods We searched the Pregnancy and Childbirth Group's Trials Register (11 July 2015), checked references of retrieved studies, and contacted authors. Selection criteria Randomised controlled trials (RCTs) conducted in pregnant women with designs that permit the independent effects of any type of pharmacotherapy or ENDS on smoking cessation to be ascertained were eligible for inclusion. The following RCT designs are included. Placebo-RCTs: any form of NRT, other pharmacotherapy, or ENDS, with or without behavioural support/cognitive behaviour therapy (CBT), or brief advice, compared with an identical placebo and behavioural support of similar intensity. RCTs providing a comparison between i) any form of NRT, other pharmacotherapy, or ENDS added to behavioural support/CBT, or brief advice and ii) behavioural support of similar (ideally identical) intensity. Parallel-or cluster-randomised trials were eligible for inclusion. Quasi-randomised, cross-over and within-participant designs were not, due to the potential biases associated with these designs. 1 Pharmacological interventions for promoting smoking cessation during pregnancy (Review)
Objective To evaluate the efficacy of financial incentives dependent on continuous smoking abstin... more Objective To evaluate the efficacy of financial incentives dependent on continuous smoking abstinence on smoking cessation and birth outcomes among pregnant smokers. Design Single blind, randomised controlled trial. setting Financial Incentive for Smoking Cessation in Pregnancy (FISCP) trial in 18 maternity wards in France. ParticiPants 460 pregnant smokers aged at least 18 years who smoked ≥5 cigarettes/day or ≥3 roll-your-own cigarettes/day and had a pregnancy gestation of <18 weeks were randomised to a financial incentives group (n=231) or a control group (n=229). interventiOns Participants in the financial incentives group received a voucher equivalent to €20 (£17; $23), and further progressively increasing vouchers at each study visit if they remained abstinent. Participants in the control group received no financial incentive for abstinence. All participants received a €20 show-up fee at each of six visits. Main OutcOMe Measures The main outcome measure was continuous smoking abstinence from the first post-quit date visit to visit 6, before delivery. Secondary outcomes in the mothers were point prevalence abstinence, time to smoking relapse, withdrawal symptoms, blood pressure, and alcohol and cannabis use in past 30 days. Secondary outcomes in the babies were gestational age at birth, birth characteristics (birth weight, length, head circumference, Apgar score), and a poor neonatal outcome-a composite measure of transfer to the neonatal unit, congenital malformation, convulsions, or perinatal death. results Mean age was 29 years. In the financial incentives and control groups, respectively, 137 (59%) and 148 (65%) were employed, 163 (71%) and 171 (75%) were in a relationship, and 41 (18%) and 31 (13%) were married. The participants had smoked a median of 60 cigarettes in the past seven days. The continuous abstinence rate was significantly higher in the financial incentives group (16%, 38/231) than control group (7%, 17/229): odds ratio 2.45 (95% confidence interval 1.34 to 4.49), P=0.004). The point prevalence abstinence rate was higher (4.61, 1.41 to 15.01, P=0.011), the median time to relapse was longer (visit 5 (interquartile range 3-6) and visit 4 (3-6), P<0.001)), and craving for tobacco was lower (β=−1.81, 95% confidence interval −3.55 to −0.08, P=0.04) in the financial incentives group than control group. Financial incentives were associated with a 7% reduction in the risk of a poor neonatal outcome: 4 babies (2%) in the financial incentives group and 18 babies (9%) in the control group: mean difference 14 (95% confidence interval 5 to 23), P=0.003. Post hoc analyses suggested that more babies in the financial incentives group had birth weights ≥2500 g than in the control group: unadjusted odds ratio 1.95 (95% confidence interval 0.99 to 3.85), P=0.055; sex adjusted odds ratio 2.05 (1.03 to 4.10), P=0.041; and sex and prematurity adjusted odds ratio 2.06 (0.90 to 4.71), P=0.086. As these are post hoc analyses, the results should be interpreted with caution. cOnclusiOns Financial incentives to reward smoking abstinence compared with no financial incentives were associated with an increased abstinence rate in pregnant smokers. Financial incentives dependent on smoking abstinence could be implemented as a safe and effective intervention to help pregnant smokers quit smoking. trial registratiOn ClinicalTrials.gov NCT02606227.
International Journal of Environmental Research and Public Health
The causative agents of COVID-19 are the variants of SARS-CoV-2 (severe acute respiratory syndrom... more The causative agents of COVID-19 are the variants of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) [...]
Le tabagisme a est la première cause de décès évitables dans le monde. Si la prévalence du tabagi... more Le tabagisme a est la première cause de décès évitables dans le monde. Si la prévalence du tabagisme est en recul dans les pays à haut revenu comme la Suisse, où 27% de la population âgée de 14 à 65 ans fumaient en 2010 contre 33% en 2001,1 la proportion de fumeurs augmente dans les pays à bas revenu.2 Les risques de cancers, de maladies respiratoires et de maladies cardiovasculaires liés au tabagisme sont bien connus, toutefois l’impact du tabagisme sur les troubles métaboliques tels que l’obésité ou le diabète le sont moins et sont sujets à davantage de controverses. Les implications au niveau clinique ainsi qu’au niveau de la santé publique sont importantes. En effet, nous assistons actuellement à une réelle pandémie de l’obésité au niveau mondial et parallèlement à cela aux conséquences qui lui sont liées comme le diabète de type 2. Selon les estimations de l’OMS, 1,1 million de personnes sont décédées de causes liées au diabète en 2005 et ce chiffre devrait doubler d’ici à 2030...
L'invention concerne l'utilisation d'inhibiteurs de la monoamine oxydase-A dans la fa... more L'invention concerne l'utilisation d'inhibiteurs de la monoamine oxydase-A dans la fabrication de medicaments destines a lutter contre la consommation des produits du tabac et, en meme temps, a limiter chez les fumeurs le syndrome de privation.
Background: To investigate the improvement in quality of life (QoL) of alcohol-dependent patients... more Background: To investigate the improvement in quality of life (QoL) of alcohol-dependent patients during a 3-week inpatient withdrawal programme, and to identify the sociodemographic, clinical and alcohol-related variables associated with baseline QoL on admission and with improvement of QoL during residential treatment. Methods: This prospective, observational study included 414 alcohol-dependent patients, hospitalised for a period of 3 weeks. QoL was measured on admission and at discharge using the French version of the Medical Outcome Study SF-36. The mean scores for each dimension and for the Physical and Mental Component Summary scores were calculated. Results: The mean scores per dimension and the mean Physical and Mental Component Summary scores were significantly lower on admission than at discharge; the lowest scores being observed for social functioning and role limitations due to emotional problems. At discharge, the mean scores per dimension were similar to those observed in the French general population. Female gender, age >45 years, living alone, working as a labourer or employee, somatic comorbidity, and the existence of at least five criteria for alcohol dependence according to the DSM-IV classification were associated with a low Physical Component Summary score on admission; psychiatric comorbidity, the presence of at least five DSM-IV dependence criteria, smoking and suicidality were associated with a low Mental Component Summary score on admission. The increase in Physical and Mental Component Summary scores during hospitalisation was more marked when the initial scores were low. Apart from the initial score, the greatest improvement in Physical Component Summary score was seen in patients with a high alcohol intake and in those without a somatic comorbidity; the increase in Mental Component Summary score was greatest in patients without psychotic symptoms and in those who abused or were dependent on illegal drugs. Conclusion: QoL improvement after a residential treatment was related to low QoL scores at admission. Improvement in physical component of QoL was related to baseline alcohol intake and good somatic status. Improvement in mental component of QoL was related to other drugs abuse/dependence.
properties similar to its parent measure, the CDS-12, but with less comprehensive content in term... more properties similar to its parent measure, the CDS-12, but with less comprehensive content in terms of tapping compulsion, withdrawal symptoms, loss of control, time allocation, neglect of other activities, and persistence in smoking despite harm. Results of direct comparisons between the FTCD and the CDS have been mixed, with the vast majority of studies involving contrasts between the FTCD and CDS-12. In general, the FTCD and CDS-12 are moderately associated with each other and both are correlated positively with cigarettes per day and age at first daily smoking, 6-8 yet neither measure is associated significantly with the
International Journal of Environmental Research and Public Health, Mar 2, 2009
The ATTEMPT cohort study is multinational , longitudinal study of smokers intending to quit recru... more The ATTEMPT cohort study is multinational , longitudinal study of smokers intending to quit recruited in the U.S.A., Canada, U.K. and France. Data on demographics, medical history, body mass index (BMI), weight concerns and smoking status were collected at baseline and after six months. A total of 2,009 subjects provided data at baseline and 1,303 at six months. High baseline BMI was associated with recent quit attempts, high weight concerns and high cigarette consumption. Weight gain was associated with low income, being single and number of cigarette-free days, but not with baseline weight concerns and confidence in preventing weight gain. Quit attempts were more frequent in subjects with a high baseline BMI and low weight concerns.
International Journal of Environmental Research and Public Health, May 20, 2021
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
In their recent analysis of the Nurses' Health Study (NHS), the NHS 2, and the Health Professiona... more In their recent analysis of the Nurses' Health Study (NHS), the NHS 2, and the Health Professionals Follow-up Study (HPFS), Ding et al 1 reported that coffee consumption, either caffeinated or decaffeinated, was nonlinearly associated with mortality. Compared with no consumption, coffee consumption of 1 to 5 cups/d was associated with a lower risk of mortality, whereas coffee consumption of >5 cups/d was not associated with risk of mortality. When the analysis was restricted to never smokers, coffee consumption was associated with lower risk of total mortality and mortality resulting from cardiovascular disease, neurological diseases, and suicide, even if coffee intake exceeded 5 cups/d. The authors suggested several plausible mechanisms that could explain the negative association of coffee consumption with cardiovascular mortality: coffee beverages contain chlorogenic acid, lignans, quinides, trigonelline, and magnesium, which are known to reduce insulin resistance and systematic inflammation. We would like to raise the fact that coffee consumption has been reported to have a hypercholesterolemic effect, leading to adverse cardiovascular outcomes. 2 Cafestol and kahweol occur naturally in coffee beans and have been identified as hypercholesterolemic compounds. 3 The effects of coffee on serum lipoprotein concentrations are largely dependent on the method of its preparation. For example, cafestol and kahweol are not present in regular coffee made with drip coffeemakers because they are largely trapped by the use of a paper filter. Espresso, which is made with high-pressure hot water through a column of coffee in a percolator, has a different composition. In a recent meta-analysis, consumption of unfiltered coffee resulted in mean increases of 11.9 mg/dL for low-density lipoprotein cholesterol and 18.8 mg/dL for triglyceride concentrations. Filtered coffee consumption did not significantly change low-density lipoprotein cholesterol or triglyceride concentrations. 4 The cohorts analyzed by Ding et al 1 began in 1976 (NHS), 1986 (HPFS), and 1989 (NHS 2) and were followed-up for ≈30 years. During this period, coffee was mostly filtered. Inversely, capsule coffee machines have recently become popular. Therefore, an increasing proportion of occidental population is switching its coffee-drinking behavior from filtered to unfiltered coffee. Sales of the leading brand have leapt 30%/y over the last decade. 5 Consequently, because the dramatic cardiovascular protective effect of coffee reported by Ding et al 1 should encourage many individuals to continue or even increase their coffee consumption, their finding might not be applicable to unfiltered coffee drinkers. Further studies should assess the difference in mortality between filtered and unfiltered coffee drinkers.
International Journal of Environmental Research and Public Health, Apr 11, 2021
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Although studies have demonstrated the validity of imagery procedures to elicit tobacco craving r... more Although studies have demonstrated the validity of imagery procedures to elicit tobacco craving responses in single sessions, few studies have examined the consistency of responding in the same individuals over multiple experimental sessions. In this study, nondeprived smokers were presented with a randomized series of imagery scripts that varied in the intensity of smoking urge content. At each of five sessions spaced over several weeks, participants were exposed to six imagery trials (two each of no-, low-, and high-intensity imagery scripts). After each trial, participants completed subjective measures of tobacco craving and mood. Ratings of craving and negative mood significantly increased as a function of smoking-urge intensity, which was consistent across the five sessions. Further, significant intraclass correlations indicated that craving and mood responses were highly reliable over the five sessions, as well as across two, three, and four sessions. These results have practical implications for examining individual differences in sensitivity to smoking cues and for studies involving repeated measurement of elicited craving over time.
The Adjustment of DOses of NIcotine in Smoking Cessation (ADONIS) clinical trial was a nicotine r... more The Adjustment of DOses of NIcotine in Smoking Cessation (ADONIS) clinical trial was a nicotine replacement therapy (NRT) dose optimization study of French smokers with a smokingrelated disease. The goal of the trial was to compare 100%
British Journal of Clinical Pharmacology, Jan 22, 2014
Strategies for assisting smoking cessation include behavioural counselling to enhance motivation ... more Strategies for assisting smoking cessation include behavioural counselling to enhance motivation and to support attempts to quit and pharmacological intervention to reduce nicotine reinforcement and withdrawal from nicotine. Three drugs are currently used as first line pharmacotherapy for smoking cessation, nicotine replacement therapy, bupropion and varenicline. Compared with placebo, the drug effect varies from 2.27 (95% CI 2.02, 2.55) for varenicline, 1.69 (95% CI 1.53, 1.85) for bupropion and 1.60 (95% CI 1.53, 1.68) for any form of nicotine replacement therapy. Despite some controversy regarding the safety of bupropion and varenicline, regulatory agencies consider these drugs as having a favourable benefit/risk profile. However, given the high rate of psychiatric comorbidity in dependent smokers, practitioners should closely monitor patients for neuropsychiatric symptoms. Second-line pharmacotherapies include nortriptyline and clonidine. This review also offers an overview of pipeline developments and issues related to smoking cessation in special populations such as persons with psychiatric comorbidity and pregnant and adolescent smokers.
Background Assessing bene ts and harms of health interventions is resource-intensive and often re... more Background Assessing bene ts and harms of health interventions is resource-intensive and often requires feasibility and pilot trials followed by adequately powered randomised clinical trials. Data from feasibility and pilot trials are used to inform the design and sample size of the adequately powered randomised clinical trials. When a randomised clinical trial is conducted, results from feasibility and pilot trials may be disregarded in terms of bene ts and harms. Methods We describe using feasibility and pilot trial data in the Trial Sequential Analysis program to estimate the required sample size for one or more trials investigating a behavioural smoking cessation intervention. We show how data from a new, planned trial can be combined with data from the earlier trials using Trial Sequential Analysis to assess the intervention's effects. Results We provide a worked example to illustrate how we successfully used Trial Sequential Analysis methods to argue for the research funds needed to undertake a randomised clinical trial. Conclusions Trial Sequential Analysis can utilise data from feasibility and pilot trials as well as other trials, to estimate a sample size for one or more future randomised clinical trials. As this method uses available data, estimated sample sizes may be smaller than they would have been using conventional sample size estimation methods.
Background Smoking in pregnancy is a public health problem. When used by non-pregnant smokers, ph... more Background Smoking in pregnancy is a public health problem. When used by non-pregnant smokers, pharmacotherapies (nicotine replacement therapy (NRT), bupropion and varenicline) are effective for smoking cessation, however, their efficacy and safety in pregnancy remains unknown. Electronic Nicotine Delivery Systems (ENDS), or e-cigarettes, are becoming widely used but their efficacy and safety when used for smoking cessation in pregnancy are also unknown. Objectives To determine the efficacy and safety of smoking cessation pharmacotherapies (including NRT, varenicline and bupropion), other medications, or ENDS when used for smoking cessation in pregnancy. Search methods We searched the Pregnancy and Childbirth Group's Trials Register (11 July 2015), checked references of retrieved studies, and contacted authors. Selection criteria Randomised controlled trials (RCTs) conducted in pregnant women with designs that permit the independent effects of any type of pharmacotherapy or ENDS on smoking cessation to be ascertained were eligible for inclusion. The following RCT designs are included. Placebo-RCTs: any form of NRT, other pharmacotherapy, or ENDS, with or without behavioural support/cognitive behaviour therapy (CBT), or brief advice, compared with an identical placebo and behavioural support of similar intensity. RCTs providing a comparison between i) any form of NRT, other pharmacotherapy, or ENDS added to behavioural support/CBT, or brief advice and ii) behavioural support of similar (ideally identical) intensity. Parallel-or cluster-randomised trials were eligible for inclusion. Quasi-randomised, cross-over and within-participant designs were not, due to the potential biases associated with these designs. 1 Pharmacological interventions for promoting smoking cessation during pregnancy (Review)
Objective To evaluate the efficacy of financial incentives dependent on continuous smoking abstin... more Objective To evaluate the efficacy of financial incentives dependent on continuous smoking abstinence on smoking cessation and birth outcomes among pregnant smokers. Design Single blind, randomised controlled trial. setting Financial Incentive for Smoking Cessation in Pregnancy (FISCP) trial in 18 maternity wards in France. ParticiPants 460 pregnant smokers aged at least 18 years who smoked ≥5 cigarettes/day or ≥3 roll-your-own cigarettes/day and had a pregnancy gestation of <18 weeks were randomised to a financial incentives group (n=231) or a control group (n=229). interventiOns Participants in the financial incentives group received a voucher equivalent to €20 (£17; $23), and further progressively increasing vouchers at each study visit if they remained abstinent. Participants in the control group received no financial incentive for abstinence. All participants received a €20 show-up fee at each of six visits. Main OutcOMe Measures The main outcome measure was continuous smoking abstinence from the first post-quit date visit to visit 6, before delivery. Secondary outcomes in the mothers were point prevalence abstinence, time to smoking relapse, withdrawal symptoms, blood pressure, and alcohol and cannabis use in past 30 days. Secondary outcomes in the babies were gestational age at birth, birth characteristics (birth weight, length, head circumference, Apgar score), and a poor neonatal outcome-a composite measure of transfer to the neonatal unit, congenital malformation, convulsions, or perinatal death. results Mean age was 29 years. In the financial incentives and control groups, respectively, 137 (59%) and 148 (65%) were employed, 163 (71%) and 171 (75%) were in a relationship, and 41 (18%) and 31 (13%) were married. The participants had smoked a median of 60 cigarettes in the past seven days. The continuous abstinence rate was significantly higher in the financial incentives group (16%, 38/231) than control group (7%, 17/229): odds ratio 2.45 (95% confidence interval 1.34 to 4.49), P=0.004). The point prevalence abstinence rate was higher (4.61, 1.41 to 15.01, P=0.011), the median time to relapse was longer (visit 5 (interquartile range 3-6) and visit 4 (3-6), P<0.001)), and craving for tobacco was lower (β=−1.81, 95% confidence interval −3.55 to −0.08, P=0.04) in the financial incentives group than control group. Financial incentives were associated with a 7% reduction in the risk of a poor neonatal outcome: 4 babies (2%) in the financial incentives group and 18 babies (9%) in the control group: mean difference 14 (95% confidence interval 5 to 23), P=0.003. Post hoc analyses suggested that more babies in the financial incentives group had birth weights ≥2500 g than in the control group: unadjusted odds ratio 1.95 (95% confidence interval 0.99 to 3.85), P=0.055; sex adjusted odds ratio 2.05 (1.03 to 4.10), P=0.041; and sex and prematurity adjusted odds ratio 2.06 (0.90 to 4.71), P=0.086. As these are post hoc analyses, the results should be interpreted with caution. cOnclusiOns Financial incentives to reward smoking abstinence compared with no financial incentives were associated with an increased abstinence rate in pregnant smokers. Financial incentives dependent on smoking abstinence could be implemented as a safe and effective intervention to help pregnant smokers quit smoking. trial registratiOn ClinicalTrials.gov NCT02606227.
International Journal of Environmental Research and Public Health
The causative agents of COVID-19 are the variants of SARS-CoV-2 (severe acute respiratory syndrom... more The causative agents of COVID-19 are the variants of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) [...]
Le tabagisme a est la première cause de décès évitables dans le monde. Si la prévalence du tabagi... more Le tabagisme a est la première cause de décès évitables dans le monde. Si la prévalence du tabagisme est en recul dans les pays à haut revenu comme la Suisse, où 27% de la population âgée de 14 à 65 ans fumaient en 2010 contre 33% en 2001,1 la proportion de fumeurs augmente dans les pays à bas revenu.2 Les risques de cancers, de maladies respiratoires et de maladies cardiovasculaires liés au tabagisme sont bien connus, toutefois l’impact du tabagisme sur les troubles métaboliques tels que l’obésité ou le diabète le sont moins et sont sujets à davantage de controverses. Les implications au niveau clinique ainsi qu’au niveau de la santé publique sont importantes. En effet, nous assistons actuellement à une réelle pandémie de l’obésité au niveau mondial et parallèlement à cela aux conséquences qui lui sont liées comme le diabète de type 2. Selon les estimations de l’OMS, 1,1 million de personnes sont décédées de causes liées au diabète en 2005 et ce chiffre devrait doubler d’ici à 2030...
L'invention concerne l'utilisation d'inhibiteurs de la monoamine oxydase-A dans la fa... more L'invention concerne l'utilisation d'inhibiteurs de la monoamine oxydase-A dans la fabrication de medicaments destines a lutter contre la consommation des produits du tabac et, en meme temps, a limiter chez les fumeurs le syndrome de privation.
Uploads
Papers by Ivan Berlin