Impulsivity and tobacco product use over time

Impulsivity, Gambling-Related Cognitions, Cognitive Reappraisal and Gambling Behaviour in a Malaysian Sample

The relationships between cognitive reappraisal and problem gambling have been widely studied in different contexts. However, previous research findings remain inconsistent. This discrepancy might be attributed to the effects of interactions between cognitive reappraisal and other risk factors for problem gambling. Using moderation models, this study examined the association between impulsivity, gambling-related cognitive distortions, cognitive reappraisal and problem gambling in a sample of Malaysian gamblers. A total of 149 community gamblers (103 males, 46 females; mean age = 32.18) completed an online questionnaire. Problem gambling was measured with the South Oaks Gambling Screen (SOGS); cognitive reappraisal was measured using the Emotion Regulation Questionnaire-Cognitive Reappraisal Subscale (ERQ-CR); impulsivity was measured with the Short-UPPS-P Impulsive Behaviour Scale (SUPPS-P); and gambling-related cognitive distortions were measured using the Gambling Related Cognitions Scale (GRCS). The results revealed impulsivity and gambling-related cognitive distortions as significant predictors of problem gambling. At high levels, impulsivity and cognitive distortions are significant moderator variables that strengthen the association between cognitive reappraisal and problem gambling. These findings demonstrate that reappraisal skills could exacerbate problem gambling severity amongst impulsive or self-deceptive gamblers. Future research with larger and more representative samples is needed to validate and generalise these findings.

Longitudinal Examination of ENDS Use Among Young Adult College Students: Associations with Depressive Symptoms and Sensation Seeking

The present study examined (1) intraindividual changes in the frequency of electronic nicotine delivery systems (ENDS) use across young adulthood, 18 to 30 years old, and (2) if depressive symptoms and sensation-seeking tendencies, independently and in interaction with one another, were associated with these changes. Data were from a longitudinal study of students recruited from 24 Texas colleges and followed across six waves from fall 2015 to spring 2019. Participants (n = 1298; 36.3% non-Hispanic white, 56.3% women) were 18 to 26 years old in fall 2015 and all reported past 30-day ENDS use on at least one wave. We used growth curve modeling for an accelerated longitudinal design to examine if ENDS use frequency changed with increasing age and if depressive symptoms and sensation seeking, independently and in interaction with one another, were associated with these changes. Results showed that ENDS use frequency increased with increasing age. Depressive symptoms and sensation seeking were not independently associated with more frequent ENDS use or an accelerated increase in ENDS use frequency across increasing age. However, a significant two-way interaction indicated that young adults with elevated depressive symptoms used ENDS more frequently, but only when they had higher levels of sensation seeking. Findings indicate that young adults with depressive symptoms are a heterogeneous population and that those with high levels of sensation-seeking tendencies are at elevated risk for more frequent ENDS use. Interventions for young adults high in both sensation-seeking and depressive symptoms may help prevent and decrease ENDS use.

Gender differences in susceptibility to smoking among high school students

AIMS

To analyse the degree of susceptibility to smoking according to gender in students between 12 and 16 years of age and study the role of factors associated with gender and the extended index of susceptibility to smoking.

DESIGN

Cross-sectional study.

METHODS

Between November 2019 and March 2020, 12- to 16-year-old students were recruited from three educational centres in western Spain. Sociodemographic, environmental, social and personal variables were analysed. The value of the extended index of susceptibility to smoking was calculated, and the associations between the students' genders and smoking susceptibility were studied. Multinomial logistic regression was used to study associations between the independent variables and Expanded Susceptibility Index (ESSI) results. The roles of factors in this association were explored through mediation analysis.

RESULTS

A total of 364 students participated in the study (53% females). A total of 79.3% of females and 61.4% of males presented a medium-high level of the extended index of susceptibility. Females reported greater cigarette use (28% vs. 12.3%), hookah (19.9% vs 9.9%) and alcohol consumption (20.7% risk alcohol consumption). They obtained higher scores on the impulsivity scale in the urgency domain and the negative affect scale. Regardless of other factors, females showed more than double the smoking susceptibility (aOR: 2.05, 95% CI: 1.03-4.07, p = .041). Mediation analysis showed that gender had a total effect on the extended susceptibility index β = .023 (95% CI: 0.07-0.38, p = .01). The effect appeared to be mediated only by having smoking friends (0.08; 95% CI: 0.03-0.15, p = .001).

CONCLUSIONS

The greater susceptibility to smoking found in females may be related to a greater influence of smoking among friends.

IMPACT

These results show that smoking friends have a strong influence among adolescent females; therefore, developing preventive programmes with gender approaches aimed at reducing the influence of these environmental factors would be of interest.

Family Conflict and the Use of Conventional and Electronic Cigarettes in Adolescence: the Role of Impulsivity Traits

Adolescents’ use of tobacco is a worldwide problem due to the negative consequences on their physical and psychosocial development. One contextual variable related to tobacco use is family conflict. Previous research has suggested that the relationship between family conflict and tobacco use could be mediated by personality traits. The aim of this study is to examine the direct and indirect effects of family conflict on tobacco use (conventional and electronic cigarettes) through specific impulsivity constructs. The sample comprised 879 adolescents (56.4% male; M(SD)age = 14.25 (1.88) years). Multiple mediational analysis showed that there was no significant direct effect between family conflict and tobacco use; however, an indirect effect was found between family conflict and conventional cigarette use through sensation seeking and premeditation. With electronic cigarettes, a significant indirect effect was found via sensation seeking. These findings have implications in terms of prevention and treatment of tobacco use during adolescence.

Impulsivity-Related Personality Traits as Predictors of E-Cigarette Use among Young Adults over Time

Introduction: There has been rising concern about e-cigarette usage among teenagers and young adults. As knowledge about the adverse health effects of e-cigarettes accumulates, it is critical to identify factors that may increase risk of vaping initiation and frequency of use. One potential risk factor known to increase risk for other substance use is impulsivity. This study tested the hypothesis that impulsivity prospectively predicts vaping over time. Methods: Active e-cigarette users (n = 137; 51.8% male; Mean age 20 years at baseline) completed 8 waves of assessment over 21 months (2017-2020). The S-UPPS-P impulse behavior scale was used at baseline to measure impulsivity, and frequency of e-cigarette, cigarette, marijuana and alcohol use was calculated at each wave thereafter. Results: Vaping frequency declined over time [Incidence Rate Ratio (IRR) = 0.92]. There were significant, stable, positive associations between e-cigarette use and lack of premeditation (IRR = 1.06) and sensation seeking (IRR = 1.09). Vaping frequency was inversely associated with negative urgency (IRR = 0.95). Positive urgency and lack of perseverance were not associated with frequency of vaping. Conclusion: These findings suggest that young adults who have higher impulsivity of certain types may use e-cigarettes more frequently. Thus, vaping interventions for young adults should address these factors to ensure the greatest impact on public health.

Recommendations of the treatment-resistant depression expert center network for promoting tobacco smoking cessation based on the results from the real-world FACE-TRD national cohort

BACKGROUND

Tobacco smoking has been associated with suicide, impulsivity and depression in non-clinical populations with differences across sexes.

OBJECTIVE

To determine the role of tobacco smoking in Treatment-Resistant Depression (TRD) according to sex in a precision-medicine approach.

METHOD

The FACE-TRD cohort is a national cohort of TRD patients recruited in 13 resistant depression expert centers between 2014 and 2021 and followed-up at 6 months. A standardized one-day long comprehensive battery was carried out, including trained-clinician and patient-reported outcomes, and patients were reevaluated at 6 months on their smoking and psychiatric hospitalization outcomes.

RESULTS

355 TRD participants were included (222 women). The smoking rate was much higher in TRD women compared to the French general population (34% vs 24%) while it was comparable for men (approximately 29%). In multivariate analyses, compared to non-smoking women, female smokers had significantly increased number of lifetime psychiatric hospitalizations (standardized beta B = 0.232, p = 0.014) and electro-convulsive therapy (adjusted odds ratio (aOR) = 2.748, p = 0.005), increased suicidal ideations (aOR = 4.047, p = 0.031), history of suicide attempt (aOR = 1.994, p = 0.033), and increased impulsivity (B = 0.210, p = 0.006) and were more frequently treated by benzodiazepines (aOR = 1.848, p = 0.035) and third- or fourth-line TRD treatments (antipsychotics aOR = 2.270, p = 0.006, mood stabilizers aOR = 2.067 p = 0.044). Tobacco smoking at baseline was predictive of psychiatric hospitalization within 6 months in persistent smoking women (aOR = 2.636, p = 0.031). These results were not replicated in men, for whom tobacco smoking was only associated with increased clinician-rated and self-reported depressive symptoms (respectively B = 0.207, p = 0.022 and B = 0.184, p = 0.048). The smoking cessation rate at 6 months was higher in women than in men (12% vs. 7%). No patient was administered nicotine substitute or varenicline at the two timepoints.

INTERPRETATION

Combining these results and those of the literature, we recommend that active tobacco cessation should be promoted in TRD to improve depression, suicide and impulsivity especially in women. Female smokers appear as a specific population with heavier mental health outcomes that should be specifically addressed.

Longitudinal Associations of Substance Use Risk Profiles with the Use of Alternative Tobacco Products and Conventional Smoking among Adolescents

Although personality is associated with the onset of substance use (i.e., conventional smoking, alcohol use, and cannabis use) during adolescence, it is unclear whether personality traits are also associated with the onset of use of alternative tobacco products (ATPs), i.e., electronic cigarettes, shisha-pens, and water pipes. This study examines whether personality traits are associated with the onset of use of both conventional cigarettes and ATPs. Longitudinal data (baseline and 18-month follow-up) were used. The sample consisted of 1114 non-user adolescents (mean age = 13.36, SD = 0.93, 56% female) at baseline. To measure personality traits, the Substance Use Risk Profile Scale was used with four subscales: anxiety sensitivity, hopelessness, sensation seeking, and impulsivity. Structural equation models were conducted using Mplus 7.3. Results showed that both hopelessness and sensation seeking were associated with the onset of use of e-cigarettes and conventional cigarettes. Further, sensation seeking and impulsivity were associated with the onset of use of shisha-pens and water pipes. In conclusion, to prevent adolescents from using ATPs and/or conventional cigarettes, it is important to take their personality traits into account. More research on other (shared) risk factors and on more advanced stages of ATP use is needed before effective prevention strategies can be developed.

The role of affective urgency and emotion regulation in vaping susceptibility

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Both positive and negative urgency are correlated with emotion dysregulation.

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Emotion dysregulation mediated the effect of negative urgency but not positive urgency on a measure of vaping susceptibility.

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Measures to prevent e-cigarette use should target individuals with high negative urgency and focus on building emotion regulation skills.

Introduction

The prevalence of E-cigarette use is increasing along with concerns about the negative health effects of their use. Understanding the psychological constructs associated with susceptibility to beginning regular e-cigarette use may be helpful for prevention efforts. Factors such as emotion regulation (ER) and impulsivity, specifically urgency, have been significantly correlated with patterns of drug addiction in the past. With few prior studies linking ER and impulsivity factors with e-cigarette susceptibility, the present study aims to assess their relationship in predicting e-cigarette susceptibility in university never-smokers.

Method

Two hundred and twenty-five students were surveyed online using a questionnaire measuring difficulties in ER, impulsivity, and e-cigarette susceptibility. Path analysis was used to understand the relationship between positive and negative urgency and ER in predicting susceptibility to use.

Results

Results indicated that negative urgency was mediated by difficulties in ER to predict susceptibility while positive urgency was not significantly related to susceptibility.

Conclusion

The results of this study offer insights into the role affective traits contribute to susceptibility to e-cigarettes, potentially improving future addiction prevention research.

Preventing E-cigarette use among high-risk adolescents: A trauma-informed prevention approach

Exposure to childhood trauma increases the risk of tobacco use during adolescence. Recent studies have also reported potentially increased vulnerabilities to electronic cigarette (e-cigarette) use among youth with a history of childhood trauma. While empirical evidence supporting the relationship between childhood trauma and adolescent e-cigarette use is emerging, few effective preventive interventions are available to curb e-cigarette use among adolescent victims of childhood trauma. This article reviews current evidence with respect to how childhood trauma could increase risk for nicotine dependence and e-cigarette use in adolescent populations. Furthermore, this paper describes the development, design, and implementation of Rise Above (RA), a randomized, controlled trial of a trauma-informed, e-cigarette preventive intervention. Lessons learned are also discussed, including the challenges of implementing evidence-informed prevention work within communities vulnerable to traumatic events.

Systematic Review of Electronic Cigarette Use (Vaping) and Mental Health Comorbidity Among Adolescents and Young Adults

Introduction

The prevalence of electronic cigarette (EC) use has risen dramatically among adolescents and young adults (AYA, ages 12–26) over the past decade. Despite extensive established relationships between combustible cigarette use and mental health problems, the mental health comorbidities of EC use remain unclear.

Aims and Methods

To provide a systematic review of existing literature on mental health comorbidities of EC use among AYA. Database searches using search terms related to EC, AYA, and mental health identified 1168 unique articles, 87 of which prompted full-text screening. Multiple authors extracted data, applied the Effective Public Health Practice Project Quality Assessment Tool to evaluate the evidence, and synthesized findings.

Results

Forty articles met eligibility criteria (n = 24 predominantly adolescent and 16 predominantly young adult). Analyses yielded three main categories of focus: internalizing disorders (including depression, anxiety, suicidality, eating disorders, post-traumatic stress disorder), externalizing disorders (attention-deficit/hyperactivity disorder and conduct disorder), and transdiagnostic concepts (impulsivity and perceived stress). Significant methodological limitations were noted.

Conclusions

Youth EC use is associated with greater mental health problems (compared with nonuse) across several domains, particularly among adolescents. Because many existing studies are cross-sectional, directionality remains uncertain. Well-designed longitudinal studies to investigate long-term mental health sequelae of EC use remain needed.

Implications

Forty recent studies demonstrate a variety of mental health comorbidities with AYA EC use, particularly among adolescents. Mental health comorbidities of EC use generally parallel those of combustible cigarette use, with a few exceptions. Future EC prevention and treatment strategies may be enhanced by addressing mental health.

Examining the relationship between impulsivity-related personality traits and e-cigarette use in adults

AIMS

The present study aimed to investigate the relationship between impulsivity-related personality traits based on the UPPS-P model and e-cigarette use. The study used a sample of mainly European adults and compared e-cigarette users with non-smokers, cigarette smokers and dual users (those who currently smoke cigarettes and use e-cigarettes). Additionally, the relationship between impulsivity-related traits and frequency and intensity of e-cigarette use was examined, while the main reasons for e-cigarette use were also assessed.

METHODS

Participants were 720 adults (234 non-smokers, 164 smokers, 150 e-cigarette users, 172 dual users), who completed online questionnaires regarding sociodemographics, smoking/e-cigarette use behaviour, and impulsivity (UPPS-P scale).

RESULTS

Impulsivity-related traits did not significantly differentiate e-cigarette users from non-smokers. E-cigarette users showed lower levels of lack of perseverance than cigarette smokers, and they exhibited lower levels of negative and positive urgency than dual users. Negative urgency also significantly differentiated smokers and non-smokers, with smokers having higher levels of the trait. No significant results were found examining the relationship between the impulsivity-related traits and e-cigarette behaviour (number of days vaping per month, number of times vaping per day, and millilitres of e-liquid used per day). The main reason given for e-cigarette use was the perception that it is less harmful than cigarettes.

CONCLUSION

The present study found that trait impulsivity differentiated e-cigarette users from cigarette smokers and dual users, but did not differentiate e-cigarette users from non-smokers. Such findings are important to not only help us identify factors associated with e-cigarette use, but also to potentially inform treatment plans and decisions.

Examining the Psychometric Properties of the CEAC (Comparing e-Cigarette and Cigarette) Questionnaire and Its Usefulness as a Predictor of e-Cigarette Use

Background: Electronic cigarette (e-cigarette) use continues to rise, while there is conflicting evidence about the health effects of its use. As such, research is needed to better determine risks factors for e-cigarette use. Accumulating evidence suggests that attitudes toward e-cigarette use could be a potential risk factor for e-cigarette use. Objectives: This study sought to examine the psychometric properties of the Comparing E-cigarette And Cigarette questionnaire (CEAC), and to replicate a structural model of the relationship between impulsive-related personality traits and e-cigarette use mediated by positive attitudes toward e-cigarettes. Methods: Participants were 525 adults (mean age = 33.42, SD = 11.27) who completed the CEAC and UPPS-P (trait impulsivity) questionnaires online. Results: Confirmatory factor analysis of the CEAC replicated the a priori factor structure of the questionnaire reasonably well (χ²(df = 32) =172.85, CFI = 0.94, TLI = 0.91, RMSEA = 0.09 (0.08-0.11, 90% Confidence Interval, SRMR = 0.06). Structural path analysis showed that deficits in conscientiousness was significantly negatively related to e-cigarette attitudes (β = -0.20, p = .01), while urgency (β = 0.19, p = .018) showed a significant positive relationship to e-cigarette attitudes. E-cigarette users showed significantly more positive attitudes toward e-cigarettes than nonusers (β = 0.59, p < .001). No significant direct effects were found between impulsivity-related traits and e-cigarette use. Conclusions: The present study suggests that impulsivity-related traits and attitudes toward e-cigarettes are likely to be important risk factors for e-cigarette use. Future prospective and experimental studies should test if the causal model described in this study predicts risk for e-cigarette use, and whether this model could therefore be used to guide strategies for reducing risk for e-cigarette use.

Interaction Between Smoking and Internet Gaming Disorder on Spontaneous Brain Activity

Converging lines of evidence indicates that smoking and internet gaming disorder (IGD) affect spontaneous brain activity, respectively. However, little is known about whether these two factors work together on the human brain. In this study, we investigated the interaction between smoking and IGD on local spontaneous brain activity using amplitude of low-frequency fluctuation (ALFF) based on resting-state fMRI (rs-fMRI). Forty-six cigarette smokers, 38 IGD individuals, 34 participants with both IGD and cigarette smoking (IGD-Smoking), and 60 healthy individuals involved in the study. Voxel-wise analysis of covariance of ALFF revealed that there were significant interactions between IGD by smoking in the right medial pre-frontal cortex (MPFC)/ventral striatum, bilateral cerebellar, and visual-related regions as well as the left temporal gyrus. In the right MPFC/ventral striatum and left temporal gyrus, ALFF in smoking group was significantly higher than healthy group while there were no significant ALFF differences between IGD-Smoking group and IGD group. While in the bilateral cerebellar and visual-related regions, ALFF in the smoking group was significantly lower than healthy group while ALFF in IGD-Smoking group did not show significant difference with IGD group. In addition, in the smoking group, ALFF of the right MPFC/ventral striatum was associated positively with anxiety and depression scores while the ALFF value in the smoking group had a trend toward negative correlation with SDS scores in the bilateral cerebellar and visual-related regions. The ALFF value in the smoking group was associated positively with anxiety score in the left temporal gyrus. These findings indicate that smoking and IGD interacted with each other in the human brain. Our results, in terms of spontaneous brain activity, may imply the fact that IGD people are more tended to get smoking. Moreover, it is possible to predict that smokers may be more easily to get internet addiction than healthy people.