Influence of Milk on Exhaled Carbon Monoxide (CO) Measurement by Portable CO Monitors.

Background: A portable breath carbon monoxide (CO) monitor has a high cross-sensitivity to hydrogen (H2). This study examined the influences of H2 after consuming milk on the detected CO values using three types of portable CO monitors. Materials and Methods: Exhaled breath from seven participants (four healthy nonsmokers and three smokers with otherwise unknown comorbidities) was collected in sampling bags. The participants then consumed 200 mL of milk, and the exhaled breath of each was collected in separate bags every 30 minutes until 9 hours later. CO and H2 in the bag were measured using a gas chromatograph as a reference analyzer, and CO was also measured using three types of portable CO monitors. Results: After consuming milk, H2 levels were significantly higher, and CO levels were not significantly elevated as measured by the reference analyzer. However, CO levels in monitors A and B were significantly elevated, even though participants did not smoke. The H2 levels in the reference analyzer significantly increased and reached a maximum 4.5 hours after consuming milk. The difference in CO levels between the reference analyzer and each monitor increased significantly after 5 or 5.5 hours. Conclusions: This study suggested that the breath CO monitors with a cross-sensitivity to H2 responded to H2 as CO in the exhaled gas and measured higher than actual values after milk consumption. The extent of the influence of H2 differed depending on the type of CO monitor. It is necessary to consider milk consumption when assessing the smoking status of people using portable CO monitors.

[On oral medications, especially varenicline].

Varenicline is an orally administered alpha4beta2 nicotinic acetylcholine receptor partial agonist. It has been widely used in smoking cessation therapy. It reduces craving and withdrawal symptoms during abstinence and lowers the reinforcing effects of nicotine. A third action of the drug is to blunt responses to smoking cues. Varenicline has higher abstinence rates than nicotine transdermal patches or bupropion. As serious neuro-psychiatric symptoms had been reported post market, including drowsiness, suicidal thoughts and suicide, clinicians are recommended to review the patient's psychiatric history and should monitor them for changes in mood and behavior when prescribing this medication. Studies on flexible dosing regimens, flexible quit dates, and an increased pre-quit medication period have indicated possible improvement to varenicline's effectiveness.

Validity and reliability of Kano Test for Social Nicotine Dependence.

PURPOSE: "Social nicotine dependence" is a newly-coined phrase for describing a psychological and psychosocial state associated with smoking. That new dependence is defined as a misperception of smoking caused by smokers' attempts, for example, to deny the ill effects of tobacco and/or to justify themselves by regarding smoking as acceptable cultural and social behavior. It can be quantified by a 10-item questionnaire, the Kano Test for Social Nicotine Dependence (KTSND). We examined the internal consistency as well as the criterion-related and construct validity and factor structure of KTSND. METHODS: Self-administered questionnaires including the KTSND, smoking status, and stages in quitting smoking only for current smokers were collected from 666 industrial workers. RESULTS: The internal consistency of the KTSND assessed by Cronbach's alpha coefficient was 0.77. In addition, we found that an 8-item combination from among 10 items had a higher coefficient of 0.80. KTSND scores differed among three groups of smoking status as a criterion. Factor analysis clarified two potential factors: "an overestimation of smoking's effects to enhance physical and mental status" and "an insistence on smoking as acceptable cultural and social behavior." CONCLUSION: The KTSND proved to be valid in terms of the internal consistency and the inclusion of two key aspects of the misperception of smoking.