Huiqiong Deng, MD, PhD

All Publications

• A telehealth inpatient addiction consult service is both feasible and effective in reducing readmission rates. Journal of addictive diseases Deng, H., Raheemullah, A., Fenno, L. E., Lembke, A. 2022: 1-8

  Abstract

  The COVID-19 pandemic compelled fast adaptation of telehealth to addiction treatment services. This study aims to examine the feasibility and effectiveness of transitioning an in-person hospital addiction consult service (ACS) to telehealth. The Stanford Hospital ACS adapted to the pandemic by transforming an in-person ACS to a telehealth ACS. We compared 30-day readmission rates in patients with and without an addiction medicine consult pre-pandemic (in-person ACS) and during the pandemic (telehealth ACS). The ACS completed 370 and 473 unique patient consults in the year preceding (in-person consults) and during the pandemic (telehealth consults) respectively. Patients seen by telehealth ACS had decreased 30-day readmission rates consistent with those seen before COVID-19. A telehealth ACS is feasible and effective in the in-patient setting. Telehealth ACS holds promise to extend the reach of substance use disorder evaluation and treatment in underserved areas.

  View details for DOI 10.1080/10550887.2022.2090822

  View details for PubMedID 35819268

• Inpatient Addiction Medicine Consultation on Readmission Rates and Length of Stay Journal of Addiction and Prevention Raheemullah, A., Deng, H., Fenno, L., Lembke, A. 2022; 10 (1)
• Gabapentin dependence and withdrawal requiring an 18-month taper in a patient with alcohol use disorder: a case report. Journal of addictive diseases Deng, H., Benhamou, O., Lembke, A. 2021: 1–6

  Abstract

  Gabapentin has been widely used to manage post-herpetic neuralgia, peripheral neuropathy, seizure disorders, alcohol use disorder (AUD), alcohol withdrawal, and insomnia. Although usually well tolerated, gabapentin has been reported to cause severe physiologic dependence and withdrawal. Tapering gabapentin in this context poses a significant clinical challenge, with little published information to date on meeting this challenge. This case highlights the need for patient-centered slow tapers in patients with severe gabapentin dependence and withdrawal. We present a 32-year-old female effectively treated for AUD with 1,200mg daily dose of gabapentin, who developed gabapentin dependence and severe withdrawal. Recognizing her intolerance to gabapentin withdrawal after a brief accidental pause of medication, a taper plan was initiated using the framework of the BRAVO Protocol. On average, she reduced daily gabapentin dose by 100mg per month until she reached 300mg. The taper then slowed to 20-30mg dose decrements per month. For the last 100mg, she tapered down at 5mg decrements every one to two weeks to 60mg, at which point she discontinued gabapentin. The entire taper process took eighteen months. The BRAVO protocol outlines a safe and compassionate strategy. Originally developed for opioids and adapted to benzodiazepines, the use of the Bravo Protocol provides a framework for a gabapentin taper. For patients in whom gabapentin treatment leads to severe dependence and withdrawal, the BRAVO Protocol provides a practical, patient-centered framework for tapering.

  View details for DOI 10.1080/10550887.2021.1907502

  View details for PubMedID 33783336

• Association of TPH1 and serotonin transporter genotypes with treatment response for suicidal ideation: a preliminary study. European archives of psychiatry and clinical neuroscience Nielsen, D. A., Deng, H., Patriquin, M. A., Harding, M. J., Oldham, J., Salas, R., Fowler, J. C., Frueh, B. C. 2019

  Abstract

  Variants in three genes coding for components of the serotonergic system, the tryptophan hydroxylase 1 (TPH1) rs1799913, serotonin transporter (SLC6A4) 5-HTTLPR, and serotonin receptor 2A (HTR2A) rs6311, were evaluated for association with suicidal ideation (SI) and with recovery from SI in a psychiatric inpatient population. Five hundred and eighty-two adult inpatients, including 390 patients who had SI, collected from December 2012 to April 2016 were assessed. SI recovery, calculated as change in SI between the first two-week period after admission and weeks 5 and 6, was appraised for association with the three variants. In this preliminary study, both TPH1 and 5-HTTLPR genotypes were associated with recovery (TPH1: recessive model, increased recovery with AC genotype, P = 0.026; additive model, increased recovery with AC genotype, P = 0.037; 5-HTTLPR: recessive model, increased recovery with AC, P = 0.043). When patients with comorbid alcohol use disorder (AUD) were removed, given that TPH1 has been associated with alcoholism, the associations of those recovered from SI with TPH1 rs1799913 remained significant for the additive (increased recovery with AC, P = 0.045) and recessive (increased recovery with C-carriers, P = 0.008) models, and with 5-HTTLPR using the dominant model (increased recovery with S'S', P = 0.016). In females, an association of SI recovery with TPH1 rs1799913 was found using a recessive model (increased recovery with C-carriers, P = 0.031), with 5-HTTLPR using additive (increased recovery with L'S', P = 0.048) and recessive (increased recovery with S'S', P = 0.042) models. Additionally, an association of SI with TPH1 rs1799913 was found in females using both additive (increased risk in AC, P = 0.033) and recessive (increased risk in C-carriers, P = 0.043) models, and with 5-HTTLPR using a recessive model (increased risk in S'S', P = 0.030). This study provides evidence that variation in the TPH1 and serotonin transporter genes play key roles in moderating recovery from SI during treatment in an inpatient psychiatric clinic.

  View details for DOI 10.1007/s00406-019-01009-w

  View details for PubMedID 30923939

• Hospital Stay in Synthetic Cannabinoid Users With Bipolar Disorder, Schizophrenia, or Other Psychotic Disorders Compared With Cannabis Users. Journal of studies on alcohol and drugs Deng, H., Desai, P. V., Mohite, S., Okusaga, O. O., Zhang, X. Y., Nielsen, D. A., Kosten, T. R. 2019; 80 (2): 230-235

  Abstract

  The use of synthetic cannabinoid (SC) products has become popular in recent years, but data regarding their impact on hospital stays are limited. The impact of SC and cannabis use on hospital length of stay and doses of antipsychotics at discharge was assessed in this study.The sample consisted of inpatients with discharge diagnoses of bipolar disorder, schizophrenia, or other psychotic disorders. Medical records of patients with self-reported SC use and negative urine drug screens (SC group, n = 77), with cannabis use confirmed by urine drug screen (cannabis group, n = 248), and with no drug use confirmed by urine drug screen (no-drug group, n = 1,336) were examined retrospectively.Length of stay (mean [SD] days) significantly differed (p < .001) among the SC (8.29 [4.29]), cannabis (8.02 [5.21]), and no-drug groups (10.19 [9.08]). Antipsychotic doses (chlorpromazine milligram equivalent doses) also significantly differed (p = .002) among the SC (254.64 [253.63]), cannabis (219.16 [216.71]), and no-drug groups (294.79 [287.85]). Unadjusted and adjusted pairwise comparisons showed that the cannabis group had a shorter length of stay (p < .001) and received lower doses of antipsychotics (p = .003) than the no-drug group. SC users did not differ significantly from the other two groups in either length of stay or doses of antipsychotics.Our findings suggest that acute SC exposure is not predictive of a more prolonged time for response to antipsychotic medications or of a need for larger doses of these medications compared with cannabis users.

  View details for PubMedID 31014468

• Psychosis and synthetic cannabinoids. Psychiatry research Deng, H., Verrico, C. D., Kosten, T. R., Nielsen, D. A. 2018; 268: 400–412

  Abstract

  Synthetic cannabinoid (SC) products have gained popularity as abused drugs over the past decade in many countries. The SCs broadly impact psychological state (e.g., mood, suicidal thoughts and psychosis) and physiological functions (e.g., cardiovascular, gastrointestinal and urinary). This review is about the effects of SCs on psychotic symptoms in clinical settings and the potentially relevant chemistry and mechanisms of action for SCs. Induction of psychotic symptoms after consuming SC products were reported, including new-onset psychosis and psychotic relapses. The role of SCs in psychosis is more complex than any single chemical component might explain, and these effects may not be a simple extension of the typical effects of cannabis or natural cannabinoids.

  View details for PubMedID 30125871

• Elevated Plasma S100B, Psychotic Symptoms, and Cognition in Schizophrenia PSYCHIATRIC QUARTERLY Deng, H., Kahlon, R. S., Mohite, S., Amin, P. A., Zunta-Soares, G., Colpo, G. D., Stertz, L., Fries, G. R., Walss-Bass, C., Soares, J. C., Okusaga, O. O. 2018; 89 (1): 53–60

  Abstract

  S100B is a calcium binding protein mainly produced by glial cells. Previous studies have shown elevated levels of S100B in patients with schizophrenia. We measured S100B levels in fasting plasma of 39 patients with schizophrenia and 19 adult healthy controls. We used linear regression to compare S100B between patients and controls. In patients only, we also investigated the relationship between S100B levels and psychotic symptoms (assessed by the Positive and Negative Syndrome Scale), and cognitive function (assessed by the NIH Toolbox Cognition Battery), respectively by calculating Pearson's correlation coefficients. Mean plasma S100B was significantly higher in the patient group than in the control group. There were no significant correlations between plasma S100B and psychotic symptoms or cognition.

  View details for DOI 10.1007/s11126-017-9514-y

  View details for Web of Science ID 000424682500005

  View details for PubMedID 28435992

• Impact of synthetic cannabinoid use on hospital stay in patients with bipolar disorder versus schizophrenia, or other psychotic disorders PSYCHIATRY RESEARCH Deng, H., Mohite, S., Suchting, R., Nielsen, D. A., Okusaga, O. O. 2018; 261: 248–52

  Abstract

  Synthetic cannabinoid products have become popular and have led to an increased number of patients presenting to emergency departments and psychiatric hospitals. The purpose of this study was to evaluate the impact of synthetic cannabinoid use at admission on length of stay and doses of antipsychotics at discharge in individuals with bipolar disorder, schizophrenia and other psychotic disorders. We retrospectively examined medical records of 324 inpatients admitted from January 2014 to July 2015. We found that synthetic cannabinoid use predicted length of stay and antipsychotic dose using structural equation modeling. Further, the association of synthetic cannabinoid use with length of stay was partly mediated by antipsychotic dose. These associations were independent of specific diagnosis. In conclusion, patients with bipolar disorder, schizophrenia, or other psychotic disorders who reported synthetic cannabinoid use at admission had shorter length of stay and received lower doses of antipsychotics, irrespective of clinical diagnoses.

  View details for DOI 10.1016/j.psychres.2017.12.089

  View details for Web of Science ID 000426222600040

  View details for PubMedID 29329043

• Mental health literacy about schizophrenia and depression: a survey among Chinese caregivers of patients with mental disorder. BMC psychiatry Chen, S., Wu, Q., Qi, C., Deng, H., Wang, X., He, H., Long, J., Xiong, Y., Liu, T. 2017; 17 (1): 89

  Abstract

  To investigate the knowledge of schizophrenia and depression among caregivers of patients with mental disorder in China.A convenience sample of 402 caregivers at the Department of Psychiatry of a general hospital in China was investigated (response rate 95.7%), using vignettes based investigation methodology.The number of caregivers using the term "depression" to describe the depression vignette was 43.6%, which was significantly higher than the number of caregivers using the term "schizophrenia" to describe the schizophrenia one (28.5%). A high percentage of caregivers believed that "psychiatrist", "psychologist" and "close family members" would be helpful, and the top three most helpful interventions were "becoming more physically active", "getting out and learning more" and "receiving psychotherapy". The number of caregivers endorsed "antipsychotics" and "antidepressants" as helpful for the schizophrenia and the depression vignettes were 82.0 and 80.7%, respectively. Regarding the causes of mental illness, items related to psychosocial factors, including "daily problems" and "work or financial problems", and "weakness of character" were highly rated, with half considered genetic or chemical imbalance causes.Caregivers expressed a high knowledge about treatments and interventions of mental disorders. But there are still some areas, particularly regarding the recognition and causes of mental disorders, that are in need of improvement. This is particularly the case for schizophrenia.

  View details for DOI 10.1186/s12888-017-1245-y

  View details for PubMedID 28274209

  View details for PubMedCentralID PMC5343538

• Smoking reduction and quality of life in chronic patients with schizophrenia in a Chinese populationA pilot study AMERICAN JOURNAL ON ADDICTIONS Deng, H., Wang, J., Zhang, X., Ma, M., Domingo, C., Sun, H., Kosten, T. 2016; 25 (2): 86–90

  Abstract

  Tobacco use is a significant public health issue on a global scale. Prevalence of daily tobacco smoking for men in China is much higher than in the United States. Although prevailing literature suggests a negative relationship between smoking and quality of life, this pilot study sought to evaluate whether smoking reduction/cessation impacted on the perception of quality of life in an in-patient population in China.Twenty Chinese patients meeting DSM-IV criteria for schizophrenia were recruited from Beijing Hui-Long-Guan Hospital, an in-patient facility in Beijing, China, for participation in this 4-week study. Seventeen participants with schizophrenia completed the study and were included in the final analysis. Cigarette consumption was recorded daily and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) was completed at baseline and at week 4. The relationships between smoking and perceived quality of life were evaluated using correlations between changes in WHOQOL-BREF and changes in cigarettes consumed as measured from baseline to week 4.We found an increase in perceived quality of life in the social relationships domain with increased cigarette consumption in contrast to a decrease in this domain with decreased consumption. However, decreased cigarette consumption was associated with an increase in the psychological domain compared to the social domain.These associations suggest a need for interventions to improve the social relationship perceptions with any successful reduction in cigarette consumption among Chinese schizophrenics in order to match their perceived psychological improvement.

  View details for DOI 10.1111/ajad.12337

  View details for Web of Science ID 000371238400001

  View details for PubMedID 26824336

• Low-Frequency Repetitive Transcranial Magnetic Stimulation Targeted to Premotor Cortex Followed by Primary Motor Cortex Modulates Excitability Differently Than Premotor Cortex or Primary Motor Cortex Stimulation Alone. Neuromodulation : journal of the International Neuromodulation Society Chen, M., Deng, H., Schmidt, R. L., Kimberley, T. J. 2015; 18 (8): 678-85

  Abstract

  The excitability of primary motor cortex (M1) can be modulated by applying low-frequency repetitive transcranial magnetic stimulation (rTMS) over M1 or premotor cortex (PMC). A comparison of inhibitory effect between the two locations has been reported with inconsistent results. This study compared the response secondary to rTMS applied over M1, PMC, and a combined PMC + M1 stimulation approach which first targets stimulation over PMC then M1.Ten healthy participants were recruited for a randomized, cross-over design with a one-week washout between visits. Each visit consisted of a pretest, an rTMS intervention, and a post-test. Outcome measures included short interval intracortical inhibition (SICI), intracortical facilitation (ICF), and cortical silent period (CSP). Participants received one of the three interventions in random order at each visit including: 1-Hz rTMS at 90% of resting motor threshold to: M1 (1200 pulses), PMC (1200 pulses), and PMC + M1 (600 pulses each, 1200 total).PMC + M1 stimulation resulted in significantly greater inhibition than the other locations for ICF (P = 0.005) and CSP (P < 0.001); for SICI, increased inhibition (group effect) was not observed after any of the three interventions, and there was no significant difference between the three interventions.The results indicate that PMC + M1 stimulation may modulate brain excitability differently from PMC or M1 alone. CSP was the assessment measure most sensitive to changes in inhibition and was able to distinguish between different inhibitory protocols. This work presents a novel procedure that may have positive implications for therapeutic interventions.

  View details for DOI 10.1111/ner.12337

  View details for PubMedID 26307511

  View details for PubMedCentralID PMC5154674

• A Multiple Indicators Multiple Causes (MIMIC) model of internal barriers to drug treatment in China DRUG AND ALCOHOL DEPENDENCE Qi, C., Kelly, B. C., Liao, Y., He, H., Luo, T., Deng, H., Liu, T., Hao, W., Wang, J. 2015; 148: 143–49

  Abstract

  Although evidence exists for distinct barriers to drug abuse treatment (BDATs), investigations of their inter-relationships and the effect of individual characteristics on the barrier factors have been sparse, especially in China. A Multiple Indicators Multiple Causes (MIMIC) model is applied for this target.A sample of 262 drug users were recruited from three drug rehabilitation centers in Hunan Province, China. We applied a MIMIC approach to investigate the effect of gender, age, marital status, education, primary substance use, duration of primary drug use, and drug treatment experience on the internal barrier factors: absence of problem (AP), negative social support (NSS), fear of treatment (FT), and privacy concerns (PC).Drug users of various characteristics were found to report different internal barrier factors. Younger participants were more likely to report NSS (-0.19, p=0.038) and PC (-0.31, p<0.001). Compared to other drug users, ice users were more likely to report AP (0.44, p<0.001) and NSS (0.25, p=0.010). Drug treatment experiences related to AP (0.20, p=0.012). In addition, differential item functioning (DIF) occurred in three items when participant from groups with different duration of drug use, ice use, or marital status.Individual characteristics had significant effects on internal barriers to drug treatment. On this basis, BDAT perceived by different individuals could be assessed before tactics were utilized to successfully remove perceived barriers to drug treatment.

  View details for DOI 10.1016/j.drugalcdep.2014.12.033

  View details for Web of Science ID 000350527200018

  View details for PubMedID 25640152

• Serial treatments of primed low-frequency rTMS in stroke: Characteristics of responders vs. nonresponders RESTORATIVE NEUROLOGY AND NEUROSCIENCE Carey, J. R., Deng, H., Gillick, B. T., Cassidy, J. M., Anderson, D. C., Zhang, L., Thomas, W. 2014; 32 (2): 323–35

  Abstract

  This study analyzed the characteristics of responders vs. nonresponders in people with stroke receiving a novel form of repetitive transcranial magnetic stimulation (rTMS) to improve hand function.Twelve people with stroke received five treatments of 6-Hz primed low-frequency rTMS to the contralesional primary motor area. We compared demographic factors, clinical features, and the ipsilesional/contralesional volume ratio of selected brain regions in those who improved hand performance (N = 7) on the single-hand component of the Test Évaluant la performance des Membres supérieurs des Personnes Âgées (TEMPA) and those who showed no improvement (N = 5).Responders showed significantly greater baseline paretic hand function on the TEMPA, greater preservation volume of the ipsilesional posterior limb of the internal capsule (PLIC), and lower scores (i.e., less depression) on the Beck Depression Inventory than nonresponders. There were no differences in age, sex, stroke duration, paretic side, stroke hemisphere, baseline resting motor threshold for ipsilesional primary motor area (M1), NIH Stroke Scale, Upper Extremity Fugl-Meyer, Mini-Mental State Examination, or preservation volume of M1, primary somatosensory area, premotor cortex, or supplementary motor area.Our results support that preserved PLIC volume is an important influential factor affecting responsiveness to rTMS.

  View details for DOI 10.3233/RNN-130358

  View details for Web of Science ID 000332478200010

  View details for PubMedID 24401168

  View details for PubMedCentralID PMC5560130

• Combined Statistical Analysis Method Assessing Fast Versus Slow Movement Training in a Patient With Cerebellar Stroke: A Single-Case Study PHYSICAL THERAPY Deng, H., Kimberley, T. J., Durfee, W. K., Dressler, B. L., Steil, C., Carey, J. R. 2013; 93 (5): 649–60

  Abstract

  Gold standards of data analysis for single-case research do not currently exist.The purpose of this study was to determine whether a combined statistical analysis method is more effective in assessing movement training effects in a patient with cerebellar stroke.A crossover single-case research design was conducted.The patient was a 69-year-old man with a chronic cerebellar infarct who received two 5-week phases of finger tracking training at different movement rates. Changes were measured with the Box and Block Test, the Jebsen-Taylor test, the finger extension force test, and the corticospinal excitability test. Both visual analysis and statistical tests (including split-middle line method, t test, confidence interval, and effect size) were used to assess potential intervention effects.The results of the t tests were highly consistent with the confidence interval tests, but less consistent with the split-middle line method. Most results produced medium to large effect sizes.The possibility of an incomplete washout effect was a confounding factor in the current analyses.The combined statistical analysis method may assist researchers in assessing intervention effects in single-case stroke rehabilitation studies.

  View details for DOI 10.2522/ptj.20120121

  View details for Web of Science ID 000318202700009

  View details for PubMedID 23329559

  View details for PubMedCentralID PMC3641404

• Complex Versus Simple Ankle Movement Training in Stroke Using Telerehabilitation: A Randomized Controlled Trial PHYSICAL THERAPY Deng, H., Durfee, W. K., Nuckley, D. J., Rheude, B. S., Severson, A. E., Skluzacek, K. M., Spindler, K. K., Davey, C. S., Carey, J. R. 2012; 92 (2): 197–209

  Abstract

  Telerehabilitation allows rehabilitative training to continue remotely after discharge from acute care and can include complex tasks known to create rich conditions for neural change.The purposes of this study were: (1) to explore the feasibility of using telerehabilitation to improve ankle dorsiflexion during the swing phase of gait in people with stroke and (2) to compare complex versus simple movements of the ankle in promoting behavioral change and brain reorganization.This study was a pilot randomized controlled trial.Training was done in the participant's home. Testing was done in separate research labs involving functional magnetic resonance imaging (fMRI) and multi-camera gait analysis.Sixteen participants with chronic stroke and impaired ankle dorsiflexion were assigned randomly to receive 4 weeks of telerehabilitation of the paretic ankle.Participants received either computerized complex movement training (track group) or simple movement training (move group).Behavioral changes were measured with the 10-m walk test and gait analysis using a motion capture system. Brain reorganization was measured with ankle tracking during fMRI.Dorsiflexion during gait was significantly larger in the track group compared with the move group. For fMRI, although the volume, percent volume, and intensity of cortical activation failed to show significant changes, the frequency count of the number of participants showing an increase versus a decrease in these values from pretest to posttest measurements was significantly different between the 2 groups, with the track group decreasing and the move group increasing.Limitations of this study were that no follow-up test was conducted and that a small sample size was used.The results suggest that telerehabilitation, emphasizing complex task training with the paretic limb, is feasible and can be effective in promoting further dorsiflexion in people with chronic stroke.

  View details for DOI 10.2522/ptj.20110018

  View details for Web of Science ID 000299717700001

  View details for PubMedID 22095209

  View details for PubMedCentralID PMC3269771

• Development, extinction and reinstatement of morphine withdrawal-induced conditioned place aversion in rats ADDICTION BIOLOGY Li, Y., Liu, X., Chen, H., Deng, H., Xiang, X., Chen, H., Hao, W. 2007; 12 (3-4): 470–77

  Abstract

  The motivational component of drug withdrawal may contribute to drug seeking and relapse through the negative reinforcement-based process. Here, we used conditioned place aversion (CPA) induced by naloxone-precipitated morphine withdrawal to measure the aversive effects. Using an unbiased conditioning paradigm, we treated rats with morphine hydrochloride [(10 mg/kg intraperitoneally (i.p.)] twice per day (at 08:00 and 20:00) for 6.5 days (from day 1 to day 7 morning), while gave them naloxone (0.3 mg/kg i.p.) on day 6, a precipitated withdrawal paired with a compartment that caused CPA to the side. Then, the rats exhibited CPA were received 12 extinction trials from days 7 to 13, by daily exposed to the two compartments for free exploration. On day 13, the rats with extinguished CPA were treated with a priming injection of morphine (10 mg/kg i.p.) followed by naloxone (0.3 mg/kg i.p.) that reliably reinstated CPA. These results demonstrated that repeatedly morphine-treated rats showed the formation, extinction and reinstatement of CPA. The present CPA model induced by these procedures may be useful for studying the biological mechanisms underlying the aversive motivational component of opiate withdrawal.

  View details for DOI 10.1111/j.1369-1600.2007.00059.x

  View details for Web of Science ID 000248511800003

  View details for PubMedID 17678507

• A comparative survey on alcohol and tobacco use in urban and rural populations in the Huaihua District of Hunan Province, China ALCOHOL Zhou, X., Su, Z., Deng, H., Xiang, X., Chen, H., Hao, W. 2006; 39 (2): 87–96

  Abstract

  Modern Chinese society is comprised primarily of two subgroups-urban and rural subpopulations. However, comparative data regarding alcohol and tobacco use between urban and rural subgroups in China is sparse. An epidemiological survey was conducted in the Huaihua District of Hunan Province of China, and 3,543 urban and 4,294 rural dwellers aged 15-65 years were interviewed. The drinking rates were higher in the urban area (45.9%) than in the rural area (39.6%), whereas the smoking rates were higher in the rural area (35.9%) than in the urban area (28.7%). Rural respondents were more likely to report heavy drinking (Adjusted odds ratio [OR]=1.77) and heavy smoking (Adjusted OR=2.46) than urban populations. Specifically, rural males had higher odds of heavy alcohol and tobacco use than urban males, whereas more urban females were more likely to drink and smoke than rural counterparts. The findings suggest that the status of alcohol and tobacco use varies in the urban and rural area. The heavy alcohol and tobacco consumption among rural populations underscores the need to develop and implement culturally appropriate public health intervention and awareness arising programs especially in rural China.

  View details for DOI 10.1016/j.alcohol.2006.07.003

  View details for Web of Science ID 000242109400004

  View details for PubMedID 17134661