Impulsivity-like traits and smoking behavior in college students

Time perspective as a determinant of smoking cessation in four countries: Direct and mediated effects from the International Tobacco Control (ITC) 4-Country Surveys

BACKGROUND

Future oriented time perspective predicts a number of important health behaviors and outcomes, including smoking cessation. However, it is not known how future orientation exerts its effects on such outcomes, and no large scale cross-national studies have examined the question prospectively. The aim of the current investigation was to examine the relationship between time perspective and success in smoking cessation, and social cognitive mediators of the association.

METHODS

The ITC-4 is a multi-wave, four country survey (Australia, Canada, United States, United Kingdom) of current smokers (N=9772); the survey includes baseline measurements of time perspective, intentions, quit attempts, and self-reported quit status at follow-up over 8 years. We examined the predictive power of time perspective for smoking cessation, as mediated through strength of quit intentions and prior history of quit attempts.

RESULTS

Findings indicated that those smokers with a stronger future orientation at baseline were more likely to have successfully quit at follow-up. This effect was partially explained by intention-mediated effects of future orientation on quit attempts.

CONCLUSIONS

Future orientation predicts smoking cessation across four English-speaking countries; the cessation-facilitating effects of future orientation may be primarily due to future oriented individuals' motivated and sustained involvement in the quit cycle over time.

The prospective effects of impulsivity on alcohol and tobacco use in a college sample

Alcohol and tobacco use are strongly associated, particularly in younger populations, and concurrent use may encourage progression toward dependence on both substances. Impulsivity has been linked to the use of alcohol and tobacco individually, but has not been studied in terms of its association with use of both. This study tested the hypothesis that the effects of impulsivity (sensation seeking and negative urgency) on smoking initiation in a sample of college students (n = 400) would be mediated by alcohol consumption. We also predicted that sensation seeking and negative urgency would predict alcohol and cigarette use and overlap among initiators. Sensation seeking and negative urgency both predicted smoking initiation, but only the former effect was mediated by alcohol use. Among initiators, sensation seeking was associated with more frequent alcohol use as well as more frequent overlap between alcohol and tobacco use but not with smoking frequency. Higher negative urgency was associated with more frequent smoking, but not with alcohol use or alcohol/tobacco overlap. Findings are consistent with previous research in college samples and suggest the existence of multiple pathways to alcohol and tobacco use and co-use in college students.

Emotion-based impulsivity, smoking expectancies, and nicotine dependence in college students

The aim of this study was to enhance our understanding of the relationship between affect-related dispositions to rash action, negative urgency (NU: the tendency to act rashly when in a negative mood), positive urgency (PU: the tendency to act rashly when in a positive mood) and level of nicotine dependence symptoms by examining how the two traits transact with affect-related smoking expectancies. Based on the Acquired Preparedness model of addictive behaviors, we hypothesized that the relationship between PU and level of nicotine dependence would be mediated by positive affect smoking expectancies. We also hypothesized that the relationship between NU and level of nicotine dependence would be mediated by negative affect reduction expectancies. We studied 139 college-aged smokers and found support for this model; positive affect expectancies for smoking mediated the relationship between PU and level of nicotine dependence symptoms. Negative affect reduction smoking expectancies mediated the relationship between NU and level of nicotine dependence. The clinical implications of this research suggest that prevention/intervention programs should include substance-free activities as reinforcement and as ways to deal with extreme positive and negative mood.

Hookah, cigarette, and marijuana use: a prospective study of smoking behaviors among first-year college women

Better understanding of the temporal sequence of hookah, cigarette, and marijuana use will help to inform smoking prevention efforts. To address this gap in the literature, we assessed all three of these smoking behaviors in a sample of 424 first-year college women. Using a longitudinal design, we investigated whether hookah use predicts initiating/resuming cigarette and/or initiating marijuana use, and whether cigarette and/or marijuana use predicts initiating hookah use. Participants (67% White, M age = 18.1 years) completed nine monthly surveys. The initial (i.e., baseline) survey assessed demographics, sensation-seeking, impulsivity, and pre-college substance use. Follow-up surveys assessed past-month substance use; outcomes were initiating/resuming cigarette use, initiating marijuana use, and initiating hookah use during the first year of college. We controlled for sensation-seeking, impulsivity, binge drinking, and other smoking behaviors in our multivariate logistic regression models. The results showed that (a) pre-college hookah use predicted initiating/resuming cigarette use; (b) pre-college marijuana use predicted initiation of hookah tobacco smoking; and (c) pre-college cigarette use predicted neither hookah nor marijuana initiation. The findings highlight the co-occurrence of smoking behaviors as well as the need for bundling preventive interventions so that they address hookah, cigarette, and marijuana use.

Mood, mood regulation expectancies and frontal systems functioning in current smokers versus never-smokers in China and Australia

Indices of mood, mood regulation expectancies and everyday executive functioning were examined in adult current smokers and never-smokers of both genders in Australia (N = 97), where anti-smoking campaigns have dramatically reduced smoking prevalence and acceptability, and in China (N = 222), where smoking prevalence and public acceptance of smoking remain high. Dependent measures included the Depression Anxiety Stress Scales (DASS-21), the Negative Mood Regulation (NMR) expectancies scale, the Frontal Systems Behavior Scale (FrSBe), the Fagerström Test for Nicotine Dependence (FTND) and the Alcohol Use Disorders Identification Test (AUDIT). Multivariate analyses of covariance (MANCOVAs) controlling for demographic and recruitment related variables revealed highly significant differences between current smokers and never-smokers in both countries such that smokers indicated worse moods and poorer functioning than never-smokers on all dependent measures. Chinese smokers scored significantly worse on all dependent measures than Australian smokers whereas Chinese and Australian never-smokers did not differ on any of the same measures. Although nicotine dependence level as measured by FTND was significantly higher in Chinese than Australian smokers and was significantly correlated with all other dependent measures, inclusion of FTND scores as another covariate in MANCOVA did not eliminate the highly significant differences between Chinese and Australian smokers. Results are interpreted in light of the relative ease of taking up and continuing smoking in China compared to Australia today.

Impulsivity as a moderator of the intention-behavior relationship for illicit drug use in patients undergoing treatment

INTRODUCTION

Evident across clinical practice and clinical trials is a divergence between stated intentions and subsequent drug-related behaviors in substance abuse treatment settings. Impulsivity, itself related to drug abuse, may be one variable which may moderate the degree of disconnect in the intention-behavior relationship. The present study examines the relationship between self-stated desire to quit, impulsivity, and drug use in a group of outpatients receiving methadone maintenance treatment. In particular, we examined the direct and moderating influence of different facets of impulsivity (urgency, lack of premeditation, sensation seeking, and lack of perseverance) on drug use in the context of a stated desire to abstain from drugs.

METHOD

84 opioid-dependent individuals undergoing counseling and methadone maintenance treatment completed a battery of self-report questionnaires including measures of impulsivity (UPPS Impulsivity Scale), stated desire to quit, and past 30-day drug use. We hypothesized that two facets of impulsivity, urgency and (lack of) premeditation, would moderate the relationship between desire to quit and past 30-day drug use, such that the relationship between intention and behavior would be weaker in those with high levels of these facets of impulsivity.

RESULTS

Consistent with the disconnect between intentions and drug-use behaviors typical of treatment settings, desire to quit was not directly associated with self-reported past month drug use. However, in separate regression analyses, 2 facets of impulsivity, premeditation and sensation seeking, moderated the relationship between desire to quit and past month use. Whereas there was not a significant relationship between desire to quit and drug use in individuals high in sensation-seeking or lack of premeditation, the relationship between intention and drug use behaviors was preserved in those low in these facets of impulsivity.

CONCLUSION

These findings indicate that the relationship between desire to quit and self-reported past-month drug use is weak for those high in sensation seeking or low in premeditation. These results are discussed in the context of current interventions for substance dependence.

Utilizing a multimodal assessment strategy to examine variations of impulsivity among young adults engaged in co-occurring smoking and binge drinking behaviors

BACKGROUND

Smoking among young adults predicts a greater severity of alcohol use and contributes to an increased difficulty in maturing out of heavy drinking behaviors that are established during college. Moreover, research has implicated impulsivity in the initiation and maintenance of both behaviors. Much less is known, however, about potential variations of impulsivity among young adults and whether a relationship exists between this construct and abstinence from smoking. As a result, this study examined differences and changes in trait and behavioral indices of impulsivity as a function of binge drinking among a sample of cigarette smokers using a multimodal assessment strategy.

METHODS

Participants (N=40) were regular cigarette smokers who reported engagement in binge drinking or no binge drinking during the past year. All participants completed self-report and behavioral assessments of impulsivity prior to and following a period of smoking abstinence.

RESULTS

Compared to their non-binge drinking peers, binge-drinking smokers reported significantly higher scores on the UPPS (lack of) Premeditation factor (p<.05), while also exhibiting a greater deficit in inhibitory control while in a nicotine satiated state (p<.05). However, no significant differences of inhibitory control were observed between groups following the 24-h deprivation period.

CONCLUSIONS

Findings suggest that baseline differences in lack of planning and inhibitory control exist among young adults who concurrently smoke and binge drink. These results provide preliminary data for the need of tailored interventions for this population.

BIS impulsivity and acute nicotine exposure are associated with discounting global consequences in the Harvard game

OBJECTIVE

The Barratt Impulsivity Scale (BIS) provides a transdiagnostic marker for a number of psychiatric conditions and drug abuse, but the precise psychological trait(s) tapped by this questionnaire remain obscure.

METHOD

To address this, 51 smokers completed in counterbalanced order the BIS, a delay discounting task and a Harvard game that measured choice between a response that yielded a high immediate monetary payoff but decreased opportunity to earn money overall (local choice) versus a response that yielded a lower immediate payoff but afforded a greater opportunity to earn overall (global choice).

RESULTS

Individual level of BIS impulsivity and self-elected smoking prior to the study were independently associated with increased preference for the local over the global choice in the Harvard game, but not delay discounting.

CONCLUSIONS

BIS impulsivity and acute nicotine exposure reflect a bias in the governance of choice by immediate reward contingencies over global consequences, consistent with contemporary dual-process instrumental learning theories.

Do time perspective and sensation-seeking predict quitting activity among smokers? Findings from the International Tobacco Control (ITC) Four Country Survey

Personality factors such as time perspective and sensation-seeking have been shown to predict smoking uptake. However, little is known about the influences of these variables on quitting behavior, and no prior studies have examined the association cross-nationally in a large probability sample. In the current study it was hypothesized that future time perspective would enhance - while sensation-seeking would inhibit - quitting activity among smokers. It was anticipated that the effects would be similar across English speaking countries. Using a prospective cohort design, this cross-national study of adult smokers (N=8845) examined the associations among time perspective, sensation-seeking and quitting activity using the first three waves of data gathered from the International Tobacco Control Four Country Survey (ITC-4), a random digit dialed telephone survey of adult smokers from the United Kingdom, United States, Canada and Australia. Findings revealed that future time perspective (but not sensation-seeking) was a significant predictor of quitting attempts over the 8-month follow-up after adjusting for socio-demographic variables, factors known to inhibit quitting (e.g., perceived addiction, enjoyment of smoking, and perceived value of smoking), and factors known to enhance quitting (e.g., quit intention strength, perceived benefit of quitting, concerns about health effects of smoking). The latter, particularly intention, were significant mediators of the effect of time perspective on quitting activity. The effects of time perspective on quitting activity were similar across all four English speaking countries sampled. If these associations are causal in nature, it may be the case that interventions and health communications that enhance future-orientation may foster more quit attempts among current smokers.

Negative urgency, problem drinking and negative alcohol expectancies among members from one First Nation: a moderated-mediation model

Problematic alcohol use is a major health concern for many Native communities in both Canada and the United States (Spillane & Smith, 2007, 2010; Spillane, Smith, & Kahler, in press). Because health disparities related to alcohol use are pronounced in this population (Beauvais, 1996; Whitesell et al., 2007), it is important to study factors that may contribute to risk for this set of problems. Alcohol expectancies represent a well known risk factor for alcohol use in non-Natives. This study sought to examine the relationship between negative urgency and negative alcohol expectancies, and to determine if this relationship is influenced by problem drinking behaviors. We hypothesized that negative urgency's effects on the development of negative alcohol expectancies would be mediated by negative urgency's influence to increase drinking behaviors in a First Nation sample (see Spillane & Smith, 2010). We also hypothesized that this relationship would be moderated by sex. We administered measures of alcohol use, negative urgency, and negative alcohol use expectancies to a total of 209 First Nation people (96 men; 113 women). Following the steps of moderated mediation outlined by Preacher, Rucker, and Hayes (2007), we found that the relationship between negative urgency and negative alcohol expectancies was significantly mediated by problem drinking for males (β=0.42, p<0.001), but not for females (β=0.13, p=0.32). The current study suggests that for males in this First Nation sample, negative urgency's effects on development of negative alcohol expectancies is mediated by problem drinking behavior.

A prospective study of the Acquired Preparedness Model: the effects of impulsivity and expectancies on smoking initiation in college students

This study reports on a prospective test of the Acquired Preparedness Model, which posits that impulsivity influences cigarette smoking through the formation of more positive and fewer negative expectancies about smoking effects. College freshman never-smokers (n = 400; 45% male) completed a baseline interview and quarterly online follow-up assessments for 15 months after baseline. Structural equation modeling indicated that the effects of the impulsivity components of sensation seeking and negative urgency on risk of smoking initiation were mediated by expectancies for positive and negative reinforcement from smoking, respectively. Expectancies about negative consequences from smoking predicted initiation but did not mediate the effects of sensation seeking or negative urgency. Findings are consistent with the Acquired Preparedness Model and suggest that heightened impulsivity is associated with heightened expectancies for reinforcement from smoking, and thus with greater risk for smoking initiation.

The acquired preparedness risk model applied to smoking in 5th grade children

The very early onset of smoking predicts numerous health problems. The authors conducted the first test of one risk model for elementary school age smoking, known as the acquired preparedness (AP) model of risk, in a cross-sectional sample of 309 5th grade children. The model posits that (a) impulsivity-related personality traits contribute to risk for a variety of risky, maladaptive behaviors; (b) smoking expectancies confer risk only for smoking; and (c) the personality traits contribute to the formation of high risk expectancies for reinforcement from smoking, which in turn increases the likelihood of early onset smoking. The model was supported: the high-risk personality traits distinguished children engaging in any risky, maladaptive behavior from other children, and the smoking expectancies differentiated smokers from all other children. The relationship between personality tendencies to act rashly when experiencing intense positive or negative emotions and smoker status was partially mediated by expectancies for reinforcement from smoking. This model should be investigated longitudinally.

The association between affect amplification and urgency

BACKGROUND

Individuals lacking effective coping skills to manage aversive affective states are more likely to behave impulsively despite harmful long-term consequences. Urgency or the propensity to act rashly in response to negative affect is associated with a host of maladaptive behaviors. However, relatively little research has evaluated the impact of affective variables--such as emotion regulation--on urgency. Moreover, the role of urgency has not been examined in populations with mood and anxiety disorders, a group for whom maladaptive coping and avoidance behaviors are common responses to heightened affect. This study evaluated the association between urgency and three variables associated with the amplification of affect (anxiety sensitivity (AS), access to emotion regulation strategies, and distress intolerance).

METHODS

Data were collected from an unselected community sample (n = 297) and a clinical sample with a mood and/or anxiety disorder (n = 99).

RESULTS

Results from a linear regression indicated significant associations between both distress intolerance and emotion regulation strategies and urgency. AS was significantly associated with urgency when considered alone, but did not remain significant when considered in the context of an alternative measure of distress intolerance and emotion regulation.

CONCLUSIONS

These findings suggest that intolerance of distressing states and lack access to a repertoire of emotion regulation strategies are strongly associated with acting impulsively in response to negative affect. Treatment implications and future research directions are discussed.

Associations among types of impulsivity, substance use problems and neurexin-3 polymorphisms

BACKGROUND

Some of the genetic vulnerability for addiction may be mediated by impulsivity. This study investigated relationships among impulsivity, substance use problems and six neurexin-3 (NRXN3) polymorphisms. Neurexins (NRXNs) are presynaptic transmembrane proteins that play a role in the development and function of synapses.

METHODS

Impulsivity was assessed with the Barratt Impulsiveness Scale Version 11 (BIS-11), the Boredom Proneness Scale (BPS) and the TIME paradigm; alcohol problems with the Michigan Alcoholism Screening Test (MAST); drug problems with the Drug Abuse Screening Test (DAST-20); and regular tobacco use with a single question. Participants (n=439 Caucasians, 64.7% female) donated buccal cells for genotyping. Six NRXN3 polymorphisms were genotyped: rs983795, rs11624704, rs917906, rs1004212, rs10146997 and rs8019381. A dual luciferase assay was conducted to determine whether allelic variation at rs917906 regulated gene expression.

RESULTS

In general, impulsivity was significantly higher in those who regularly used tobacco and/or had alcohol or drug problems. In men, there were modest associations between rs11624704 and attentional impulsivity (p=0.005) and between rs1004212 and alcohol problems (p=0.009). In women, there were weak associations between rs10146997 and TIME estimation (p=0.03); and between rs1004212 and drug problems (p=0.03). The dual luciferase assay indicated that C and T alleles of rs917906 did not differentially regulate gene expression in vitro.

CONCLUSIONS

Associations between impulsivity, substance use problems and polymorphisms in NRXN3 may be gender specific. Impulsivity is associated with substance use problems and may provide a useful intermediate phenotype for addiction.

Recent advances in understanding the personality underpinnings of impulsive behavior and their role in risk for addictive behaviors

Impulsivity has been a widely explored construct, particularly as a personality-based risk factor for addictive behaviors. The authors review evidence that (a) there is no single impulsivity trait; rather, there are at least five different personality traits that dispose individuals to rash or impulsive action; (b) the five traits predict different behaviors longitudinally; for example, the emotion-based urgency traits predict problematic involvement in several risky behaviors and sensation seeking instead predicts the frequency of engaging in such behaviors; (c) the traits can be measured in preadolescent children; (d) individual differences in the traits among preadolescent children predict the subsequent onset of, and increases in, risky behaviors including alcohol use; (e) the traits may operate by biasing the learning process, such that high-risk traits make high-risk learning more likely, thus leading to maladaptive behavior; (f) the emotion-based urgency traits may contribute to compulsive engagement in addictive behaviors; and (g) there is evidence that different interventions are appropriate for the different trait structures.

The German multi-centre study on smoking-related behavior-description of a population-based case-control study

Tobacco smoking is a major risk factor for most of the diseases leading in mortality. Nicotine dependence (ND), which sustains regular smoking, is now acknowledged to be under substantial genetic control with some environmental contribution. At present, however, genetic studies on ND are mostly conducted in populations that have been poorly characterized with regard to ND-related phenotypes for the simple reason that the respective populations were not primarily collected to study ND. The German multi-centre study 'Genetics of Nicotine Dependence and Neurobiological Phenotypes', which is funded by the German Research Foundation (Deutsche Forschungsgemeinschaft, DFG) as part of the Priority Program (Schwerpunktprogramm) SPP1226: 'Nicotine-Molecular and Physiological Effects in CNS', was intended to overcome some of these inherent problems of current genetic studies of ND. The multi-centre study is a population-based case-control study of smokers and never-smokers (n = 2396). The study was unique worldwide because it was the first large-scale genetic study specifically addressing ND with the collection of a wide range of environmental, psychosocial and neurobiological phenotypes. Study design and major population characteristics with emphasis on risk prediction of smoking status were presented in this paper.

Impulsivity and symptoms of nicotine dependence in a young adult population

Introduction:

Impulsivity is widely regarded as a risk factor for drug dependence. However, its relationship with the symptomatology of nicotine dependence is poorly understood.

Methods:

To examine the nature of these relationships, we recruited 404 daily and occasional smokers from a predominantly student population and assessed the association between impulsivity, as measured by the Barratt Impulsiveness Scale (BIS-11) and several self-reported measures of smoking rate and nicotine dependence, including the Diagnostic and Statistical Manual’s (DSM-IV) criteria.

Results:

Overall, impulsivity was high throughout the entire sample but only modestly associated with nicotine dependence. Within the diagnostic criteria of nicotine dependence, two symptoms, which reflect automatized or habitual smoking, were most strongly associated with impulsivity.

Conclusion:

These data support recent human and animal work, which suggests that impulsivity is linked to the formation of habitual drug use, and are discussed within the framework of a dual-system account of drug seeking.