Tag: tobacco

Reading of the Week: Tobacco, with Papers from JAMA and NEJM

January 22, 2026 /

From the Editor

The waiting room was filled with patients to see, so I concentrated on his history of alcohol misuse and opioids, and I glossed over his nicotine use. But does the path to sobriety in fact start with smoking cessation?

In a new JAMA Psychiatry paper, Michael J. Parks (of the National Institutes of Health) and his co-authors attempt to answer that question. They looked at whether smoking cessation increased sustained remission from substance use disorder (SUD) over time. They describe a longitudinal survey cohort study of more than 2 600 participants from the United States, followed for four years, finding that quitting cigarettes increased the odds of recovery from other SUDs by 30%. “In this cohort study, smoking cessation was linked to better SUD recovery outcomes, and it could improve overall health among the millions of US adults with a current SUD.” We discuss the paper and its implications.

In the second selection from The New England Journal of Medicine, Simon Gilbody (of the University of York) and his colleagues write about the challenges of tobacco in low- and middle- income countries. They note that 80% of tobacco users are in such countries, yet cessation programs aren’t prioritized, particularly absent for those with mental health conditions. “Therapeutic nihilism (the belief that no intervention will work) impedes change and is unjustified in this instance.”

And, in the third selection from JAMA Oncology, Dr. Chadi Nabhan (of the University of South Carolina) writes about his patient and lung cancer. He describes the incredible draw of tobacco – including as a way for his patient to cope with loneliness and isolation. “The cigarette was more than a source of nicotine.”

DG

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Reading of the Week: ED Visits & Suicide Attempts – the New AJP Study; Also, Smoking Cessation, and Pappas on Her Genes & Her Olympic Drive

August 8, 2024 /

From the Editor

Are ED visits for suicide attempts becoming more frequent? What are the implications for care?

In the first selection from The American Journal of Psychiatry, Dr. Tanner J. Bommersbach (of the Mayo Clinic) and his co-authors attempt to answer these questions by considering US trends in ED visits for suicide attempts and intentional self-harm. Using national survey data collected over a 10-year period, they estimate that the absolute number of suicide attempts tripled to 5.3 million. “A significant national increase in emergency department visits for suicide attempts and intentional self-harm occurred from 2011 to 2020, as a proportion of total emergency department visits and as visits per capita.” We analyze this study.

In the second selection, Drs. Robert A. Kleinman (of the University of Toronto) and Brian S. Barnett (of the Cleveland Clinic) write about smoking cessation and mental illness in a Viewpoint just published in JAMA Psychiatry. They note societal progress – smoking rates are sharply down over the past five decades – yet many with mental illness still use tobacco. They argue that psychiatrists have a significant role to play in addressing this problem. “Patients who stop smoking can limit tobacco-related illness, avoid the distressing effects of nicotine withdrawal and craving, and live longer.”

Later this week, the Olympics conclude in Paris. In the third selection, former Olympian Alexi Pappas discusses her mother’s suicide and her own struggles with depression. In a deeply personal essay from The New York Times, she contemplates genes and destiny and healing. “My future – the universe where my fear lives – was never set in stone, and neither was my mom’s. I’m more than my genes, and I would not reroll the dice if given the option.”

There will be no Readings for the next two weeks.

DG

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Reading of the Week: Tobacco & Cessation – the New NEJM Paper; Also, the Health of Health Care Workers (JAMA)

August 4, 2022 /

From the Editor

He could barely get out of bed because his depression was so severe. Yet he asked to be discharged because he wanted to smoke.

So often our patients struggle with their tobacco use disorder. But what medications have the most evidence? Do apps help? What should a clinician say during a brief encounter? This week, we consider a new paper written by Dr. Peter Selby and Laurie Zawertailo (both of the University of Toronto), just published in The New England Journal of Medicine. The authors summarize the latest in the literature, offering a relevant review that provides answers to these and other questions. And they note the devastation caused by tobacco use: “The risk of lung cancer is 25 times as high and the risk of coronary heart disease or stroke is 2 to 4 times as high among smokers as among nonsmokers.” We summarize the paper and mull its clinical implications.

And in the other selection, Dr. Lisa S. Rotenstein (of Harvard University) and her co-authors think about well-being and burnout in a JAMA paper. In recent years, this topic has gathered more and more attention. That said, Dr. Rotenstein and her co-authors don’t focus on physicians and nurses, as many authors have, but consider other health care workers. They argue: “The everyday functioning of the health care system depends on hundreds of role types. Leaders must seek to address obstacles and causes of work-related frustration not only for physicians and nurses, but also for the home health care workers, nurses’ aides, respiratory therapists, and many others who serve patients every day.” 

DG

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