1
|
Lin CH, Wang CY, Chen KF, Chiu SP, Huang WT, Fan SY. The trajectory of smoking cessation after treatment and its related factors in Taiwan. Sci Rep 2024; 14:13270. [PMID: 38858540 PMCID: PMC11164964 DOI: 10.1038/s41598-024-64311-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 06/07/2024] [Indexed: 06/12/2024] Open
Abstract
Smoking has multiple negative effects on health; therefore, the Taiwanese government provides smoking cessation clinics to smokers. This study aimed to explore the trajectory of smoking cessation after smokers received treatment and the variables related to different trajectories. A retrospective longitudinal study was conducted, in which 735 adult smokers who received smoking cessation medications were recruited. The participants' demographic characteristics, chronic diseases, smoking characteristics, and cigarette dependence were collected from chart review. The amount of smoking was collected at baseline, and at 1 week, 1 month, 3 months, and 6 months after treatment. The Proc Traj procedure for group-based modeling and multinomial logistic regression were used for statistical analysis. Three trajectories were identified: early quitters (28.03%), late quitters (11.43%) and reducers (60.54%). Compared with early quitters, reducers were younger and had a higher probability of severe cigarette dependence. Compared with early quitters, late quitters had a higher number of taking smoking cessation medications. The findings revealed that approximately 60% of participants who received smoking cessation treatment could not completely quit smoking, and that age, number of medications taken, and cigarette dependence were significant predictors of different trajectories.
Collapse
Affiliation(s)
- Chia-Hong Lin
- Department of Family Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan
| | - Cing-Ya Wang
- Community Nursing Room, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan
| | - Kuan-Fen Chen
- Community Nursing Room, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan
| | - Shu-Pi Chiu
- Community Nursing Room, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan
| | - Wan-Ting Huang
- Clinical Medicine Research Center, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan
| | - Sheng-Yu Fan
- Institute of Gerontology, College of Medicine, National Cheng Kung University, No. 1 University Road, Tainan, 701, Taiwan.
| |
Collapse
|
2
|
Chirokoff V, Dupuy M, Abdallah M, Fatseas M, Serre F, Auriacombe M, Misdrahi D, Berthoz S, Swendsen J, Sullivan EV, Chanraud S. Craving dynamics and related cerebral substrates predict timing of use in alcohol, tobacco, and cannabis use disorders. ADDICTION NEUROSCIENCE 2023; 9:100138. [PMID: 38389954 PMCID: PMC10883348 DOI: 10.1016/j.addicn.2023.100138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
Background Patients treated for Substance Use Disorders exhibit highly fluctuating patterns of craving that could reveal novel prognostic markers of use. Accordingly, we 1) measured fluctuations within intensively repeated measures of craving and 2) linked fluctuations of craving to connectivity indices within resting-state (rs) brain regions to assess their relation to use among patients undergoing treatment for Alcohol, Tobacco and Cannabis Use Disorders. Method Participants -64 individuals with SUD for tobacco, alcohol, or cannabis and 35 healthy controls-completed a week of Ecological Momentary Assessment (EMA) during which they reported craving intensity and substance use five times daily. Before EMA, a subsample of 50 patients, and 34 healthy controls also completed resting-state (rs)-MRI acquisitions. Craving temporal dynamics within each day were characterized using Standard Deviation (SD), Auto-Correlation Factor (ACF), and Mean Successive Square Difference (MSSD). Absolute Difference (AD) in craving between assessments was a prospective prediction measure. Results Within-day, higher MSSD predicted greater substance use while controlling for mean craving. Prospectively higher AD predicted later increased substance use independently of previous use or craving level. Moreover, MSSD was linked to strength in five functional neural connections, most involving frontotemporal systems. Cerebello-thalamic and thalamo-frontal connectivity were also linked to substance use and distinguished the SUD from the controls. Conclusion To the best of our knowledge, this is the first study to indicate that instability in craving may be a trigger for use in several SUD types, beyond the known effect of craving intensity.
Collapse
Affiliation(s)
- Valentine Chirokoff
- University of Bordeaux, CNRS-UMR 5287 - Institut de Neurosciences Cognitives et Intégratives d'Aquitaine (INCIA), Bordeaux, France
- EPHE, PSL Research University, Paris, France
| | - Maud Dupuy
- University of Bordeaux, CNRS-UMR 5287 - Institut de Neurosciences Cognitives et Intégratives d'Aquitaine (INCIA), Bordeaux, France
| | - Majd Abdallah
- Bordeaux University, CNRS, Bordeaux Bioinformatics Center, IBGC UMR 5095, Bordeaux, France
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives-UMR 5293, CNRS, Univeristy of Bordeaux, Bordeaux, France
| | - Melina Fatseas
- University of Bordeaux, CNRS-UMR 5287 - Institut de Neurosciences Cognitives et Intégratives d'Aquitaine (INCIA), Bordeaux, France
- CH Charles Perrens, Bordeaux, France
- CHU Bordeaux, Bordeaux, France
| | - Fuschia Serre
- University of Bordeaux, CNRS UMR 6033- Sleep, Addiction and Neuropsychiatry (SANPSY), Bordeaux, France
| | - Marc Auriacombe
- CH Charles Perrens, Bordeaux, France
- University of Bordeaux, CNRS UMR 6033- Sleep, Addiction and Neuropsychiatry (SANPSY), Bordeaux, France
| | - David Misdrahi
- University of Bordeaux, CNRS-UMR 5287 - Institut de Neurosciences Cognitives et Intégratives d'Aquitaine (INCIA), Bordeaux, France
- CH Charles Perrens, Bordeaux, France
| | - Sylvie Berthoz
- University of Bordeaux, CNRS-UMR 5287 - Institut de Neurosciences Cognitives et Intégratives d'Aquitaine (INCIA), Bordeaux, France
- Institut Mutualiste Montsouris, Department of Psychiatry for Adolescents and Young Adults, Paris, France
| | - Joel Swendsen
- University of Bordeaux, CNRS-UMR 5287 - Institut de Neurosciences Cognitives et Intégratives d'Aquitaine (INCIA), Bordeaux, France
- EPHE, PSL Research University, Paris, France
| | - Edith V Sullivan
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Sandra Chanraud
- University of Bordeaux, CNRS-UMR 5287 - Institut de Neurosciences Cognitives et Intégratives d'Aquitaine (INCIA), Bordeaux, France
- EPHE, PSL Research University, Paris, France
| |
Collapse
|
3
|
Kim HC, Kaplan CM, Islam S, Anderson AS, Piper ME, Bradford DE, Curtin JJ, DeYoung KA, Smith JF, Fox AS, Shackman AJ. Acute nicotine abstinence amplifies subjective withdrawal symptoms and threat-evoked fear and anxiety, but not extended amygdala reactivity. PLoS One 2023; 18:e0288544. [PMID: 37471317 PMCID: PMC10358993 DOI: 10.1371/journal.pone.0288544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 06/29/2023] [Indexed: 07/22/2023] Open
Abstract
Tobacco smoking imposes a staggering burden on public health, underscoring the urgency of developing a deeper understanding of the processes that maintain addiction. Clinical and experience-sampling data highlight the importance of anxious withdrawal symptoms, but the underlying neurobiology has remained elusive. Mechanistic work in animals implicates the central extended amygdala (EAc)-including the central nucleus of the amygdala and the neighboring bed nucleus of the stria terminalis-but the translational relevance of these discoveries remains unexplored. Here we leveraged a randomized trial design, well-established threat-anticipation paradigm, and multidimensional battery of assessments to understand the consequences of 24-hour nicotine abstinence. The threat-anticipation paradigm had the expected consequences, amplifying subjective distress and arousal, and recruiting the canonical threat-anticipation network. Abstinence increased smoking urges and withdrawal symptoms, and potentiated threat-evoked distress, but had negligible consequences for EAc threat reactivity, raising questions about the translational relevance of prominent animal and human models of addiction. These observations provide a framework for conceptualizing nicotine abstinence and withdrawal, with implications for basic, translational, and clinical science.
Collapse
Affiliation(s)
- Hyung Cho Kim
- Department of Psychology, University of Maryland, College Park, Maryland, United States of America
- Neuroscience and Cognitive Science Program, University of Maryland, College Park, Maryland, United States of America
| | - Claire M Kaplan
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Samiha Islam
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Allegra S Anderson
- Department of Psychological Sciences, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Megan E Piper
- Center for Tobacco Research and Intervention and Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Daniel E Bradford
- School of Psychological Sciences, Oregon State University, Corvallis, Oregon, United States of America
| | - John J Curtin
- Department of Psychology, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Kathryn A DeYoung
- Department of Psychology, University of Maryland, College Park, Maryland, United States of America
| | - Jason F Smith
- Department of Psychology, University of Maryland, College Park, Maryland, United States of America
| | - Andrew S Fox
- Department of Psychology, University of California, Davis, California, United States of America
- California National Primate Research Center, University of California, Davis, California, United States of America
| | - Alexander J Shackman
- Department of Psychology, University of Maryland, College Park, Maryland, United States of America
- Neuroscience and Cognitive Science Program, University of Maryland, College Park, Maryland, United States of America
- Maryland Neuroimaging Center, University of Maryland, College Park, Maryland, United States of America
| |
Collapse
|
4
|
Rodriguez L, Read JP. Trauma cue-elicited emotional response profiles influence acute experiences of alcohol urge. J Behav Ther Exp Psychiatry 2022; 77:101772. [PMID: 36113909 DOI: 10.1016/j.jbtep.2022.101772] [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: 09/28/2021] [Revised: 05/24/2022] [Accepted: 07/29/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND AND OBJECTIVES Affective responses to trauma cues in individuals with posttraumatic stress (PTS) can evoke a desire to drink and may shed light on novel mechanisms of PTS-drinking. The present study aimed to (1) identify and characterize patterns of acute emotional responses (ER) to trauma cues and (2) examine how these patterns influence drinking urge. METHODS University students (N = 304; Mage = 19; 52.3% female) completed a structured clinical interview to confirm trauma history and PTS. At an experimental session one week later, participants completed a series of three trauma cue exposures. Affect and drinking urge were measured at baseline, after each cue exposure, and at experiment's end. RESULTS Latent profile analysis of ER yielded a five-profile solution: (1) Nonresponders (2) Low Responders (3) Moderate Responders (4) Resilient Responders and (5) High Responders. Profiles differed by trait neuroticism, PTS, and emotion dysregulation, with High Responders as the most severe group. In latent growth curve models, profiles significantly predicted alcohol urge trajectories in a graded pattern. High Responders, with the greatest affective intensity, showed the strongest urge. Duration of affect was also implicated with Resilient Responders, who had similar intensity but faster overall affective recovery time compared to High Responders, demonstrating lower mean levels of urge. LIMITATIONS External validity is limited. CONCLUSIONS Individual differences in ER to trauma cues are important for understanding alcohol urge. Findings can inform integrative treatments for PTS-drinking by targeting ER to shorten affective recovery to trauma reminders and reduce the need for alcohol use as a regulation strategy.
Collapse
Affiliation(s)
- Lauren Rodriguez
- Department of Psychology, State University of New York, University at Buffalo, USA; 386 Park Hall, Buffalo, NY, 14260-4110, USA.
| | - Jennifer P Read
- Department of Psychology, State University of New York, University at Buffalo, USA; 231 Park Hall, Buffalo, NY, 14260-4110, USA.
| |
Collapse
|
5
|
Paciorkowski M, Baty F, Pohle S, Bürki E, Brutsche M. Identification of smoking cessation phenotypes as a basis for
individualized counseling: An explorative real-world cohort
study. Tob Induc Dis 2022; 20:81. [PMID: 36212737 PMCID: PMC9502004 DOI: 10.18332/tid/152546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/30/2022] [Accepted: 08/01/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The rate of relapse in smokers attempting to quit is generally high. In order to maximize the chances of success, it is of interest to better understand the dynamic of lapse and relapse during smoking cessation. We hypothesized that specific behavioral patterns in tobacco consumption could predict the probability of quitting success and could open the possibility for a more targeted approach. The aim of the current study was to characterize clusters of quitting trajectories among participants involved in a smoking cessation program. METHODS In a retrospective real-world cohort study, data from 843 consecutive participants between March 2012 and December 2014 were collected. Data consisted of baseline information on demographics, smoking history and dependence level, as well as longitudinal data about tobacco consumption. The correlations among time series were characterized using principal coordinates analysis. Clusters were identified using k-means clustering and the average profile associated with each cluster was computed. The association between the participant’s baseline characteristics and clusters of tobacco consumption was assessed. RESULTS Four distinct clusters of transition phenotypes were identified based on tobacco consumption during the cessation phase: the long-term quitters (30%), the persistent smokers/reducers (44%), the short-term returners (16%) and the repeated try and failers (10%). Significant between-cluster differences were found in terms of baseline characteristics and smoking behavior during follow-up. CONCLUSIONS Meaningful clusters of quitting trajectories could be identified. Such specific behavioral patterns were useful for the application of personalized assistance needed to achieve successful and long-term cessation.
Collapse
Affiliation(s)
| | - Florent Baty
- Lung Center, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Susanne Pohle
- Lung Center, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Esther Bürki
- Lung Center, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Martin Brutsche
- Lung Center, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| |
Collapse
|
6
|
Nahum-Shani I, Potter LN, Lam CY, Yap J, Moreno A, Stoffel R, Wu Z, Wan N, Dempsey W, Kumar S, Ertin E, Murphy SA, Rehg JM, Wetter DW. The mobile assistance for regulating smoking (MARS) micro-randomized trial design protocol. Contemp Clin Trials 2021; 110:106513. [PMID: 34314855 PMCID: PMC8824313 DOI: 10.1016/j.cct.2021.106513] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/13/2021] [Accepted: 07/16/2021] [Indexed: 11/30/2022]
Abstract
Smoking is the leading preventable cause of death and disability in the U.S. Empirical evidence suggests that engaging in evidence-based self-regulatory strategies (e.g., behavioral substitution, mindful attention) can improve smokers' ability to resist craving and build self-regulatory skills. However, poor engagement represents a major barrier to maximizing the impact of self-regulatory strategies. This paper describes the protocol for Mobile Assistance for Regulating Smoking (MARS) - a research study designed to inform the development of a mobile health (mHealth) intervention for promoting real-time, real-world engagement in evidence-based self-regulatory strategies. The study will employ a 10-day Micro-Randomized Trial (MRT) enrolling 112 smokers attempting to quit. Utilizing a mobile smoking cessation app, the MRT will randomize each individual multiple times per day to either: (a) no intervention prompt; (b) a prompt recommending brief (low effort) cognitive and/or behavioral self-regulatory strategies; or (c) a prompt recommending more effortful cognitive or mindfulness-based strategies. Prompts will be delivered via push notifications from the MARS mobile app. The goal is to investigate whether, what type of, and under what conditions prompting the individual to engage in self-regulatory strategies increases engagement. The results will build the empirical foundation necessary to develop a mHealth intervention that effectively utilizes intensive longitudinal self-report and sensor-based assessments of emotions, context and other factors to engage an individual in the type of self-regulatory activity that would be most beneficial given their real-time, real-world circumstances. This type of mHealth intervention holds enormous potential to expand the reach and impact of smoking cessation treatments.
Collapse
Affiliation(s)
- Inbal Nahum-Shani
- Institute for Social Research, University of Michigan, Ann Arbor, MI, United States of America.
| | - Lindsey N Potter
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States of America
| | - Cho Y Lam
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States of America
| | - Jamie Yap
- Institute for Social Research, University of Michigan, Ann Arbor, MI, United States of America
| | - Alexander Moreno
- College of Computing, Georgia Institute of Technology, Atlanta, GA, United States of America
| | - Rebecca Stoffel
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States of America
| | - Zhenke Wu
- School of Public Health, University of Michigan, Ann Arbor, MI, United States of America
| | - Neng Wan
- Department of Geography, University of Utah, Salt Lake City, UT, United States of America
| | - Walter Dempsey
- School of Public Health, University of Michigan, Ann Arbor, MI, United States of America
| | - Santosh Kumar
- Department of Computer Science, University of Memphis, Memphis, TN, United States of America
| | - Emre Ertin
- Department of Electrical and Computer Engineering, The Ohio State University, Columbus, OH, United States of America
| | - Susan A Murphy
- Departments of Statistics & Computer Science, Harvard University, Cambridge, MA, United States of America
| | - James M Rehg
- College of Computing, Georgia Institute of Technology, Atlanta, GA, United States of America
| | - David W Wetter
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States of America
| |
Collapse
|
7
|
Cho D, Milbury K, Liao Y, Pettaway CA, Gregg JR, Li Y, McNeill LH. Study protocol: One plus one can be greater than two-Ecological momentary assessment for Black prostate cancer survivors and partners. PLoS One 2021; 16:e0255614. [PMID: 34370761 PMCID: PMC8351991 DOI: 10.1371/journal.pone.0255614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 07/20/2021] [Indexed: 11/18/2022] Open
Abstract
Given that romantic partners play a pivotal role in patients' survivorship period, integrating partners into survivorship care and broadening the focus of behavioral interventions from the individual (survivor) to the survivor-partner dyad may make healthy lifestyle behaviors more easily adopted and potentially maintained. Understanding the role of dyadic processes in Black survivors is particularly important because their lifestyle behaviors are poor and they have higher cancer-specific and all-cause mortality. To develop an effective dyadic lifestyle behavior intervention for Black survivors, micro-level investigations of interactions between Black survivors and their partners are necessary to pinpoint how survivors and partners facilitate or hinder each other's lifestyle behaviors in their natural, everyday lives. Accordingly, the objective of the present study is to fill these gaps using ecological momentary assessment to eventually develop more effective lifestyle interventions for Black prostate cancer (PCa) survivors and partners. A total of 120 dyads (i.e., 240 individuals) who are Black adult survivors diagnosed with non-metastatic PCa and their romantic partners will be asked to complete four assessments per day for 14 consecutive days on a smartphone after an initial retrospective survey. Over the 14 days, participants will be asked to complete a brief survey regarding their lifestyle behaviors (physical activity, sedentariness and eating behaviors), contexts of lifestyle behaviors, stress, and coping. Physical activity and sedentary behavior will be assessed via accelerometer; eating behaviors will be assessed with the Automated Self-Administered 24-hour Dietary Assessment Tool. After completing the 14-day assessment, participants will be asked to complete a final retrospective survey. Results of the proposed study will inform the rigorous development of a theory-based dyadic lifestyle intervention in this vulnerable survivorship population with the ultimate goal to improve overall survival and reduce morbidities (for survivors) and reduce cancer incidence (for partners).
Collapse
Affiliation(s)
- Dalnim Cho
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Kathrin Milbury
- Department of Behavioral Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Yue Liao
- Department of Kinesiology, The University of Texas at Arlington, Dallas, Texas, United States of America
| | - Curtis A. Pettaway
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Justin R. Gregg
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Yisheng Li
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Lorna H. McNeill
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| |
Collapse
|
8
|
Smith SS, Piper ME, Bolt DM, Kaye JT, Fiore MC, Baker TB. Revision of the Wisconsin Smoking Withdrawal Scale: Development of brief and long forms. Psychol Assess 2021; 33:255-266. [PMID: 33779203 PMCID: PMC8010906 DOI: 10.1037/pas0000978] [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] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The assessment of tobacco withdrawal is important for both research and clinical purposes. This study describes the psychometric development of a revised version of the 28-item Wisconsin Smoking Withdrawal Scale (WSWS; Welsch et al., Experimental and Clinical Psychopharmacology, 1999, 7, p. 354). Because the different contexts of use sometimes permit only brief assessment, this revision has produced both a brief and longer form using an updated pool of candidate items. For the revised Wisconsin Smoking Withdrawal Scale 2 (WSWS2), a candidate pool of 37 items was developed to measure nine putative withdrawal constructs. The stem and wording of items were revised as was the response scale. Data for psychometric analyses were derived from three smoking cessation randomized clinical trials conducted at the University of Wisconsin Center for Tobacco Research and Intervention. Dimensionality, internal consistency, and item characteristic analyses of the candidate items were conducted in a derivation sample to ascertain the factor structure and to identify items that could be used in the WSWS2 scales. Confirmatory factor analyses (CFAs) of reduced item sets and factor structure were conducted in two validation samples along with reliability and validity analyses. Derivation and validation sample analyses yielded a longer version of the WSWS2 (WSWS2-L) with 19 items and six subscales (Craving, Negative Affect, Hunger, Sleep, Restlessness, and Concentration) and a brief 6-item version (WSWS2-B). In validation sample analyses, both the WSWS2-L and the WSWS2-B demonstrated good reliability and validity as well as good fit in CFAs. The WSWS2-L and WSWS2-B possess improved construct coverage, fewer items, and other enhancements relative to the WSWS. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Collapse
Affiliation(s)
- Stevens S. Smith
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, WI
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Megan E. Piper
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, WI
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Daniel M. Bolt
- Department of Educational Psychology, University of Wisconsin-Madison, Madison, WI
| | - Jesse T. Kaye
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, WI
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
- William S. Middleton Memorial Veterans Hospital, Madison, WI
| | - Michael C. Fiore
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, WI
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Timothy B. Baker
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, WI
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
| |
Collapse
|
9
|
Conti AA, Tolomeo S, Steele JD, Baldacchino AM. Severity of negative mood and anxiety symptoms occurring during acute abstinence from tobacco: A systematic review and meta-analysis. Neurosci Biobehav Rev 2020; 115:48-63. [PMID: 32454051 DOI: 10.1016/j.neubiorev.2020.04.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 04/17/2020] [Accepted: 04/17/2020] [Indexed: 01/20/2023]
Abstract
This review was conducted with the following goals: To quantify the severity of mood and anxiety symptoms emerging during acute abstinence from tobacco (1). To explore sex differences related to the experience of specific symptoms (2). To investigate the early time course of symptoms (3). A meta-analysis was performed from 28 studies assessing mood and anxiety symptoms during the earliest phases of tobacco abstinence (up to 24 hrs post-quit) conducted from 1999 to 2019. Results revealed a significant (p < 0.0001) increase in 'anxiety', 'anger/irritability', 'depressed mood /sadness', and composite negative affect ('NA') in the 24 hours following smoking cessation. The largest effect size was detected for 'anxiety' (0.63). A qualitative analysis was performed to investigate sex differences and the time course of the specific symptoms. Results indicated that female smokers may experience worse mood symptoms compared to male smokers and that these symptoms may emerge within 3 hrs post-quit. Smoking cessation programs should implement sex-tailored interventions in order to improve their effectiveness, while future research should focus on alternative methods of nicotine administration.
Collapse
Affiliation(s)
- A A Conti
- University of St Andrews, School of Medicine, Division of Population and Behavioural Science, UK
| | - S Tolomeo
- National University of Singapore (NUS), Department of Psychology, Singapore
| | - J D Steele
- University of Dundee, School of Medicine, Division of Imaging Science and Technology, UK
| | - A M Baldacchino
- University of St Andrews, School of Medicine, Division of Population and Behavioural Science, UK.
| |
Collapse
|
10
|
Pang RD, Bello MS, Liautaud MM, Weinberger AH, Leventhal AM. Gender Differences in Negative Affect During Acute Tobacco Abstinence Differ Between African American and White Adult Cigarette Smokers. Nicotine Tob Res 2020; 21:1072-1078. [PMID: 29917091 DOI: 10.1093/ntr/nty122] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 06/12/2018] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Prior studies have found heightened negative affect following tobacco abstinence in women compared to men. However, experimental work addressing whether these findings generalize across racial groups is scarce. This study investigated whether race (non-Hispanic White vs. non-Hispanic African American) moderated gender differences in abstinence-induced negative affect and smoking behavior. METHODS Data were collected from 2010 to 2017 from two separate laboratory studies investigating experimentally manipulated tobacco abstinence. Following a baseline session, adult daily smokers (≥10 cigarettes/day; women: n = 297, 83.8% non-Hispanic African American; men: n = 492, 86.2% non-Hispanic African American) attended two counterbalanced lab sessions (16 hours abstinent vs. non-abstinent) and completed self-report measures of negative affect followed by a laboratory analogue smoking reinstatement task. RESULTS We found a gender × race interaction for several negative affect states and composite negative affect (βs = -.12 to -.16, Ps < .05). Analyses stratified by race showed that non-Hispanic White women compared to non-Hispanic White men exhibited greater abstinence-induced increases in anger, anxiety, and composite negative affect (βs = -.20 to -.29, Ps < .05). No significant gender differences in abstinence-induced negative affect were found for non-Hispanic African American smokers (βs = .00 to - .04, Ps > .05). CONCLUSION These findings suggest that negative affect during acute tobacco abstinence may be a clinically important and intervenable factor that can inform cessation interventions specifically for non-Hispanic White women smokers. Further empirical exploration of mechanisms underlying interactions of gender and race in tobacco addiction may benefit smoking cessation efforts in non-Hispanic African American women smokers. IMPLICATIONS This study contributes to a scant body of research examining the intersectional influence of race and gender on abstinence-induced negative affect-a central, motivationally prepotent feature of tobacco withdrawal. Using a laboratory-based design to experimentally manipulate abstinence, we provide evidence of a gender × race interaction on negative affect-related withdrawal. Our findings suggest that gender differences in abstinence-induced negative affect observed among non-Hispanic White smokers may not generalize to non-Hispanic African American smokers, highlighting the need for future work to address potential mechanisms underlying the racially discrepant impact of gender on affective tobacco withdrawal.
Collapse
Affiliation(s)
- Raina D Pang
- Department of Preventive Medicine, Keck School of Medicine at University of Southern California, Los Angeles, CA
| | - Mariel S Bello
- Department of Psychology, University of Southern California, Los Angeles, CA
| | - Madalyn M Liautaud
- Department of Preventive Medicine, Keck School of Medicine at University of Southern California, Los Angeles, CA
| | - Andrea H Weinberger
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, NY.,Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Adam M Leventhal
- Department of Preventive Medicine, Keck School of Medicine at University of Southern California, Los Angeles, CA.,Department of Psychology, University of Southern California, Los Angeles, CA
| |
Collapse
|
11
|
Woodcock EA, Zakiniaeiz Y, Morris ED, Cosgrove KP. Sex and the dopaminergic system: Insights from addiction studies. HANDBOOK OF CLINICAL NEUROLOGY 2020; 175:141-165. [PMID: 33008522 DOI: 10.1016/b978-0-444-64123-6.00011-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Sex differences are present in psychiatric disorders associated with disrupted dopamine function, and thus, sex differences in dopamine neurobiology may underlie these clinical disparities. In this chapter, we review sex differences in the dopaminergic system with a focus on substance use disorders, especially tobacco smoking, as our exemplar disorder. This chapter is organized into five sections describing sex differences in the dopaminergic system: (1) neurobiology, (2) role of sex hormones, (3) genetic underpinnings, (4) cognitive function, and (5) influence on addiction. In each section, we provide an overview of the topic area, summarize sex differences identified to date, highlight addiction research, especially clinical neuroimaging studies, and suggest avenues for future research.
Collapse
Affiliation(s)
- Eric A Woodcock
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, United States; Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States; Yale Positron Emission Tomography (PET) Center, Yale University, New Haven, CT, United States
| | - Yasmin Zakiniaeiz
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, United States; Yale Positron Emission Tomography (PET) Center, Yale University, New Haven, CT, United States
| | - Evan D Morris
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, United States; Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States; Department of Biomedical Engineering, Yale University, New Haven, CT, United States; Department of Biomedical Engineering, Yale University, New Haven, CT, United States; Invicro, LLC, New Haven, CT, United States
| | - Kelly P Cosgrove
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, United States; Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States; Yale Positron Emission Tomography (PET) Center, Yale University, New Haven, CT, United States.
| |
Collapse
|
12
|
Zakiniaeiz Y, Hillmer AT, Matuskey D, Nabulsi N, Ropchan J, Mazure CM, Picciotto MR, Huang Y, McKee SA, Morris ED, Cosgrove KP. Sex differences in amphetamine-induced dopamine release in the dorsolateral prefrontal cortex of tobacco smokers. Neuropsychopharmacology 2019; 44:2205-2211. [PMID: 31269510 PMCID: PMC6897943 DOI: 10.1038/s41386-019-0456-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 05/31/2019] [Accepted: 06/19/2019] [Indexed: 12/18/2022]
Abstract
Sex differences exist in the neurochemical mechanisms underlying tobacco smoking and smoking-related behaviors. Men tend to smoke for the reinforcing effects of nicotine, whereas women tend to smoke for stress and mood regulation, and have a harder time maintaining long-term abstinence. The mesolimbic dopamine (DA) system drives the reinforcing effects of tobacco smoking, whereas the mesocortical DA system-including the dorsolateral prefrontal cortex (dlPFC)-is critical for stress-related cognitive functioning and inhibitory control. This study is the first to investigate dlPFC D2/3-type receptor (D2R) availability and amphetamine-induced cortical DA release in smokers and nonsmokers. Forty-nine subjects (24 tobacco smokers (12 females) and 25 sex- and age-matched nonsmokers) participated in two same-day [11C]FLB457 positron emission tomography (PET) scans before and 3-hours after amphetamine administration (0.4-0.5 mg/kg, PO). D2R availability (non-displaceable binding potential; BPND) was measured pre- and post-amphetamine. The percent fractional change in BPND (%ΔBPND) between pre- and post-amphetamine, an index of DA release, was compared between male and female smokers and nonsmokers. Smokers showed significantly lower dlPFC D2R availability (BPND = 0.77 ± 0.05) than nonsmokers (BPND = 0.92 ± 0.04), p = 0.016, driven by males. Female smokers showed significantly less amphetamine-induced DA release in dlPFC (%ΔBPND = 1.9 ± 3.0%) than male smokers (%ΔBPND = 14.0 ± 4.3%), p < 0.005, and female nonsmokers (%ΔBPND = 9.3 ± 3.3%), p < 0.005. This study shows that in the prefrontal cortex, smokers have lower D2R availability than nonsmokers and that female vs. male smokers have a blunted amphetamine-induced DA release. These findings demonstrate that tobacco smoking differentially affects the mesocortical DA system in men vs. women, suggesting a potential target for gender-specific treatments.
Collapse
Affiliation(s)
- Yasmin Zakiniaeiz
- 0000000419368710grid.47100.32Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT USA ,0000000419368710grid.47100.32Yale Positron Emission Tomography (PET) Center, Yale University, New Haven, CT USA
| | - Ansel T. Hillmer
- 0000000419368710grid.47100.32Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT USA ,0000000419368710grid.47100.32Yale Positron Emission Tomography (PET) Center, Yale University, New Haven, CT USA ,0000000419368710grid.47100.32Department of Psychiatry, Yale University, New Haven, CT USA
| | - David Matuskey
- 0000000419368710grid.47100.32Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT USA ,0000000419368710grid.47100.32Yale Positron Emission Tomography (PET) Center, Yale University, New Haven, CT USA ,0000000419368710grid.47100.32Department of Psychiatry, Yale University, New Haven, CT USA
| | - Nabeel Nabulsi
- 0000000419368710grid.47100.32Yale Positron Emission Tomography (PET) Center, Yale University, New Haven, CT USA
| | - Jim Ropchan
- 0000000419368710grid.47100.32Yale Positron Emission Tomography (PET) Center, Yale University, New Haven, CT USA
| | - Carolyn M. Mazure
- 0000000419368710grid.47100.32Department of Psychiatry, Yale University, New Haven, CT USA ,0000000419368710grid.47100.32Women’s Health Research at Yale, Yale University, New Haven, CT USA
| | - Marina R. Picciotto
- 0000000419368710grid.47100.32Department of Psychiatry, Yale University, New Haven, CT USA
| | - Yiyun Huang
- 0000000419368710grid.47100.32Yale Positron Emission Tomography (PET) Center, Yale University, New Haven, CT USA
| | - Sherry A. McKee
- 0000000419368710grid.47100.32Department of Psychiatry, Yale University, New Haven, CT USA
| | - Evan D. Morris
- 0000000419368710grid.47100.32Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT USA ,0000000419368710grid.47100.32Yale Positron Emission Tomography (PET) Center, Yale University, New Haven, CT USA ,0000000419368710grid.47100.32Department of Psychiatry, Yale University, New Haven, CT USA ,0000000419368710grid.47100.32Department of Biomedical Engineering, Yale University, New Haven, CT USA
| | - Kelly P. Cosgrove
- 0000000419368710grid.47100.32Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT USA ,0000000419368710grid.47100.32Yale Positron Emission Tomography (PET) Center, Yale University, New Haven, CT USA ,0000000419368710grid.47100.32Department of Psychiatry, Yale University, New Haven, CT USA
| |
Collapse
|
13
|
Dziak JJ, Coffman DL, Reimherr M, Petrovich J, Li R, Shiffman S, Shiyko MP. Scalar-on-function regression for predicting distal outcomes from intensively gathered longitudinal data: Interpretability for applied scientists. STATISTICS SURVEYS 2019; 13:150-180. [PMID: 31745402 PMCID: PMC6863606 DOI: 10.1214/19-ss126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Researchers are sometimes interested in predicting a distal or external outcome (such as smoking cessation at follow-up) from the trajectory of an intensively recorded longitudinal variable (such as urge to smoke). This can be done in a semiparametric way via scalar-on-function regression. However, the resulting fitted coefficient regression function requires special care for correct interpretation, as it represents the joint relationship of time points to the outcome, rather than a marginal or cross-sectional relationship. We provide practical guidelines, based on experience with scientific applications, for helping practitioners interpret their results and illustrate these ideas using data from a smoking cessation study.
Collapse
Affiliation(s)
- John J Dziak
- The Methodology Center, The Pennsylvania State University, University Park, PA
| | - Donna L Coffman
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadelphia, PA
| | - Matthew Reimherr
- Department of Statistics, The Pennsylvania State University, University Park, PA
| | - Justin Petrovich
- Department of Business Administration, St. Vincent College, Latrobe, PA
| | - Runze Li
- Department of Statistics and The Methodology Center, The Pennsylvania State University, University Park, PA
| | - Saul Shiffman
- Department of Psychology, University of Pennsylvania, Pittsburgh, PA
| | | |
Collapse
|
14
|
Spears CA, Li L, Wu C, Vinci C, Heppner WL, Hoover DS, Lam C, Wetter DW. Mechanisms linking mindfulness and early smoking abstinence: An ecological momentary assessment study. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2019; 33:197-207. [PMID: 30829517 DOI: 10.1037/adb0000451] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Research has suggested that individuals with greater dispositional mindfulness (i.e., nonjudgmental, present-focused attention) are more likely to quit smoking, but the underlying mechanisms are unclear. This study investigated mechanisms linking mindfulness and early smoking abstinence using ecological momentary assessment (EMA). Participants were 355 smokers (33% Caucasian, 33% African American, 32% Latino; 55% female) receiving smoking cessation treatment. Mindfulness was assessed at baseline and on the quit date. For 4 days prequit and 1 week postquit, participants completed up to 4 EMAs per day indicating levels of negative affect (NA), positive affect (PA), smoking urges, and affect regulation expectancies. Mean, slope, and volatility were calculated for each prequit and postquit EMA variable. Associations among mindfulness, EMA parameters, and abstinence on the quit day and 7 days postquit, as well as indirect effects of mindfulness on abstinence through EMA parameters, were examined. Mindfulness predicted higher odds of abstinence in unadjusted but not covariate-adjusted models. Mindfulness predicted lower NA, higher PA, and lower affective volatility. Lower stress mediated the association between mindfulness and quit-day abstinence. Higher ratings of happy and relaxed, and lower ratings of bored, sad, and angry, mediated the association between mindfulness and postquit abstinence. Mindfulness appeared to weaken the association between craving and postquit abstinence. This study elucidates real-time, real-life mechanisms underlying dispositional mindfulness and smoking abstinence. During the early process of quitting smoking, more mindful individuals appeared to have more favorable emotional profiles, which predicted higher likelihood of achieving abstinence 1 week after the quit date. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Collapse
Affiliation(s)
| | - Liang Li
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center
| | - Cai Wu
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center
| | | | - Whitney L Heppner
- Department of Psychological Science, Georgia College & State University
| | - Diana S Hoover
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center
| | - Cho Lam
- Department of Population Health Sciences, University of Utah
| | - David W Wetter
- Department of Population Health Sciences, University of Utah
| |
Collapse
|
15
|
Pericot-Valverde I, Secades-Villa R, Gutiérrez-Maldonado J. A randomized clinical trial of cue exposure treatment through virtual reality for smoking cessation. J Subst Abuse Treat 2019; 96:26-32. [DOI: 10.1016/j.jsat.2018.10.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 09/24/2018] [Accepted: 10/15/2018] [Indexed: 01/22/2023]
|
16
|
Kendzor DE, Businelle MS, Waters AF, Frank SG, Hébert ET. Financial strain indirectly influences smoking cessation through withdrawal symptom severity. Drug Alcohol Depend 2018; 183:55-61. [PMID: 29227838 DOI: 10.1016/j.drugalcdep.2017.10.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 10/10/2017] [Accepted: 10/17/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Financial strain has an adverse impact on smoking cessation. However, the mechanisms through which financial strain influences cessation remain unclear. The purpose of the current study was to determine whether financial strain indirectly influenced smoking cessation through withdrawal symptom severity. METHODS Participants (N=139) were primarily Black (63.3%) and female (57.6%) adults enrolled in a smoking cessation program at a safety-net hospital. A self-report financial strain questionnaire was completed one week prior to the scheduled quit date, and the Wisconsin Smoking Withdrawal Scale (WSWS) was completed on the day after the scheduled quit date. Biochemically-verified 7-day point prevalence abstinence was assessed four weeks after the scheduled quit date. Adjusted mediation analyses were conducted using the PROCESS macro for SPSS to evaluate the indirect effects of financial strain on smoking cessation via post-quit withdrawal symptom severity. RESULTS Analyses indicated a significant indirect effect of financial strain on smoking cessation through total withdrawal symptom severity, B=0.027; 95% CI (0.003, 0.066); and specifically anger, B=0.035; 95% CI (0.008, 0.074), anxiety, B=0.021; 95% CI (0.001, 0.051), and sleep symptoms, B=0.015; 95% CI (0.005, 0.043). Greater pre-quit financial strain was associated with greater post-quit withdrawal symptom severity, which increased the likelihood of non-abstinence 4 weeks after the scheduled quit attempt. The direct effect of financial strain on smoking cessation was not significant in any of the mediation models. CONCLUSIONS Findings: suggest that withdrawal severity is an underlying mechanism through which financial strain influences smoking cessation.
Collapse
Affiliation(s)
- Darla E Kendzor
- The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Stephenson Cancer Center, Oklahoma Tobacco Research Center, 655 Research Parkway, Suite 400, Oklahoma City, OK, 73104, USA.
| | - Michael S Businelle
- The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Stephenson Cancer Center, Oklahoma Tobacco Research Center, 655 Research Parkway, Suite 400, Oklahoma City, OK, 73104, USA.
| | - Aaron F Waters
- Louisiana State University, Department of Psychology, 236 Audubon Hall, Baton Rouge, LA, 70803, USA.
| | - Summer G Frank
- The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Stephenson Cancer Center, Oklahoma Tobacco Research Center, 655 Research Parkway, Suite 400, Oklahoma City, OK, 73104, USA.
| | - Emily T Hébert
- The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Stephenson Cancer Center, Oklahoma Tobacco Research Center, 655 Research Parkway, Suite 400, Oklahoma City, OK, 73104, USA.
| |
Collapse
|
17
|
Heppner WL, Spears CA, Correa-Fernández V, Castro Y, Li Y, Guo B, Reitzel LR, Vidrine JI, Mazas CA, Cofta-Woerpel L, Cinciripini PM, Ahluwalia JS, Wetter DW. Dispositional Mindfulness Predicts Enhanced Smoking Cessation and Smoking Lapse Recovery. Ann Behav Med 2017; 50:337-47. [PMID: 26743533 DOI: 10.1007/s12160-015-9759-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Although mindfulness has been hypothesized to promote health behaviors, no research has examined how dispositional mindfulness might influence the process of smoking cessation. PURPOSE The current study investigated dispositional mindfulness, smoking abstinence, and recovery from a lapse among African American smokers. METHODS Participants were 399 African Americans seeking smoking cessation treatment (treatments did not include any components related to mindfulness). Dispositional mindfulness and other psychosocial measures were obtained pre-quit; smoking abstinence was assessed 3, 31 days, and 26 weeks post-quit. RESULTS Individuals higher in dispositional mindfulness were more likely to quit smoking both initially and over time. Moreover, among individuals who had lapsed at day 3, those higher in mindfulness were more likely to recover abstinence by the later time points. The mindfulness-early abstinence association was mediated by lower negative affect, lower expectancies to regulate affect via smoking, and higher perceived social support. CONCLUSIONS Results suggest that mindfulness might enhance smoking cessation among African American smokers by operating on mechanisms posited by prominent models of addiction.
Collapse
Affiliation(s)
- Whitney L Heppner
- Department of Psychological Science, Georgia College & State University, Milledgeville, GA, USA.
| | - Claire Adams Spears
- Department of Psychology, The Catholic University of America, Washington, DC, USA
| | | | - Yessenia Castro
- School of Social Work, The University of Texas at Austin, Austin, TX, USA
| | - Yisheng Li
- Department of Biostatistics, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Beibei Guo
- Department of Experimental Statistics, Louisiana State University, Baton Rouge, LA, USA
| | - Lorraine R Reitzel
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX, USA
| | - Jennifer Irvin Vidrine
- Stephenson Cancer Center and Department of Family & Preventive Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Carlos A Mazas
- Department of Health Disparities Research, UT MD Anderson Cancer Center, Houston, TX, USA
| | | | - Paul M Cinciripini
- Department of Behavioral Science, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Jasjit S Ahluwalia
- Department of Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA
| | - David W Wetter
- Department of Psychology, Rice University, Houston, TX, USA
| |
Collapse
|
18
|
Worley MJ, Heinzerling KG, Shoptaw S, Ling W. Volatility and change in chronic pain severity predict outcomes of treatment for prescription opioid addiction. Addiction 2017; 112:1202-1209. [PMID: 28164407 PMCID: PMC5461207 DOI: 10.1111/add.13782] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 11/14/2016] [Accepted: 02/01/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIMS Buprenorphine-naloxone (BUP-NLX) can be used to manage prescription opioid addiction among persons with chronic pain, but post-treatment relapse is common and difficult to predict. This study estimated whether changes in pain over time and pain volatility during BUP-NLX maintenance would predict opioid use during the taper BUP-NLX taper. DESIGN Secondary analysis of a multi-site clinical trial for prescription opioid addiction, using data obtained during a 12-week BUP-NLX stabilization and 4-week BUP-NLX taper. SETTING Community clinics affiliated with a national clinical trials network in 10 US cities. PARTICIPANTS Subjects with chronic pain who entered the BUP-NLX taper phase (n = 125) with enrollment occurring from June 2006 to July 2009 (52% male, 88% Caucasian, 31% married). MEASUREMENTS Outcomes were weekly biologically verified and self-reported opioid use from the 4-week taper phase. Predictors were estimates of baseline severity, rate of change and volatility in pain from weekly self-reports during the 12-week maintenance phase. FINDINGS Controlling for baseline pain and treatment condition, increased pain [odds ratio (OR) = 2.38, P = 0.02] and greater pain volatility (OR = 2.43, P = 0.04) predicted greater odds of positive opioid urine screen during BUP-NLX taper. Increased pain (IRR = 1.40, P = 0.04) and greater pain volatility [incidence-rate ratio (IRR) = 1.66, P = 0.009] also predicted greater frequency of self-reported opioid use. CONCLUSIONS Adults with chronic pain receiving out-patient treatment with buprenorphine-naloxone (BUP-NLX) for prescription opioid addiction have an elevated risk for opioid use when tapering off maintenance treatment. Those with relative persistence in pain over time and greater volatility in pain during treatment are less likely to sustain abstinence during BUP-NLX taper.
Collapse
Affiliation(s)
- Matthew J. Worley
- Department of Psychiatry, University of California, San Diego, San Diego, CA,Veterans Affairs San Diego Healthcare System, San Diego, CA
| | - Keith G. Heinzerling
- Department of Family Medicine, University of California, Los Angeles, Los Angeles, CA
| | - Steven Shoptaw
- Department of Family Medicine, University of California, Los Angeles, Los Angeles, CA
| | - Walter Ling
- Department of Psychiatry, University of California, Los Angeles, Los Angeles, CA
| |
Collapse
|
19
|
Zuo Y, Rabinovich NE, Gilbert DG. Negative affect subtypes and craving differentially predict long-term cessation success among smokers achieving initial abstinence. Psychopharmacology (Berl) 2017; 234:761-771. [PMID: 28028602 PMCID: PMC5309162 DOI: 10.1007/s00213-016-4509-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Accepted: 12/12/2016] [Indexed: 01/09/2023]
Abstract
OBJECTIVE This study aimed to examine the associations of individual trajectories of three types of negative affect (NA: anxiety, depression, and anger) and craving during a 44-day period of incentivized smoking abstinence period with cessation outcome at 3 months and at 1 year. METHODS Adult smokers (N = 140) completed questionnaire assessments of NA and craving during pre-quit baseline sessions and 15 postquit sessions over the 45 days of biochemically verified abstinence while on nicotine or placebo patch treatment. Growth curve and logistic regression analyses were used to examine the associations of trajectory parameters of the individual NA states and craving with the abstinence outcomes at 3 months and 1 year postquit. RESULTS Greater declines in anxiety, depression, and anger symptoms over the first 44 days of smoking cessation were predictive of higher odds of abstinence at both 3 months and 1 year. Moreover, the greater declines in anxiety and anger remained as significant predictors of abstinence at both time points, independent of the predictive ability of the trajectory profiles of craving. CONCLUSIONS The findings suggest that slower dissipation of NA, especially anxiety and anger, represents a greater risk for relapse to smoking beyond that predicted by craving during early abstinence. Thus, temporal profiles of the affective symptoms convey unique motivational significance in relapse. Reduction in NA during early abstinence may be a valid target for interventions to increase long-term cessation success rates particularly among individuals with refractory affective symptoms.
Collapse
Affiliation(s)
- Yantao Zuo
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA;
| | - Norka E. Rabinovich
- Department of Psychology, Southern Illinois University, Carbondale, IL 62901-6502; mail:
| | - David G. Gilbert
- Department of Psychology, Southern Illinois University, Mailcode 6502, Carbondale, IL 62901, USA. Phone: 1-618-453-3527; Fax: 1-618-453-3563;
| |
Collapse
|
20
|
Toward precision smoking cessation treatment II: Proximal effects of smoking cessation intervention components on putative mechanisms of action. Drug Alcohol Depend 2017; 171:50-58. [PMID: 28013097 PMCID: PMC5262527 DOI: 10.1016/j.drugalcdep.2016.11.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 11/08/2016] [Accepted: 11/22/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND Understanding how smoking cessation treatments exert their effects can inform treatment development and use. Factorial designs allow researchers to examine whether multiple intervention components affect hypothesized change mechanisms, and whether the affected mechanisms are related to cessation. METHODS This is a secondary data analysis of smokers recruited during primary care visits (N=637, 55% women, 87% white) who were motivated to quit. Participants in this fractional factorial experiment were randomized to one level of each of six intervention factors: Prequit Nicotine Patch vs None, Prequit Nicotine Gum vs None, Preparation Counseling vs None, Intensive In-Person Counseling vs Minimal, Intensive Phone Counseling vs Minimal, and 16 vs 8 Weeks of Combination Nicotine Replacement (nicotine patch+nicotine gum). Data on putative mechanisms (e.g., medication use, withdrawal, self-efficacy) and smoking status were gathered using daily assessments and during follow-up assessment calls. RESULTS Some intervention components influenced hypothesized mechanisms. Prequit Gum and Patch each reduced prequit smoking and enhanced prequit coping and self-efficacy. In-Person Counseling increased prequit motivation to quit, postquit self-efficacy, and postquit perceived intratreatment support. Withdrawal reduction and reduced prequit smoking produced the strongest effects on cessation. The significant effect of combining Prequit Gum and In-Person Counseling on 26-week abstinence was mediated by increased prequit self-efficacy. CONCLUSIONS This factorial experiment identified which putative treatment mechanisms were influenced by discrete intervention components and which mechanisms influenced cessation. Such information supports the combined use of prequit nicotine gum and intensive in-person counseling as cessation interventions that operate via increased prequit self-efficacy.
Collapse
|
21
|
Piper ME, Vasilenko SA, Cook JW, Lanza ST. What a difference a day makes: differences in initial abstinence response during a smoking cessation attempt. Addiction 2017; 112:330-339. [PMID: 27633341 PMCID: PMC5233552 DOI: 10.1111/add.13613] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 07/04/2016] [Accepted: 09/15/2016] [Indexed: 12/18/2022]
Abstract
AIMS To (1) identify distinct classes of smokers based on quit day withdrawal symptoms and (2) explore the relations between withdrawal classes and demographics, tobacco dependence, treatment and smoking outcomes. DESIGN Secondary data analysis of participants (n = 1504) in a randomized double-blind placebo-controlled multi-site smoking cessation trial who provided ecological momentary assessments of withdrawal symptoms on their quit day. Participants received smoking cessation counseling and were randomized to receive placebo or one of five active pharmacotherapies. SETTING Research offices in Madison and Milwaukee, Wisconsin, USA. PARTICIPANTS Adult smokers (n = 1236; 58% female, 86% white), recruited from the community via advertisements, who abstained on their quit day. MEASUREMENTS Demographics and tobacco dependence were assessed at baseline and participants carried palmtop computers to record withdrawal symptoms (craving, negative affect, difficulty concentrating, hunger and anhedonia) on their quit day. Point-prevalence abstinence and latency to relapse were assessed at 8 weeks and 6 months post-quit. FINDINGS Latent class analysis identified four withdrawal classes [Akaike information criterion (AIC) = 70.09]: Moderate withdrawal (64% of sample), high craving-anhedonia (8% of sample), affective withdrawal (13% of sample) and hunger (15% of sample). The high craving-anhedonia class reported significantly higher dependence (P < 0.01), were less likely to have received combination nicotine replacement, reported lower week 8 abstinence rates and relapsed sooner than those in the moderate withdrawal class (P < 0.05). The affective withdrawal class reported higher levels of baseline negative affect and life-time psychopathology (P < 0.05) and relapsed more quickly than the moderate withdrawal class (P < 0.01). CONCLUSIONS While the majority of smokers report typical levels of withdrawal symptoms on their quit day, more than one-third report extreme craving or extreme negative affective or extreme hunger responses to initial abstinence. These distinct quit-day withdrawal symptom patterns are related to baseline characteristics, treatment and cessation success.
Collapse
Affiliation(s)
- Megan E. Piper
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison,Department of Medicine, University of Wisconsin, Madison
| | | | - Jessica W. Cook
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison,Department of Medicine, University of Wisconsin, Madison,William S. Middleton Memorial Veterans Hospital
| | - Stephanie T. Lanza
- The Methodology Center, The Pennsylvania State University,Department of Biobehavioral Health and Human Development, The Pennsylvania State University
| |
Collapse
|
22
|
Development of a Behavioral Activation–Based Intervention for Cigarette-Smoking Young Adults. COGNITIVE AND BEHAVIORAL PRACTICE 2017. [DOI: 10.1016/j.cbpra.2016.03.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
23
|
Ma P, Kendzor DE, Poonawalla IB, Balis DS, Businelle MS. Daily nicotine patch wear time predicts smoking abstinence in socioeconomically disadvantaged adults: An analysis of ecological momentary assessment data. Drug Alcohol Depend 2016; 169:64-67. [PMID: 27776246 DOI: 10.1016/j.drugalcdep.2016.10.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 09/12/2016] [Accepted: 10/10/2016] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Individuals who use the nicotine patch are more likely to quit smoking than those who receive placebo or no medication. However, studies have not yet examined the association between actual daily nicotine patch wear time during the early phase of a smoking cessation attempt and later smoking abstinence. The purpose of this study was to address this gap in the literature. METHODS Participants who enrolled in a safety-net hospital smoking cessation program were followed for 13 weeks (i.e., 1 week pre-quit through 12 weeks post-quit). Participants completed in-person assessments and daily ecological momentary assessments on study provided smartphones. Multivariate logistic regressions were used to determine if daily patch wear time during the first week post-quit predicted 7-day biochemically verified point prevalence smoking abstinence 4 and 12 weeks following the scheduled quit date. Demographic characteristics and smoking behaviors were adjusted as covariates. RESULTS Participants (N=74) were primarily non-White (78.7%) and most (86%) had an annual household income of <$20,000. Greater average hours of daily nicotine patch wear time during the first week post-quit was associated with a greater likelihood of abstinence at the 4 and 12 week post-quit visits (aOR=2.22, 95% CI:1.17-4.23; aOR=2.24, 95% CI:1.00-5.03). Furthermore, more days of wearing the patch for ≥19h was associated with a greater likelihood of abstinence at the 4 and 12 week post-quit visits (aOR=1.81, 95% CI:1.01-3.22; aOR=2.18, 95% CI:1.03-4.63). CONCLUSIONS Greater adherence to the nicotine patch early in a quit attempt may increase the likelihood of smoking cessation among socioeconomically disadvantaged adults.
Collapse
Affiliation(s)
- Ping Ma
- Children's Health/Children's Medical Center at Dallas, Dallas, TX, United States.
| | - Darla E Kendzor
- University of Oklahoma Health Sciences Center, Oklahoma Tobacco Research Center, Oklahoma, OK, United States
| | - Insiya B Poonawalla
- Department of Health Promotion and Behavioral Sciences, Dallas, TX, United States
| | - David S Balis
- University of Texas Southwestern Medical Center, Department of General Internal Medicine, Dallas, TX, United States
| | - Michael S Businelle
- University of Oklahoma Health Sciences Center, Oklahoma Tobacco Research Center, Oklahoma, OK, United States
| |
Collapse
|
24
|
Etcheverry PE, Waters AJ, Lam C, Correa-Fernandez V, Vidrine JI, Cinciripini PM, Wetter DW. Attentional bias to negative affect moderates negative affect's relationship with smoking abstinence. Health Psychol 2016; 35:881-890. [PMID: 27505211 DOI: 10.1037/hea0000338] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To examine whether initial orienting (IO) and inability to disengage (ITD) attention from negative affective stimuli moderate the association of negative affect with smoking abstinence during a quit attempt. METHOD Data were from a longitudinal cohort study of smoking cessation (N = 424). A negative affect modified Stroop task was administered 1 week before and on quit day to measure IO and ITD. Ecological Momentary Assessments were used to create negative affect intercepts and linear slopes for the week before quitting and on quit day. Quit day and long-term abstinence measures were collected. RESULTS Continuation ratio logit model analyses found significant interactions for prequit negative affect slope with prequit ITD, odds ratio (OR) = 0.738 (0.57, 0.96), p = .02, and for quit day negative affect intercept with quit day ITD, OR = 0.62 (0.41, 950), p = .03, predicting abstinence. The Prequit Negative Affect Intercept × Prequit IO interaction predicting quit day abstinence was significant, OR = 1.42 (1.06, 1.90), p = .02, as was the Quit Day Negative Affect Slope × Quit Day IO interaction predicting long-term abstinence, OR = 1.45 (1.02, 2.08), p = .04. CONCLUSION The hypothesis that the association of negative affect with smoking abstinence would be moderated by ITD was generally supported. Among individuals with high ITD, negative affect was inversely related to abstinence, but unrelated to abstinence among individuals with lower levels of ITD. Unexpectedly, among individuals with low IO, negative affect was inversely related to abstinence, but unrelated to abstinence among individuals with higher levels of ITD. (PsycINFO Database Record
Collapse
Affiliation(s)
| | - Andrew J Waters
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences
| | - Cho Lam
- Department of Psychology, Rice University
| | | | | | - Paul M Cinciripini
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center
| | | |
Collapse
|
25
|
Adams CE, Chen M, Guo L, Lam CY, Stewart DW, Correa-Fernández V, Cano MA, Heppner WL, Vidrine JI, Li Y, Ahluwalia JS, Cinciripini PM, Wetter DW. Mindfulness predicts lower affective volatility among African Americans during smoking cessation. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2016; 28:580-5. [PMID: 24955676 DOI: 10.1037/a0036512] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Recent research suggests that mindfulness benefits emotion regulation and smoking cessation. However, the mechanisms by which mindfulness affects emotional and behavioral functioning are unclear. One potential mechanism, lower affective volatility, has not been empirically tested during smoking cessation. This study examined longitudinal associations among mindfulness and emotional responding over the course of smoking cessation treatment among predominantly low-socioeconomic status (SES) African American smokers, who are at high risk for relapse to smoking and tobacco-related health disparities. Participants (N = 399, 51% female, mean age = 42, 48% with annual income <$10,000) completed a baseline measure of trait mindfulness. Negative affect, positive affect, and depressive symptoms were assessed at five time points during smoking cessation treatment (up to 31 days postquit). Volatility indices were calculated to quantify within-person instability of emotional symptoms over time. Over and above demographic characteristics, nicotine dependence, and abstinence status, greater baseline trait mindfulness predicted lower volatility of negative affect and depressive symptoms surrounding the quit attempt and up to 1 month postquit, ps < 0.05. Although volatility did not mediate the association between greater mindfulness and smoking cessation, these results are the first to show that mindfulness is linked to lower affective volatility (or greater stability) of negative emotions during the course of smoking cessation. The present study suggests that mindfulness is linked to greater emotional stability and augments the study of mindfulness in diverse populations. Future studies should examine the effects of mindfulness-based interventions on volatility and whether lower volatility explains effects of mindfulness-based treatments on smoking cessation.
Collapse
Affiliation(s)
- Claire E Adams
- Department of Psychology, Catholic University of America
| | - Minxing Chen
- Department of Biostatistics, UT MD Anderson Cancer Center
| | - Lin Guo
- Department of Health Disparities Research, UT MD Anderson Cancer Center
| | - Cho Y Lam
- Department of Health Disparities Research, UT MD Anderson Cancer Center
| | - Diana W Stewart
- Department of Health Disparities Research, UT MD Anderson Cancer Center
| | | | - Miguel A Cano
- Department of Health Disparities Research, UT MD Anderson Cancer Center
| | - Whitney L Heppner
- Department of Psychological Science, Georgia College & State University
| | | | - Yisheng Li
- Department of Biostatistics, UT MD Anderson Cancer Center
| | | | | | - David W Wetter
- Department of Health Disparities Research, UT MD Anderson Cancer Center
| |
Collapse
|
26
|
Worley MJ, Heinzerling KG, Shoptaw S, Ling W. Pain volatility and prescription opioid addiction treatment outcomes in patients with chronic pain. Exp Clin Psychopharmacol 2015; 23:428-35. [PMID: 26302337 PMCID: PMC4658240 DOI: 10.1037/pha0000039] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The combination of prescription opioid dependence and chronic pain is increasingly prevalent and hazardous to public health. Variability in pain may explain poor prescription opioid addiction treatment outcomes in persons with chronic pain. This study examined pain trajectories and pain volatility in patients with chronic pain receiving treatment for prescription opioid addiction. We conducted secondary analyses of adults with chronic pain (n = 149) who received buprenorphine/naloxone (BUP/NLX) and counseling for 12 weeks in an outpatient, multisite clinical trial. Good treatment outcome was defined as urine-verified abstinence from opioids at treatment endpoint (Week 12) and during at least 2 of the previous 3 weeks. Pain severity significantly declined over time during treatment (b = -0.36, p < .001). Patients with greater pain volatility were less likely to have a good treatment outcome (odds ratio = 0.55, p < .05), controlling for baseline pain severity and rate of change in pain over time. A 1 standard deviation increase in pain volatility was associated with a 44% reduction in the probability of endpoint abstinence. The significant reduction in subjective pain during treatment provides observational support for the analgesic effects of BUP/NLX in patients with chronic pain and opioid dependence. Patients with greater volatility in subjective pain during treatment have increased risk of returning to opioid use by the conclusion of an intensive treatment with BUP/NLX and counseling. Future research should examine underlying mechanisms of pain volatility and identify related therapeutic targets to optimize interventions for prescription opioid addiction and co-occurring chronic pain.
Collapse
Affiliation(s)
- Matthew J. Worley
- Department of Family Medicine, University of California, Los Angeles
| | | | - Steven Shoptaw
- Department of Family Medicine, University of California, Los Angeles
| | - Walter Ling
- Integrated Substance Abuse Program, University of California Los Angeles
| |
Collapse
|
27
|
Dziak JJ, Li R, Tan X, Shiffman S, Shiyko MP. Modeling intensive longitudinal data with mixtures of nonparametric trajectories and time-varying effects. Psychol Methods 2015; 20:444-69. [PMID: 26390169 PMCID: PMC4679529 DOI: 10.1037/met0000048] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Behavioral scientists increasingly collect intensive longitudinal data (ILD), in which phenomena are measured at high frequency and in real time. In many such studies, it is of interest to describe the pattern of change over time in important variables as well as the changing nature of the relationship between variables. Individuals' trajectories on variables of interest may be far from linear, and the predictive relationship between variables of interest and related covariates may also change over time in a nonlinear way. Time-varying effect models (TVEMs; see Tan, Shiyko, Li, Li, & Dierker, 2012) address these needs by allowing regression coefficients to be smooth, nonlinear functions of time rather than constants. However, it is possible that not only observed covariates but also unknown, latent variables may be related to the outcome. That is, regression coefficients may change over time and also vary for different kinds of individuals. Therefore, we describe a finite mixture version of TVEM for situations in which the population is heterogeneous and in which a single trajectory would conceal important, interindividual differences. This extended approach, MixTVEM, combines finite mixture modeling with non- or semiparametric regression modeling, to describe a complex pattern of change over time for distinct latent classes of individuals. The usefulness of the method is demonstrated in an empirical example from a smoking cessation study. We provide a versatile SAS macro and R function for fitting MixTVEMs.
Collapse
Affiliation(s)
- John J Dziak
- The Methodology Center, The Pennsylvania State University
| | - Runze Li
- Department of Statistics, The Pennsylvania State University
| | - Xianming Tan
- Research Institute of the McGill University Health Centre, McGill University
| | | | - Mariya P Shiyko
- Department of Counseling and Applied Educational Psychology, Northeastern University
| |
Collapse
|
28
|
Lam CY, Businelle MS, Cofta-Woerpel L, McClure JB, Cinciripini PM, Wetter DW. Positive smoking outcome expectancies mediate the relation between alcohol consumption and smoking urge among women during a quit attempt. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2015; 28:163-72. [PMID: 24731113 DOI: 10.1037/a0034816] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Social learning models of addiction hypothesize that situational factors interact with cognitive determinants to influence a person's motivation to use substances. Ecological momentary assessment was used to examine the association between alcohol consumption, smoking outcome expectancies, and smoking urge during the first 7 days of a smoking quit attempt. Participants were 113 female smokers who enrolled in a study that tested an individually tailored smoking cessation treatment. Participants carried a palm-top personal computer for 7 days and were instructed to complete 4 random assessments each day and to initiate an assessment when they were tempted to smoke. Multilevel mediational analyses were used to examine (a) the effects of alcohol consumption before time j and positive smoking outcome expectancies at time j on smoking urge at time j + 1 (Model 1) and (b) the effects of alcohol consumption before time j and smoking urge at time j on positive smoking outcome expectancies at time j + 1 (Model 2). Model 1 found a significant effect of alcohol consumption before time j on smoking urge at time j + 1 (p = .04), and this effect was significantly mediated by positive smoking outcome expectancies at time j (p < .0001). Model 2 failed to find a significant effect of alcohol consumption before time j on positive smoking outcome expectancies at time j + 1. The findings suggest that alcohol consumption is significantly associated with increased positive smoking outcome expectancies that, in turn, are associated with increased smoking urge in women seeking to quit smoking.
Collapse
Affiliation(s)
- Cho Y Lam
- Department of Health Disparities Research
| | - Michael S Businelle
- Division of Health Promotion and Behavioral Sciences, University of Texas School of Public Health
| | | | | | - Paul M Cinciripini
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center
| | | |
Collapse
|
29
|
Perkins KA, Karelitz JL. Sex differences in acute relief of abstinence-induced withdrawal and negative affect due to nicotine content in cigarettes. Nicotine Tob Res 2015; 17:443-8. [PMID: 25762754 PMCID: PMC4425834 DOI: 10.1093/ntr/ntu150] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 07/24/2014] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Acute cigarette smoking may relieve withdrawal and negative affect due to tobacco abstinence to a greater extent in women versus men. Yet, the relative contribution of the cigarette's nicotine content to this sex difference is not clear. METHODS Non-quitting dependent adult smokers (N = 44; 21 males, 23 females) participated in 2 virtually identical sessions, each after abstaining overnight (CO < 10 ppm) and differing only in the nicotine content of the designated cigarette. While blind to brand markings, they consumed a total of 24 puffs in controlled fashion for 2 hr in each session, either from a nicotine (Quest 1, 0.6 mg) or denicotinized (Quest 3, 0.05 mg) cigarette. Withdrawal symptoms were obtained before and after smoking, and negative affect was assessed after each period of cigarette exposure consisting of 6 puffs every 25 min. RESULTS Men and women did not differ in baseline withdrawal and negative affect due to overnight abstinence, but reductions in each symptom were significantly influenced by the interaction of sex × nicotine/denicotinized cigarette (both p < .05). In men, but not in women, each symptom was generally decreased more by the nicotine versus denicotinized cigarette, and the nicotine cigarette reduced each to a greater degree in men versus women. CONCLUSIONS Sex differences in relief of abstinence-induced withdrawal and negative affect due to the nicotine content in cigarettes are consistent with prior research indicating that nicotine per se, compared to non-nicotine smoke stimuli, is less rewarding in women versus men.
Collapse
|
30
|
Piper ME. Withdrawal: Expanding a Key Addiction Construct. Nicotine Tob Res 2015; 17:1405-15. [PMID: 25744958 DOI: 10.1093/ntr/ntv048] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 02/16/2015] [Indexed: 02/03/2023]
Abstract
Withdrawal is an essential component of classical addiction theory; it is a vital manifestation of dependence and motivates relapse. However, the traditional conceptualization of withdrawal as a cohesive collection of symptoms that emerge during drug deprivation and decline with either the passage of time or reinstatement of drug use, may be inadequate to explain scientific findings or fit with modern theories of addiction. This article expands the current understanding of tobacco withdrawal by examining: (1) withdrawal variability; (2) underlying causes of withdrawal variability, including biological and person factors, environmental influences, and the influence of highly routinized behavioral patterns; (3) new withdrawal symptoms that allow for enhanced characterization of the withdrawal experience; and (4) withdrawal-related cognitive processes. These topics provide guidance regarding the optimal assessment of withdrawal and illustrate the potential impact modern withdrawal conceptualization and assessment could have on identifying treatment targets.
Collapse
Affiliation(s)
- Megan E Piper
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, WI
| |
Collapse
|
31
|
Serre F, Fatseas M, Swendsen J, Auriacombe M. Ecological momentary assessment in the investigation of craving and substance use in daily life: a systematic review. Drug Alcohol Depend 2015; 148:1-20. [PMID: 25637078 DOI: 10.1016/j.drugalcdep.2014.12.024] [Citation(s) in RCA: 213] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 12/18/2014] [Accepted: 12/19/2014] [Indexed: 12/17/2022]
Abstract
BACKGROUND Craving is viewed as a major determinant of relapse in persons with substance addiction, but this association remains poorly understood due to its time-limited nature and the biases associated with retrospective reporting. Ecological momentary assessment (EMA) offers new opportunities to examine both craving and substance use with strong ecological validity by collecting real-time data in daily life. This review examined all published studies using EMA to: (1) assess the link between craving and substance use; and (2) identify relevant moderators of craving among substance users. METHODS We searched PubMed and PsycInfo databases up to October 31, 2013. RESULTS Ninety-one studies were selected, involving mostly tobacco smokers (73%). A majority of studies (92%) reported a positive relationship between craving and substance use, concurrently and prospectively, and among users with different levels of use for both legal and illegal substances. Results suggest that craving is a stronger predictor of relapse episodes when assessed in close temporal proximity to substance use. EMA data also confirmed the influence of diverse within-person and between-person sources of variation in daily life craving reports. CONCLUSIONS This review provides strong support for the link between craving and substance use, and underscores the importance of the timing of assessments.
Collapse
Affiliation(s)
- Fuschia Serre
- University of Bordeaux, PAC Carreire, 146 rue Léo Saignat, CS 61292, 33076 Bordeaux Cedex, France; SANPSY (Addiction Psychiatry), CNRS USR 3413, University of Bordeaux, PAC Carreire, 146 rue Léo Saignat, CS 61292, 33076 Bordeaux Cedex, France; Pôle Addictologie, CH Charles Perrens and CHU de Bordeaux, 121 rue de la Béchade, CS 81285, 33076 Bordeaux Cedex, France
| | - Melina Fatseas
- University of Bordeaux, PAC Carreire, 146 rue Léo Saignat, CS 61292, 33076 Bordeaux Cedex, France; SANPSY (Addiction Psychiatry), CNRS USR 3413, University of Bordeaux, PAC Carreire, 146 rue Léo Saignat, CS 61292, 33076 Bordeaux Cedex, France; INCIA, CNRS UMR 5287, University of Bordeaux, PAC Carreire, 146 rue Léo Saignat, CS 61292, 33076 Bordeaux Cedex, France; Pôle Addictologie, CH Charles Perrens and CHU de Bordeaux, 121 rue de la Béchade, CS 81285, 33076 Bordeaux Cedex, France
| | - Joel Swendsen
- University of Bordeaux, PAC Carreire, 146 rue Léo Saignat, CS 61292, 33076 Bordeaux Cedex, France; INCIA, CNRS UMR 5287, University of Bordeaux, PAC Carreire, 146 rue Léo Saignat, CS 61292, 33076 Bordeaux Cedex, France; Ecole Pratique des Hautes Etudes, 75014 Paris, France
| | - Marc Auriacombe
- University of Bordeaux, PAC Carreire, 146 rue Léo Saignat, CS 61292, 33076 Bordeaux Cedex, France; SANPSY (Addiction Psychiatry), CNRS USR 3413, University of Bordeaux, PAC Carreire, 146 rue Léo Saignat, CS 61292, 33076 Bordeaux Cedex, France; Pôle Addictologie, CH Charles Perrens and CHU de Bordeaux, 121 rue de la Béchade, CS 81285, 33076 Bordeaux Cedex, France; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| |
Collapse
|
32
|
Albrithen AA, Singleton EG. Brief Arabic tobacco craving questionnaire: An investigation into craving and heavy smoking in Saudi Arabian males. J Family Community Med 2015; 22:8-12. [PMID: 25657605 PMCID: PMC4317997 DOI: 10.4103/2230-8229.149573] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Research in the United States has shown that craving tobacco is associated with smoking, yet no investigation has been done into the relationship between craving and the use of tobacco in Saudi Arabian smokers. The aim of this cross-sectional study was to examine the craving of tobacco by Saudi males and its influence on daily smoking. Subjects were recruited under the auspices of the Tobacco Control Program in Jeddah City and Riyadh. METHODS The American English version of the tobacco craving questionnaire (TCQ-12) is a valid measure of four distinct aspects (factors) of tobacco craving. The TCQ-12 was translated into Arabic tobacco craving questionnaire (ATCQ-12) and administered to a sample of 322 male smokers. Predictive validity was determined by examining the relationship between the factors and the number of cigarettes smoked per day (CPD). RESULTS In a general linear multivariate analysis of variance model, CPD increased significantly as either ATCQ-12 Factor 1 (emotionality) or Factor 3 (compulsiveness) increased. A significant Factor 1 by Factor 3 interaction indicated that Factor 1 was a better predictor of heavy smoking, but only when Factor 3 was low. Factor 3 was a better predictor of heavy smoking, but only when Factor 1 was low. CONCLUSIONS The ATCQ-12 is a rapid measure of craving and valid predictor of CPD and heavy smoking. Craving in anticipation of smoking as relief from a negative mood (emotionality) is an indicator of psychological withdrawal symptoms, while craving in anticipation of the inability to control tobacco use (compulsiveness) is an indicator of physical dependence.
Collapse
|
33
|
Businelle MS, Ma P, Kendzor DE, Reitzel LR, Chen M, Lam CY, Bernstein I, Wetter DW. Predicting quit attempts among homeless smokers seeking cessation treatment: an ecological momentary assessment study. Nicotine Tob Res 2014; 16:1371-8. [PMID: 24893602 PMCID: PMC4207873 DOI: 10.1093/ntr/ntu088] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 04/25/2014] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Homeless adults are more likely to smoke tobacco and are less likely to successfully quit smoking than smokers in the general population, despite comparable numbers of cessation attempts and desire to quit. To date, studies that have examined smoking cessation in homeless samples have used traditional lab/clinic-based assessment methodologies. Real-time assessment of key variables may provide new insights into the process of quitting among homeless smokers. METHODS The purpose of the current study was to identify predictors of a quit attempt using real-time assessment methodology during the 6 days prior to a scheduled quit attempt among homeless adults seeking care at a shelter-based smoking cessation clinic. Parameters for multiple variables (i.e., motivation for quitting, smoking expectancies, quit self-efficacy, smoking urges, negative affect, positive affect, restlessness, hostility, and stress) were calculated and were used as predictors of biochemically verified quit date abstinence (i.e., ≥13hr abstinent) using logistic regression analyses. RESULTS Participants (n = 57) were predominantly male (59.6%), non-White (68.4%), and smoked an average of 18 cigarettes per day. A total of 1,132 ecological momentary assessments (83% completion rate) were collected at random times (i.e., up to 4 assessments/day) during the 6 days prior to a scheduled quit attempt. Results indicated that declining (negative slope) negative affect, restlessness, and stress predicted quit date abstinence. Additionally, increasing positive coping expectancies across the prequit week predicted quit date abstinence. CONCLUSIONS Study findings highlight multiple variables that may be targeted during the precessation period to increase smoking cessation attempts in this difficult to treat population of smokers.
Collapse
Affiliation(s)
- Michael S Businelle
- University of Texas Health Science Center School of Public Health, Dallas, TX; University of Texas Southwestern Medical Center, Dallas, TX;
| | - Ping Ma
- University of Texas Health Science Center School of Public Health, Dallas, TX; University of Texas Southwestern Medical Center, Dallas, TX
| | - Darla E Kendzor
- University of Texas Health Science Center School of Public Health, Dallas, TX; University of Texas Southwestern Medical Center, Dallas, TX
| | - Lorraine R Reitzel
- Department of Educational Psychology, University of Houston, Houston, TX
| | - Minxing Chen
- Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Cho Y Lam
- Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Ira Bernstein
- University of Texas Southwestern Medical Center, Dallas, TX
| | - David W Wetter
- Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, Houston, TX
| |
Collapse
|
34
|
Cano MÁ, Lam CY, Chen M, Adams CE, Correa-Fernández V, Stewart DW, McClure JB, Cinciripini PM, Wetter DW. Positive smoking outcome expectancies mediate the association between negative affect and smoking urge among women during a quit attempt. Exp Clin Psychopharmacol 2014; 22:332-40. [PMID: 24796849 PMCID: PMC4115029 DOI: 10.1037/a0036749] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Ecological momentary assessment was used to examine associations between negative affect, positive smoking outcome expectancies, and smoking urge during the first 7 days of a smoking quit attempt. Participants were 302 female smokers who enrolled in an individually tailored smoking cessation treatment study. Multilevel mediation analysis was used to examine the temporal relationship among the following: (a) the effects of negative affect and positive smoking outcome expectancies at 1 assessment point (e.g., time j) on smoking urge at the subsequent time point (e.g., time j + 1) in Model 1; and, (b) the effects of negative affect and smoking urge at time j on positive smoking outcome expectancies at time j + 1 in Model 2. The results from Model 1 showed a statistically significant effect of negative affect at time j on smoking urge at time j + 1, and this effect was mediated by positive smoking outcome expectancies at time j, both within- and between-participants. In Model 2, the within-participant indirect effect of negative affect at time j on positive smoking outcome expectancies at time j + 1 through smoking urge at time j was nonsignificant. However, a statistically significant indirect between-participants effect was found in Model 2. The findings support the hypothesis that urge and positive smoking outcome expectancies increase as a function of negative affect, and suggest a stronger effect of expectancies on urge as opposed to the effect of urge on expectancies.
Collapse
Affiliation(s)
- Miguel Ángel Cano
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center
| | - Cho Y. Lam
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center
| | - Minxing Chen
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center
| | - Claire E. Adams
- Department of Psychology, The Catholic University of America
| | | | - Diana W. Stewart
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center
| | | | - Paul M. Cinciripini
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center
| | - David W. Wetter
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center
| |
Collapse
|
35
|
Kurti AN, Dallery J. Effects of exercise on craving and cigarette smoking in the human laboratory. Addict Behav 2014; 39:1131-7. [PMID: 24656643 DOI: 10.1016/j.addbeh.2014.03.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 02/27/2014] [Accepted: 03/04/2014] [Indexed: 11/28/2022]
Abstract
Exercise is increasingly being pursued as a treatment to reduce cigarette smoking. The efficacy of clinical, exercise-based cessation interventions may be enhanced by conducting laboratory studies to determine maximally effective conditions for reducing smoking, and the mechanisms through which the effects on smoking are achieved. The main purpose of this study was to assess whether the effects of exercise on two components of craving (anticipated reward from smoking, anticipated relief from withdrawal) mediated the relationship between exercise and delay (in min) to ad libitum smoking. Experiment 1 (N=21) assessed the effects of exercise intensity (inactivity, low, moderate) on craving components up to 60 min post-exercise. Because moderate-intensity exercise most effectively reduced craving on the reward component, all participants exercised at a moderate intensity in Experiment 2. Using an ABAB within-subjects design, Experiment 2 (N=20) evaluated whether the effects of moderate-intensity exercise on reward and relief components of craving mediated the relationship between exercise and participants' delays (in min) to ad libitum smoking. Delays were significantly longer after exercise (M=21 min) versus inactivity (M=4 min), and the effects of exercise on delay were mediated through the reward component of craving. Future research should continue to explore the mechanisms through which exercise influences behavioral indices of smoking in the human laboratory. Additionally, given the benefits uniquely afforded by exercise-based cessation interventions (e.g., improving mood and other health outcomes), implementing these interventions in clinical settings may contribute substantially to improving public health.
Collapse
Affiliation(s)
- Allison N Kurti
- Department of Psychology, University of Florida, P.O. Box 112250, Gainesville, FL 32611, United States.
| | - Jesse Dallery
- Department of Psychology, University of Florida, P.O. Box 112250, Gainesville, FL 32611, United States.
| |
Collapse
|
36
|
Castro Y, Cano MÁ, Businelle MS, Correa-Fernández V, Heppner WL, Mazas CA, Wetter DW. A cross-lagged path analysis of five intrapersonal determinants of smoking cessation. Drug Alcohol Depend 2014; 137:98-105. [PMID: 24529688 PMCID: PMC3986920 DOI: 10.1016/j.drugalcdep.2014.01.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 01/13/2014] [Accepted: 01/14/2014] [Indexed: 12/20/2022]
Abstract
BACKGROUND Prominent theories of drug use underscore the importance of considering the inter-relationships (e.g., reciprocal relations, indirect effects) of determinants of drug use behavior. In the area of smoking, few studies have examined multiple determinants of cessation in this way, and in prospective analyses. The current study is an examination of the prospective cross-lagged relationships among five intrapersonal determinants of cessation. METHODS Data from a longitudinal cohort study on racial differences in the process of smoking cessation were used to examine reciprocal relations among abstinence motivation, abstinence self-efficacy, positive affect, negative affect, and craving. Each of these five measures assessed on the quit day were regressed onto the same measures assessed 1-2 weeks pre-quit. The relationships of these variables at quit day with 1-week post-quit abstinence from smoking were also examined. RESULTS When the five variables were examined simultaneously in a cross-lagged path analysis, motivation and self-efficacy, and self-efficacy and positive affect showed cross-lagged relations. Only self-efficacy on the quit day uniquely predicted 1-week post quit abstinence. There were significant indirect effects of motivation and positive affect on cessation via self-efficacy. CONCLUSIONS The current study reaffirms the importance of motivation and self-efficacy in smoking cessation, and suggests that positive affect may play a role in smoking cessation.
Collapse
Affiliation(s)
- Yessenia Castro
- School of Social Work, The University of Texas at Austin, 1 University Station, D3500, Austin, TX 78712, United States.
| | - Miguel Ángel Cano
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Unit 1440, PO Box 301402, Houston, TX 77230, United States
| | - Michael S Businelle
- Division of Health Promotion and Behavioral Science, The University of Texas School of Public Health Dallas Regional Campus, 5323 Harry Hines Building, V8.112, Dallas, TX 75390-9128, United States
| | - Virmarie Correa-Fernández
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Unit 1440, PO Box 301402, Houston, TX 77230, United States
| | - Whitney L Heppner
- Department of Psychological Science, Georgia College and State University, 1-03 Arts & Sciences Building, Milledgeville, GA 31061, United States
| | - Carlos A Mazas
- Memorial Brain and Behavior Center, 915 Gessner Rd Suite 550. 770242527 Houston, TX, USA
| | - David W Wetter
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Unit 1440, PO Box 301402, Houston, TX 77230, United States
| |
Collapse
|
37
|
Kendzor DE, Businelle MS, Reitzel LR, Castro Y, Vidrine JI, Mazas CA, Cinciripini PM, Lam CY, Adams CE, Correa-Fernández V, Cano MÁ, Wetter DW. The influence of discrimination on smoking cessation among Latinos. Drug Alcohol Depend 2014; 136:143-8. [PMID: 24485880 PMCID: PMC3967740 DOI: 10.1016/j.drugalcdep.2014.01.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Revised: 01/06/2014] [Accepted: 01/06/2014] [Indexed: 11/22/2022]
Abstract
BACKGROUND Although studies have shown a cross-sectional link between discrimination and smoking, the prospective influence of discrimination on smoking cessation has yet to be evaluated. Thus, the purpose of the current study was to determine the influence of everyday and major discrimination on smoking cessation among Latinos making a quit attempt. METHODS Participants were 190 Spanish speaking smokers of Mexican Heritage recruited from the Houston, TX metropolitan area who participated in the study between 2009 and 2012. Logistic regression analyses were conducted to evaluate the associations of everyday and major discrimination with smoking abstinence at 26 weeks post-quit. RESULTS Most participants reported at least some everyday discrimination (64.4%), and at least one major discrimination event (56%) in their lifetimes. Race/ethnicity/nationality was the most commonly perceived reason for both everyday and major discrimination. Everyday discrimination was not associated with post-quit smoking status. However, experiencing a greater number of major discrimination events was associated with a reduced likelihood of achieving 7-day point prevalence smoking abstinence, OR=.51, p=.004, and continuous smoking abstinence, OR=.29, p=.018, at 26 weeks post-quit. CONCLUSIONS Findings highlight the high frequency of exposure to discrimination among Latinos, and demonstrate the negative impact of major discrimination events on a smoking cessation attempt. Efforts are needed to attenuate the detrimental effects of major discrimination events on smoking cessation outcomes.
Collapse
Affiliation(s)
- Darla E Kendzor
- The University of Texas Health Science Center, School of Public Health, United States; The UT Southwestern Harold C. Simmons Comprehensive Cancer Center, United States.
| | - Michael S Businelle
- The University of Texas Health Science Center, School of Public Health, United States; The UT Southwestern Harold C. Simmons Comprehensive Cancer Center, United States
| | | | - Yessenia Castro
- The University of Texas, School of Social Work, United States
| | - Jennifer I Vidrine
- The University of Texas MD Anderson Cancer Center, Department of Health Disparities Research, United States
| | - Carlos A Mazas
- The University of Texas MD Anderson Cancer Center, Department of Health Disparities Research, United States
| | - Paul M Cinciripini
- The University of Texas MD Anderson Cancer Center, Department of Behavioral Science, United States
| | - Cho Y Lam
- The University of Texas MD Anderson Cancer Center, Department of Health Disparities Research, United States
| | - Claire E Adams
- The Catholic University of America, Department of Psychology, United States
| | - Virmarie Correa-Fernández
- The University of Texas MD Anderson Cancer Center, Department of Health Disparities Research, United States
| | - Miguel Ángel Cano
- The University of Texas MD Anderson Cancer Center, Department of Health Disparities Research, United States
| | - David W Wetter
- The University of Texas MD Anderson Cancer Center, Department of Health Disparities Research, United States
| |
Collapse
|
38
|
Allen AM, Oncken C, Hatsukami D. Women and Smoking: The Effect of Gender on the Epidemiology, Health Effects, and Cessation of Smoking. CURRENT ADDICTION REPORTS 2014; 1:53-60. [PMID: 27213132 PMCID: PMC4871621 DOI: 10.1007/s40429-013-0003-6] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Smoking is still the leading cause of premature morbidity and mortality. This paper examines new research on gender differences and the epidemiology of smoking, smoking-related morbidity and mortality, and factors that affect smoking cessation. The rate of decline in the prevalence of smoking has been slowing, especially among adolescent girls. New research suggests that, compared with men, women may be more susceptible to smoking-related morbidity and mortality. Gender-related barriers to smoking cessation include weight gain, sex hormones, and mood. Furthermore, the sensory aspects of smoking may have more of an effect on smoking treatment for women than for men. We discuss new studies that examine smoking-cessation interventions that may be particularly beneficial for women, including exercise (as an adjunct intervention), very low nicotine content cigarettes, and a variety of pharmacotherapy. Further research is needed to identify and target the gender-specific needs of smokers.
Collapse
Affiliation(s)
- Alicia M Allen
- Department of Family Medicine and Community Health, Medical School, University of Minnesota, 717 Delaware Street SE, Room 422, Minneapolis, MN 55414, USA
| | - Cheryl Oncken
- Department of Medicine and Obstetrics and Gynecology, University of Connecticut School of Medicine, 263 Farmington, Farmington, CT 06030, USA,
| | - Dorothy Hatsukami
- Department of Psychiatry, Medical School, University of Minnesota, 717 Delaware Street SE, Room 256, Minneapolis, MN 55414, USA,
| |
Collapse
|
39
|
Lam CY, Businelle MS, Aigner CJ, McClure JB, Cofta-Woerpel L, Cinciripini PM, Wetter DW. Individual and combined effects of multiple high-risk triggers on postcessation smoking urge and lapse. Nicotine Tob Res 2013; 16:569-75. [PMID: 24323569 DOI: 10.1093/ntr/ntt190] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Negative affect, alcohol consumption, and presence of others smoking have consistently been implicated as risk factors for smoking lapse and relapse. What is not known, however, is how these factors work together to affect smoking outcomes. This paper uses ecological momentary assessment (EMA) collected during the first 7 days of a smoking cessation attempt to test the individual and combined effects of high-risk triggers on smoking urge and lapse. METHODS Participants were 300 female smokers who enrolled in a study that tested an individually tailored smoking cessation treatment. Participants completed EMA, which recorded negative affect, alcohol consumption, presence of others smoking, smoking urge, and smoking lapse, for 7 days starting on their quit date. RESULTS Alcohol consumption, presence of others smoking, and negative affect were, independently and in combination, associated with increase in smoking urge and lapse. The results also found that the relationship between presence of others smoking and lapse and the relationship between negative affect and lapse were moderated by smoking urge. CONCLUSIONS The current study found significant individual effects of alcohol consumption, presence of other smoking, and negative affect on smoking urge and lapse. Combing the triggers increased smoking urge and the risk for lapse to varying degrees, and the presence of all 3 triggers resulted in the highest urge and lapse risk.
Collapse
Affiliation(s)
- Cho Y Lam
- Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | | | | | | | | |
Collapse
|
40
|
Berlin I, Singleton EG, Heishman SJ. Predicting smoking relapse with a multidimensional versus a single-item tobacco craving measure. Drug Alcohol Depend 2013; 132:513-20. [PMID: 23623506 DOI: 10.1016/j.drugalcdep.2013.03.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Revised: 03/26/2013] [Accepted: 03/27/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Research suggests that craving is a predictor of smoking relapse. Craving can be assessed by multiple item or multifactorial scales or by single items. However, no systematic comparisons of their prognostic validity or accuracy have been published. METHODS The French versions of the 12-item Tobacco Craving Questionnaire (FTCQ-12) and the single craving item on the Minnesota Nicotine Withdrawal Scale (MNWS) are brief, valid, and reliable self-report measures of tobacco craving. In this secondary study, we analyzed data from French smokers with health-related problems enrolled in the Adjustment of DOses of NIcotine in Smoking (ADONIS) cessation trial. We estimated prediction models for each measure and compared their ability to distinguish correctly participants who relapsed from those who did not at 1-8 weeks after their quit date. RESULTS Adjusted for all potential confounders FTCQ-12 risk score (RS; Factor 2, Expectancy plus Factor 4, Purposefulness) and MNWS craving were valid predictors of smoking relapse at endpoints measured 1-7 weeks apart. Prognostic accuracy of FTCQ-12 RS was greatest at 1-2 weeks follow-up compared to only 1 week for MNWS craving. Sensitivity for FTCQ-12 RS and MNWS craving was 85% and 53%, respectively. CONCLUSIONS FTCQ-12 RS suggests a relapse process involving urges and desires in anticipation of the positive benefits of smoking linked with intent and planning to smoke. Findings also suggest that FTCQ-12 RS may be a better predictor instrument for smoking relapse than MNWS craving.
Collapse
Affiliation(s)
- Ivan Berlin
- Département de Pharmacologie, Hôpital Pitié-Salpêtrière-Faculté de médicine, Université P. and M. Curie - INSERM U669, Paris, France.
| | | | | |
Collapse
|
41
|
Wray JM, Gass JC, Tiffany ST. A systematic review of the relationships between craving and smoking cessation. Nicotine Tob Res 2013; 15:1167-82. [PMID: 23291636 PMCID: PMC3682845 DOI: 10.1093/ntr/nts268] [Citation(s) in RCA: 152] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Accepted: 11/12/2012] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Craving is often portrayed as a defining feature of addiction, but the role of craving in the addictive process is controversial. Particularly contentious is the extent to which drug craving predicts subsequent relapse. METHODS This review synthesizes findings from 62 smoking cessation studies published through December 2011. Eligible studies measured craving for cigarettes in treatment-seeking smokers and related this to subsequent smoking status. The relationships of general craving and cue-specific craving with treatment outcome were examined separately. Further, analyses that related general craving to smoking status were divided into those that used craving data collected before the quit attempt, after the quit attempt, and those that used change in craving over time as a predictor. RESULTS Results across studies revealed a total of 198 indices of association with 94 (47%) of these being significant. In general, the findings indicated (a) there were only a few cases of significant associations between craving collected as part of cue-reactivity studies and treatment outcome, (b) postquit craving was a stronger predictor of treatment outcome than prequit craving, and (c) several moderators likely influence the relationship between craving and cessation outcome. CONCLUSIONS The overall results suggest that craving is not a necessary condition of relapse. In addition, inconsistent relationships between craving and treatment outcome call into question the value of craving as a target of treatment and underscore limitations in the prognostic utility of craving.
Collapse
Affiliation(s)
- Jennifer M Wray
- Department of Psychology, University at Buffalo, The State University of New York, Buffalo, NY 14260, USA.
| | | | | |
Collapse
|
42
|
Businelle MS, Lam CY, Kendzor DE, Cofta-Woerpel L, McClure JB, Cinciripini PM, Wetter DW. Alcohol consumption and urges to smoke among women during a smoking cessation attempt. Exp Clin Psychopharmacol 2013; 21:29-37. [PMID: 23379613 PMCID: PMC3854865 DOI: 10.1037/a0031009] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Laboratory and ad libitum smoking studies have indicated that alcohol consumption increases the frequency and intensity of smoking urges. However, few studies have examined the relation between smoking urges and alcohol use in natural settings during a quit attempt. The purpose of this study was to examine the relationships between smoking urge and alcohol use in women who reported drinking on at least one occasion during the first 7 days of a smoking quit attempt (N = 134). Participants were asked to use a palmtop computer to complete assessments that recorded smoking urges and recent alcohol use. Multilevel analyses examined the relation between smoking urge parameters and alcohol use. Smoking urges were higher during assessments where alcohol had been recently consumed compared to assessments where no alcohol had been consumed. Interestingly, the first urge rating of the day was higher and urges were more volatile on days where alcohol would eventually be consumed as compared to days where no alcohol was consumed. A closer examination of urge parameters on drinking days indicated that smoking urge trajectory was significantly flatter and urge volatility was significantly higher following alcohol consumption. However, smoking urge trajectory also flattened later in the day on nondrinking days. The findings suggest that there may be reciprocal relations between smoking urge and alcohol use (e.g., higher initial urges and more volatile urges may increase the likelihood of alcohol use, and alcohol use may impact within-day smoking urge parameters), and these relations could potentially impact smoking cessation and relapse.
Collapse
Affiliation(s)
- Michael S Businelle
- Division of Health Promotion and Behavioral Sciences, University of Texas School of Public Health, TX 75390-9128, USA.
| | | | | | | | | | | | | |
Collapse
|
43
|
Yeh VM, McCarthy DE, Baker TB. An ecological momentary assessment analysis of prequit markers for smoking-cessation failure. Exp Clin Psychopharmacol 2012; 20:479-88. [PMID: 22924702 PMCID: PMC3568770 DOI: 10.1037/a0029725] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study aimed to identify correlates of smoking-cessation failure, a failure to establish abstinence during a quit-smoking attempt. Identifying risk factors for early failure could facilitate the development of tailored interventions to promote cessation. The current study used existing ecological momentary assessment (EMA) data to investigate the extent to which prequit craving, negative affect, and recent smoking were associated with cessation failure in 374 smokers (189, 50.5% female). Subjects were prompted to complete 4-7 real-time reports of craving, negative affect, and recent smoking daily in the four days prior to quitting. Multilevel models of craving and negative affect (mean level, growth, volatility, and association with smoking) were estimated. Results indicated that recent smoking was associated with significantly lower craving among smokers who failed to quit than those who achieved a full day of cessation, but this held only among smokers who reduced smoking by at least 10% in the days preceding the quit attempt. Smokers who failed to quit on the quit day also experienced slower increases in negative affect in the days preceding the quit attempt than did initial abstainers, but delayed quitters and delayed cessation failures did not differ in negative-affect trajectories. These results suggest that successful abstainers and cessation failures can be differentiated by specific dimensions of prequit craving and negative-affect experiences, but the effects hold only in certain circumstances.
Collapse
Affiliation(s)
- Vivian M Yeh
- Department of Psychology, Rutgers, The State University of New Jersey, 152 Frelinghuysen Road, Piscataway, NJ 08854, USA.
| | | | | |
Collapse
|
44
|
Bachmann MS, Znoj H, Brodbeck J. Identifying Distinct Quitting Trajectories after an Unassisted Smoking Cessation Attempt: An Ecological Momentary Assessment Study. ACTA ACUST UNITED AC 2012. [DOI: 10.4236/ojmp.2012.13008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
45
|
Reitzel LR, Mazas CA, Cofta-Woerpel L, Li Y, Cao Y, Businelle MS, Cinciripini PM, Wetter DW. Subjective social status affects smoking abstinence during acute withdrawal through affective mediators. Addiction 2010; 105:928-36. [PMID: 20219054 PMCID: PMC2857594 DOI: 10.1111/j.1360-0443.2009.02875.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Direct and mediated associations between subjective social status (SSS), a subjective measure of socio-economic status, and smoking abstinence were examined during the period of acute withdrawal among a diverse sample of 421 smokers (33% Caucasian, 34% African American, 33% Latino) undergoing a quit attempt. METHODS Logistic regressions examined relations between SSS and abstinence, controlling for socio-demographic variables. Depression, stress, positive affect and negative affect on the quit day were examined as potential affective mediators of the SSS-abstinence association, with and without adjusting for pre-quit mediator scores. RESULTS SSS predicted abstinence to 2 weeks post-quit. Abstinence rates were 2.6 (postquit week 1) and 2.4 (postquit week 2) times higher in the highest versus the lowest SSS quartile. Depression and positive affect mediated the SSS-abstinence relationships, but only depression maintained significance when adjusting for the baseline mediator score. CONCLUSIONS Among a diverse sample of quitting smokers, low SSS predicted relapse during acute withdrawal after controlling for numerous covariates, an effect accounted for partially by quit day affective symptomatology. Smokers endorsing lower SSS face significant hurdles in achieving cessation, highlighting the need for targeted interventions encompassing attention to quit day mood reactivity.
Collapse
Affiliation(s)
- Lorraine R. Reitzel
- Department of Health Disparities Research, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Carlos A. Mazas
- Department of Health Disparities Research, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Ludmila Cofta-Woerpel
- Department of Behavioral Science, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Yisheng Li
- Department of Biostatistics, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Yumei Cao
- Department of Health Disparities Research, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Michael S. Businelle
- Department of Health Disparities Research, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Paul M. Cinciripini
- Department of Behavioral Science, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - David W. Wetter
- Department of Health Disparities Research, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|