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Subcortical white matter (WM), thalamus, cerebellar cortex, and corpus callosum were most affected. Higher cigarette pack-years related to smaller volumes in several subcortical regions. Magnetic resonance imaging studies of cigarette smoking-related effects on human brain structure have primarily employed voxel-based morphometry, and the most consistently reported finding was smaller volumes or lower density in anterior frontal regions and the insula. Much less is known about the effects of smoking on subcortical regions. We compared smokers and non-smokers on regional subcortical volumes, and predicted that smokers demonstrate greater age-related volume loss across subcortical regions than non-smokers. Non-smokers (n = 43) and smokers (n = 40), 22–70 years of age, completed a 4 T MRI study. Bilateral total subcortical lobar white matter (WM) and subcortical nuclei volumes were quantitated via FreeSurfer. In smokers, associations between smoking severity measures and subcortical volumes were examined. Smokers demonstrated greater age-related volume loss than non-smokers in the bilateral subcortical lobar WM, thalamus, and cerebellar cortex, as well as in the corpus callosum and subdivisions. In smokers, higher pack-years were associated with smaller volumes of the bilateral amygdala, nucleus accumbens, total corpus callosum and subcortical WM.
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We examined the trends in use of bupropion and varenicline before and after the BBW. We observed a significant decline in the use of varenicline after the passage of BBW. The BBW was not associated with decline in the use of bupropion. Passage of BBW may have a substantial impact on the utilization of certain medications. In 2009, the FDA required a black box warning (BBW) on bupropion and varenicline, the two commonly prescribed smoking cessation agents due to reports of adverse neuropsychiatric events. We investigated if there was a decline in use of bupropion and varenicline after the BBW by comparing the percent using these medications before and after BBW. We conducted a retrospective observational study using data from the Medical Expenditure Panel Survey from 2007 to 2014. The study sample consisted of adult smokers, who were advised by their physicians to quit smoking. We divided the time period into “pre-warning”, “post-warning: immediate”, and “post-warning: late.” Unadjusted analysis using chi-square tests and adjusted analyses using logistic regressions were conducted to evaluate the change in bupropion and varenicline use before and after the BBW.
The goal is to reach a mock-up resolution by Oct. 23. The 1998 Master Settlement Agreement with 46 state attorneys general led to significant industry changes that included banning cigarette billboards, stadium advertisements and brand-name merchandise. Restrictions became more extensive in 2009 when Congress gave the Food and Drug Administration broad regulatory authority over nearly every aspect of tobacco product manufacturing and marketing. “We remain committed to aligning our business practices with society’s expectations of a responsible company,” Garnick said. “This includes communicating openly about the health effects of our products, continuing to support cessation efforts, helping reduce underage tobacco use and developing potentially reduced-risk products.” Matthew Myers, the president of Campaign for Tobacco-Free Kids, said in April that he had mixed feelings about the appellate court’s ruling. “While the ruling should clear the way for publication of these long-overdue corrective statements, it is disappointing that the court rejected the ‘here is the truth’ requirement,” Myers said. “The fact that tobacco companies have repeatedly fought this simple phrase shows they haven’t changed and remain as allergic to the truth as ever,” he said. In court filings, the manufacturers have argued that the 2009 Tobacco Control Act eliminated any reasonable likelihood the companies would commit future violations, thus making the need for remedies, such as corrective statements, moot. The manufacturers filed a joint appeal of Kessler’s ruling in January 2013.