Authors :
Presenting Author: Kataryzna Czerniak, MLA, MPH, PhD Candidate – UT Health Houston
Ross Shegog, PhD – UT Health Houston
Refugio Sepulveda, PhD – University of Arizona
Robert Addy, PhD – UT Health Houston
Kimberly Martin, MPH – Epilepsy Foundation Central & South Texas
Suzanne Thomas, Master's Degree in Professional Counseling – Epilepsy Foundation of Texas
Rosalia Guerrero, MPH, PhD Candidate – UTHealth School of Public Health
Myrka Torres, MD – University of Arizona
Sharada Wali, MD, MPH – UT Health Houston
David Labiner, MD – University of Arizona
Rationale: People with epilepsy (PWE) have elevated co-morbidities of anxiety, depression, and cognitive deficits that are well known predictors of substance use, as well as elevated needs for social services compared to the general population. There is a dearth of studies examining behaviors and antecedent factors associated with tobacco use among PWE. The purpose of this study was to analyze the association of tobacco use with seizure frequency, epilepsy-related co-morbidities, and social determinants in a sample of PWE.
Methods: Baseline data from 140 PWE enrolled in two CDC-funded RCTs was analyzed. PWE were recruited from clinics affiliated with the Epilepsy Foundation Central and South Texas (n=4), Epilepsy Foundation of Texas (n=4), and Banner in Arizona (n=2) from August 2023 through March 2024 to test the efficacy of MINDSET, a decision support enhancing epilepsy self-management tool. Data on tobacco use was collected using self-report items (n=4) in a baseline demographic survey. Seizure frequency was assessed for the previous 3 months. Validated scales, embedded in MINDSET, were used to assess depression (NDDI-E), quality of life (QoLIE-10), cognitive (memory) function (QoLIE-31 cognitive subscale) and social determinants of health (Health Leader). PWE tobacco users and non-users were compared on these parameters using two-sample t-tests.
Results: The analytic sample comprised 140 PWE who were 45±14 years of age (Range=20-79), mainly female (60%), white (78%), and non-Hispanic/Latino (64%). Fifty four (38%) reported ever using a tobacco product. Of those, 26 (48%) were current tobacco users who reported using at least once in the past month. Among current users, cigarette use (56%) and vaping (48%) were most frequently used. Current users were mainly female (54%) and white (88%). There was no statistical difference in seizure frequency reported in the last 30 days between current users (3.38±5.76) and non-users (1.91±4.0)(p< 0.12). NDDI-E scores were ≥ 15 for 18 PWE (33%) indicating depressive symptoms. Tobacco use was associated with higher NDDI-E scores
(14.15±5.0) compared to non-use (11.8±3.9)(p< 0.01). Tobacco use was also associated with lower QoLIE-31 cognitive scores (50.25±30.8) compared to non-use (64.18±24.80)(p< 0.01). Most frequently reported social needs were social isolation (33.3%), financial strain (29.6%), and food insecurity (29.6%).
Conclusions: According to the most recent 2022 National Survey on Drug Use and Health, 22.7% of Americans reported using a tobacco product in the past month. The reported rate of current tobacco use among this sample of PWE was more than double that of the general population. Tobacco use was also found to be associated with significantly more depressive symptoms and significantly higher rates of cognitive issues. These results underscore the need for integrating cessation-related programs into epilepsy clinics.
Funding: This research was funded by CDC Special Interest Research Projects 19-003 and 20-006.