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A review of recent developments (2012–15) on the use of financial incentives with pregnant smokers
Abstracts / Drug and Alcohol Dependence 171 (2017) e2–e226
vey, a group of participants brainstormed statements in response to a series of prompts regarding personal experiences/opinions about e-cigarettes. Statements were synthesized and a unique set was presented to a second group of participants who sorted the statements based on perceived similarity and rated according to importance for understanding e-cigarettes. A similarity matrix was generated from these data, from which multidimensional scaling (MDS) and a hierarchical cluster analysis was performed. Participants were recruited via Craigslist in 12 U.S. cities with varying population size and smoking rates. Eligibility included: 21+, English speaking, ability to access email and the Internet. Results: A total of 1379 statements were generated by 36 participants during brainstorming. These statements were synthesized into 98 unique statements which were sorted and rated by 55 participants. Results from the MDS and hierarchical cluster analysis were reviewed and the eight cluster map was selected as the best conceptual fit for the data. The clusters included in the final concept map were characterized as pertaining to: health benefits, personal health risks, negative public health concerns, regulation/safety considerations, consumer attributes, positive product attributes, new users’ experiences, and neutral statements. Conclusions: The concept map derived from this evaluation provides a pictorial representation of participants’ thoughts regarding e-cigarettes and was used to establish content validity of a qualitative coding manual for postmarket surveillance of Internet forum data related to e-vapor products. Financial support: Inflexxion, Inc., Altria Client Services LLC. http://dx.doi.org/10.1016/j.drugalcdep.2016.08.151 Increasing abuse of gabapentin and pregabalin as reported to U.S. poison centers 2006 through 2014 Richard C. Dart 2,∗ , Becki Bucher Bartelson 4 , Stevan G. Severtson 3 , Gabrielle Bau 3 , Jody L. Green 1 1
RADARS System, Denver Health, Denver, CO, United States 2 RMPDC, Denver, CO, United States 3 Rocky Mountain Poison and Drug Center, Denver, CO, United States 4 Research, Rocky Mountain Poison and Drug Center, Denver, CO, United States
Aims: To determine if abuse of gabapentin and pregabalin are changing over time and to describe the outcomes of poison center cases involving abuse. Methods: Data from the Nation Poison Data System from January, 2006 to December, 2014 were queried for gabapentin and pregabalin product codes and were utilized to determine if the category of Intentional Abuse cases were increasing in the US. The total number of cases of Intentional Abuse where the exposure was to gabapentin, pregabalin or both was computed and divided by the estimated population of the US and scaled per 100,000 population. A Poisson regression model was used to determine the percent change per quarter in the intentional abuse population rates. Results: Of 4152 Intentional Abuse cases exposed to gabapentin or pregabalin, 2279 (54.9%) were male. The median age of 3907 cases in which age was reported was 30 years (IQR: 21–42). Only 1325 (31.9%) of the exposures involved only a single substance. The rate in first quarter 2006 was 0.0144 per 100,000 population while the rate for fourth quarter 2014 was 0.0618 per 100,000 population a 4.3-fold increase. Using Poisson regression Intentional Abuse population rates increased at a rate of 4.0% (95% CI: 3.6–4.3%) per
e51
quarter. The medical outcomes were death 18 (0.4%), major effect 254 (6.1%), and moderate effect 1238 (29.8%) with the balance of minor effects. Conclusions: Population based rates of intentional gabapentin and pregabalin abuse have increased since 2006. A high proportion of cases had an outcome that was moderate, major, or death. Continued monitoring and increased awareness of these rates is warranted. Financial Support: The authors are affiliated with the RADARS System, an independent nonprofit postmarketing surveillance system that is supported by subscription fees from pharmaceutical manufacturers. None of the authors have a direct financial, commercial, or other relationship with any of the subscribers. http://dx.doi.org/10.1016/j.drugalcdep.2016.08.152 A review of recent developments (2012–15) on the use of financial incentives with pregnant smokers Danielle Rose Davis 1,2,∗ , Laura J. Solomon 2 , Stephen Higgins 1,2 1
Psychology, University of Vermont, Burlington, VT, United States 2 Psychiatry, University of Vermont, Burlington, VT, United States Aims: Smoking during pregnancy is a leading preventable cause of poor pregnancy outcomes and immediate and longer-term adverse health outcomes among exposed offspring. Developing more effective smoking-cessation interventions for pregnant women is a public-health priority. We reviewed developments over the past three years (2012–15) on the use of financial incentives for smoking cessation among pregnant women using PubMed, bibliographies of published articles, and input from colleagues. Conclusions: The search revealed several important developments, with the following three being especially noteworthy. First, the review identified four new randomized controlled trials, three of which further supported the efficacy of this treatment approach. One of the three trials supporting efficacy also included the first econometric showing financial incentives with pregnant smokers to be highly cost-effective. Second, two Cochrane reviews were reported supporting the efficacy of the approach. Lastly, the first effectiveness trial was reported demonstrating that financial incentives increased abstinence rates above control levels when implemented by obstetrical clinic staff in a large urban hospital working with community tobacco interventionists. Overall, there is a growing and compelling body of evidence supporting the efficacy and cost-effectiveness of financial incentives for smoking cessation among pregnant women. Financial Support: This research was supported by Research Grants R01HD075669 and R01HD078332 from the National Institute of Child Health and Human Development and Center of Biomedical Research Excellence award P20GM103644 from the National Institute of General Medical Sciences. http://dx.doi.org/10.1016/j.drugalcdep.2016.08.153
vey, a group of participants brainstormed statements in response to a series of prompts regarding personal experiences/opinions about e-cigarettes. Statements were synthesized and a unique set was presented to a second group of participants who sorted the statements based on perceived similarity and rated according to importance for understanding e-cigarettes. A similarity matrix was generated from these data, from which multidimensional scaling (MDS) and a hierarchical cluster analysis was performed. Participants were recruited via Craigslist in 12 U.S. cities with varying population size and smoking rates. Eligibility included: 21+, English speaking, ability to access email and the Internet. Results: A total of 1379 statements were generated by 36 participants during brainstorming. These statements were synthesized into 98 unique statements which were sorted and rated by 55 participants. Results from the MDS and hierarchical cluster analysis were reviewed and the eight cluster map was selected as the best conceptual fit for the data. The clusters included in the final concept map were characterized as pertaining to: health benefits, personal health risks, negative public health concerns, regulation/safety considerations, consumer attributes, positive product attributes, new users’ experiences, and neutral statements. Conclusions: The concept map derived from this evaluation provides a pictorial representation of participants’ thoughts regarding e-cigarettes and was used to establish content validity of a qualitative coding manual for postmarket surveillance of Internet forum data related to e-vapor products. Financial support: Inflexxion, Inc., Altria Client Services LLC. http://dx.doi.org/10.1016/j.drugalcdep.2016.08.151 Increasing abuse of gabapentin and pregabalin as reported to U.S. poison centers 2006 through 2014 Richard C. Dart 2,∗ , Becki Bucher Bartelson 4 , Stevan G. Severtson 3 , Gabrielle Bau 3 , Jody L. Green 1 1
RADARS System, Denver Health, Denver, CO, United States 2 RMPDC, Denver, CO, United States 3 Rocky Mountain Poison and Drug Center, Denver, CO, United States 4 Research, Rocky Mountain Poison and Drug Center, Denver, CO, United States
Aims: To determine if abuse of gabapentin and pregabalin are changing over time and to describe the outcomes of poison center cases involving abuse. Methods: Data from the Nation Poison Data System from January, 2006 to December, 2014 were queried for gabapentin and pregabalin product codes and were utilized to determine if the category of Intentional Abuse cases were increasing in the US. The total number of cases of Intentional Abuse where the exposure was to gabapentin, pregabalin or both was computed and divided by the estimated population of the US and scaled per 100,000 population. A Poisson regression model was used to determine the percent change per quarter in the intentional abuse population rates. Results: Of 4152 Intentional Abuse cases exposed to gabapentin or pregabalin, 2279 (54.9%) were male. The median age of 3907 cases in which age was reported was 30 years (IQR: 21–42). Only 1325 (31.9%) of the exposures involved only a single substance. The rate in first quarter 2006 was 0.0144 per 100,000 population while the rate for fourth quarter 2014 was 0.0618 per 100,000 population a 4.3-fold increase. Using Poisson regression Intentional Abuse population rates increased at a rate of 4.0% (95% CI: 3.6–4.3%) per
e51
quarter. The medical outcomes were death 18 (0.4%), major effect 254 (6.1%), and moderate effect 1238 (29.8%) with the balance of minor effects. Conclusions: Population based rates of intentional gabapentin and pregabalin abuse have increased since 2006. A high proportion of cases had an outcome that was moderate, major, or death. Continued monitoring and increased awareness of these rates is warranted. Financial Support: The authors are affiliated with the RADARS System, an independent nonprofit postmarketing surveillance system that is supported by subscription fees from pharmaceutical manufacturers. None of the authors have a direct financial, commercial, or other relationship with any of the subscribers. http://dx.doi.org/10.1016/j.drugalcdep.2016.08.152 A review of recent developments (2012–15) on the use of financial incentives with pregnant smokers Danielle Rose Davis 1,2,∗ , Laura J. Solomon 2 , Stephen Higgins 1,2 1
Psychology, University of Vermont, Burlington, VT, United States 2 Psychiatry, University of Vermont, Burlington, VT, United States Aims: Smoking during pregnancy is a leading preventable cause of poor pregnancy outcomes and immediate and longer-term adverse health outcomes among exposed offspring. Developing more effective smoking-cessation interventions for pregnant women is a public-health priority. We reviewed developments over the past three years (2012–15) on the use of financial incentives for smoking cessation among pregnant women using PubMed, bibliographies of published articles, and input from colleagues. Conclusions: The search revealed several important developments, with the following three being especially noteworthy. First, the review identified four new randomized controlled trials, three of which further supported the efficacy of this treatment approach. One of the three trials supporting efficacy also included the first econometric showing financial incentives with pregnant smokers to be highly cost-effective. Second, two Cochrane reviews were reported supporting the efficacy of the approach. Lastly, the first effectiveness trial was reported demonstrating that financial incentives increased abstinence rates above control levels when implemented by obstetrical clinic staff in a large urban hospital working with community tobacco interventionists. Overall, there is a growing and compelling body of evidence supporting the efficacy and cost-effectiveness of financial incentives for smoking cessation among pregnant women. Financial Support: This research was supported by Research Grants R01HD075669 and R01HD078332 from the National Institute of Child Health and Human Development and Center of Biomedical Research Excellence award P20GM103644 from the National Institute of General Medical Sciences. http://dx.doi.org/10.1016/j.drugalcdep.2016.08.153