Preventive medicine
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Food security is a condition achieved when all members of a household have access to adequate food at all times for a healthy, active lifestyle. As of 2014, 14% of households in the United States were food insecure. ⋯ Moreover, we begin to speculate about behavioral and physiological mechanisms by which these conditions may influence one another, and discuss possible interventions through enhanced screening and treatment, parent training, and provision of high quality foods to vulnerable households. Further research is needed to the effects of child and parental mental health on metabolic outcomes in families with food insecurity.
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Preventive medicine · Nov 2016
A behavioral economic perspective on smoking persistence in serious mental illness.
Serious mental illness (SMI) is associated with disproportionately high rates of cigarette smoking. The identification of factors that contribute to persistent smoking in people with SMI may lead to the development and adoption of tobacco control policies and treatment approaches that help these smokers quit. This commentary examines factors underlying smoking persistence in people with SMI from the perspective of behavioral economics, a discipline that applies economic principles to understanding drug abuse and dependence. Studies, conducted in the Northeastern US within the past 30years, that compare the reinforcing effects of nicotine and the costs of smoking in smokers with and without schizophrenia and depression are discussed, and interventions that may reduce the reinforcing efficacy of nicotine and increase the costs of smoking in people with SMI are described.
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Preventive medicine · Nov 2016
Trends in tobacco use among US adults with chronic health conditions: National Survey on Drug Use and Health 2005-2013.
Chronic conditions are among the most common and costly of all health problems. Addressing tobacco use among adults with chronic conditions is a public health priority due to high prevalence as well as greater potential harm from continued use. ⋯ These findings have tobacco control and regulatory implications for addressing higher tobacco use among adults with chronic conditions. Provider advice and cessation resources targeting tobacco use among those with chronic conditions are recommended.
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Preventive medicine · Nov 2016
American health improvement depends upon addressing class disparities.
The gap in health status between the United States and other (OECD) developed countries not only persists but has widened over the past decade. This has occurred despite major declines in smoking prevalence. But as with other health problems, such as obesity, gun violence, and teenage pregnancy, progress against smoking has disproportionately benefitted the better off segments of the American population. ⋯ This national health disparity is not simply a factor of the multicultural nature of American society, because it persists when the health of the whites only is compared with the more racially homogeneous OECD nations. The complexity of our poor health performance rules out a single intervention. But it is clear that without focusing on the less fortunate members of our society, especially those in the Southeast, our performance will continue to lag, and possibly deteriorate further.
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Preventive medicine · Nov 2016
Randomized Controlled TrialCorrelates of nicotine withdrawal severity in smokers during a smoke-free psychiatric hospitalization.
Psychiatric hospitals are increasingly adopting smoke-free policies. Tobacco use is common among persons with mental illness, and nicotine withdrawal (NW), which includes symptoms of depression, anxiety, anger/irritability, and sleep disturbance, may confound psychiatric assessment and treatment in the inpatient setting. This study aimed to characterize NW and correlates of NW severity in a sample of smokers hospitalized for treatment of mental illness in California. ⋯ Those who refused NRT reported milder cigarette dependence and stated no prior use of NRT. Among smokers hospitalized for mental illness, NW severity appears multidetermined, related to cigarette dependence, demographic variables, psychiatric symptom severity, and other substance use. Assessment and treatment of NW in the psychiatric hospital is clinically warranted and with extra attention to groups that may be more vulnerable or naïve to cessation pharmacotherapy.