1
|
Xiong H, Ma F, Tang D, Liu D. Correlations among nicotine dependence, health-related quality of life, and depression in current smokers: a cross-sectional study with a mediation model. Front Psychiatry 2024; 15:1455918. [PMID: 39257561 PMCID: PMC11384568 DOI: 10.3389/fpsyt.2024.1455918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Accepted: 08/07/2024] [Indexed: 09/12/2024] Open
Abstract
Background Although the negative impact of smoking and health-related quality of life (HRQoL) on depression has been confirmed in various studies, There has been little exploration of how HRQoL mediates the relationship between smoking and depression. The purpose of the current study was to examine the relationship between smoking and depression in the Chinese current smokers with nicotine dependence and the mediating role of HRQoL. Methods A cross-sectional study named "Psychology and Behavior Investigation of Chinese Residents" was conducted from July 10 to September 15, 2021 in China. Nicotine dependence, HRQoL and depression were measured by Fagerstrom Test for Nicotine Dependence (FTND), the European Five Dimensional Five Level Health scale (EQ-5D-5L) and the 9-item Patient Health Questionnaire (PHQ-9) respectively. Information on age, gender, place of residence, household registration, education level, marital status, employment status, average family monthly income, drinking frequency, living status, BMI, multiple chronic conditions were also collected. Pearson's correlation test and logistic regression analysis were conducted to explore the association between nicotine dependence, HRQoL and depression and a mediation analysis was applied to explore the mediating effect of the HRQoL on this relationship. Results A total of 1,381 current smokers were included in the study. The participants showed a moderate level of nicotine dependence with a mean of 1.36(SD=1.50), a relatively high level of HRQoL scores (Mean=0.94, SD=0.13), and a depression score with a mean of 6.48(SD=6.09). Approximately 22.74% (314/1,381) of the participants were considered to indicate depression. In the univariable regression model, it was found that nicotine dependence was positively associated with depression (OR:1.094, 95%CI: 1.008-1.187), while HRQoL was negatively associated with depression (OR:0.011, 95%CI: 0.004-0.033). In the multivariable regression model, HRQoL was still notably associated with depression (OR:0.008, 95%CI: 0.002-0.027), however, the positive association was not observed between nicotine dependence and depression. The Pearson's correlation test demonstrated that nicotine dependence was negatively correlated with HRQoL(rs= -0.147, P<0.001) and HRQoL was negatively correlated with depression(rs= -0.275, P<0.001). In contrast, nicotine dependence was positively correlated with depression(rs= 0.136, P<0.001). Mediation analysis found that HRQoL moderated the relationship between nicotine dependence and depression with a mediating effect of 26.49%. Conclusions The findings support that nicotine dependence is positively associated with depression and HRQoL is negatively associated with depression in current smokers. HRQoL mediated the relationship between nicotine dependence and depression. The well-established imperative interventions aimed at promoting smoking cessation and improving quality of life may benefit for alleviation of depression in current smokers.
Collapse
Affiliation(s)
- Huali Xiong
- Department of Public Health, Health Commission of Rongchang District, Chongqing, China
- Center for Mental Health of Rongchang District, Chongqing, China
| | - Fengxun Ma
- Department of Public Health, The People's Hospital of Rongchang District, Chongqing, China
| | - Dayi Tang
- First Clinical College, Mudanjiang Medical College, Mudanjiang, Heilongjiang, China
| | - Daiqiang Liu
- Department of Hospital Information, The People's Hospital of Rongchang District, Chongqing, China
| |
Collapse
|
2
|
Park SK, Oh CM, Kim E, Ryoo JH, Jung JY. The longitudinal analysis for the association between smoking and the risk of depressive symptoms. BMC Psychiatry 2024; 24:364. [PMID: 38750466 PMCID: PMC11094926 DOI: 10.1186/s12888-024-05828-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 05/09/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Despite high smoking rate in people with depressive symptoms, there is ongoing debate about relationship between smoking and depressive symptoms. METHODS Study participants were 57,441 Korean men. We collected their baseline data between 2011 and 2012, and conducted follow-up from 2013 to 2019. They were categorized by smoking status (never: < 100 cigarettes smoking in life time, former: currently quitting smoking, and current smoker: currently smoking), smoking amount (pack/day and pack-year) and urine cotinine excretion. The development of depressive symptoms was determined in CES-D score ≥ 16. Cox proportional hazards model was used to analyze the multivariable-adjusted hazard ratio (HR) and 95% confidence intervals (CI) for depressive symptoms in relation to smoking status, smoking amount, and urine cotinine excretion. RESULTS During 6.7 years of median follow-up, the risk of depressive symptoms increased in order of never (reference), former (HR = 1.08, 95% CI: 1.01-1.15) and current smoker (HR = 1.24, 95% CI: 1.16-1.32). Among current smoker, the risk of depressive symptoms increased proportionally to daily smoking amount (< 1 pack; HR = 1.21, 95% CI: 1.13-1.29, and ≥ 1 pack; HR = 1.34, 95% CI: 1.23 - 1.45). This pattern of relationship was consistently observed for pack-year in former smoker and current smoker. Additionally, urine cotinine excretion was proportionally associated with the risk of depressive symptoms. CONCLUSION Exposure to smoking was associated with the increased risk of depressive symptoms. Dose dependent relationship was observed between smoking amount and the risk of depressive symptoms.
Collapse
Affiliation(s)
- Sung Keun Park
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chang-Mo Oh
- Departments of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Eugene Kim
- Department of Orthopaedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae-Hong Ryoo
- Departments of Occupational and Environmental Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Ju Young Jung
- Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea.
| |
Collapse
|
3
|
Wu Z, Yue Q, Zhao Z, Wen J, Tang L, Zhong Z, Yang J, Yuan Y, Zhang X. A cross-sectional study of smoking and depression among US adults: NHANES (2005-2018). Front Public Health 2023; 11:1081706. [PMID: 36794066 PMCID: PMC9922891 DOI: 10.3389/fpubh.2023.1081706] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 01/12/2023] [Indexed: 01/31/2023] Open
Abstract
Background The relationship between smoking and depression remains controversial. This study aimed to investigate the association between smoking and depression from three aspects: smoking status, smoking volume, and smoking cessation. Methods Data from adults aged ≥20 who participated in the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2018 were collected. The study gathered information about the participants' smoking status (never smokers, previous smokers, occasional smokers, daily smokers), smoking quantity per day, and smoking cessation. Depressive symptoms were assessed using the Patient Health Questionnaire (PHQ-9), with a score ≥10 indicating the presence of clinically relevant symptoms. Multivariable logistic regression was conducted to evaluate the association of smoking status, daily smoking volume, and smoking cessation duration with depression. Results Previous smokers [odds ratio (OR) = 1.25, 95% confidence interval (CI): 1.05-1.48] and occasional smokers (OR = 1.84, 95% CI: 1.39-2.45) were associated with a higher risk of depression compared with never smokers. Daily smokers had the highest risk of depression (OR = 2.37, 95% CI: 2.05-2.75). In addition, a tendency toward a positive correlation was observed between daily smoking volume and depression (OR = 1.65, 95% CI: 1.24-2.19) (P for trend < 0.05). Furthermore, the longer the smoking cessation duration, the lower the risk of depression (OR = 0.55, 95% CI: 0.39-0.79) (P for trend < 0.05). Conclusions Smoking is a behavior that increases the risk of depression. The higher the smoking frequency and smoking volume, the higher the risk of depression, whereas smoking cessation is associated with decreased risk of depression, and the longer the smoking cessation duration, the lower the risk of depression.
Collapse
Affiliation(s)
- Zhaoping Wu
- Department of Neurology, Zhuzhou Central Hospital, Zhuzhou, Hunan, China
| | - Qiang Yue
- Department of Neurology, First People's Hospital of Changde City, Changde, Hunan, China
| | - Zhen Zhao
- Department of Neurology, Zhuzhou Central Hospital, Zhuzhou, Hunan, China
| | - Jun Wen
- Department of Neurology, First People's Hospital of Changde City, Changde, Hunan, China
| | - Lanying Tang
- Department of Neurology, Zhuzhou Central Hospital, Zhuzhou, Hunan, China
| | - Zhenzhen Zhong
- Department of Neurology, First People's Hospital of Changde City, Changde, Hunan, China
| | - Jiahui Yang
- Department of Neurology, Zhuzhou Central Hospital, Zhuzhou, Hunan, China
| | - Yingpu Yuan
- Department of Critical Care Medicine, First People's Hospital of Changde City, Changde, Hunan, China
| | - Xiaobo Zhang
- Department of Neurology, First People's Hospital of Changde City, Changde, Hunan, China,*Correspondence: Xiaobo Zhang ✉
| |
Collapse
|
4
|
González-Roz A, Secades-Villa R, Aonso-Diego G, Weidberg S, Fernández-Hermida JR. No evidence of the clinical utility of single-item breakpoint to inform on tobacco demand in persons with substance use disorders. Psychopharmacology (Berl) 2021; 238:2525-2533. [PMID: 34031700 DOI: 10.1007/s00213-021-05875-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 05/10/2021] [Indexed: 11/30/2022]
Abstract
RATIONALE Behavioral economics has shown that single-item demand indicators are promising for capturing crucial aspects of nicotine reinforcement. It is suggested that brief breakpoint measures perform comparably to full-length demand indices in characterizing nicotine dependence; however, there have been no thorough assessments of their validity in clinical settings. OBJECTIVES This study aimed to assess the validity and accuracy of a single-item breakpoint in informing on tobacco demand. METHODS The sample consisted of 88 treatment-seeking smokers (% males = 70.5%) enrolled in substance use treatment. Participants provided data on smoking characteristics and completed the Fagerström Test for Nicotine Dependence, a single-item breakpoint measure and a 14-item cigarette purchase task (CPT). Hierarchical regressions were performed to compare the predictive capability of a single-item breakpoint and full-length tobacco demand indicators in determining nicotine addiction severity. RESULTS The single-item breakpoint was significantly correlated with all indices stemmed from the CPT and both latent factors (all r values = .250-.368). Neither the brief breakpoint nor the full-length breakpoint significantly predicted nicotine dependence. After controlling for sex and smoking variables, factor 2 [β = .565, p < .001] and its observed variables Omax [β = .279, p = .006], 1/elasticity [β = .340, p = .001], and intensity [β = .551, p < .001], robustly predicted nicotine dependence severity. CONCLUSIONS Our findings do not support the validity of single-item breakpoint measures for characterizing nicotine dependence in substance users. In a bid to foster translational research, brief demand measures capturing Omax, intensity, and elasticity should be developed.
Collapse
Affiliation(s)
- Alba González-Roz
- Department of Psychology, University of Oviedo, Plaza Feijóo s/n, 33003, Oviedo, Spain.
- Department of Psychology/Research Institute of Health Sciences (IUNICS), University of the Balearic Islands, Valldemossa Km. 7.5, E-07122, Palma de Mallorca, Spain.
| | - Roberto Secades-Villa
- Department of Psychology, University of Oviedo, Plaza Feijóo s/n, 33003, Oviedo, Spain
| | - Gema Aonso-Diego
- Department of Psychology, University of Oviedo, Plaza Feijóo s/n, 33003, Oviedo, Spain
| | - Sara Weidberg
- Department of Psychology, University of Oviedo, Plaza Feijóo s/n, 33003, Oviedo, Spain
| | | |
Collapse
|
5
|
Snell M, Harless D, Shin S, Cunningham P, Barnes A. A longitudinal assessment of nicotine dependence, mental health, and attempts to quit Smoking: Evidence from waves 1-4 of the Population Assessment of Tobacco and Health (PATH) study. Addict Behav 2021; 115:106787. [PMID: 33383566 PMCID: PMC7837319 DOI: 10.1016/j.addbeh.2020.106787] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/10/2020] [Accepted: 12/10/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Adult smokers with symptoms of any mental illness (AMI) are highly dependent on nicotine and may face additional difficulty quitting smoking. While there is evidence that adult smokers with AMI have high dependence, there is insufficient evidence regarding the unique role that AMI may play in moderating the relationship between dependence and cessation outcomes over time. METHODS 7290 current established adult smokers at Wave 1 (2013-2014) of the PATH Study also participated in data collection in Waves 2-4 (2014-2018). Linear probability models with individual-level random effects were fit to the data, modeling associations between AMI, nicotine dependence, and the 1) likelihood of achieving cessation during the study period, 2) making a cessation attempt within the previous 12 months, and 3) log of past 30-day total consumption of cigarettes. RESULTS Adults who experienced both AMI symptoms and high dependence were 4.7 percentage points (PP) less likely to achieve cessation at any point during the study period (p < 0.01) and smoked more cigarettes per month (β = 0.214, p < 0.05) than adults with AMI who were not highly dependent, despite being as likely to attempt to quit. Adults with AMI who were not highly dependent were 4.6 PP more likely to report a quit attempt and 1.6 PP more likely to achieve cessation than those with neither AMI nor high dependence. CONCLUSIONS Adults with AMI are particularly affected by the burden of tobacco use, in part because of the likely interaction between nicotine dependence and AMI. Tobacco control efforts that focus on this interplay may provide an opportunity to better target interventions for this vulnerable population.
Collapse
Affiliation(s)
- Morgan Snell
- Department of Health Behavior and Policy, Virginia Commonwealth University, 830 East Main St, Richmond 23219, VA, United States.
| | - David Harless
- Department of Economics, Virginia Commonwealth University, Richmond, VA, United States
| | - Sunny Shin
- School of Social Work, Virginia Commonwealth University, Richmond, VA, United States
| | - Peter Cunningham
- Department of Health Behavior and Policy, Virginia Commonwealth University, 830 East Main St, Richmond 23219, VA, United States
| | - Andrew Barnes
- Department of Health Behavior and Policy, Virginia Commonwealth University, 830 East Main St, Richmond 23219, VA, United States
| |
Collapse
|
6
|
Aston ER, Smith JE, DiBello AM, Farris SG. Effects of acute distress and tobacco cues on tobacco demand. Drug Alcohol Depend 2021; 221:108522. [PMID: 33582490 PMCID: PMC8026530 DOI: 10.1016/j.drugalcdep.2021.108522] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 11/18/2020] [Accepted: 12/24/2020] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Cigarette demand, or relative value, can be assessed via analysis of performance on a hypothetical behavioral economic cigarette purchase task (CPT). Substance purchase tasks are highly amenable to manipulation, namely, external stimuli, instructional changes, or acute stressors. In this regard, the current secondary analysis evaluates the role a novel, computerized stress induction paradigm, the Contextual-Frustration Intolerance Typing Task (C-FiTT), plays in eliciting varying levels of stress and resulting demand. METHOD Daily smokers (n = 484) completed the C-FiTT wherein they were randomly assigned to one of five distress conditions: combination of task difficulty (low or high difficulty) with neutral or withdrawal cues, and a neutral control group. Tobacco demand was assessed immediately following the distress task using the hypothetical CPT. RESULTS The C-FiTT distress-induction task significantly increased key cigarette demand indices, including price at maximum expenditure (Pmax) and first price where consumption was suppressed to zero (breakpoint). Moreover, demand increased with severity of C-FiTT condition, with the high-difficulty condition resulting in significantly higher breakpoint and Pmax, compared to other conditions. C-FiTT condition was not related to a significant increase in Omax, intensity, or elasticity. DISCUSSION The novel C-FiTT paradigm produced comparable effects on tobacco demand relative to in vivo withdrawal induction, indicating that the C-FiTT is a viable procedure by which to influence demand. Reduction of internal and external stressors may be effective in lowering motivation for tobacco. These results highlight the importance of state distress in tobacco demand, and offer a potential avenue for intervention.
Collapse
Affiliation(s)
- Elizabeth R Aston
- Brown University School of Public Health, Center for Alcohol and Addiction Studies, Providence, RI USA.
| | - Jacqueline E Smith
- Brown University School of Public Health, Center for Alcohol and Addiction Studies, Providence, RI USA
| | - Angelo M DiBello
- Brown University School of Public Health, Center for Alcohol and Addiction Studies, Providence, RI USA; City University of New York (CUNY), Brooklyn College, Brooklyn, NY USA
| | | |
Collapse
|
7
|
Reed DD, Naudé GP, Salzer AR, Peper M, Monroe-Gulick AL, Gelino BW, Harsin JD, Foster RNS, Nighbor TD, Kaplan BA, Koffarnus MN, Higgins ST. Behavioral economic measurement of cigarette demand: A descriptive review of published approaches to the cigarette purchase task. Exp Clin Psychopharmacol 2020; 28:688-705. [PMID: 31961164 PMCID: PMC8428680 DOI: 10.1037/pha0000347] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The cigarette purchase task (CPT) is a behavioral economic method for assessing demand for cigarettes. Growing interest in behavioral correlates of tobacco use in clinical and general populations as well as empirical efforts to inform policy has seen an increase in published articles employing the CPT. Accordingly, an examination of the published methods and procedures for obtaining these behavioral economic metrics is timely. The purpose of this investigation was to provide a review of published approaches to using the CPT. We searched specific Boolean operators (["behavioral economic" AND "purchase task"] OR ["demand" AND "cigarette"]) and identified 49 empirical articles published through the year 2018 that reported administering a CPT. Articles were coded for participant characteristics (e.g., sample size, population type, age), CPT task structure (e.g., price framing, number and sequence of prices; vignettes, contextual factors), and data analytic approach (e.g., method of generating indices of cigarette demand). Results of this review indicate no standard approach to administering the CPT and underscore the need for replicability of these behavioral economic measures for the purpose of guiding clinical and policy decisions. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Collapse
Affiliation(s)
- Derek D. Reed
- University of Kansas and Cofrin Logan Center for Addiction Research and Treatment, Lawrence, Kansas
| | - Gideon P. Naudé
- University of Kansas and Cofrin Logan Center for Addiction Research and Treatment, Lawrence, Kansas
| | - Allyson R. Salzer
- University of Kansas and Cofrin Logan Center for Addiction Research and Treatment, Lawrence, Kansas
| | | | | | - Brett W. Gelino
- University of Kansas and Cofrin Logan Center for Addiction Research and Treatment, Lawrence, Kansas
| | - Joshua D. Harsin
- University of Kansas and Cofrin Logan Center for Addiction Research and Treatment, Lawrence, Kansas
| | - Rachel N. S. Foster
- University of Kansas and Cofrin Logan Center for Addiction Research and Treatment, Lawrence, Kansas
| | - Tyler D. Nighbor
- Vermont Center on Behavior and Health, Burlington, Vermont, and University of Vermont
| | | | | | - Stephen T. Higgins
- Vermont Center on Behavior and Health, Burlington, Vermont, and University of Vermont
| |
Collapse
|
8
|
González-Roz A, Secades-Villa R, Weidberg S, García-Pérez Á, Reed DD. Latent Structure of the Cigarette Purchase Task Among Treatment-Seeking Smokers With Depression and Its Predictive Validity on Smoking Abstinence. Nicotine Tob Res 2020; 22:74-80. [PMID: 30371826 DOI: 10.1093/ntr/nty236] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 10/24/2018] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Research has recently shown that nicotine reinforcement is better characterized by a bifactorial latent structure: persistence (insensitivity to cigarette pricing) and amplitude (consumption at inexpensive prices). No study to date has examined its value as a predictor of abstinence. This study aimed to provide new evidence on the latent structure of the cigarette purchase task (CPT) in smokers with depressive symptoms and to examine whether the latent structure performs better as a predictor of continuous abstinence than do the individual indices. METHODS Participants (n = 205 smokers; 72% female: Beck Depression Inventory, Second Edition, M = 24.68, SD = 10.45) were randomized to two smoking cessation treatments for quitting smoking: cognitive behavioral treatment (CBT) or CBT + contingency management (CM). A principal-components analysis was conducted to examine the latent structure of the CPT and a set of regression models were performed to assess its predictive validity. RESULTS The principal-components analysis revealed a bifactorial solution, which was interpreted as persistence (breakpoint, Omax, Pmax, and elasticity) and psychological inertia (intensity and elasticity of demand). Evidence on the convergent validity was obtained through significant associations between the two latent factors and smoking variables (all r values ≥.17). Psychological inertia was negatively related to the number of days of continuous abstinence at the end of treatment regardless of the treatment condition [R2 = .038; F(2, 202) = 4.989, p = .008]. CONCLUSIONS Psychological inertia informs on which patients benefit less from smoking cessation treatments incorporating CM and CBT. Treatment components that affect individuals' excessive valuation of cigarettes might improve cessation outcomes. IMPLICATIONS This is the first attempt to examine the latent structure of the CPT in depressed smokers and to yield evidence on its predictive validity. A specific bifactorial solution exists for this population: persistence (breakpoint, Omax, Pmax, and elasticity) and psychological inertia (intensity and elasticity). Isolating demand indices and factors provides a high-resolution characterization of nicotine reinforcement for depressed smokers in that it informs on treatment response. Compared to the individual CPT indices, psychological inertia more effectively predicts which patients benefit most from either CM or CBT. Treatment components that affect individuals' excessive valuation of cigarettes (eg, episodic future thinking) should be integrated into smoking cessation treatments.
Collapse
Affiliation(s)
| | | | - Sara Weidberg
- Department of Psychology, University of Oviedo, Oviedo, Spain
| | | | - Derek D Reed
- Department of Applied Behavioral Science, University of Kansas, Lawrence, KS
| |
Collapse
|
9
|
González-Roz A, Jackson J, Murphy C, Rohsenow DJ, MacKillop J. Behavioral economic tobacco demand in relation to cigarette consumption and nicotine dependence: a meta-analysis of cross-sectional relationships. Addiction 2019; 114:1926-1940. [PMID: 31313403 PMCID: PMC7837316 DOI: 10.1111/add.14736] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 02/13/2019] [Accepted: 06/28/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND AIMS A cigarette purchase task (CPT) aims to characterize individual variation in the reinforcing value of tobacco. This meta-analysis estimated the associations between cigarette demand, tobacco consumption and nicotine dependence using this task. DESIGN A meta-analysis of cross-sectional studies identified by PubMed and PsycINFO databases was conducted. Fixed- and random-effects models were used. The study also examined the model used to derive elasticity of demand (exponential or exponentiated) as a potential moderator. Publication bias was assessed using 'fail-safe N', Begg-Mazumdar test, Egger's test, Tweedie's trim-and-fill approach and meta-regression of publication year with effect size. SETTING Studies from any setting that reported coefficient correlations on the tested associations. PARTICIPANTS Daily cigarette users (i.e. 5 to 38 cigarettes per day; n = 7649). MEASUREMENTS Cigarette consumption, nicotine dependence and five tobacco demand indicators: intensity (i.e. consumption at no cost), elasticity (i.e. sensitivity to rises in costs), Omax (maximum expenditure), Pmax (i.e. price at which consumption becomes elastic) and breakpoint (i.e. price at which consumption ceases). FINDINGS Twenty-three studies met inclusion criteria. All the CPT indices were significantly correlated with smoking behavior (rs = 0.044-0.572, Ps = 0.012-10-8 ). Medium-to-large effect size associations were present for intensity, Omax, and elasticity, whereas small effects were obtained for breakpoint and Pmax . Evidence of a moderating effect of the different elasticity modeling approaches was not present. There was limited evidence of publication bias. CONCLUSIONS All five demand indices derived from the cigarette purchase task by (CPT) were robustly associated with cigarette consumption and tobacco dependence. Of the demand indices, maximum expenditure, intensity and elasticity exhibited the largest magnitude associations.
Collapse
Affiliation(s)
- Alba González-Roz
- Faculty of Psychology, University of Oviedo
- Peter Boris Centre for Addictions Research, McMaster University & St. Joseph’s Healthcare Hamilton
| | - Jacob Jackson
- Peter Boris Centre for Addictions Research, McMaster University & St. Joseph’s Healthcare Hamilton
| | - Cara Murphy
- Center for Alcohol and Addiction Studies, Brown University
| | | | - James MacKillop
- Peter Boris Centre for Addictions Research, McMaster University & St. Joseph’s Healthcare Hamilton
- Center for Alcohol and Addiction Studies, Brown University
| |
Collapse
|
10
|
Zvorsky I, Nighbor TD, Kurti AN, DeSarno M, Naudé G, Reed DD, Higgins ST. Sensitivity of hypothetical purchase task indices when studying substance use: A systematic literature review. Prev Med 2019; 128:105789. [PMID: 31400376 PMCID: PMC6879840 DOI: 10.1016/j.ypmed.2019.105789] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 07/30/2019] [Accepted: 08/06/2019] [Indexed: 01/09/2023]
Abstract
Hypothetical Purchase Tasks (HPTs) simulate demand for a substance as a function of escalating price. HPTs are increasingly used to examine relationships between substance-related correlates and outcomes and demand typically characterized using a common battery of indices (Intensity, Omax, Pmax, Breakpoint, Elasticity). This review examines the relative sensitivity of the HPT indices. Reports were identified using the search term "purchase task" in PubMed and Web of Science. For inclusion, reports had to be original studies in English, examine relationships between HPT indices and substance-related correlates or outcomes, and appear in a peer-reviewed journal through December 2017. Indices were compared using effect sizes (Cohen's d) and the proportion of studies in which statistically significant relationships were observed. The search identified 1274 reports with 114 (9%) receiving full-text review and 82 (6%) meeting inclusion criteria. 41 reports examined alcohol, 34 examined cigarettes/nicotine products, and 10 examined other substances. Overall, statistically significant relationships between HPT indices and substance-related correlates and outcomes were most often reported for Intensity (88.61%, 70/79), followed by Omax (81.16%, 56/69), Elasticity (72.15%, 57/59), Breakpoint (62.12%, 41/66), and Pmax (48.08%; 25/52). The largest effect sizes were observed for Intensity (0.75 ± 0.04, CI 0.67-0.84) and Omax (0.64 ± 0.04, CI 0.56-0.71), followed by Elasticity (0.44 ± 0.04, CI 0.37-0.51), Breakpoint (0.30 ± 0.03, CI 0.25-0.36), and Pmax (0.25 ± 0.04, CI 0.18-0.33). Patterns were largely consistent across substances. In conclusion, HPTs can be highly effective in revealing relationships between demand and substance-related correlates and outcomes, with Intensity and Omax exhibiting the greatest sensitivity.
Collapse
Affiliation(s)
- Ivori Zvorsky
- Vermont Center on Behavior and Health, United States of America; Department of Psychiatry, University of Vermont, United States of America; Department of Psychological Science, University of Vermont, United States of America
| | - Tyler D Nighbor
- Vermont Center on Behavior and Health, United States of America; Department of Psychiatry, University of Vermont, United States of America
| | - Allison N Kurti
- Vermont Center on Behavior and Health, United States of America; Department of Psychiatry, University of Vermont, United States of America; Department of Psychological Science, University of Vermont, United States of America
| | - Michael DeSarno
- Department of Biomedical Statistics, University of Vermont, United States of America
| | - Gideon Naudé
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, United States of America
| | - Derek D Reed
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, United States of America
| | - Stephen T Higgins
- Vermont Center on Behavior and Health, United States of America; Department of Psychiatry, University of Vermont, United States of America; Department of Psychological Science, University of Vermont, United States of America.
| |
Collapse
|