Publications by authors named "Anne-Laurence Le Faou"

37 Publications

Smoking and diabetes interplay: A comprehensive review and joint statement.

Diabetes Metab 2022 Jun 29;48(6):101370. Epub 2022 Jun 29.

Outpatient Addiction Center, Georges Pompidou European Hospital, AP-HP, Sorbonne Paris Cité, Paris, France.

Evidence shows that smoking increases the risk of pre-diabetes and diabetes in the general population. Among persons with diabetes, smoking has been found to increase the risk of all-cause mortality and aggravate chronic diabetic complications and glycemic control. The current paper, which is a joint position statement by the French-Speaking Society on Tobacco (Société Francophone de Tabacologie) and the French-Speaking Society of Diabetes (Société Francophone du Diabète), summarizes the data available on the association between smoking and diabetes and on the impact of smoking and smoking cessation among individuals with type 1, type 2, and gestational diabetes mellitus. It also provides evidence-based information about the pharmacological and behavioral strategies for smoking cessation in these patients.
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http://dx.doi.org/10.1016/j.diabet.2022.101370DOI Listing
June 2022

Cardiovascular Risk Among Patients Who Smoke: Risk Profiles and Differences by Sex.

Am J Prev Med 2022 Jun 27. Epub 2022 Jun 27.

Outpatient Addictology Center, AP-HP Center, University of Paris, Paris, France; Groupement d'intérêt Scientifique du Réseau français d'excellence de Recherche sur Tabac, nicotine et produit connexes (GIS REfer Tab), Paris, France; DMU Psychiatry and Addictology, AP-HP Centre-University of Paris, Paris, France; University Hospital Federation - Network of Research in Substance Use Disorder, Paris, France.

Introduction: Smoking is particularly harmful to the cardiovascular system, and smoking-cessation is a key target for cardiovascular prevention. From a large nationwide database on subjects who visited smoking-cessation services, this study assessed the profile and abstinence rate comparing female with male smokers at high cardiovascular risk.

Methods: This was an observational study from the French smoking-cessation services cohort (French national cohort Consultations de Dépendance Tabagique) between 2001 and 2018. Inclusion criteria were being aged ≥18 years and having ≥1 cardiovascular risk factor. Abstinence was self-reported (stopping cigarettes or other tobacco products use ≥28 consecutive days) and confirmed by exhaled carbon monoxide <10 parts per million. Analysis was conducted in 2021.

Results: Among 36,864 people who smoke, 15,407 (42%) were women. Women were 3 years younger (48 vs 51 years, p<0.001) and more educated (≥high school diploma: 54% vs 45%, p<0.001) than men. The burden of cardiovascular risk factors was slightly lower in women than in men and, for hypercholesterolemia, hypertension, diabetes, and cardiovascular diseases, were half as frequent in women as they were in men (16% vs 32%, p<0.001). However, women suffered more often from obesity, respiratory diseases, and anxiety‒depression symptoms (53% vs 39%, p<0.001). Finally, although women were less nicotine dependent, their abstinence rate was slightly lower (52.6% vs 55.2%, p<0.001).

Conclusions: Women who smoked had a high burden of risk factors, especially obesity and elevated rates of lung diseases, and a lower abstinence rate, with more common anxiety‒depression symptoms. Men who smoked had a higher prevalence of cardiovascular disease, higher nicotine dependence, and coaddictions. These findings highlight the need to strengthen cardiovascular prevention strategies through comprehensive sex-tailored smoking-cessation interventions.
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http://dx.doi.org/10.1016/j.amepre.2022.04.028DOI Listing
June 2022

Work Conditions are Associated with Alcohol Use after Taking into Account Life Conditions Outside of Work: Findings from a French Occupational Health Service.

Subst Use Misuse 2021 16;56(14):2259-2263. Epub 2021 Oct 16.

Department of Psychiatry and Addictology, AP-HP Centre-University of Paris, Paris, France.

: Our aim was to examine whether work conditions could be associated with alcohol use even after taking into account life conditions outside of work. : In 2019, 591 consecutive French workers were screened for alcohol use with the (FACE). Ten different work conditions and four life conditions outside of work were assessed with 5-item Likert scales. Sociodemographic factors, smoking status and the were also collected. The associations between each work condition and FACE total score were examined with generalized linear models. : After adjusting for sociodemographic factors, the following work conditions were associated with a decreased FACE total score: "positive and/or grateful feedback on your work" ( = -0.22 (95%CI: -0.37; -0.07),  = 0.004), "time to do your job well" ( = -0.19 (95%CI: -0.35; -0.03),  = 0.019) and "freedom to organize your work" ( = -0.25(95%CI: -0.43; -0.08),  = 0.004). After further adjusting for life conditions outside of work, "positive and/or grateful feedback on your work" ( = -0.18 (95%CI: -0.33; -0.03),  = 0.021) and "freedom to organize your work" ( = -0.20(95%CI: -0.38; -0.02),  = 0.027) remained significantly associated with FACE total score. Additional adjustments for smoking status and burnout did not alter these results. : Life conditions outside of work should not interfere with how improvements work conditions can help reduce alcohol use.
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http://dx.doi.org/10.1080/10826084.2021.1990335DOI Listing
March 2022

Tobacco-related cardiovascular risk in women: New issues and therapeutic perspectives.

Arch Cardiovasc Dis 2021 Nov 28;114(11):694-706. Epub 2021 Sep 28.

Team Physiopathlogy and Epidemiology Cerebro-Cardiovascular (PEC2), EA 7460, University of Burgundy Franche-Comté, Faculté des Sciences de Santé, 7, boulevard Jeanne d'Arc, 21000 Dijon, France. Electronic address:

Background: Smoking is the main modifiable risk factor for stroke and myocardial infarction, particularly in women; its prevalence in France is evolving, and new patterns of nicotine consumption have emerged.

Aims: To present contemporary data on smoking prevalence and the use of electronic cigarettes, and to describe current knowledge of the cardiovascular risk specificities and the effectiveness of withdrawal methods in women.

Method: We identified studies by searching the MEDLINE bibliographic database between 1995 and 2020, and the Weekly Epidemiological Bulletin (Bulletin Épidémiologique Hebdomadaire) published by the French health authorities.

Result: In recent years, smoking prevalence among French women has decreased overall, except in the oldest age group (aged>55 years). At the same time, the incidence of hospitalization for cardiovascular events has increased worryingly among women smokers aged<65 years. Active smoking in women is associated with an increased risk of premature myocardial infarction, and a risk of stroke that increases with the number of cigarettes consumed per day; it is also responsible for increased cardiovascular events in women taking oestrogen-progestin contraception. Quitting smoking reverses these effects in the long term, and women are just as likely to quit smoking as men.

Conclusions: Stopping smoking must be a priority objective for women smokers, for primary and secondary prevention, and they should systematically be offered a validated method of cessation or even electronic cigarettes.
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http://dx.doi.org/10.1016/j.acvd.2021.06.013DOI Listing
November 2021

Alcohol use disorder severity and readiness to change: The moderating roles of sex, age and referral to treatment in at-risk alcohol users visiting the emergency department.

Gen Hosp Psychiatry 2021 Nov-Dec;73:133-134. Epub 2021 Sep 14.

DMU Psychiatrie et Addictologie, AP-HP, Centre-Université de Paris, Paris, France; Université de Paris, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266 Paris, France.

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http://dx.doi.org/10.1016/j.genhosppsych.2021.09.005DOI Listing
March 2022

Sociodemographic and Clinical Characteristics of Vapers Using E-Cigarettes Exclusively: The French Vapoquid Study.

Subst Use Misuse 2021 15;56(13):2035-2043. Epub 2021 Sep 15.

Centre Ambulatoire d'Addictologie, Département Médico-Universitaire de Psychiatrie et Addictologie, AP-HP.Centre-Université de Paris, Paris, France.

Background: Electronic cigarettes are increasingly being used as smoking cessation aids. Most studies assess the dual use of e-cigarettes and traditional cigarettes, but there remains a paucity of literature concerning individuals who use e-cigarettes exclusively. : The aim of this study is to examine the sociodemographic and clinical characteristics of exclusive e-cigarette users, and consider their willingness to quit e-cigarette use. : A French online survey was conducted from March to December 2017. We assessed the following factors: sociodemographic factors; the clinical characteristics of e-cigarette use and its social acceptability; and the self-perceived effectiveness of nicotine replacement therapy (NRT). Associations between the listed factors and a willingness to quit e-cigarette use were examined. : A total of 386 exclusive e-cigarette users (70% men) participated in the study and were included in the analysis. Most respondents were not planning to quit e-cigarette use (75%). Compared to those who did not want to quit, a desire to quit was associated with using smoking cessation services (OR [95%CI]: 3.45 [1.82-6.56]), e-cigarette craving (OR [95%CI]: 2.63 [1.44-4.80]) and NRT past-use (1.78 [1.12-2.87]). Users who planned to quit expressed more concerns about smoking initiation among youths using e-cigarettes (OR [95%CI]: 3.62 [1.90-6.93]). In multivariate analysis, these associations remained significant for the use of smoking cessation services, e-cigarette cravings, and concerns about youth tobacco initiation. : Most exclusive e-cigarette users were not likely to quit. Planned cessation was associated with using smoking cessation services, experiencing e-cigarette dependence symptoms, and being concerned about smoking initiation among teenager e-cigarette users.
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http://dx.doi.org/10.1080/10826084.2021.1967987DOI Listing
October 2021

Smoking cessation using preference-based tools among socially disadvantaged smokers: study protocol for a pragmatic, multicentre randomised controlled trial.

BMJ Open 2021 06 30;11(6):e048859. Epub 2021 Jun 30.

Sorbonne Université, INSERM UMR_S 1136, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), department of Social epidemiology, Paris, France.

Introduction: Many smoking cessation aids such as nicotine replacement treatments and e-cigarettes have been proven effective in aiding smoking cessation attempts. Encouraging smokers with low socioeconomic position (SEP) to choose their smoking aid tool based on their preferences, and giving that tool free of charge, might increase the odds of smoking cessation. This trial examines the effectiveness of the 'STOP' (: Smoking cessation using preference-based tools), a preference-based smoking cessation intervention for smokers with low SEP.

Methods And Analysis: The STOP study is a randomised, multicentre, controlled trial (RCT). Smokers with low SEP and wishing to quit will be randomised to either the intervention or the control group (standard care). Participants in the intervention group will be asked to choose between different types of nicotine substitutes (patches, inhalers, gum, tablets, etc) and/or an electronic cigarette which will be delivered free of charge to aid their smoking cessation attempt.The primary outcome will be smoking abstinence at 6 months after inclusion, defined as self-reported 7-day point prevalence of tobacco abstinence. Secondary outcomes include the total number of days of abstinence at 6 months after inclusion, 7-day point prevalence tobacco abstinence at 1 and 3 months after inclusion and number of relapses.The study will also include an economic evaluation, and a process evaluation using a mixed methods approach.

Ethics And Dissemination: The study was approved by the 'Île de France II' Institutional Review Board on 8 September 2020 (CPP Île de France II; Ref No: 20.01.31.65528 RIPH2 HPS), and results will be published in a peer-reviewed journal.

Trial Registration Number: NCT04654585.
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http://dx.doi.org/10.1136/bmjopen-2021-048859DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8246378PMC
June 2021

Smoking cessation using preference-based tools: a mixed method pilot study of a novel intervention among smokers with low socioeconomic position.

Addict Sci Clin Pract 2021 06 30;16(1):43. Epub 2021 Jun 30.

Social Epidemiology Departement, Sorbonne Université, INSERM UMR_S 1136, Institut Pierre Louis d'Épidémiologie et de Santé Publique IPLESP, 27 rue Chaligny, Paris, 75012, France.

Background: Compared to smokers with favorable socio-economic position (SEP), those with low SEP are less likely to have a successful smoking cessation attempt. Tailored approaches are therefore needed, and general practitioners could help reaching and assisting usually hard-to-reach population.

Method: STOP (Sevrage Tabagique à l'aide d'Outils dédiés selon la Préférence) is a pilot study, examining the feasibility, acceptability and potentiality of a smoking cessation intervention centered on smoker's preference. Smokers with low SEP, wishing to quit, were recruited in six healthcare centers in the Greater Paris area. They were asked to choose between different types of nicotine replacement therapy (NRT) products and/or e-cigarette with liquids delivered free of charge to aid their smoking cessation attempt. We describe the characteristics of recruited participants, their perception of smoking cessation aids, and the evolution of their smoking status 4 to 6 weeks after recruitment.

Results: We recruited 49 participants, of which 29% chose an e-cigarette, 29% chose NRT and 42% chose both an e-cigarette and NRT. The intervention was shown to be acceptable by participants and health professionals. Among the 24 participants followed for at least one month, 14 (28% of all participants) stopped smoking, and 9 (18%) considerably reduced their consumption.

Conclusion: The STOP intervention is feasible and acceptable, even if more efforts should be made to limit lost-to-follow-up. This preference-based intervention also shows interesting prospect in helping smokers with low SEP quit smoking. We will test the efficacy of this preference-based intervention in a randomized controlled trial.
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http://dx.doi.org/10.1186/s13722-021-00254-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8243481PMC
June 2021

Smoking cessation in pregnant women

Rev Prat 2021 03;71(3):265-267

Centre ambulatoire d’addictologie, DMU psychiatrie et addictologie, AP-HP Centre université de Paris, France

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March 2021

Do the associations between the use of electronic cigarettes and smoking reduction or cessation attempt persist after several years of use? Longitudinal analyses in smokers of the CONSTANCES cohort.

Addict Behav 2021 06 26;117:106843. Epub 2021 Jan 26.

INSERM, Population-based Epidemiological Cohorts, UMS 011, Villejuif, France; University of Paris, Faculty of Medicine, Paris, France.

Introduction: We examined whether duration of electronic cigarette (e-cigarette) use could be associated with smoking reduction or cessation attempt.

Methods: 5,409 current smokers at baseline enrolled in the French CONSTANCES cohort in 2015 or 2016 were included. Duration of e-cigarette use was categorized as follows: never; former user for more than one year; former user for less than one year; new user for less than one year; return to use for less than one year; regular use for one to two years; regular use for more than two years. Two outcomes were considered at one-year of follow-up: change in the number of cigarettes per day and cessation attempt.

Results: Compared to never users, former users had an increase in the number of cigarettes per day at follow-up (B = 0.95[95%CI:0.57-1.33] and B = 1.03[95%CI:0.47-1.59] for former users of more than one year and less than one year, respectively). Compared to never users, all categories of current users had a decrease in the number of cigarettes per day (B = -3.31[95%CI:-4.07;-2.54] and B = -4.18[95%CI:-5.06;-3.29] for new users of less than one year and users of more than two years, respectively). Compared to never users, former users had a decreased likelihood of cessation attempt (OR = 0.80[95%CI:0.67-0.95] and OR = 0.77[95%CI:0.60-0.99] for former users of more than one year and less than one year, respectively). Compared to never users, all categories of current users had an increased likelihood of cessation attempt (OR = 3.12[95%CI:2.32;4.19] and OR = 3.36[95%CI:2.39;4.72] for new users of less than one year and users of more than two years, respectively).

Conclusions: E-cigarette use was associated with smoking reduction and cessation attempt for individuals who have used it for less than one year and additional benefits are expected to occur with a longer duration of use. Former users of e-cigarettes had poorer outcomes than those who have never used them.
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http://dx.doi.org/10.1016/j.addbeh.2021.106843DOI Listing
June 2021

Interventions brèves aux services d’accueil des urgences pour le trouble de l’usage de l’alcool.

Sante Publique 2020 July August;32(4):315-327

Introduction: Given the high prevalence of alcohol use disorder (AUD) amongst patients in Emergency Rooms (ER), it is recommended to carry out a systematized screening of at-risk drinkers, followed if necessary by a brief intervention (BI) to prevent AUD-related damages. This intervention has been the subject of numerous efficacy and feasibility studies. The purpose of this review of the literature is to identify optimal strategies for systematic screening and BI that can be deployed in the ER.

Methods: We selected randomized controlled trials, meta-analysis and reviews of the literature published between July 2014 and March 2019 evaluating the effectiveness of BI in the ER on reducing alcohol consumption.

Results: Thirteen articles were included. There is a significant heterogeneity of the methodologies used and the interventions carried out. The majority of studies conclude in the effectiveness of BI on reducing alcohol consumption, with however differences between the studies in effect size, and an effectiveness that seems to decrease over time.

Conclusion: The BI in the ER appears to be effective on reducing alcohol consumption but with a modest effect size and heterogeneity of the interventions tested, so that the optimal modalities of its implementation remain to be defined. Further studies to compare different interventions and identify at-risk subgroups would be needed to optimize the use of BI in the ER.
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http://dx.doi.org/10.3917/spub.204.0315DOI Listing
February 2021

Effectiveness of the e-Tabac Info Service application for smoking cessation: a pragmatic randomised controlled trial.

BMJ Open 2020 10 27;10(10):e039515. Epub 2020 Oct 27.

Population Health Research Center, UMR 1219, CIC-EC 1401, Université Bordeaux, Bordeaux, Nouvelle Aquitaine, France.

Objective: To compare the effectiveness of the mobile e-Tabac Info Service (e-TIS) application (app) for helping adult smokers quit smoking with current practices.

Design: Pragmatic randomised controlled trial with a 1-year follow-up (2017-2018).

Setting: France, population-wide level.

Participants: 2806 adult smokers who wished to quit smoking were recruited via the website of the French National Mandatory Health Insurance fund. Of them, 1400 were randomised to the e-TIS app arm and 1406 were randomised to the current practices arm (control).

Intervention: The app involved personalised interactive contacts that included questionnaires, advice, activities and text messages. All contacts were individually tailored and based on each smoker's progress.In the control group, recommended practices for quitting smoking were described on a non-interactive website.

Primary And Secondary Outcomes Measures: The primary outcome was 7-day point prevalence abstinence (PPA) at 6 months. The secondary outcomes included continuous abstinence rates at 6 and 12 months, minimum 24-hour point abstinence at 3 months, minimum 30-day point abstinence at 12 months and number and duration of quit attempts.

Results: There was no difference between the e-TIS and control arms for the primary outcome (12.6% vs 13.7% for 7-day PPA at 6 months, p=0.3949, intention-to-treat analysis). However, e-TIS participants with high levels of exposure to the app, which was defined by the completion of at least eight activities or questionnaires, showed higher rates of smoking cessation than the control participants (17.6% vs 12.9% for 7-day PPA at 6 months, p=0.0169, per-protocol analysis).

Conclusion: Use of the e-TIS app was not associated with a higher rate of smoking cessation. However, high level of exposure to the e-TIS app may have been more effective than current practices.

Trial Registration Number: NCT02841683.
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http://dx.doi.org/10.1136/bmjopen-2020-039515DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7592285PMC
October 2020

Association between severity of alcohol use disorder and consent to follow up in the emergency department.

Eur J Emerg Med 2021 01;28(1):72-74

Department UMR_S1266, Université de Paris, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP).

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http://dx.doi.org/10.1097/MEJ.0000000000000730DOI Listing
January 2021

Does a standardized screening for alcohol use disorder at the Emergency Department inform the risk of repeated ED visit?

Gen Hosp Psychiatry 2021 Mar-Apr;69:115-116. Epub 2020 Jul 12.

AP-HP.Centre-Université de Paris, DMU Psychiatrie et Addictologie, Paris, France; Université de Paris, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France.

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http://dx.doi.org/10.1016/j.genhosppsych.2020.07.003DOI Listing
November 2021

Predictors of Smoking Cessation Attempt and Continued Abstinence among Low-Income Disabled Smokers: Evidence from the French National Smoking Cessation Cohort CDT-Net.

Subst Use Misuse 2020 19;55(10):1724-1731. Epub 2020 May 19.

Department of Psychiatry and Addictology, AP-HP. Centre, Université de Paris, Paris, France.

: In France, daily smoking has been highly prevalent among low-income smokers.: Our aim was to search for factors associated with both continued abstinence and attempting to quit among low-income disabled smokers. : From the French national smoking cessation cohort CDT-net, we included 1624 adults living with disability pension or disabled adult allowance. Our dependent variables (abstainers, attempting to quit among non-abstainers) were used in logistic regressions. Continued abstinence was defined as self-reports of no smoking for more than 28days and attempting to quit was defined as self-reports of no smoking for less than 28 days; both validated with carbon monoxide < 10 ppm. : The average age was 48.5 years, with a predominance of men (55.5%). Achieved continued abstinence was 29.9% and was positively associated with age ≥ 55, history of previous attempts, low-dependence, and number of consultations during follow-up (all  < .05). Depression history, anxiety symptoms and cannabis use were negatively associated with continued abstinence ( < .05). Quit attempts were associated with lower dependence and number of consultations during follow-up. Pharmacological treatments prescribed at inception did not contribute to improve continued abstinence rates but varenicline was found to increase quit attempts unless the number of prescriptions was scarce. : Even among low-income disabled smokers, achieving continued abstinence and attempting to quit could be promoted with similar predictors than among affluent smokers. Treatment of anxiety symptoms and specific support for smokers with a depression history could be included in the follow-up of quit attempts.
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http://dx.doi.org/10.1080/10826084.2020.1759644DOI Listing
June 2021

COVID-19 and Smoking.

Nicotine Tob Res 2020 08;22(9):1650-1652

Centre Universitaire de Médecine Générale et Santé Publique, UNISANTE, Université de Lausanne, Lausanne, Switzerland.

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http://dx.doi.org/10.1093/ntr/ntaa059DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7184428PMC
August 2020

E-cigarette or Vaping product use Associated Lung Injury (EVALI): Health issues going beyond anaesthetic and surgical perioperative procedures.

Anaesth Crit Care Pain Med 2019 12;38(6):563-564

Service d'Anesthésie, CHU Nîmes, Université de Montpellier, 30000 Nîmes, France. Electronic address:

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http://dx.doi.org/10.1016/j.accpm.2019.10.012DOI Listing
December 2019

Electronic cigarette use is associated with depressive symptoms among smokers and former smokers: Cross-sectional and longitudinal findings from the Constances cohort.

Addict Behav 2019 03 16;90:85-91. Epub 2018 Oct 16.

Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Hôpitaux Universitaires Paris Ouest, Service de Psychiatrie de l'adulte et du sujet âgé, Paris, France; Inserm, U894, Centre Psychiatrie et Neurosciences, Paris, France.

Aims: To examine the cross-sectional and longitudinal associations between depressive symptoms and electronic cigarette (e-cig) use in a large population-based sample while taking into account smoking status and sociodemographic confounders.

Methods: Participants from the French Constances cohort were included from February 2012 to December 2016. Smoking status, e-cig use (never/ever/current) and nicotine concentration were self-reported. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression (CES-D) scale. Logistic regressions were used to provide odds ratios (ORs) and 95% confidence intervals (95%CI) of e-cig use according to depressive symptoms, adjusting for age, sex and education.

Results: In cross-sectional analyses (n = 35,337), depressive symptoms (i.e. a CES-D score ≥ 19) were associated with both ever (OR [95%CI]: 1.67 [1.53-1.82]) and current (1.73 [1.53-1.96]) e-cig use with a dose-dependent relationship (p-trend<0.001). In longitudinal analyses (n = 30,818), depressive symptoms at baseline were associated with current e-cig use at follow-up (2.02 [1.72-2.37]) with a similar dose-dependent relationship. These associations were mainly significant among smokers or former smokers at baseline. Furthermore, among smokers at baseline, depressive symptoms were associated with dual consumption at follow-up (1.58 [1.41-1.77]), whereas among former smokers, they were associated with either smoking only (1.52 [1.34-1.73]) or e-cig use only (2.02 [1.64-2.49]), but not with dual consumption (1.11 [0.73-1.68]) at follow-up. Finally, depressive symptoms were positively associated with nicotine concentration among e-cig users at baseline.

Conclusions: Depressive symptoms were positively associated with e-cig use in both cross-sectional and longitudinal analyses with a dose-dependent relationship. In addition, nicotine concentration and depressive symptoms were positively associated.
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http://dx.doi.org/10.1016/j.addbeh.2018.10.021DOI Listing
March 2019

[The role of the nurse in supporting smoking cessation].

Soins 2018 Mar;63(823):16-21

Centre ambulatoire d'addictologie, hôpital européen Georges-Pompidou (HEGP), AP-HP, 20, rue Leblanc, 75015 Paris, France; UMRS 1123, Université Sorbonne Paris Cité, 100-104, avenue de France, 75013 Paris, France.

A study was carried out in May 2014 of the first 100 patients who came to seek help to stop smoking in 2013 with the first contact led by a nurse. A mail-questionnaire was sent to this group of patients to evaluate their smoking status and the nurse's first contact organization. Among 34% respondents, 40% had not smoked for at least eight months. Three quarters had found this nursing support useful highlighting the added value of a nurse in supporting first contact in the smoking cessation process.
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http://dx.doi.org/10.1016/j.soin.2018.01.002DOI Listing
March 2018

[Tribute to Professor Gilbert Lagrue (1922-2016), the tireless runner against smoking].

Rev Prat 2017 03;67(3):343-346

Présidente de la Société francophone de tabacologie

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March 2017

French smoking cessation services provide effective support even to the more dependent.

Prev Med 2016 09 23;90:34-8. Epub 2016 Jun 23.

AP-HP, Hôpital Européen Georges Pompidou, 20 rue Leblanc, F-75015 Paris, France; Univ Paris Diderot, Sorbonne Paris Cité, UMRS1123, Hôtel-Dieu 1, place du Parvis Notre-Dame, F-75004 Paris, France.

Objective: France is one the few European countries offering a national quit line along with partially cost-covered nicotine replacement therapy (NRT) and cessation services. This study assesses outcomes and predictors of continued abstinence in French smoking cessation services.

Method: The French national smoking cessation registry (CDTnet) included 23,810 adult smokers followed-up between 2011 and 2013. We assessed 1-month continued abstinence among 10,161 who initiated a quit attempt before or during follow-up. Predictors of abstinence were determined using multivariable regression model.

Results: Among quitters, 45.2% achieved CO-validated abstinence. Prescription of pharmacotherapy was associated with abstinence rates as high as 47% for combination NRT and 53% for varenicline. The effect of behavioural support associated with combination NRT versus behavioural support alone increased with attendance: OR 1.11 (95% CI 0.89-1.39) for 2-3 visits, OR 1.43 (95% CI 1.13-1.80) for 4-6 visits, OR 1.60 (95% CI 1.21-2.12) for ≥7 visits. Unemployed participants were as likely to be successful as participants in employment (OR 0.88; 95% CI 0.75-1.04). High cigarette dependence also did not significantly hinder abstinence. Young adults achieved the lowest abstinence rates. Predictors that significantly reduced odds of abstinence were: being aged 18 to 24 and a history of alcohol abuse.

Conclusion: With adapted treatment, even the more dependent or less affluent maintained abstinence. Our findings suggest that French cessation services have been successful in providing cessation support. Nevertheless, there is room for improvement in tailoring treatment for some subgroups of smokers.
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http://dx.doi.org/10.1016/j.ypmed.2016.06.024DOI Listing
September 2016

Percutaneous vertebroplasty in vertebral metastases from breast cancer: interest in terms of pain relief and quality of life.

Interv Neuroradiol 2014 Oct 17;20(5):591-602. Epub 2014 Oct 17.

Department of Diagnostic and Interventional Neuroradiology, Pitié-Salpêtrière Hospital; Paris, France.

Percutaneous vertebroplasty (PV) is a therapeutic option in patients with vertebral metastases (VM). However its efficacy in pain relief, improvement in quality of life and safety in patients with VM from breast cancer has not been reported. We present a longitudinal retrospective study of 31 consecutively treated female patients with VM from breast cancer where 88 vertebrae were treated in 44 sessions of PV, in which osteolytic, osteoblastic and mixed lesions were recorded. The visual analogue pain scale (VAS) was used to evaluate pain pre-PV, at one, three, six and 12 months post-PV. The Eastern Cooperative Group (ECOG) performance status scale was used at the same time intervals to measure quality of life: 90.3% pain relief was identified with a VAS reduction from 5.7 ± 2.0 pre-PV to 2.9 ± 2.2 post-PV at one-month follow-up (p<0.001) and 0.6 ± 1.0 at 12-month follow-up (p<0.001). In our series 48.4% of patients were classified as having an ECOG grade 0 and 1 pre-PV, which increased to 80.8% at the 12-month follow-up. While 22.6% of the patients were classified at ECOG grades 3 and 4 pre-PV, this improved to 0% at 12 months follow-up. The morbidity rate for this procedure was 12.9% immediately and only 3.2% at 30 days post-PV with all complications being resolved medically or with CT-guided infiltration. PV is a safe procedure with a high efficacy in pain relief, and improvement of quality of life in patients with diverse types of VM from breast cancer.
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http://dx.doi.org/10.15274/INR-2014-10084DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4243229PMC
October 2014

Gradual versus abrupt quitting among French treatment-seeking smokers.

Prev Med 2014 Jun 20;63:96-102. Epub 2014 Mar 20.

Univ Paris Diderot, Sorbonne Paris Cité, EA 4069, Hôtel-Dieu 1, place du Parvis Notre-Dame, F-75004 Paris, France; AP-HP, Hôpital Européen Georges Pompidou, 20 rue Leblanc, F-75015 Paris, France.

Objective: This study examined the prevalence and predictors of gradual quitting among treatment-seeking smokers.

Method: This study examined quit attempts among 28,156 adult smokers who attended French smoking cessation services nationwide between 2007 and 2010. Predictors of gradual quitting were determined using multivariate regression models.

Results: Only 4.4% quit gradually whereas 48.7% quit abruptly and 46.9% continued smoking. 34.1% of abrupt quitters and 31.9% of gradual quitters were abstinent at 1month post-quit (p=0.108). Gradual quitting was associated with: older age, heavy smoking at baseline, no previous quit attempts, low self-efficacy, baseline intake of anxiolytics, symptoms of depression and history of depressive episodes. Gradual quitters had a similar anxio-depressive profile than continued smokers but were more educated and more likely to have reported previous quit attempts. Prescription of oral nicotine replacement therapy (NRT) only as opposed to combination NRT doubled the odds of gradual quitting. Likelihood of gradual quitting compared with continued smoking improved with the number of follow-up visits.

Conclusion: Our findings suggest that hard-to-treat smokers may be more likely to quit gradually than abruptly. However, intense follow-up with adapted treatment appears to be crucial to achieve cessation gradually in French smoking cessation services.
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http://dx.doi.org/10.1016/j.ypmed.2014.03.014DOI Listing
June 2014

Perceived risks to smoking cessation among treatment-seeking French light smokers.

Prev Med 2013 Oct 26;57(4):372-6. Epub 2013 Jun 26.

Université Paris Descartes, Sorbonne Paris Cité, 15 rue de l'Ecole de Médecine, F-75006, Paris, France. Electronic address:

Objective: This study investigated perceived risks to cessation expressed by light smokers and the association with cessation outcomes at one month post-quit date.

Method: Data from adult light smokers attending French smoking cessation services nationwide between October 2007 and December 2010 were analyzed, retrospectively. In order to identify perceived risks, we performed a thematic analysis of answers to an open-ended question. Bivariate analysis and multivariate logistic modelling were used to assess predictors of abstinence and relapse.

Results: Eleven themes were identified, among which weight concerns were the most important for women while men cited withdrawal most often. A protective effect of nicotine replacement therapy prescription on cessation was uncovered among men concerned about withdrawal as well as weight-concerned women. Fear of depression and need for moral support doubled the odds of relapse for women only.

Conclusions: Considering the growing prevalence of light smokers in the general population, our findings suggest the importance of taking into account perceived risks to quitting. Without adapted treatment and counselling, they represent significant barriers to abstinence for treatment seeking light smokers.
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http://dx.doi.org/10.1016/j.ypmed.2013.06.020DOI Listing
October 2013

[Smoking cessation in case of chronic kidney disease].

Nephrol Ther 2013 Apr 27;9(2):73-84. Epub 2012 Nov 27.

Service de néphrologie et de dialyse, hôpital privé Claude-Galien, 20, route de Boussy, 91480 Quincy-sous-Sénart, France.

Smoking is one of the main causes of morbidity and mortality around the world. In France, despite increase of cost of cigarettes and exclusion of smoking in public places, daily smoking consummation remains high, particularly in women and young. Now, smoking is considered as a compartmental and/or psychologic and/or physic addiction. There are many categories of smokers and smoking cessation strategies must be tailored to individual level. Whatever the etiology of chronic kidney disease, in dialysis patient as transplanted, hypertension and vascular diseases are strong determinants of prognosis. In this way, there is a need for stronger involvement of nephrologists in the process of smoking cessation of their patients. Therapeutics and strategies are reviewed.
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http://dx.doi.org/10.1016/j.nephro.2012.10.008DOI Listing
April 2013

[Policy and routine practice for smoking cessation in France].

Presse Med 2012 Dec 22;41(12 Pt 1):1279-85. Epub 2012 Oct 22.

Hôpital européen Georges-Pompidou (AP-HP), université Paris Diderot, UE 4067, PRES Paris Sorbonne Cité, centre d'addictologie, unité de tabacologie, 75015 Paris, France.

In France, daily tobacco consumption increased among adults between 18 and 75 years between 2005 and 2010, particularly women. At 17 age-old, it raised 10% between 2008 and 2011 (32.7% in boys and 30.2% in girls). The number of cigarettes smoked per day decreased between 2005 and 2010 in France, from 15.4 to 13.9 cigarettes smoked per day. But active exposition to cigarette smoke and consequently to cigarette toxins exposure did not change and even increased. Tobacco prevention should follow the World Health Organization Framework Convention on Tobacco Control, which was signed in 2004 by French representatives. Smoking cessation methods include: minimal counseling provided by general practitioners (when given during a medical visit for another motive than smoking cessation, one out of 50 smokers stops); minimal counseling given by any health professional; and the smoking cessation services framework. Evidence-based medications associated with a non-pharmacologic support and with a regular follow-up significantly increase smoking cessation rates. Risk reduction by decreasing progressively tobacco consumption with the help of medications is only suggested nowadays.
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http://dx.doi.org/10.1016/j.lpm.2012.07.035DOI Listing
December 2012

Workplace smoking ban effects on unhappy smokers.

Health Econ 2011 Sep 4;20(9):1043-55. Epub 2011 Jul 4.

Paris School of Economics, Paris, France.

Economists usually draw a distinction between smokers. They distinguish 'happy addicts' à la Becker-Murphy from 'unhappy addicts' who state that smoking is a mistake and call for some help to quit. When evaluating tobacco control policies, it might be important to distinguish their effects on those two types of population. Indeed, such policies are welfare improving only if they help unhappy addicts to quit. We investigate the effect of the French workplace smoking ban on a sample of presumably 'unhappy addicts', smokers who consult tobacco cessation services. We show that the ban caused an increase in the demand for such services, and that this increase was larger in cold and rainy areas. It also induced an increase in the percentage of successful attempts to quit. Workplace smoking bans might be welfare improving since they seem to help 'unhappy addicts' to reconcile their behavior with their preferences.
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http://dx.doi.org/10.1002/hec.1763DOI Listing
September 2011

Smoking and the consumption of antidepressants, anxiolytics and hypnotic drugs: results of a large, French epidemiological study in 2005.

Addict Behav 2011 Jul 1;36(7):743-8. Epub 2011 Mar 1.

Versailles Saint-Quentin University, France.

The aim of this study was to describe and analyse the links between the consumption of psychotropic drugs and smoking, based on data from individuals subscribing to a health insurance organisation (a mutuelle) in France in 2005. Data on smoking status, depression, anxiety and alcohol consumption from a large transversal epidemiological study carried out in 2005 were analysed in parallel to individual data concerning the reimbursement of medical prescriptions for psychotropic drugs. We compared reimbursement data for psychotropic drugs between individuals who had smoked for at least 15 years and continued to smoke and individuals who had stopped smoking after at least 15 years of smoking. This group of ex-smokers was subdivided into three subgroups on the basis of the number of years elapsed since the time point at which the individual had been smoking for 15 years: 1 to 9 years, 10 to 19 years and 20 years or more. "Ex-smoker" status was associated with a lower risk of psychotropic drug prescription than "current smoker" status (OR=0.81 for anxiolytics, OR=0.74 for antidepressants). Analysis of the subgroups of smokers and ex-smokers also showed that mean annual consumption of antidepressants and anxiolytics was significantly lower for individuals who had stopped smoking after at least 15 years of the habit than for those who continued to smoke (respectively 1.34 versus 0.65 for anxiolytics, and 1.17 versus 0.62 for antidepressants). Our findings suggest that stopping smoking is associated with a decrease in the consumption of psychotropic drugs. They highlight the need to evaluate the medium- and long-term effects of stopping smoking on psychotropic drug consumption in more detail, taking into account the anxious and depressive disorders to which smokers are particularly prone.
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http://dx.doi.org/10.1016/j.addbeh.2011.02.013DOI Listing
July 2011

Smoking cessation interventions offered to French adult light smokers: a heterogeneous population with specific needs.

Eur Addict Res 2010 7;16(3):162-9. Epub 2010 May 7.

Ecole doctorale de Santé Publique, Faculté de médecine Paris VI, Université Pierre et Marie Curie, Paris, France.

Aims: We addressed the understudied topic of cessation interventions for adult light smokers (< or =10 cigarettes daily). We identified cessation aids offered in French cessation services and their impact on cessation outcomes at 1-month follow-up.

Methods: We retrospectively analyzed data from 36,594 smokers in cessation services nationwide. Smokers could be offered pharmacotherapy as well as cognitive behavioral therapy (CBT). Bivariate methods and multivariate logistic regression analyses were used.

Results: Light smokers were 1.23 times more likely to drop out than heavy smokers. 13.3% were abstinent at follow-up versus 14.5% for heavy smokers (p = 0.013). Light smokers were offered pharmacotherapy less often than heavy smokers. Yet, among light smokers, varenicline doubled the odds of abstinence as did nicotine patch. CBT improved abstinence only when combined with nicotine patch. Intervention outcomes differed according to various profiles: light smokers self-referred or with several previous quit attempts achieved better outcomes than those not interested in quitting or referred through hospitalization.

Conclusion: Light smokers' poor intervention outcomes might partly be explained by inadequate treatment plans in French cessation services. Our results reveal that pharmacotherapy is effective and that tailored CBT should be offered according to the variety of profiles among light smokers.
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http://dx.doi.org/10.1159/000314360DOI Listing
September 2010

[Consumption of medical services and the economics of health].

Rev Prat 2009 Oct;59(8):1123-4

MCU-PH en épidémiologie, économie de la santé et prévention, centre de tabacologie, Hôpital européen Georges-Pompidou, 75908 Paris Cedex 15, France.

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October 2009
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