Rationale: Cigarette cravings are one of the most important clinical phenomena in tobacco addiction. A wide range of studies and research designs may help to increase understanding of the relationship between physical activity (PA) and cigarette cravings. Aims: (i) To investigate the acute effects of walking and isometric exercise on cigarette cravings, withdrawal, and attentional bias among temporarily abstaining smokers. (ii) To quantify the effects of short bouts of PA on cigarette cravings among temporarily abstaining smokers. (iii) To examine who most benefits from PA, whether changes in affect mediate these effects, and whether a specific attribute of PA is associated with cravings. (iv) To investigate whether any association between habitual PA and cravings in smokers could be found. Methods: A randomised controlled crossover trial with three arms addressed aim (i). A systematic review of literature and individual participant data meta-analysis using hierarchical modelling addressed aims (ii) and (iii). Aim (iv) was achieved by using linear regression modelling of cross-sectional data from a smoking cessation study. Results: No difference in cravings, withdrawal, and attentional bias between walking and isometric exercise versus control was found. Bouts of PA decreased cigarette cravings by approximately 30%. Moderate intensity PA provided increased benefit when compared with light intensity, whereas vigorous intensity did not confer additional benefits compared with moderate intensity PA. Also bouts of medium (10 minutes) and longer duration (≥15minutes) appeared to be more effective than short duration (≤ 5 min). No moderators and mediators of this association were identified. Habitual moderate intensity PA was the strongest predictor of cigarette cravings in smokers, MPSS was an additional predictor and alcohol consumption moderated the effects of habitual PA on cravings. Conclusion: Moderate intensity PA could be recommended to smokers to help decrease cigarette cravings.

This dissertation is divided into three parts. The first part aimed to investigate the cannabidiol anxiolytic effect in treatment-naïve individuals with social anxiety disorder through simulation of public speaking. Twenty-four never-treated social anxiety disorder subjects were allocated to receive 0 or 600 mg cannabidiol (CBD; n=12) in a double-blind randomized design. The same number of controls performed the simulation of a public speaking test without receiving any medication. Pretreatment with CBD significantly reduced anxiety, cognitive impairment, and discomfort in speech performance and significantly decreased alertness in their anticipatory speech. The placebo group displayed higher anxiety, cognitive impairment, discomfort, and alertness when compared with controls as assessed with the Visual Analogue Mood Scale (VAMS). The SSPS-N scores showed significant increases during testing of the placebo group that was almost abolished in the cannabidiol group. No significant differences were observed between the cannabidiol and control groups in SSPS-N scores or in cognitive impairment, discomfort, and alertness factors of the VAMS. The second part evaluated healthy subjects\' x y during a public speaking test following a high rimonabant oral dose, to understand better the possible pharmacological approaches for anxiety disorder treatment. Twenty four participants were randomly allocated to receive 0 or 90 mg rimonabant (n=12) in a double-blind design. No significant adverse effects were reported in either group. Participants who received rimonabant showed increased anxiety levels compared to placebo during anticipatory speech and performance measurements. Rimonabant treatment did not affect sedation, cognitive impairment, discomfort, blood pressure, heart rate, self-statements during public speaking, or bodily symptoms scales. Increased anxiety may reflect lower endocannabinoid activity in CB1 receptors and CB1 p \' possible role in modulation of anxiety and anxiety disorders. The third part aimed to monitor cannabinoid blood concentrations during sustained abstinence from chronic daily cannabis smoking. Thirty male chronic daily cannabis smokers resided on a secure clinical research unit for up to 33 days, with blood collected once daily. ?9-tetrahydrocannabinol (THC), 11-hydroxy-THC (11-OH-THC), and 11-nor-9-carboxy-THC (THCCOOH) whole blood concentrations were quantified by two-dimensional gas chromatography-mass spectrometry. Twenty-seven of 30 participants were THC-positive on admission, with a median (range) concentration 1.4 ng/mL (0.3-6.3). THC decreased gradually with only 1 of 11 participants negative at 26 days; 2 of 5 participants remained THC-positive (0.3 ng/mL) for 30 days. 5.0% f p p h TH >=1 0 g/ L f 12 y M 11-OH-THC w 1 1 g/ L w h >=1 0 g/ L 24h THCCOOH detection rates were 96.7 on admission, decreasing slowly to 95.7 and 85.7% on days 8 and 22, respectively; four of 5 participants remained THCCOOH positive (0.6-2.7 ng/mL) after 30 days and one remained positive on discharge at 33 days. THC was quantified in some participants for 30 days, albeit in low concentrations, due to the large cannabinoid body burden from extended exposure / Esta tese é dividida em três partes. A primeira parte consiste em investigar o efeito ansiolítico do canabidiol na ansiedade social através do teste de simulação de falar em público. Vinte e quatro sujeitos com ansiedade social, nunca tratados, receberam placebo ou canabidiol (CBD) 600 mg (n=12) em um estudo randomizado e duplo-cego. O mesmo número de indivíduos saudáveis realizaram o teste de simulação de falar em público sem receber medicação. A administração do CBD reduziu significativamente a ansiedade, sedação física e outros sentimentos e atitudes durante a fase de estresse, e diminui o nível de alerta na fase pré-estresse. O grupo placebo apresentou níveis elevado de ansiedade, sedação física, outros sentimentos e atitudes, e alerta comparado com o grupo controle. A pontuação do SSPS-N evidenciou aumento significativo durante o teste no grupo placebo, enquanto que o CBD reduziu estes níveis. Não houve diferenças significativas entre os grupos CBD e controle na SSPS-N e nos fatores sedação física, outros sentimentos e atitudes e alerta, da Visual Analogue Mood Scale (VAMS). A segunda parte do estudo avaliou a ansiedade em indivíduos saudáveis que receberam alta dose oral de rimonabanto e submetidos ao teste de simulação de falar em público, para melhor entendimento do possível mecanismo farmacológico para tratamento de transtornos de ansiedade. Vinte e quatro sujeitos saudáveis receberam placebo ou rimonabanto 90 mg (n=12) em um randomizado e duplo-cego. Não foi observado efeitos adversos significativo em ambos grupos. O grupo rimonabanto apresentou maiores níveis de ansiedade na fase pré-estresse e durante o estresse. Não houve diferença significativa quanto aos demais fatores avaliados entre os grupos. O aumento na ansiedade após administração do rimonabanto pode-se ao fato de haver diminuição no sistema endocanabinóide nos receptores CB1 e a possível modulação na ansiedade clínica e patológica. A terceira parte objetivou quantificar canabinóides no sangue total em usuários crônicos de cannabis durante abstinência supervisionada. Trinta usuários crônicos de cannabis, do sexo masculino, permaneceram no centro de pesquisa por até 33 dias, com coleta de sangue uma vez ao dia. ?9-tetrahidrocanabinol (THC), 11-hidróxi-THC (11-OH-THC) e 11-nor-9-carbóxi-THC (THCCOOH) foram quantificados no sangue por meio da cromatografia gasosa-espectrometria de massa bidimensional. Vinte e sete de 30 usuários foram positivos para THC no ingresso do estudo, com concentração mediana (variação) de 1.4 ng/mL (0.3-6.3). Níveis de THC diminuíram gradativamente com somente 1 de 11 participantes negativo no dia 26; 2 de 5 indivíduos permaneceram positivos para THC (0.3 g/ L p 30 5 0% j TH >=1 0 g/ L p 12 ç mediana de 11-OH-TH f 1 1 g/ L g >=1 0 g/ L pó 24h. A taxa de detecção de THCCOOH foi 96.7% no ingresso, diminuindo gradativamente para 95.7 e 85.7% nos dias 8 e 22, respectivamente; 4 de 5 sujeitos permaneceram positivo para THCCOOH (0.6-2.7 ng/mL) após 30 dias e um permaneceu positivo no 33º dia. Foi detectado THC em alguns indivíduos por 30 dias, porém em baixas concentrações, devido a extensa eliminação do canabinóide em decorrência da exposição crônica

This dissertation is divided into three parts. The first part aimed to investigate the cannabidiol anxiolytic effect in treatment-naïve individuals with social anxiety disorder through simulation of public speaking. Twenty-four never-treated social anxiety disorder subjects were allocated to receive 0 or 600 mg cannabidiol (CBD; n=12) in a double-blind randomized design. The same number of controls performed the simulation of a public speaking test without receiving any medication. Pretreatment with CBD significantly reduced anxiety, cognitive impairment, and discomfort in speech performance and significantly decreased alertness in their anticipatory speech. The placebo group displayed higher anxiety, cognitive impairment, discomfort, and alertness when compared with controls as assessed with the Visual Analogue Mood Scale (VAMS). The SSPS-N scores showed significant increases during testing of the placebo group that was almost abolished in the cannabidiol group. No significant differences were observed between the cannabidiol and control groups in SSPS-N scores or in cognitive impairment, discomfort, and alertness factors of the VAMS. The second part evaluated healthy subjects\' x y during a public speaking test following a high rimonabant oral dose, to understand better the possible pharmacological approaches for anxiety disorder treatment. Twenty four participants were randomly allocated to receive 0 or 90 mg rimonabant (n=12) in a double-blind design. No significant adverse effects were reported in either group. Participants who received rimonabant showed increased anxiety levels compared to placebo during anticipatory speech and performance measurements. Rimonabant treatment did not affect sedation, cognitive impairment, discomfort, blood pressure, heart rate, self-statements during public speaking, or bodily symptoms scales. Increased anxiety may reflect lower endocannabinoid activity in CB1 receptors and CB1 p \' possible role in modulation of anxiety and anxiety disorders. The third part aimed to monitor cannabinoid blood concentrations during sustained abstinence from chronic daily cannabis smoking. Thirty male chronic daily cannabis smokers resided on a secure clinical research unit for up to 33 days, with blood collected once daily. ?9-tetrahydrocannabinol (THC), 11-hydroxy-THC (11-OH-THC), and 11-nor-9-carboxy-THC (THCCOOH) whole blood concentrations were quantified by two-dimensional gas chromatography-mass spectrometry. Twenty-seven of 30 participants were THC-positive on admission, with a median (range) concentration 1.4 ng/mL (0.3-6.3). THC decreased gradually with only 1 of 11 participants negative at 26 days; 2 of 5 participants remained THC-positive (0.3 ng/mL) for 30 days. 5.0% f p p h TH >=1 0 g/ L f 12 y M 11-OH-THC w 1 1 g/ L w h >=1 0 g/ L 24h THCCOOH detection rates were 96.7 on admission, decreasing slowly to 95.7 and 85.7% on days 8 and 22, respectively; four of 5 participants remained THCCOOH positive (0.6-2.7 ng/mL) after 30 days and one remained positive on discharge at 33 days. THC was quantified in some participants for 30 days, albeit in low concentrations, due to the large cannabinoid body burden from extended exposure / Esta tese é dividida em três partes. A primeira parte consiste em investigar o efeito ansiolítico do canabidiol na ansiedade social através do teste de simulação de falar em público. Vinte e quatro sujeitos com ansiedade social, nunca tratados, receberam placebo ou canabidiol (CBD) 600 mg (n=12) em um estudo randomizado e duplo-cego. O mesmo número de indivíduos saudáveis realizaram o teste de simulação de falar em público sem receber medicação. A administração do CBD reduziu significativamente a ansiedade, sedação física e outros sentimentos e atitudes durante a fase de estresse, e diminui o nível de alerta na fase pré-estresse. O grupo placebo apresentou níveis elevado de ansiedade, sedação física, outros sentimentos e atitudes, e alerta comparado com o grupo controle. A pontuação do SSPS-N evidenciou aumento significativo durante o teste no grupo placebo, enquanto que o CBD reduziu estes níveis. Não houve diferenças significativas entre os grupos CBD e controle na SSPS-N e nos fatores sedação física, outros sentimentos e atitudes e alerta, da Visual Analogue Mood Scale (VAMS). A segunda parte do estudo avaliou a ansiedade em indivíduos saudáveis que receberam alta dose oral de rimonabanto e submetidos ao teste de simulação de falar em público, para melhor entendimento do possível mecanismo farmacológico para tratamento de transtornos de ansiedade. Vinte e quatro sujeitos saudáveis receberam placebo ou rimonabanto 90 mg (n=12) em um randomizado e duplo-cego. Não foi observado efeitos adversos significativo em ambos grupos. O grupo rimonabanto apresentou maiores níveis de ansiedade na fase pré-estresse e durante o estresse. Não houve diferença significativa quanto aos demais fatores avaliados entre os grupos. O aumento na ansiedade após administração do rimonabanto pode-se ao fato de haver diminuição no sistema endocanabinóide nos receptores CB1 e a possível modulação na ansiedade clínica e patológica. A terceira parte objetivou quantificar canabinóides no sangue total em usuários crônicos de cannabis durante abstinência supervisionada. Trinta usuários crônicos de cannabis, do sexo masculino, permaneceram no centro de pesquisa por até 33 dias, com coleta de sangue uma vez ao dia. ?9-tetrahidrocanabinol (THC), 11-hidróxi-THC (11-OH-THC) e 11-nor-9-carbóxi-THC (THCCOOH) foram quantificados no sangue por meio da cromatografia gasosa-espectrometria de massa bidimensional. Vinte e sete de 30 usuários foram positivos para THC no ingresso do estudo, com concentração mediana (variação) de 1.4 ng/mL (0.3-6.3). Níveis de THC diminuíram gradativamente com somente 1 de 11 participantes negativo no dia 26; 2 de 5 indivíduos permaneceram positivos para THC (0.3 g/ L p 30 5 0% j TH >=1 0 g/ L p 12 ç mediana de 11-OH-TH f 1 1 g/ L g >=1 0 g/ L pó 24h. A taxa de detecção de THCCOOH foi 96.7% no ingresso, diminuindo gradativamente para 95.7 e 85.7% nos dias 8 e 22, respectivamente; 4 de 5 sujeitos permaneceram positivo para THCCOOH (0.6-2.7 ng/mL) após 30 dias e um permaneceu positivo no 33º dia. Foi detectado THC em alguns indivíduos por 30 dias, porém em baixas concentrações, devido a extensa eliminação do canabinóide em decorrência da exposição crônica

No description available.

En el marc del model transteòric de canvi (Prochaska, DiClemente i Norcross, 1992) i del model de l'autocontrol (Rachlin, 1989), s'examinen les característiques de la conducta de fumar així com la percepció de la magnitud i la demora de les conseqüències positives i negatives d'aquest consum, a fi de conèixer la seva relació amb l'etapa de canvi en la cessació tabàquica.Amb aquest objectiu s'entrevista a una mostra representativa de 281 membres (54,8% homes i 45,2% dones; mitjana d'edat = 37,26 anys, DT = 8,77; 48,8% no fumadors, 27,4% fumadors i 23,8% exfumadors) del personal acadèmic i d'administració i serveis de la Universitat de Girona.Els resultats mostren que més de la meitat dels fumadors es troben a l'etapa de Precontemplació (sense intenció ferma d'abandonar el consum de tabac en els propers 6 mesos) i la majoria d'exfumadors se situen a l'etapa de Manteniment (mínim de sis mesos sense fumar).També s'observen diferències en algunes de les variables examinades segons l'etapa de canvi de manera que els fumadors en Contemplació-Preparació (amb intenció ferma d'abandonar el consum de tabac en els propers 6 mesos) presenten un elevat índex de perjudicis percebuts, informen d'haver rebut més consell mèdic i realitzen amb major freqüència inhalacions a cada cigarreta.En canvi, els fumadors en Precontemplació són els qui més responen consumir tabac baix en nicotina mentre que els exfumadors en Acció o Manteniment són els qui més tendeixen a relacionar de manera immediata fumar i les seves conseqüències negatives a curt i mitjà termini, i els qui presenten major puntuació en l'índex de beneficis percebuts. Aquestes dades corroboren la importància de les intervencions clíniques específiques en les diferents etapes de l'abandonament del consum de tabac, suggereixen que les campanyes preventives s'haurien de focalitzar preferentment en les conseqüències negatives immediates de fumar i apunten a la conveniència de tenir en compte la notable valoració positiva dels beneficis de fumar per part dels exfumadors en els programes de prevenció de recaigudes. Així mateix, la constatació del poder explicatiu de la variable demora en la diferenciació dels subjectes en funció de l'etapa de canvi, planteja la conveniència d'incloure aquesta variable en les avaluacions dels pros i contres de fumar a fi de conèixer amb major precisió els seus pesos relatius. / Whitin the frame of the transtheoretical model of change (Prochaska, DiClemente and Norcross, 1992) and the self-control model (Rachlin, 1989) the features of smoking cessation are studied as well as the perception of the magnitude and delay of both positive and negative consequences of this consumption, in order to know its relation with the changing stage when giving up smoking.To reach this goal a representative sample of 281 people are interviewed (54,8% men and 45,2% women; average age: 37,26 years old, SD: 8,77; 48,8% non-smokers, 27,4% smokers and 23,8 ex-smokers) of the academic and administrative staff at the University of Girona.The results show that more than a half of smokers are at the Precontemplation stage (without a strong intention of giving up smoking within the next six months) and most of ex-smokers are at the Maintaining stage (six months minimum without smoking).Some differences are also observed in some of the examined variables according to the changing stage, in a way that smokers who are at the Contemplation-Preparation stage (with a strong intention of giving up smoking within the next six months) show a high index of perceived cons of smoking and they also inform they have been given more medical advice. On the other hand, ex-smokers who are in the Action stage or Maintaining stage are those who tend closely relate smoking and its inmediate and delayed consequences, also those who show the highest scoring on the perceived benefit index. This data corroborates the importance of specific clinical actions in the different stages of giving up smoking process, it also suggest that preventive campaigns should focus preferably on the inmediate negative consequences of smoking and write down the convenience of taking into account the notable positive valuation of the benefits of giving up smoking on behalf of the exsmokers in the preventive relapse programs.Also this data evidence the convenience of including the delay parameter in the pros and cons of smoking evaluation with the aim of knowing with more precision their relative weights.

Syftet med uppsatsen är att undersöka hur andelen rökare av cigaretter påverkar denrökningsrelaterade sjukvårdskostnaden för den svenska vården. Studien presenterar treframtidsprognoser för den framtida andelen rökare under de kommande 15 åren. I den förstaprognosen antas andelen rökare vara på dagens nivå, sju procent, de kommande 15 åren. Iden andra prognosen minskar andelen rökare initialt och når sedan ett lägre steady-statejämfört med den första prognosen. I den sista prognosen minskar andelen rökare enligt dentrend som varit sedan 2004.För att kunna kalkylera de framtida sjukvårdskostnaderna har tillskrivningsfaktorer använtspå ett urval av rökningsrelaterade sjukdomar. Resultaten visar olika rökningsrelateradesjukvårdskostnader utifrån prognoserna. Kostnaderna i den första prognosen är konstantagenom hela prognosperioden. I den andra prognosen minskade de rökningsrelateradesjukvårdskostnaderna till år 2028, därefter var kostnaden lika stor för varje år. I den sistaprognosen halverades nästan kostnaden fram till år 2033.Slutsatsen som kan dras är att andelen rökare har en direkt påverkan på de rökningsrelateradesjukvårdskostnaderna. Utvecklingen av andelen rökare innebär en stor skillnad iprognostiserade kostnader och den bör undersökas noggrannare i framtiden för att kunna fåbättre prognoser. / The purpose of the thesis is to investigate how the proportion of cigarette smokers affects thesmoking-related healthcare cost for the Swedish healthcare. The study presents threeforecasts regarding the development of future proportion of smokers in the coming 15 yearsand the estimated healthcare costs with each scenario. In the first forecast, the proportion ofsmokers is at today's 7 percent and is expected to be constant for the next 15 years. Thesecond forecast deals with a future scenario in which the proportion of smokers decreases andthen evens out, thus reaching a lower steady-state compared to the first forecast. In the lastforecast, the proportion of smokers decreases according to the trend seen since 2004.To calculate future healthcare costs, attribution factors were used on a selection of smokingrelated diseases. The results show different smoking-related health care costs based on theforecasts. The costs of the first forecast show no significant changes. In the second forecast,smoking-related healthcare costs decreased until 2028. After that, the cost was the same foreach year. For the last forecast, the cost almost halved by 2033.The conclusion that can be drawn is that the proportion of smokers has a direct impact onsmoking-related health care costs. The difference in the proportion of smokers makes a bigdifference to the costs incurred.

This diploma paper deals with the tax incidence of cigarette tax in the period of the changes in rates of this duty in the Czech Republic. The main aim of this paper is to find out how the cigarette tax shifts on consumer and producer. Moving of tax burden was found out thanks to investigation of cigarette prices in the period from September 2007 to February 2008. The amount of tax was calculated from these prices. Various periods were compared and results were closely analysed. Fiscal and educative function of cigarette tax was monitored in this paper too. Educative function was found out by the help of trend in the number of smokers and their cigarettes consumption, whilst fiscal function was demonstrated by trend of payment excise duties. At the close of diploma paper are mentioned also tax avoidances of the excise duty on cigarettes, that are large problem all the time not only in the Czech Republic.