Editor’s note: Happy Friday! In today’s post, we present a sampling of new research on drug use among different professions. These entries are part of an ongoing drug-related dissertation bibliography being compiled by Jonathon Erlen, which was formerly published in the Social History of Alcohol and Drugs journal but is now periodically featured on the Points blog. Contact Dr. Erlen through the link above.
Workplace smoking bans and daily smoking patterns: Implications for nicotine maintenance and determinants of smoking in restricted environments
Author: Dunbar, Michael Stephen
Abstract: Background : Daily smokers are thought to strive to maintain blood nicotine levels above a certain threshold. Workplace smoking bans pose a substantial barrier to nicotine maintenance. Individuals may compensate for time spent in smoking-restricted environments by smoking more before (“anticipatory”) or after work (“make-up” compensation), but this has not been quantitatively examined. Methods: 124 smokers documented smoking occasions over 3 weeks using ecological momentary assessment (EMA), and provided information on nicotine dependence and stringency of workplace smoking policy (full, partial, or no bans). Hierarchical linear modeling examined effects of workplace policy, time of day block, and weekday vs weekend on mean cigarettes per hour (CPH) and simulated nicotine levels based upon EMA smoking data. Nicotine levels were assessed relative to two subject-specific standards of comparison: 1) “optimal maintenance,” levels achieved through evenly-spaced smoking (ΔEvenNL); and 2) “preferred” nicotine levels achieved at comparable times on weekends (%WeekendNL). Moderating effects of dependence, nicotine clearance rate, and home smoking restrictions were examined. Results: Individuals were most likely to change locations to smoke during work hours, regardless of work policy, and frequency of EMA reports of restrictions at work was associated with increased likelihood of changing locations to smoke (OR=1.14, 95% CI 1.08 – 1.21; p=0.0002). Workplace smoking policy, time block, and weekday/weekend interacted to predict CPH (p<0.01), and %WeekendNL (policy*time on weekdays, p<0.05), such that individuals with partial work bans – but not those with full bans – smoked more and had higher nicotine levels at Night (9 pm – bed) on weekdays compared to weekends. There was little evidence for interference with nicotine maintenance, although individuals with full or partial bans demonstrated more frequent lownicotine (<50%WeekendNL) ‘trough’ events (p=0.04). Conclusion: Smokers may largely compensate for exposure to workplace smoking bans by escaping restrictions. However, full bans may suppress smoking even after they are lifted, perhaps by extinguishing stimulus associations or denormalization of smoking, whereas partial bans may not have these effects. This may suggest a stronger role for contextual factors in driving temporal variations in smoking. There was little evidence of true compensatory smoking to maintain nicotine levels in the face of smoking restrictions.
Publication year: 2015
Advisor: Shiffman, Saul
University/institution: University of Pittsburgh
Would not-for-cause randomized drug testing reduce the incidence of drug misuse among certified registered nurse anesthetists?
Author: Gavin, Katy Gayle
Abstract: Healthcare providers have easy access to drugs of various types and strengths, often times highly addictive drugs, all the while working long hours in high stress environments. Studies show that anesthesia providers, among other healthcare providers, are at highest risk for drug misuse. There are numerous ways substance abuse and addiction among anesthesia providers could be decreased significantly or prevented completely including, but not limited to, education, routine mental health evaluations, stress coping through exercise, debriefing sessions, and mentoring. This project focused on prevention through randomized not-for-cause drug testing. After an exhaustive review of the literature was performed, implications for practice and suggestions were summarized in a white paper proposal, which will be presented to key stakeholders to include state and national governing bodies of the nurse anesthesia profession, anesthesia providers, students, and residents.
Publication year: 2015
Advisor: Stuart, Vickie
Committee member: Anderson, Patsy; Rayborn, Michong
University/institution: The University of Southern Mississippi
Predictors of alcohol misuse across the deployment cycle
Author: Fissette, Caitlin Lee
Abstract: The present study sought to identify predictors of alcohol misuse in an active-duty sample of United States Air Force (USAF) Security Forces Airmen using a longitudinal design targeting concurrent and prospective factors as well as predictors of increase in alcohol misuse. Given the well-documented relation between alcohol misuse and negative consequences at the individual, work, and community levels, predictors of alcohol misuse were explored to determine risk factors for developing alcohol-related problems across the deployment cycle. Based upon prior evidence for the association of sociodemographic variables, mental health symptoms, interpersonal factors, and exposure to traumatic events with alcohol misuse in other military samples, the current investigation assessed the utility of these predictors within a sample of USAF Airmen following a year-long, high-risk deployment to Iraq. Results indicated that sociodemographic variables and combat exposure were largely unrelated to alcohol misuse at either pre- or post-deployment in this sample; by comparison, intrapersonal factors such as posttraumatic stress disorder (PTSD) and depressive symptoms significantly predicted concurrent alcohol misuse at both time points. However, the most striking finding was the large effect size for the predictive utility of intimate relationship distress, especially at post-deployment. Indeed, Airmen who endorsed relationship distress at post-deployment were over seven times more likely to engage in concurrent alcohol misuse and eight times as likely to shift from drinking within recommended limits to engaging in alcohol misuse. Implications of these findings for assessment and intervention as well as future directions for research regarding alcohol misuse across the deployment cycle were examined.
Publication year: 2015
Advisor: Snyder, Douglas K.
Committee member: Balsis, Steve; Rae, William A.; Worthy, Darrell A.
University/institution: Texas A & M University