Cognitive avoidance as a method of coping with a provocative smoking cue: the moderating effect of nicotine dependence

Factors influencing adolescent experimental and current smoking behaviors based on social cognitive theory: A cross-sectional study in Xiamen

Introduction

China has the largest youth population in the world. To better implement the Smoke-free School Initiative, this study aims to examine the protective and risk factors for different smoking behaviors (never smoked, experimental smoking, and current smoking) among school adolescents based on social cognitive theory.

Methods

This research was a secondary analysis of a cross-sectional survey of middle schools in Huli District of Xiamen, China. The final sample consisted of 1937 participants with an average age of 15.41 (SD = 1.64). Descriptive statistics were used to summarize the sociodemographic characteristics of the sample. Multivariate multinomial logistic regression analysis was performed using four models.

Results

Of the respondents, 1685 (86.99%) were never smokers, 210 (10.84%) were experimental smokers, and 42 (2.17%) were current smokers. Social norms, positive outcome expectations, anti-smoking self-efficacy, and attitudes toward control tobacco policies were associated with adolescents' smoking behaviors. The number of smoking family members, classmates smoking, the perception that smoking is cool and attractive, and attitudes toward control tobacco policies were the predictors of current smoking behavior (p < 0.05). In contrast, friends smoking and individual and social relationship motivation were associated with only experimental smoking (p < 0.05).

Discussion

The relationship of social norms, positive outcome expectations, anti-smoking self-efficacy, and attitudes toward control tobacco policies varied across smoking behaviors. Family, school, society and the government need to cooperate in prevention and intervention programs for adolescent smoking. The relationships between these factors and adolescents' different smoking behaviors needs to be further verified.

Self-efficacy modulates the neural correlates of craving in male smokers and ex-smokers: an fMRI study

The regulation of cue-induced craving for cigarettes is a key factor in smoking cessation. Outcomes of smoking cessation have been linked to self-efficacy, faith in one's own ability, in smokers. However, no study has examined the neural basis of self-efficacy during the control of craving. We examined whether self-efficacy can affect the neural response to smoking cues in smokers and ex-smokers using functional magnetic resonance imaging. During scanning, participants were instructed (1) to view smoking-related images passively, (2) to view the smoking-related images with a strategy focused on self-efficacy to control cue-induced craving or (3) to view neutral images. In smokers, the self-efficacy strategy significantly reduced self-reported craving. This strategy was related to increased activation in the rostral medial prefrontal cortex (rmPFC) and the pregenual anterior cingulate cortex in smokers compared with ex-smokers. Furthermore, smokers showed increased effective connectivity between rmPFC and hippocampus and between pregenual anterior cingulate cortex and parahippocampus gyrus when employing the self-efficacy strategy compared with ex-smokers. The magnitude of the rmPFC-hippocampus connectivity was positively correlated with self-reported self-efficacy. Our findings suggest that in smokers, self-efficacy is related to activation and connectivity in brain regions involved in regulating craving and self-assessment. The current study provides evidence for understanding the vunderlying cognitive and neurobiological mechanisms involved in the control of craving to smoke cigarettes.

Effects of smoking cues and argument strength of antismoking advertisements on former smokers' self-efficacy, attitude, and intention to refrain from smoking

INTRODUCTION

This study examines the impact of smoking cues employed in antismoking advertisements on former smokers. Previous findings indicate that visual smoking cues in antismoking advertisements with weak antismoking arguments can elicit smoking urges in smokers and undermine message effectiveness. This study extends these observations to former smokers asking whether smoking cues in antismoking advertisements influence former smokers' self-efficacy, attitudes, and intention to refrain from smoking, along with smoking urges and perceived message effectiveness.

METHODS

The study was a mixed 2 (smoking cues; present vs. absent) × 2 (argument strength [AS]; high vs. low) design where smoking cue was a between-subject factor and AS was a within-subject factor. Potential participants recruited via online ads were screened in a phone interview for their eligibility. A total of 105 former smokers (aged 21-65) participated in the study, which was conducted in a laboratory setting. Repeated measure ANOVA and MANOVA were used for the analyses.

RESULTS

The results showed that the presence of smoking cues in antismoking ads undermines former smokers' behavioral self-efficacy, attitude, and intention about smoking abstinence, which increased as AS for the ads increased. Former smokers' reports of smoking urge were not affected by smoking cues or AS. However, consistent with previous findings for smokers, the presence of cues weakened perceived message effectiveness of antismoking ads rated by former smokers.

CONCLUSIONS

The effect of smoking cues on former smokers' self-efficacy, attitude, and intention to refrain from smoking is problematic. Inclusion of smoking cues in antismoking ads should be undertaken only when accompanied by strong arguments.

Coping strategies for craving management in nicotine dependent patients

OBJECTIVE

The aim of this study was to investigate the association between the intensity of craving and the types of coping skills used by nicotine-dependent patients.

METHOD

This was an experimental study. The sample comprised 201 subjects, mean age 38.15 years. The participants were randomly divided into groups of zero, 30 and 60 minutes of nicotine abstinence. The following instruments were administered: the Chart of Sociodemographic Data, the Fagerström Test for Nicotine Dependence, the Questionnaire of Smoking Urges, and the Coping Strategies Inventory.

RESULTS

The most frequently used coping strategies are presented in descending order: accepting responsibility, self-control and distancing. There was a positive correlation between the confrontive coping strategy and the total score on the Questionnaire of Smoking Urges (rs = 0.146; p = 0.045) and the score on Factor 1 (rs = 0.165; p = 0.023).

CONCLUSION

The most intense craving can lead nicotine-dependent individuals to use confrontive coping strategies that make them unable to control their emotions or to face the situations of high risk of relapse. This finding demonstrates that the treatment of smokers should include psychological education about the pitfalls of using these types of strategy and should teach them new types of coping strategies for craving management.

Prolonged duration of craving, mood, and autonomic responses elicited by cues and imagery in smokers: Effects of tobacco deprivation and sex

Increases in self-reported craving and changes in autonomic functioning are reliably elicited when smokers are exposed to tobacco-related stimuli compared with neutral stimuli. However, few studies have reported the time course of cue-elicited craving or have directly compared the effectiveness of smoking cues versus imagery to evoke a craving response. In addition to these two issues, we investigated the influence of tobacco deprivation and sex on craving, mood, and autonomic responses. Sixty cigarette smokers (30 men, 30 women) were tested in two counterbalanced sessions, one after overnight tobacco deprivation and one during ad libitum smoking. At each session, participants were exposed to four randomized experimental trials: smoking imagery, neutral imagery, smoking cues, and neutral cues. Tobacco craving and mood were assessed repeatedly and physiological measures were recorded continuously for 30 min after imagery or cue exposure. Compared with neutral trials, smoking cues and smoking imagery reliably increased tobacco craving, negative mood, heart rate, and blood pressure and decreased positive mood ratings. Changes were observed immediately after cue and imagery presentation and remained unchanged for 30 min. Responding was greater in the nondeprived condition, and cues elicited more robust responding than imagery for most measures. Women responded more robustly to smoking cues only in the nondeprived condition, whereas imagery evoked greater responses in men during both conditions. These findings provide new data on the time course, magnitude, and tobacco deprivation effects on elicited craving. Sex differences were dependent on stimulus type and deprivation condition.

What underlies appraisals? Experimentally testing a Knowledge-and-Appraisal Model of Personality Architecture among smokers contemplating high-risk situations

We tested a theoretical model of personality structures underlying patterns of intra-individual variability in contextualized appraisals. The KAPA (Knowledge-and-Appraisal Personality Architecture) model was tested experimentally among smokers appraising their efficacy to resist the urge to smoke in high-risk situations. In a novel design, we assessed self-knowledge and situational beliefs idiographically and employed cognitive priming to manipulate the accessibility of self-knowledge experimentally. The results confirmed the unique KAPA-model prediction that priming would affect appraisals in a contextualized manner. Priming positively valenced self-knowledge enhanced self-efficacy appraisals specifically within that subset of situations that were relevant to the primed knowledge. The results were consistent with the hypothesis that systems of self- and situational knowledge underlie consistency and variability in appraisals.

Values and beliefs about consequences related to smoking among pregnant and non-pregnant women

The purpose of the study was to test a model based on the product of value and belief, called expected utility (EU), on the addictive behaviour of smoking. A total of 40 pregnant and 40 non-pregnant women over a period of 2 weeks performed judgements on values and beliefs about consequences related to smoking for the conditions of continuing and stopping smoking. There were no differences between pregnant and non-pregnant women in the EU of smoking. Differences in expected utility between the conditions of continuing and stopping smoking were larger for health consequences compared with psychological and social consequences and consequences related to pregnancy. Expected utility gives a good description of judgements over time. Values as well as beliefs related to health consequences should be stressed in smoking cessation programmes, especially among pregnant women.

Smoking as a decision among pregnant and non-pregnant women

OBJECTIVES

The purpose was to examine values and beliefs related to smoking, and to test the validity of a decision model based on the product of the value of smoking-related events and states, and the belief that these will occur, (in decision research labeled Expected Utility, or EU).

METHODS

Over a two-week period eighty women, divided into subgroups consisting of pregnant vs. non-pregnant women, and those intending vs. those not intending to quit smoking, performed evaluations of values and beliefs for the two conditions of quitting and not quitting smoking.

RESULTS

For both pregnant and non-pregnant women expected utility of smoking was negative. Of all the four groups pregnant women not intending to quit smoking estimated the expected utility of smoking as least negative.

CONCLUSIONS

A decision analytic approach is applicable to describe the addictive behavior of smoking. Values as well as beliefs about smoking should be stressed in smoking cessation programs, especially among pregnant women.

Evaluating social-cognitive mechanisms that regulate self-efficacy in response to provocative smoking cues: an experimental investigation

Smokers' self-efficacy appraisals strongly predict smoking outcomes. However, the cognitive structures that regulate smokers' self-efficacy appraisals have not yet been identified. Knowledge of such structures could assist in designing treatments that target self-efficacy appraisals to improve smoking outcomes. This study evaluated whether 2 abstinence-related self-schemas, the abstainer ideal- and abstainer ought-possible selves, regulated self-efficacy to resist smoking when smokers were exposed to provocative smoking cues. Craving responses to the cues were a secondary outcome. Cognitively priming both of these abstainer selves increased self-efficacy and decreased craving compared with when a smoking-related self-schema was cognitively primed under the same provocative cue conditions. Higher levels of self-efficacy were consistently associated with decreased craving. These results have both theoretical and clinical implications for smoking cessation.

Self-efficacy: A predictor for smoking cessation contemplators in Kuwaiti adults

The failure of most of the smoking cessation programs might be due to negligence of including self-efficacy as an imperative factor in changing many adverse behaviors such as smoking. This study investigates the role of self-efficacy as a predictor for smoking cessation contemplators and precontemplators in adult male Kuwaiti smoker employees. A sample of 657 Kuwaiti male smokers represented the target population. Factor analysis with varimax rotation to the self-efficacy 16-items scale revealed four essential factors-mood changes, relaxation, stress, and self-image-for smoking urge in the studied population. Contemplators had significant higher mean self-efficacy total scores and Factor IV (self-image) subtotal scores than precontemplators. Stepwise multivariate logistic binary regression analysis illustrated that self-efficacy is the first predictor for contemplating smoking cessation followed by monthly income. Self-efficacy as a cognitive determinant should be considered to mediate improvement in the smoking cessation programs.

Imagery-induced tobacco craving: duration and lack of assessment reactivity bias

The duration of imagery-induced tobacco craving and whether craving responses are biased by repeated assessment (reactivity) was studied. Nonabstinent smokers (n = 40) either imagined a scene describing smoking urges or rested. They then either completed the Tobacco Craving Questionnaire (TCQ; S. J. Heishman, E. G. Singleton, & E. T. Moolchan, 2003) every minute for 15 min or completed it after imagery or rest (Minute 1) and 15 min later. TCQ scores were greater after imagery compared with rest and remained significantly elevated at Minute 15. There was no evidence that TCQ responses were affected by repeated measurement. These data suggest that imagery-induced craving can persist for at least 15 min and that craving responses are not biased by assessment reactivity.

Pregnant and nonpregnant smokers attitude toward smoking

OBJECTIVES

The purpose was to study changes in attitude toward smoking over a relatively short span of 14 days after an initiation period during which period 40 women had decided to quit smoking and maintaining abstinence during their participation in the study. In the study were also included 40 women still smoking.

METHODS

Eighty women participated in the study, with twenty in each group formed by the variables pregnancy/nonpregnancy and wishing to quit smoking/not wishing to quit smoking. The women were for each day (i.e., Days 1-7 and 14) asked to respond to the question 'How do you like smoking?' reflecting the participants' general attitude toward smoking.

RESULTS

The main effects were decreased liking of smoking across time and across all groups, with an overall less liking in those who quit. This less liking did not differ across pregnancy status. There was only small effect for time giving a more negative attitude toward smoking, not actual outcomes, which were already different at baseline and stayed that way throughout.

CONCLUSIONS

Motivational and psychological aspects have a larger impact on behavior change compared to physical variables like being pregnant or not.

Effect of different cue stimulus delivery channels on craving reactivity: comparing in vivo and video cues in regular cigarette smokers

Exposure to smoking cues reliably produces increases in craving compared to exposure to appropriately matched neutral cues. While different types of stimuli have been used as cue materials in such studies, the channel through which cues are delivered is not often varied in a systematic fashion in smoking research. This study compared the effect of exposure to active in vivo cues compared to two cues, matched for content and time, delivered via videotape on self-reported smoking craving. Results revealed that active in vivo cues produced the highest Craving ratings. followed next by active video cues, and last by neutral video cues. These results suggest that craving is sensitive to stimulus delivery channel and that video presentation of smoking cues is a viable manipulation option in cue reactivity studies.