Farah Taha

Hookah use among college students: Prevalence, drug use, and mental health

BACKGROUND There is consistent evidence that hookah use is as, if not more, harmful than cigarette use. Yet, hookah users underestimate the potential deleterious effects of hookah use. This study examined the rates of hookah use and associated demographic characteristics in a sample of undergraduates at a small Northeastern university. This study also examined the relationships between hookah use and other substance use, mental health problems, and perceived levels of stress. METHODS Data were drawn from the Spring 2009 American Health Association-National College Health Assessment (ACHA-NCHA) at one small, Northeastern university (N=1799). The relationships between hookah use and other substance use, mental health problems, and perceived stress levels were examined using logistic regression analyses. RESULTS Hookah use (in the past month) was reported among 14.1% (253/1799) of this sample of undergraduates. Hookah users were more likely to use other substances, including cigarettes, cannabis, alcohol, cocaine, and amphetamines. The strongest associations emerged between hookah use and alcohol and cigarette use. There were no significant associations found between hookah use and any mental health problems or perceived stress levels. CONCLUSIONS Hookah users are significantly more likely to use other substances, including alcohol, cigarettes, cannabis, cocaine, and amphetamines compared with non-hookah users. In contrast to cigarette smoking, hookah use does not appear to be associated with mental health problems or perceived stress levels in this sample of undergraduates. Further investigation into the prevalence and correlates of hookah use is needed in representative population samples.

Depression and cigarette smoking behavior: A critical review of population-based studies

ABSTRACT Background: Smoking and depression are both leading causes of disability, mortality and morbidity around the world. Using epidemiologic data to study the association between depression and the severity, course, and persistence of smoking in the general population is important for understanding the scope of the problem of smoking among people with depression. Objectives: The current paper aims to critically review existing epidemiologic research on the smoking behaviors of persons with depressive symptoms and disorders and to identify gaps in the literature that warrant further study. Methods: Literature searches of Medline and EMBASE were used to identify articles that analyzed epidemiologic data and examined an aspect of smoking behavior in persons with depressive symptoms or disorders. Six hundred ninety-three abstracts were reviewed and 45 studies met all of the inclusion criteria to be included in the review. Results: Persons with depression, compared to those without depression, are more likely to smoke, and meet criteria for nicotine dependence, are less likely to quit smoking, and are more likely to relapse. Little is known about the association between depression and smoking behavior by age, socioeconomic status, or race/ethnicity or with regard to the use of tobacco products other than cigarettes. Conclusion: Persons with depression are more likely to smoke cigarettes and have greater difficulty quitting smoking. Community-based and public health approaches may need to begin considering the links between depression and smoking in order to best target the current smokers in the population and develop more effective tobacco control campaigns.

Understanding the Link Between Multiple Oppressions and Depression Among African American Women The Role of Internalization

The purpose of our study was to examine the multiple oppression experiences of sexual objectification, racism, and gendered racism as predictors of depressive symptoms among a clinical sample of low-income African American women. In addition, we examined coping with oppression via internalization (i.e., the tendency to attribute responsibility or the cause of an oppressive event to oneself) as a mediator between these three intersecting forms of oppression and depressive symptoms. Participants included 144 African American women who sought some type of mental health treatment at a U.S. southeastern, public, urban, university-affiliated hospital that attends to a primarily indigent and underserved population. The results of our mediational analysis using bootstrapping provided support for a theorized model in which coping with oppressive events via internalization mediated the links between sexual objectification and depression and between racist events and depression but not between gendered racism and depression. In addition, a unique and direct effect of racist events on depression was found. Finally, the four variables in the model accounted for 42% of variance in depression scores. The study includes implications for future research and clinical work such as exploration of other mediators and the importance of comprehensive intake assessments and multicultural/feminist coping interventions.

Big five personality factors and cigarette smoking: A 10-year study among US adults

The present study examined the relation between the big five personality traits and any lifetime cigarette use, progression to daily smoking, and smoking persistence among adults in the United States (US) over a ten-year period. Data were drawn from the Midlife Development in the US (MIDUS) I and II (N = 2101). Logistic regression was used to examine the relationship between continuously measured personality factors and any lifetime cigarette use, smoking progression, and smoking persistence at baseline (1995-1996) and at follow-up (2004-2006). The results revealed that higher levels of openness to experience and neuroticism were each significantly associated with increased risk of any lifetime cigarette use. Neuroticism also was associated with increased risk of progression from ever smoking to daily smoking and persistent daily smoking over a ten-year period. In contrast, conscientiousness was associated with decreased risk of lifetime cigarette use, progression to daily smoking, and smoking persistence. Most, but not all, associations between smoking and personality persisted after adjusting for demographic characteristics, depression, anxiety disorders, and substance use problems. The findings suggest that openness to experience and neuroticism may be involved in any lifetime cigarette use and smoking progression, and that conscientiousness appears to protect against smoking progression and persistence. These data add to a growing literature suggesting that certain personality factors--most consistently neuroticism--are important to assess and perhaps target during intervention programs for smoking behavior.

A 10-year prospective study of respiratory disease and depression and anxiety in adulthood

BACKGROUND Several cross-sectional studies have found an association between respiratory disease and increased mood or anxiety disorders among adults. Little is known about the nature of these associations over time or the role of potential confounders in these links. OBJECTIVES To investigate the association between respiratory disease and incident and persistent depression or anxiety disorders 10 years later and to examine potential pathways of these associations. METHODS Data were drawn from the Midlife Development in the United States survey, a representative sample of adults in the United States ages 18 to 74 years. Participants (N = 2,101) were interviewed on a range of health domains at baseline at wave 1 (1994) and again at wave 2 (2005). RESULTS Respiratory disease was associated with increased odds of depression and anxiety disorders cross-sectionally at both time points. Respiratory disease at wave 1 was not associated with incident depression or anxiety disorders at wave 2. Respiratory disease at wave 1 was associated with increased odds of persistent depression or anxiety disorders 10 years later among those with depression or anxiety disorders at wave 1. Associations were not explained by differences in demographic characteristics, secondhand smoke exposure, cigarette smoking, or history of exposure to childhood maltreatment. CONCLUSION Findings shed new light on the association between respiratory disease and depression or anxiety disorders. Individuals with respiratory disease appear to have higher prevalence of concurrent depression or anxiety disorders and persistent depression or anxiety disorders compared with those without respiratory disease. However, a history of respiratory disease does not appear to confer increased risk of new onset of depression or anxiety disorders.

Symptoms of alcohol dependence and smoking initiation and persistence: A longitudinal study among US adults

BACKGROUND A large number of adults report symptoms of, but do not meet diagnostic criteria for, an alcohol use disorder. Yet, little is known about the relationship between symptoms of alcohol use disorders and the initiation and persistence of smoking. This study prospectively examines the relationship between having 1-2 symptoms of alcohol dependence (without abuse) and smoking initiation and persistence as well as nicotine dependence over a 3-year period among adults in the United States. METHODS Data were drawn from Wave 1 (2001-2002) and Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. Relationships between Wave 1 symptoms of alcohol dependence, alcohol abuse, and alcohol dependence and initiation and persistence of cigarette smoking and nicotine dependence at Wave 2 were examined using logistic regression analyses. Analyses were adjusted for demographics, mood and anxiety disorders. RESULTS Symptoms of alcohol dependence were associated with smoking initiation at Wave 2. There was no association between symptoms of alcohol dependence and smoking persistence. Symptoms of alcohol dependence predicted incident and persistent nicotine dependence. Findings persisted after adjusting for demographic characteristics and mood/anxiety disorders. CONCLUSIONS Even 1-2 symptoms of alcohol dependence are associated with increased vulnerability to smoking initiation and onset and persistence of nicotine dependence at a similar strength as alcohol use disorders. Efforts at smoking cessation must address problematic alcohol use, even at the subclinical level, in order to improve efficacy.

Secondhand smoke exposure across the life course and the risk of adult-onset depression and anxiety disorder

INTRODUCTION The aim of this paper was to investigate the association between childhood and adulthood exposure to secondhand smoke (SHS) and depression, panic attack, and generalized anxiety disorder among adults in the United States over a 10-year period. METHODS Data were drawn from the Midlife Development in the United States (MIDUS) Waves 1 and 2 (N=2053). Self-reported childhood and adulthood SHS exposure at Wave 1 (1994) was examined in relation to incident depression, panic attack, and generalized anxiety disorder 10 years later at Wave 2 (2005). RESULTS Childhood SHS alone was not associated with mood and anxiety disorders in adulthood. Exposure to SHS in both childhood and adulthood was associated with increased depression and panic attack in adulthood. These associations did not appear to be due to confounding. LIMITATIONS SHS exposure was measured via self-report; biological data confirming exposure were not collected. More objective measures of SHS exposure are needed in future studies. CONCLUSIONS In summary, persistent exposure to SHS across the life course may be associated with increased risk of depression and panic attacks. Our results are consistent with prior findings and extend earlier results by showing a relationship between SHS exposure and mental health problems over time. Replication with biological measures of SHS over time is a necessary next step toward better understanding the pathways explaining these relationships.

Depression and the risk of autoimmune disease: a nationally representative, prospective longitudinal study.

BACKGROUND Autoimmune diseases are associated with substantial morbidity and mortality, yet the etiology remains unclear. Depression has been implicated as a risk factor for various immune-related disorders but little is known about the risk of autoimmune disease. This study examined the association between depression and the risk of autoimmune disease, and investigated the temporal and dose-response nature of these relationships. METHOD A prospective population-based study including approximately 1.1 million people was conducted using linked Danish registries. Depression and autoimmune diseases were diagnosed by physicians and documented in medical records. In total, 145 217 individuals with depression were identified between 1995 and 2012. Survival analyses were used to estimate the relative risk of autoimmune disease among those with, compared to without, depression. Analyses were adjusted for gender, age, and co-morbid mental disorders. RESULTS Depression was associated with a significantly increased risk of autoimmune disease [incidence rate ratio (IRR) 1.25, 95% CI 1.19-1.31], compared to those without a history of depression. Results suggest a general increased risk of autoimmune diseases following the onset of depression during first year (IRR 1.29, 95% CI 1.05-1.58), which remained elevated for the ensuing 11 years and beyond (IRR 1.53, 95% CI 1.34-1.76). Findings did not support a dose-response relationship. CONCLUSIONS Depression appears to be associated with an increased risk of a range of autoimmune diseases. Depression may play a role in the etiology of certain autoimmune conditions. If replicated, findings could highlight additional clinical implications in the treatment and management of depression. Future studies are needed to investigate the possible social, genetic, and neurobiological underpinnings of these relationships.

Childhood maltreatment and the persistence of smoking: a longitudinal study among adults in the US.

The current study examined the relationship between childhood maltreatment-emotional, physical, and severe physical maltreatment-and the initiation and persistence of smoking. Data were drawn from the Midlife Development in the United States (MIDUS) Survey Waves 1 and 2. Frequency of childhood emotional, physical, and severe physical maltreatment (never, rare, intermittent, frequent) reported at Wave 1 was examined in relation to ever smoking, smoking daily, and persistent daily smoking at Waves 1 and 2. Logistic regression analyses were used to calculate odds ratios (with 95% confidence intervals), which were then adjusted for potential confounders. Childhood emotional, physical, and severe physical maltreatment were associated with increased odds of ever smoking, smoking daily, and persistent smoking at Waves 1 and 2. The majority of these associations remained significant after adjusting for confounding variables. These results suggest a history of trauma may play a prominent role in recalcitrant cigarette smoking and suggest that the success rates of treatments for smoking cessation may be improved by integrating trauma treatment where appropriate.

Depression and the risk of severe infections: prospective analyses on a nationwide representative sample

BACKGROUND Preliminary research suggests an association between depression and subsequent increased risk of infections, yet little is known on this topic. This study investigated the association between depression and risk of various types of infections, including temporal and dose-response relationships. METHODS A prospective population-based study including 976,398 individuals, of whom 142,169 had a history of depression between 1995 and 2012, was conducted using linked Danish registries. Survival analyses were used to estimate the relative risk of infections among those with depression, compared with those without depression, while adjusting for gender and age. RESULTS Depression was associated with increased risk of a wide range of infections [incidence rate ratio (IRR) = 1.61, 95% confidence interval (CI) = 1.49-1.74, P = 0.000, for any infection]. There was no evidence of a specific temporal effect but rather a general increased risk of infection subsequent to the onset of depression, as the risk during first year (IRR = 1.67, 95% CI = 1.25-2.22, P = 0.000) remained elevated for the ensuing 11 years and beyond (IRR = 1.61, 95% CI = 1.39-1.85, P = 0.000). Dose-response analyses revealed that the risk of infection increased by 59% (IRR = 1.59, 95% CI = 1.45-1.75, P = 0.000) following a single depressive episode and was elevated even further (IRR = 1.97, 95% CI = 0.92-4.22, P = 0.082) following four or more depressive episodes. However, results did not indicate a perfect linear association. CONCLUSIONS Findings suggest the presence of depression may confer an increased risk of infection and that this increased susceptibility is not confined to a specific time period following the onset of depression. A dose-response relationship may be present, but more research is needed to further examine and confirm a link between depression and risk of infection.