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Erath TG, Schulz JA, Hinton A, Mehta T, Reed DD, Tidey JW, Wagener TL, Villanti AC. Examining the predictive utility of behavioral economic demand indices and subjective effects on the actualized reinforcing value of menthol cigarettes and potential alternatives. Nicotine Tob Res 2024:ntae086. [PMID: 38616654 DOI: 10.1093/ntr/ntae086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Indexed: 04/16/2024]
Abstract
INTRODUCTION Considering recent and proposed bans on menthol cigarettes, methods are needed to understand the substitutability of potential menthol cigarette alternatives (MCAs) for menthol cigarettes. This study examined the prospective relationship between behavioral economic demand indices and subjective effects of usual brand menthol cigarettes (UBMC) and preferred MCAs with subsequent performance on a laboratory-based concurrent-choice task comparing UBMC and MCAs. METHODS Eighty participants who typically smoked menthol cigarettes completed this clinical lab study. After sampling each product, participants completed the cigarette purchase task (CPT) and modified cigarette evaluation questionnaire (mCEQ). Following one-week of substituting their preferred MCA for their UBMC, participants completed a 90-min concurrent-choice self-administration task comparing their UBMC and preferred MCA. Linear regression models explored associations between CPT demand indices and mCEQ subjective effects in the lab with subsequent response effort for UBMCs on the concurrent-choice task. RESULTS Three demand indices for UBMC were positively associated with UBMC response effort: Essential Value (EV; p=.02), Omax (p=.02), and breakpoint (p=.04). Four CPT demand indices for the preferred MCA significantly corresponded with UBMC response effort: EV (p=.03), Pmax (p=.04), Omax (p=.03), and breakpoint (p=.03). Subjective effects captured by the mCEQ were not associated with response effort. CONCLUSIONS Demand indices reflecting Persistence (i.e., sensitivity to escalating price) predicted effort to obtain UBMC puffs on the concurrent-choice task. Among this sample, the CPT captured information on the relative reinforcing value (i.e., addiction potential) of combustible tobacco products similar to the longer self-administration task. IMPLICATIONS In an ever-changing product market, assessing the reinforcing efficacy of menthol cigarettes and putative substitutes quickly and with validity is an important methodological tool for understanding abuse liability. Results suggest that behavioral economic demand indices of cigarette purchase task efficiently capture information on the relative reinforcing value of usual brand menthol cigarettes and plausible alternative tobacco products, similar to a 90-min in-laboratory self-administration task.
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Affiliation(s)
- Tyler G Erath
- Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont
| | - Jonathan A Schulz
- Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont
- Department of Psychology, University of Nevada Reno
| | - Alice Hinton
- Center for Tobacco Research, The Ohio State University James Comprehensive Cancer Center, Department of Internal Medicine, The Ohio State University
| | - Toral Mehta
- Center for Tobacco Research, The Ohio State University James Comprehensive Cancer Center, Department of Internal Medicine, The Ohio State University
| | - Derek D Reed
- Institutes for Behavior Resources, Baltimore, Maryland
| | - Jennifer W Tidey
- Department of Behavioral and Social Sciences, Brown University School of Public Health
| | - Theodore L Wagener
- Center for Tobacco Research, The Ohio State University James Comprehensive Cancer Center, Department of Internal Medicine, The Ohio State University
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Pulvers K, Tracy L, Novotny TE, Satybaldiyeva N, Hunn A, Romero DR, Dodder NG, Magraner J, Oren E. Switching people who smoke to unfiltered cigarettes: perceptions, addiction and behavioural effects in a cross-over randomised controlled trial. Tob Control 2023; 32:520-523. [PMID: 34799433 PMCID: PMC10977032 DOI: 10.1136/tobaccocontrol-2021-056815] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 11/03/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Behavioural research is needed to inform a ban on sales of filtered cigarettes that could reduce plastic waste due to discarded filters. This study reports on differences in perceptions, nicotine dependence and behaviour among participants in a cross-over randomised trial of filtered compared with unfiltered cigarettes. METHOD This proof-of-concept study involved 43 people who smoke filtered cigarettes (41.9% women, mean age 36.7 years). Participants were provided 2 weeks' supply of filtered cigarettes, 2 weeks of the same brand of unfiltered cigarettes and randomly assigned to starting conditions. Measures included the Modified Cigarette Evaluation Questionnaire; single-item cigarette perception questions; Fagerström Test of Nicotine Dependence; 7-day cigarette consumption, urinary cotinine and intention to quit. Analyses included linear and ordinal repeated measures mixed-effects models and paired t-tests. RESULTS Filtered cigarettes were perceived as better tasting, more satisfying, more enjoyable, less aversive, less harsh, less potent and less negatively reinforcing than unfiltered cigarettes. Filtered cigarettes were smoked at a higher rate during the trial than unfiltered cigarettes (p<0.05). There was no difference in cotinine, dependence or intention to quit between filtered versus unfiltered cigarette conditions (p>0.05). CONCLUSION People who smoke perceived unfiltered cigarettes as having greater nicotine effects and less desirable sensory effects than filtered cigarettes, and they smoked fewer of these during the trial. Although cotinine, dependence and intention to quit were similar for smoking unfiltered and filtered cigarettes in this small trial, results suggest that banning the sale of filtered cigarettes might make smoking less attractive overall to people who smoke. TRIAL REGISTRATION NUMBER NCT03749876.
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Affiliation(s)
- Kim Pulvers
- Department of Psychology, California State University San Marcos, San Marcos, California, USA
| | - LaRee Tracy
- School of Public Health, San Diego State University, San Diego, CA, USA
| | - Thomas E Novotny
- School of Public Health, San Diego State University, San Diego, CA, USA
| | | | - Adam Hunn
- School of Public Health, San Diego State University, San Diego, CA, USA
| | - Devan R Romero
- Department of Kinesiology, California State University San Marcos, San Marcos, California, USA
| | - Nathan G Dodder
- School of Public Health, San Diego State University, San Diego, CA, USA
- San Diego State University Research Foundation, San Diego, CA, USA
| | - Jose Magraner
- School of Public Health, San Diego State University, San Diego, CA, USA
| | - Eyal Oren
- School of Public Health, San Diego State University, San Diego, CA, USA
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Berry MS, Naudé GP, Johnson PS, Johnson MW. The Blinded-Dose Purchase Task: assessing hypothetical demand based on cocaine, methamphetamine, and alcohol administration. Psychopharmacology (Berl) 2023; 240:921-933. [PMID: 36869212 PMCID: PMC10006272 DOI: 10.1007/s00213-023-06334-6] [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: 07/28/2022] [Accepted: 01/30/2023] [Indexed: 03/05/2023]
Abstract
RATIONALE Behavioral economic drug purchase tasks quantify the reinforcing value of a drug (i.e., demand). Although widely used to assess demand, drug expectancies are rarely accounted for and may introduce variability across participants given diverse drug experiences. OBJECTIVES Three experiments validated and extended previous hypothetical purchase tasks by using blinded drug dose as a reinforcing stimulus, and determined hypothetical demand for experienced effects while controlling for drug expectancies. METHODS Across three double-blind, placebo-controlled, within-subject experiments, cocaine (0, 125, 250 mg/70 kg; n=12), methamphetamine (0, 20, 40 mg; n=19), and alcohol (0, 1 g/kg alcohol; n=25) were administered and demand was assessed using the Blinded-Dose Purchase Task. Participants answered questions regarding simulated purchasing of the blinded drug dose across increasing prices. Demand metrics, subjective effects, and self-reported real-world monetary spending on drugs were evaluated. RESULTS Data were well modeled by the demand curve function, with significantly higher intensity (purchasing at low prices) for active drug doses compared to placebo for all experiments. Unit-price analyses revealed more persistent consumption across prices (lower α) in the higher compared to lower active dose condition for methamphetamine (a similar non-significant finding emerged for cocaine). Significant associations between demand metrics, peak subjective effects, and real-world spending on drugs also emerged across all experiments. CONCLUSIONS Orderly demand curve data revealed differences across drug and placebo conditions, and relations to real-world measures of drug spending, and subjective effects. Unit-price analyses enabled parsimonious comparisons across doses. Results lend credence to the validity of the Blinded-Dose Purchase Task, which allows for control of drug expectancies.
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Affiliation(s)
- Meredith S Berry
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD, 21224, USA.
- Department of Health Education and Behavior, University of Florida, Yon Hall Room 031, Gainesville, FL, 32611, USA.
| | - Gideon P Naudé
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD, 21224, USA
| | - Patrick S Johnson
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD, 21224, USA
| | - Matthew W Johnson
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD, 21224, USA.
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Varshneya NB, Dunn KE, Grubb CJ, Okobi SI, Huhn AS, Bergeria CL. Can initial experiences with drugs predict future drug abuse risks? Exp Clin Psychopharmacol 2023; 31:186-193. [PMID: 35266780 PMCID: PMC9463404 DOI: 10.1037/pha0000559] [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] [Indexed: 02/03/2023]
Abstract
Initial experiences with drugs may influence an individual's motivations for continued use. This study evaluated the relationship between subjective effects elicited by an individual's first use of alcohol or cannabis, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) alcohol use disorder (AUD) or cannabis use disorder (CUD) severity, and behavioral economic demand for alcohol or cannabis. Self-reports of initial subjective effects associated with drugs were analyzed for N = 463 participants whose first substance use was either alcohol or cannabis. The likelihood that a particular subjective effect at the time of first use was associated with current AUD/CUD was assessed using ordinal logistic regression with subjective effects as predictors of DSM-5 severity. Behavioral economic demand was assessed using a hypothetical purchase task in which participants indicated their hypothetical consumption of alcohol or cannabis as a function of price. Significant associations were observed for initial subjective effects elicited by alcohol or cannabis and increased DSM-5 severity: (alcohol) relief (OR = 2.52 [95% CI 1.51-4.25], p = .0005) and (cannabis) energetic (OR = 2.31 [95% CI 3.27-55.5], p = .0004). The mean (± SEM) Pmax value for the alcohol subgroup endorsing relief ($96.22 ± $26.48) was significantly greater than the Pmax value for the alcohol subgroup not endorsing relief ($33.81 ± $12.93), t(237) = 2.276, p = .0237. These results suggest that the initial subjective effects associated with a given substance may predict the development and/or severity of substance misuse and substance use disorders (SUDs). These findings are consistent with anecdotal reports that persons with SUD feel energized by the use of substances whereas persons without SUD do not report experiencing such subjective effects upon first use. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Diaz D, Luo X, Hatsukami DK, Donny EC, O'Connor RJ. Cigarette filter ventilation, smoking topography, and subjective effects: A mediational analysis. Drug Alcohol Depend 2022; 241:109683. [PMID: 36379192 DOI: 10.1016/j.drugalcdep.2022.109683] [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: 03/25/2022] [Revised: 09/28/2022] [Accepted: 10/21/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Filter ventilation in cigarettes has been associated with alterations in smoking topography in order to compensate for the lower nicotine yields. Subjective effects of cigarettes include sensations, which can be affected by how a person smokes a cigarette. We look at smoking topography as a mediator in the relationship between filter ventilation levels and subjective effects. METHODS Smoking topography and subjective effects data come from the baseline usual cigarette brand laboratory visits of participants (N = 607) in a randomized clinical trial on reduced nicotine cigarettes. Conditional process analysis was done using PROCESS macro version 3.5 in SPSS. RESULTS There was a positive indirect effect of ventilation on satisfaction through total puff volume (0.004, 95% CI: 0.002, 0.007]) as well as ventilation on satisfaction through puff count then total puff volume, sequentially (0.001, 95% CI: [0.000, 0.003]). There was a positive indirect effect of ventilation on enjoyment through puff count for individuals less than 43 years of age (0.01, 95% CI: [0.002, 0.013]). There was a positive indirect effect of ventilation on enjoyment through total puff volume for individuals who smoke less than 14.33 cigarettes per day (0.009, 95% CI: [0.004, 0.015]). CONCLUSIONS We found preliminary evidence that topography measures (puff count and total puff volume), mediate the relationship between filter ventilation and specific subjective effects of smoking (satisfaction and enjoyment). Age and cigarettes smoked per day moderated these relationships. These results could have implications regarding filter ventilation restrictions and smokers' perceptions of using such cigarettes.
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Affiliation(s)
- Destiny Diaz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY 14263, USA.
| | - Xianghua Luo
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA; Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA.
| | - Dorothy K Hatsukami
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA; Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA.
| | - Eric C Donny
- Baptist Comprehensive Cancer Center and Department of Physiology and Pharmacology, Wake Forest University, Winston-Salem, NC, USA.
| | - Richard J O'Connor
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY 14263, USA. richard.o'
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Rose JE, Behm FM, Botts TL, Botts DR, Willette PN, Vocci F, McCarty J. Novel rapid-acting sublingual nicotine tablet as a cigarette substitution strategy. Psychopharmacology (Berl) 2022; 239:2853-2862. [PMID: 35768615 DOI: 10.1007/s00213-022-06171-z] [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: 03/14/2022] [Accepted: 05/26/2022] [Indexed: 10/17/2022]
Abstract
RATIONALE Current nicotine replacement products provide a much slower onset of nicotine delivery than cigarettes, and hence are only marginally effective at supplanting cigarette smoking. Therefore, more effective forms of nicotine replacement are needed. OBJECTIVES This initial investigation characterized the pharmacokinetic (PK) and subjective effects of a novel sublingual (SL) nicotine tablet designed to deliver nicotine more rapidly to the bloodstream of smokers. METHODS Study 1 (N = 6) characterized the pharmacokinetics of a 2 mg nicotine SL tablet in comparison to an FDA-approved, marketed 2 mg nicotine lozenge. Study 2 (N = 24) assessed subjective responses of smokers to a single use of a 1 mg and 2 mg SL tablet. RESULTS Study 1 found that the time to maximum blood nicotine concentrations was significantly shorter for the SL tablet (14 min) than for the lozenge (82 min), and the initial rate of nicotine absorption was higher (0.4 ng/mL*min vs. 0.0 ng/mL*min), supporting the hypothesis that the SL tablet delivered nicotine more rapidly. Study 2 found that participants reported immediate relief of nicotine withdrawal symptoms after tablet administration, and craving reduction after the 2 mg tablet approached the degree reported for their usual brands of cigarettes (4.2 vs. 4.6 on a 7-point scale). Other subjective responses showed the tablet to be an appealing alternative to smoking. CONCLUSIONS The novel SL tablet studied shows promise as a nicotine substitution strategy for tobacco harm reduction and smoking cessation treatment. Additional studies are warranted to further investigate the potential of this new approach.
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Affiliation(s)
- Jed E Rose
- Rose Research Center, 7240 ACC Blvd., Raleigh, NC, 27617, USA.
| | | | - Tanaia L Botts
- Rose Research Center, 7240 ACC Blvd., Raleigh, NC, 27617, USA
| | - David R Botts
- Rose Research Center, 7240 ACC Blvd., Raleigh, NC, 27617, USA
| | | | - Frank Vocci
- Friends Research Institute, 1040 Park Avenue, Suite 103, Baltimore, MD, 21201, USA
| | - John McCarty
- Nicotine BRST LLC, 8250 SW 27th Avenue, Ocala, FL, 34476, USA
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Karelitz JL, Perkins KA. Acute subjective sensory perceptions predict relative reinforcing effects of smoked nicotine. Addict Behav 2021; 117:106835. [PMID: 33517233 DOI: 10.1016/j.addbeh.2021.106835] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 12/30/2020] [Accepted: 01/11/2021] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Smoking is believed partially reinforcing via immediate sensory perceptions. Yet, unknown is whether a cigarette's relative reinforcing efficacy can be predicted by these perceptions and whether this relationship may vary due to constituents known to alter those perceptions. METHODS Sensory perceptions of acute smoking were examined as predictors of subsequent cigarette choice behavior. Also tested was whether nicotine content or menthol affected this relationship. Adult dependent smokers (N = 37) participated in five sessions comparing cigarettes varying in nicotine contents (NIC; 1.3, 2.3, 5.5, 11.2, and 17.4 mg/g), relative to the very lowest nicotine content, 0.4 mg/g (VLNC). Non-menthol (n = 17) and menthol (n = 20) cigarettes-matched on nicotine-were provided based on participant preference. One NIC was compared versus VLNC per session (single-blinded); NIC content order was randomized across sessions on separate days. Perceptions (e.g., "liking", "satisfying") were measured immediately after initial sampling of NIC or VLNC, followed by a validated puff-by-puff choice procedure to determine preference for each NIC versus VLNC. RESULTS NIC perceptions (difference from VLNC) and puff choices increased with nicotine. Menthol moderated associations between perceptions and nicotine; and between puff choices and nicotine. Perceptions were predictive of puff choice-greater magnitude of difference in perceptions between VLNC and NIC led to more NIC puff choices. When testing perceptions' prediction of puff choices, neither the main effect of menthol or interaction of Perceptions X Nicotine Condition were significant. CONCLUSIONS Consistent with assumed-but rarely tested-causes of smoking reinforcement, sensory perceptions from a cigarette predict its relative reinforcing efficacy.
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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.
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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
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Gades MS, Petersen A, Meier E, Lindgren BR, O'Connor RJ, Shields PG, Hatsukami D. The role of subjective responses in electronic cigarette uptake and substitution in adult smokers. Drug Alcohol Depend 2020; 212:107999. [PMID: 32409110 PMCID: PMC7315796 DOI: 10.1016/j.drugalcdep.2020.107999] [Citation(s) in RCA: 4] [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: 01/06/2020] [Revised: 03/19/2020] [Accepted: 03/28/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND While a majority of cigarette smokers who use electronic cigarettes (e-cigarettes) choose to continue using cigarettes, completely switching to e-cigarettes is necessary to reduce tobacco-related harm. Whether specific subjective responses to e-cigarettes are associated with extent of smoking reduction and complete switching from cigarettes to e-cigarettes is unclear. This study determined whether initial subjective responses to e-cigarettes related to the successful substitution of e-cigarettes for cigarettes and extent of cigarette and e-cigarette use. METHODS Adult cigarette smokers (N = 58) uninterested in quitting were asked to completely substitute their cigarettes with an e-cigarette (Vuse Solo) for 8 weeks. At week 1, subjective responses to e-cigarettes were measured using the Product Evaluation Scale and Drug Effects/Liking Survey. A Poisson regression examined whether any of these initial subjective responses were associated with smoke-free days, e-cigarette puffs, and cigarettes smoked between weeks 6 and 8 after adjustment for potential confounders. A logistic regression examined the relationship between subjective measures and exhaled carbon monoxide (CO) verified 7-day abstinence at week 8 after adjustment for potential confounders. RESULTS Following Holm's p-value adjustment, e-cigarette liking and desire were associated with increased e-cigarette use (adjusted p < 0.01) and decreased cigarette use (adjusted p < 0.05). Measures of psychological reward and drug liking were associated with 7-day abstinence, however this association was no longer significant following p-value adjustment. CONCLUSIONS Initial subjective responses were related to cigarette and e-cigarette use at weeks 6-8, but not smoke-free days or CO-verified 7-day abstinence.
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Affiliation(s)
- Mari S Gades
- University of Minnesota, Department of Psychology, 75 E. River Road, Minneapolis, MN, 55454, United States.
| | - Ashley Petersen
- University of Minnesota, School of Public Health Division of Biostatistics, 420 Delaware St. SE, Minneapolis, MN, 55455, United States
| | - Ellen Meier
- University of Wisconsin Stevens Point, Department of Psychology, Science Building, Stevens Point, WI, United States
| | - Bruce R Lindgren
- University of Minnesota, Department of Psychiatry and Masonic Cancer Center, 717 Delaware St SE, Minneapolis, MN, 55414, United States
| | | | | | - Dorothy Hatsukami
- University of Minnesota, Department of Psychiatry and Masonic Cancer Center, 717 Delaware St SE, Minneapolis, MN, 55414, United States
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Bergeria CL, Dolan SB, Johnson MW, Campbell CM, Dunn KE. Evaluating the co-use of opioids and cannabis for pain among current users using hypothetical purchase tasks. J Psychopharmacol 2020; 34:654-662. [PMID: 32267192 PMCID: PMC7246164 DOI: 10.1177/0269881120914211] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Cannabinoids may potentiate opioid analgesia and therefore could be used to reduce reliance on opioids for analgesia. AIMS The current study evaluated whether the concurrent availability of cannabis influences opioid consumption using a behavioral economic demand framework. METHODS An online survey assessed cannabis and opioid use frequency and dependence measures, pain severity, and demand for both cannabis and opioids alone and when concurrently available using hypothetical purchase tasks. Adults reporting current use of opioids for pain management and past 30-day cannabis exposure (N=155) completed two hypothetical purchase tasks in which only grams of cannabis or units of participants' index opioids were available for purchase, and two hypothetical tasks in which both were concurrently available and the price of one drug increased whereas the other was kept constant. Paired-sample t-tests compared the demand of each drug alone with when it was available concurrently with an alternative. RESULTS Demand intensity was significantly reduced and demand elasticity was significantly increased for both cannabis and opioids when the alternate commodity was available, although the reductions in cannabis consumption were more pronounced than they were for opioid consumption in the presence of the alternate commodity. CONCLUSIONS These data provide behavioral economic evidence that cannabis access may modestly reduce demand for opioids in persons who have pain. Additional clinical studies that evaluate the analgesic effects of cannabis and cannabis-opioid effects on pain are warranted.
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Affiliation(s)
- Cecilia L Bergeria
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Sean B Dolan
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Matthew W Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Claudia M Campbell
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Kelly E Dunn
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, USA
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Smith TT, Donny EC, Luo X, Allen AM, Carroll DM, Denlinger-Apte RL, Dermody SS, Koopmeiners JS, McClernon FJ, Pacek LR, Vandrey R, Hatsukami DK. The Impact of Gradual and Immediate Nicotine Reduction on Subjective Cigarette Ratings. Nicotine Tob Res 2019; 21:S73-S80. [PMID: 31867651 PMCID: PMC6939762 DOI: 10.1093/ntr/ntz158] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 08/24/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND A recent clinical trial showed that an immediate transition to very low nicotine content (VLNC) cigarettes, compared with a gradual transition, produced greater reductions in smoking behavior, smoke exposure, and dependence. However, there was less compliance with the instruction to smoke only VLNC cigarettes in the immediate versus gradual reduction condition. The goal of this study was to test whether nicotine reduction method alters subjective ratings of VLNC cigarettes, and whether subjective ratings mediate effects of nicotine reduction method on smoking behavior, smoke exposure, dependence, and compliance. METHODS This is a secondary analysis of a randomized trial conducted across 10 sites in the United States. Smokers (n = 1250) were randomized to either a control condition, or to have the nicotine content of their cigarettes reduced immediately or gradually to 0.04 mg nicotine/g of tobacco during a 20-week study period. Participants completed the modified Cigarette Evaluation Questionnaire (mCEQ). RESULTS After Week 20, the immediate reduction group scored significantly lower than the gradual reduction group on multiple subscales of the mCEQ (ps < .001). The Satisfaction subscale of the mCEQ mediated the impact of nicotine reduction method on smoke exposure, smoking behavior, dependence, compliance, and abstinence. Other subscales also mediated a subset of these outcomes. CONCLUSIONS An immediate reduction in nicotine content resulted in lower product satisfaction than a gradual reduction, suggesting that immediate reduction further reduces cigarette reward value. This study will provide the Food and Drug Administration with information about the impact of nicotine reduction method on cigarette reward value. IMPLICATIONS These data suggest that an immediate reduction in nicotine content will result in greater reductions in cigarette satisfaction than a gradual reduction, and this reduction in satisfaction is related to changes in smoking behavior and dependence.
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Affiliation(s)
- Tracy T Smith
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC
- Baptist Comprehensive Cancer Center and Department of Physiology and Pharmacology, Wake Forest University, Winston-Salem, NC
| | - Eric C Donny
- Baptist Comprehensive Cancer Center, Wake Forest University, Winston-Salem, NC
- Department of Physiology and Pharmacology, Wake Forest University, Winston-Salem, NC
| | - Xianghua Luo
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Alicia M Allen
- Department of Family and Community Medicine, University of Arizona, Tucson, AZ
| | - Dana M Carroll
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Rachel L Denlinger-Apte
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI
| | - Sarah S Dermody
- School of Psychological Science, Oregon State University, Corvallis, OR
| | - Joseph S Koopmeiners
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN
| | - F Joseph McClernon
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
| | - Lauren R Pacek
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
| | - Ryan Vandrey
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD
| | - Dorothy K Hatsukami
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN
- Department of Psychiatry, University of Minnesota, Minneapolis, MN
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