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Lancaster JH, Apsley HB, Brick TR, Ren W, Cleveland HH. The day-level effects of recovery community center attendance on indicators of recovery wellbeing and risk. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 165:209459. [PMID: 39067768 DOI: 10.1016/j.josat.2024.209459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 05/10/2024] [Accepted: 07/11/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND Recovery community centers (RCCs) are a relatively new resource in the recovery support landscape aimed at building their members' recovery capital. In recent years, interest in the value of RCCs has grown, however, no studies have used within-person methods to consider how RCCs may impact the day-to-day lives of their attendees. Using within-person data drawn from members of RCCs, this study examined how visiting RCCs was associated with several same-day indicators of recovery wellbeing and risk: daily sense of meaningfulness, recovery identity, negative affect, and positive affect. METHODS Participants were 94 visitors of six RCCs in western Pennsylvania. Daily diary methods collected 10 nightly reports of daily RCC attendance and end-of-day meaningfulness, recovery identity, negative affect, and positive affect. Multilevel modeling accounted for nesting in the intensive longitudinal data. In independent models, the study regressed meaningfulness, recovery identity, negative affect, and positive affect onto day- and person-level RCC attendance. RESULTS Within-person associations between RCC attendance and meaningfulness (b = 6.96, SE = 1.66, p < .001), recovery identity (b = 4.75, SE = 1.08, p < .001), and PA (b = 3.82, SE = 1.45, p < .01) were significant, although NA was not (b = -2.41, SE = 1.34, n.s.). All day- by person-level RCC attendance interactions (in preliminary models) and between-person associations were non-significant across recovery outcomes. CONCLUSIONS The results indicated that on days participants visited RCCs, they reported significantly higher levels of meaningfulness, recovery identity, and positive affect, although negative affect levels did not significantly differ. Also, those who attended RCCs more frequently did not generally report different levels of recovery wellbeing and risk. Taken together, results suggest visiting RCCs works on a daily basis to support interpersonal processes related to positive recovery outcomes. That RCC visits do not appear to reduce negative affect suggests that additional programs may be needed to address negative affect. The within-person design provided insight into the dynamic processes that contribute to the intrapersonal states that support recovery and a practical approach to examining whether and how RCCs might support recovery. By using individuals as their own controls, the study design provided strong counterfactual inference.
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Affiliation(s)
- Joseph H Lancaster
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA.
| | - Hannah B Apsley
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA.
| | - Timothy R Brick
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA; Institute for Computational and Data Sciences, The Pennsylvania State University, University Park, PA, USA.
| | - Wen Ren
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA.
| | - H Harrington Cleveland
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA.
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2
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Benvegnù G, Perotti S, Vegher A, Chiamulera C. Virtual Reality Environmental Enrichment Effects on Craving for Cigarette in Smokers. Games Health J 2024. [PMID: 38985569 DOI: 10.1089/g4h.2023.0188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2024] Open
Abstract
Background: Preclinical studies suggested the exposure to environmental enrichment (EE) as an intervention able to prevent or reduce nicotine-taking and nicotine-seeking behaviors. Virtual reality (VR) may help to test the effects of EE in smokers in a reproducible and feasible manner. Materials and Methods: In the present study, 31 smokers (14 women) were divided into two groups: (1) exposure to a virtual EE (VR-EE) and (2) exposure to a virtual neutral environment (VR-NoEE). Cigarette craving was assessed as basal and evoked, at different timepoints during the session. Behavior activity during VR exposure, mood, and subjective measures were also collected. Results: EE exposure in VR significantly reduced craving scores from basal timepoint. This was not observed in the VR-NoEE group, which significantly increased craving compared with values at neutral scenario. When both groups were exposed to smoking-related VR scenario, the VR-EE group showed an increased craving compared with previous timepoint up to score values not different from those in the VR-NoEE group. A significant positive correlation between basal craving scores and interactive behavior with virtual smoking cues was observed in the VR-NoEE but not in the VR-EE group. Conclusion: These findings suggest that virtual EE might have an inhibitory effect in smokers on basal, but not on evoked cigarette craving. Noteworthily, the interactive activity correlation to craving scores in the VR-NoEE participants was not observed in the VR-EE group, adding further evidence that the enrichment simulation was nonetheless able to modify behavior in the smoking-related scenario.
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Affiliation(s)
- Giulia Benvegnù
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Samuele Perotti
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Alessia Vegher
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Cristiano Chiamulera
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
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Hashim MAB, Ismail IHB, Md Sabri BAB. "We're tough, but so is quitting." Barriers to Smoking Cessation: The Royal Malaysian Navy Perspective. Mil Med 2023; 188:e3386-e3392. [PMID: 37525946 DOI: 10.1093/milmed/usad268] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/06/2022] [Accepted: 07/06/2023] [Indexed: 08/02/2023] Open
Abstract
INTRODUCTION Tobacco kills half of its users. Despite this, there are over 1.1 billion smokers worldwide. Its harmful effects impair performance and readiness. Unfortunately, smoking has deeply ingrained in the military culture, as evidenced by the high prevalence. Hence, this study aims to identify the barriers to smoking cessation among this population. METHODS A study involving two groups of current smokers (commissioned officers and non-commissioned officers) was conducted using the modified nominal group technique (mNGT), a qualitative research method of judgmental decision-making involving four phases: Generating ideas, recording, evaluation, and prioritization. The mNGT was used to solicit respondents' barriers to smoking cessation. RESULTS The mNGT yielded seven main barriers to smoking cessation: (1) Addiction, (2) difficulty in staying focused without the usage of cigarettes, (3) smoking has been incorporated into an individual's lifestyle, (4) environmental influence, (5) coping mechanism, (6) the long-interval period between orders and duties exacerbates the desire to smoke, and (7) smoking has evolved into a permanent habit. Although nicotine addiction and habit were ranked as the most important barriers, the military working environment and nature of the job exposed them physically and mentally to unfavorable situations, complicating the quitting attempt. Furthermore, the acceptance of smoking in military culture leads to a positive smoker identity, further hindering cessation. CONCLUSIONS The findings indicate that in addition to barriers affecting the general population, military-specific barriers related to the nature of the job exist, complicating cessation. Hence, any intervention program should address these barriers to achieve positive outcomes.
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Affiliation(s)
- Muhamad Arham Bin Hashim
- Faculty of Dentistry, Universiti Teknologi MARA (UiTM) Sungai Buloh Campus, Jalan Hospital, Sungai Buloh, Selangor Darul Ehsan 47000, Malaysia
- The Malaysian Armed Forces, Malaysia
| | - Ikmal Hisham Bin Ismail
- Faculty of Dentistry, Universiti Teknologi MARA (UiTM) Sungai Buloh Campus, Jalan Hospital, Sungai Buloh, Selangor Darul Ehsan 47000, Malaysia
| | - Budi Aslinie Binti Md Sabri
- Faculty of Dentistry, Universiti Teknologi MARA (UiTM) Sungai Buloh Campus, Jalan Hospital, Sungai Buloh, Selangor Darul Ehsan 47000, Malaysia
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Kegler M, Owolabi S, Reilly K, Pouncy J, Kaufmann J, Marra A, Haardörfer R, Berg C. A qualitative study on the influence of COVID-19 on smoking behaviors through changing social and physical contexts. HEALTH EDUCATION RESEARCH 2023; 38:445-457. [PMID: 37489701 PMCID: PMC11007391 DOI: 10.1093/her/cyad031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 06/30/2023] [Accepted: 07/07/2023] [Indexed: 07/26/2023]
Abstract
Globally, COVID-19 has been a major societal stressor and disrupted social and physical environments for many. Elucidating mechanisms through which societal disruptions influence smoking behavior has implications for future tobacco control efforts. Qualitative interviews were conducted among 38 adults who smoked combustible cigarettes in 2020 and 2021. The majority were women (75.7%), identified as Black (56.8%), were employed (61.3%), had a smoke-free home (66.7%) and lived in a small metro or rural (79.0%) county, primarily in rural southwest Georgia. Participants reported more time at home, increased isolation and less socializing, changed work and financial situations and altered household and family contexts. The vast majority of participants smoked more at some point during the pandemic with about half of these continuing to smoke more at the time of the interview. More time at home, multiple sources of stress and boredom were the main reasons for increased smoking. Decreases in smoking were attributed to financial strain, smoke-free home rules and nonsmoking family members, concerns about COVID-19 and less socializing with friends who smoke. Future tobacco control efforts during societal stressors such as pandemics should take into account specific psychosocial and environmental influences in attempts to minimize negative changes to smoking patterns.
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Affiliation(s)
- M Kegler
- Emory Prevention Research Center, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - S Owolabi
- Emory Prevention Research Center, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - K Reilly
- Emory Prevention Research Center, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - J Pouncy
- Emory Prevention Research Center, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - J Kaufmann
- Emory Prevention Research Center, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - A Marra
- Emory Prevention Research Center, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - R Haardörfer
- Emory Prevention Research Center, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - C Berg
- Department of Prevention & Community Health, Milken Institute School of Public Health, George Washington University, Science and Engineering Hall, 800 22nd Street NW, Washington, DC 20052, USA
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Walters KJ, Gray KM, Gex KS, McClure EA. The Role of Emotion Differentiation in the Association Between Momentary Affect and Tobacco/Nicotine Craving in Young Adults. Nicotine Tob Res 2023; 25:1261-1268. [PMID: 36610804 PMCID: PMC10256884 DOI: 10.1093/ntr/ntad001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/13/2022] [Accepted: 01/03/2023] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Tobacco/nicotine use is commonly initiated during adolescence or young adulthood, which increases the likelihood of continued use into adulthood and related adverse health outcomes. Despite interest in cessation, achieving and maintaining abstinence is difficult among this population. Cravings are often a barrier to abstinence, which have been associated with intensity of affect at the moment level. Emotion differentiation involves the ability to distinguish between discrete emotion states, and previous work suggests it may moderate the effect of momentary affect on craving, which has never been explored among young adults who are smoking or vaping nicotine. AIMS AND METHODS In a sample of young adults (N = 37, observations = 2020, ages 18-25, 51% female, and 78% white) interested in quitting smoking or vaping, we used real-time, naturalistic data capture via mobile phones to examine the interaction of momentary affect and trait emotion differentiation on nicotine craving. Participants were prompted with four surveys per day for 35 days and asked to make a 48-h quit attempt on day 7. RESULTS Multilevel models showed moments of higher-than-average momentary negative affect (NA; b = 0.39, p < .001), and positive affect (PA; b = 0.26, p = .001) were associated with greater levels of craving. NA emotion differentiation significantly moderated the associations between PA and craving (b = -0.63, p = .031) and NA and craving (b = -0.67, p = .003). CONCLUSIONS Findings from this exploratory analysis suggest that for young adults engaging in a nicotine quit attempt, greater ability to differentiate NA weakens the momentary association between intense affect and craving. IMPLICATIONS Results of this study show that the ability to differentiate between discrete emotional experiences may protect young adults against nicotine craving during moments of intense affective experience. These preliminary findings suggest that emotion differentiation, a modifiable construct, could be an important treatment target for individuals engaged in treatment for nicotine dependence.
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Affiliation(s)
- Kyle J Walters
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Kevin M Gray
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Kathryn S Gex
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Erin A McClure
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
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Peters EN, Pickworth WB, Monahan E, Smith CE, Triplett CA, Coleman-Cowger VH. Effect of very low nicotine content cigarettes on alcohol drinking and smoking among adult smokers who are at-risk alcohol drinkers. Exp Clin Psychopharmacol 2023; 31:733-744. [PMID: 36174143 PMCID: PMC10118745 DOI: 10.1037/pha0000603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Alcohol and tobacco use are interrelated. This study examined response to very low nicotine content (VLNC) and moderate nicotine content (MNC) cigarettes by problematic drinking. We utilized a double-blind, randomized, within-subjects crossover design of VLNC and MNC cigarettes in two groups of adult cigarette smokers: with at-risk drinking (ARD; n = 23) and without ARD (n = 24). Participants smoked only their assigned experimental cigarette in their home environment for 7 days, and completed laboratory visits, including ad libitum smoking of the assigned experimental cigarette, at the beginning and end of each experimental week. Participants smoked their usual cigarettes for 7 days between conditions. Participants provided daily reports of alcohol and cigarette consumption. Current Diagnostic and Statistical Manual of Mental Disorders-5th edition (DSM-5) alcohol use disorder (AUD) was assessed at baseline and the end of each experimental week. Compliance with smoking of experimental cigarettes was good. Adjusting for baseline drinking, there was no significant effect of experimental cigarette or ARD group on drinks per day or alcohol urges. There was no effect of experimental cigarette or ARD group on cigarettes per day, or on any puff topography outcome or postsmoking exhaled carbon monoxide during laboratory smoking. No participant had a change in AUD status or AUD severity. After 7 days of exposure to VLNC cigarettes, adult cigarette smokers with ARD did not show compensatory drinking or compensatory smoking behavior. A future policy change in the United States to reduce nicotine content in cigarettes may not produce unintended compensatory drinking or smoking among this vulnerable and prevalent population of smokers. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | | | - Erin Monahan
- Battelle Public Health Research Center, Baltimore, MD, USA
| | | | - Cheryl A. Triplett
- Health Analytics, Health Outcomes and Biotechnology Solutions, Battelle, Columbus, OH, USA
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Veilleux JC, Warner EA, Chamberlain KD, Brott KH, Schreiber RE, Clift JB. Contextual variation in beliefs about emotion and associated emotion regulation efforts. MOTIVATION AND EMOTION 2023. [DOI: 10.1007/s11031-022-09992-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Juengst SB, Wright B, Sander AM, Preminger S, Nabasny A, Terhorst L. The Behavioral Assessment Screening Tool for Mobile Health (BAST mHealth): Development and Compliance in 2 Weeks of Daily Reporting in Chronic Traumatic Brain Injury. Arch Phys Med Rehabil 2023; 104:203-210. [PMID: 35964700 PMCID: PMC9898098 DOI: 10.1016/j.apmr.2022.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 07/25/2022] [Accepted: 07/28/2022] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To develop and evaluate the feasibility of a short form of the Behavioral Assessment Screening Tool (BASTmHealth) for high frequency in situ self-reported assessment of neurobehavioral symptoms using mobile health technology for community-dwelling adults with traumatic brain injury (TBI). DESIGN Prospective, repeated-measures study of mHealth assessment of self-reported neurobehavioral symptoms in adults with and without a lifetime history of TBI over a 2-week period. SETTING Community. PARTICIPANTS Community-dwelling adults with (n=52) and without (n=12) a lifetime TBI history consented to the study (N=64). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES BASTmHealth subscales (2-items each): negative affect, fatigue, executive function, substance abuse, impulsivity; feasibility measured via compliance (assessments assigned/assessments completed) and participant-reported usability. RESULTS We developed the 10-item BASTmHealth as a screener for high frequency in situ self-reported assessment of neurobehavioral symptoms leveraging mHealth. Compliance for 2 weeks of BASTmHealth supports its feasibility. Fifty-six of 64 participants (87.5%) who completed baseline assessments completed the 2 weeks of daily assessments; all 8 participants who did not complete ecological momentary assessment had a history of TBI. Overall compliance was 81.4% (496 completed of 609 assigned assessments) among all 52 participants with TBI and 96.7% (494 completed of 511 assigned assessments) among the 44 who completed any daily measures, compared with 91.8% (135 completed of 147 assigned assessments) among those with no TBI history. Participants thought the daily surveys were easy to understand and complete and the number of prompts were reasonable. CONCLUSIONS Conducting daily high-frequency in situ self-reported assessment of neurobehavioral symptoms using the BASTmHealth is feasible among individuals with and without a lifetime history of TBI. Developing and evaluating self-reported assessments for community-based assessment is a critical step toward expanding remote clinical monitoring systems to improve post-TBI outcomes.
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Affiliation(s)
- Shannon B Juengst
- From the Department of Physical Medicine & Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX; Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX; TIRR Memorial Hermann, Brain Injury Research Center, Houston, TX.
| | - Brittany Wright
- From the Department of Physical Medicine & Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX; Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX
| | - Angelle M Sander
- TIRR Memorial Hermann, Brain Injury Research Center, Houston, TX; H. Ben Taub Department of Physical Medicine & Rehabilitation, Baylor College of Medicine, Houston, TX
| | - Samuel Preminger
- From the Department of Physical Medicine & Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX
| | - Andrew Nabasny
- Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX
| | - Lauren Terhorst
- Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA; Center for Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA
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Perry RN, Girgulis JP, Harrison SL, Barrett SP. Dual users' perceptions of the addictive properties of cigarettes versus E-cigarettes. Addict Behav 2023; 136:107483. [PMID: 36084416 DOI: 10.1016/j.addbeh.2022.107483] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 08/25/2022] [Accepted: 08/29/2022] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Electronic cigarettes ("e-cigarettes") are commonly promoted as a less-harmful alternative to combustible cigarettes, yet many individuals concurrently use both products ("dual users"). Little is known about the extent to which dual users' perceptions of the addictive properties of these products differ, or to what extent there are differences in the factors that elicit craving for each product. METHODS An online survey evaluated beliefs about the addictive properties of cigarettes vs e-cigarettes and the situational and affective precipitants of product craving, on a scale from 1 to 10, in a sample of Canadian adults that reported past-month use of combustible and e-cigarettes (N = 175; 79 female). RESULTS Participants rated cigarettes as more addictive than e-cigarettes, and on average reported higher levels of dependence on combustible cigarettes. While the addictive properties of both combustible and e-cigarettes were largely attributed to nicotine, non-nicotine factors (e.g. flavouring, other non-nicotine ingredients) were believed to make a relatively stronger contribution to the addictive properties of e-cigarettes, particularly among women. Participants reported greater increases in craving for combustible cigarettes in response to negative affective states and situational factors, and these effects were strongest among participants that displayed greater dependence on combustible tobacco relative to e-cigarettes. CONCLUSIONS Dual users perceived cigarettes to be more addictive than e-cigarettes and attributed the addictive properties of each product to different factors. Further, cravings for combustible cigarettes were more strongly linked to certain negative affective states and situational factors relative to e-cigarettes. Findings suggest that there may be limited substitutability between combustible and e-cigarettes.
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Affiliation(s)
- Robin N Perry
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada.
| | - Jane P Girgulis
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada; Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
| | - Sarah L Harrison
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada.
| | - Sean P Barrett
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada.
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Abo-Tabik M, Benn Y, Costen N. Are Machine Learning Methods the Future for Smoking Cessation Apps? SENSORS 2021; 21:s21134254. [PMID: 34206167 PMCID: PMC8271573 DOI: 10.3390/s21134254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/07/2021] [Accepted: 06/16/2021] [Indexed: 11/16/2022]
Abstract
Smoking cessation apps provide efficient, low-cost and accessible support to smokers who are trying to quit smoking. This article focuses on how up-to-date machine learning algorithms, combined with the improvement of mobile phone technology, can enhance our understanding of smoking behaviour and support the development of advanced smoking cessation apps. In particular, we focus on the pros and cons of existing approaches that have been used in the design of smoking cessation apps to date, highlighting the need to improve the performance of these apps by minimizing reliance on self-reporting of environmental conditions (e.g., location), craving status and/or smoking events as a method of data collection. Lastly, we propose that making use of more advanced machine learning methods while enabling the processing of information about the user’s circumstances in real time is likely to result in dramatic improvement in our understanding of smoking behaviour, while also increasing the effectiveness and ease-of-use of smoking cessation apps, by enabling the provision of timely, targeted and personalised intervention.
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Affiliation(s)
- Maryam Abo-Tabik
- Department of Computing and Mathematics, Manchester Metropolitan University, Manchester M1 5GD, UK;
| | - Yael Benn
- Department of Psychology, Manchester Metropolitan University, Manchester M15 6GX, UK
- Correspondence: (Y.B.); (N.C.)
| | - Nicholas Costen
- Department of Computing and Mathematics, Manchester Metropolitan University, Manchester M1 5GD, UK;
- Correspondence: (Y.B.); (N.C.)
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Williams MT, Lewthwaite H, Fraysse F, Gajewska A, Ignatavicius J, Ferrar K. Compliance With Mobile Ecological Momentary Assessment of Self-Reported Health-Related Behaviors and Psychological Constructs in Adults: Systematic Review and Meta-analysis. J Med Internet Res 2021; 23:e17023. [PMID: 33656451 PMCID: PMC7970161 DOI: 10.2196/17023] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 03/01/2020] [Accepted: 10/31/2020] [Indexed: 01/08/2023] Open
Abstract
Background Mobile ecological momentary assessment (mEMA) permits real-time capture of self-reported participant behaviors and perceptual experiences. Reporting of mEMA protocols and compliance has been identified as problematic within systematic reviews of children, youth, and specific clinical populations of adults. Objective This study aimed to describe the use of mEMA for self-reported behaviors and psychological constructs, mEMA protocol and compliance reporting, and associations between key components of mEMA protocols and compliance in studies of nonclinical and clinical samples of adults. Methods In total, 9 electronic databases were searched (2006-2016) for observational studies reporting compliance to mEMA for health-related data from adults (>18 years) in nonclinical and clinical settings. Screening and data extraction were undertaken by independent reviewers, with discrepancies resolved by consensus. Narrative synthesis described participants, mEMA target, protocol, and compliance. Random effects meta-analysis explored factors associated with cohort compliance (monitoring duration, daily prompt frequency or schedule, device type, training, incentives, and burden score). Random effects analysis of variance (P≤.05) assessed differences between nonclinical and clinical data sets. Results Of the 168 eligible studies, 97/105 (57.7%) reported compliance in unique data sets (nonclinical=64/105 [61%], clinical=41/105 [39%]). The most common self-reported mEMA target was affect (primary target: 31/105, 29.5% data sets; secondary target: 50/105, 47.6% data sets). The median duration of the mEMA protocol was 7 days (nonclinical=7, clinical=12). Most protocols used a single time-based (random or interval) prompt type (69/105, 65.7%); median prompt frequency was 5 per day. The median number of items per prompt was similar for nonclinical (8) and clinical data sets (10). More than half of the data sets reported mEMA training (84/105, 80%) and provision of participant incentives (66/105, 62.9%). Less than half of the data sets reported number of prompts delivered (22/105, 21%), answered (43/105, 41%), criterion for valid mEMA data (37/105, 35.2%), or response latency (38/105, 36.2%). Meta-analysis (nonclinical=41, clinical=27) estimated an overall compliance of 81.9% (95% CI 79.1-84.4), with no significant difference between nonclinical and clinical data sets or estimates before or after data exclusions. Compliance was associated with prompts per day and items per prompt for nonclinical data sets. Although widespread heterogeneity existed across analysis (I2>90%), no compelling relationship was identified between key features of mEMA protocols representing burden and mEMA compliance. Conclusions In this 10-year sample of studies using the mEMA of self-reported health-related behaviors and psychological constructs in adult nonclinical and clinical populations, mEMA was applied across contexts and health conditions and to collect a range of health-related data. There was inconsistent reporting of compliance and key features within protocols, which limited the ability to confidently identify components of mEMA schedules likely to have a specific impact on compliance.
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Affiliation(s)
- Marie T Williams
- Innovation, Implementation And Clinical Translation in Health, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Hayley Lewthwaite
- Innovation, Implementation And Clinical Translation in Health, Allied Health and Human Performance, University of South Australia, Adelaide, Australia.,Department of Kinesiology and Physical Education, Faculty of Education, McGill University, Montreal, QC, Canada
| | - François Fraysse
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Alexandra Gajewska
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Jordan Ignatavicius
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Katia Ferrar
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
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Benvegnù G, Tommasi F, Ferraro S, Libener E, Di Chio M, Bosi S, Zandonai T, Chiamulera C. Smokers "Context Reactivity" in Virtual Domestic Environments. Eur Addict Res 2021; 27:439-446. [PMID: 33940577 DOI: 10.1159/000515301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 02/12/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Although the effects of proximal smoking cues have been widely studied in smokers, little is known on the features associated with background spatial context effect, that is, "context reactivity." The aim of this study was to investigate context reactivity exhibited by smokers in virtual cue-free domestic scenarios. METHODS Sixty-nine participants divided in 2 cohorts (33 smokers and 36 non-smokers) were exposed to a virtual reality session with 4 domestic room scenarios presented in a balanced order: bedroom, bathroom, kitchen, and living room. RESULTS We showed that (i) it is possible to elicit smoking craving in smokers in virtual reality, and (ii) these effects are room dependent and (iii) associated with a lower sense of presence; furthermore, (iv) smokers reported higher craving scores for alcohol and food in a room-dependent fashion compared to non-smokers. CONCLUSION Our study provides an experimental paradigm for assessing context reactivity in smokers and suggests a potential use for the identification of non-pharmacological interventions as a co-adjuvant of smoking cessation treatment.
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Affiliation(s)
- Giulia Benvegnù
- Department of General Psychology, University of Padua, Padua, Italy.,Department of Diagnostic and Public Health, Pharmacology Section, Neuropsychopharmacology Lab, University of Verona, Verona, Italy
| | - Francesco Tommasi
- Department of Diagnostic and Public Health, Pharmacology Section, Neuropsychopharmacology Lab, University of Verona, Verona, Italy
| | - Stefano Ferraro
- Department of Diagnostic and Public Health, Pharmacology Section, Neuropsychopharmacology Lab, University of Verona, Verona, Italy
| | - Elettra Libener
- Department of Diagnostic and Public Health, Pharmacology Section, Neuropsychopharmacology Lab, University of Verona, Verona, Italy
| | - Marzia Di Chio
- Department of Diagnostic and Public Health, Pharmacology Section, Neuropsychopharmacology Lab, University of Verona, Verona, Italy
| | - Sandra Bosi
- Italian League against Cancer (LILT), Reggio Emilia, Italy
| | - Thomas Zandonai
- Department of Pharmacology, Paediatrics and Organic Chemistry, Miguel Hernández University of Elche, Alicante, Spain
| | - Cristiano Chiamulera
- Department of Diagnostic and Public Health, Pharmacology Section, Neuropsychopharmacology Lab, University of Verona, Verona, Italy
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Gunter R, Szeto E, Suh S, Kim Y, Jeong SH, Waters A. Associations between affect, craving, and smoking in Korean smokers: An ecological momentary assessment study. Addict Behav Rep 2020; 12:100301. [PMID: 33364310 PMCID: PMC7752717 DOI: 10.1016/j.abrep.2020.100301] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 07/23/2020] [Accepted: 08/28/2020] [Indexed: 10/25/2022] Open
Abstract
Cigarette smoking remains the largest cause of preventable death in the United States and worldwide. In South Korea and other Asian countries, a large proportion of males smoke, increasing the need to examine cigarette smoking in these populations. Research suggests that the association between positive affect and negative affect, and between affect and craving, may differ across cultures, and that it is useful to examine these associations using Ecological Momentary Assessment (EMA). South Korean smokers (N = 20, Mean Age = 21.15, 25% female) completed baseline questionnaires and downloaded an EMA app which prompted 4 random assessments (RAs) each day for 1-week. At each assessment, participants responded to items assessing momentary negative affect (NA) and positive affect (PA), craving, and number of cigarettes smoked since the previous EMA assessment. Linear mixed models (LMMs) were used to analyze EMA data (544 assessments), separating out between- and within- subject associations. There was a significant positive association between positive affect and negative affect at the between-subjects level. Both positive affect and negative affect were significantly positively associated with craving at between-subjects and within-subject levels. Craving was associated with subsequent smoking behavior at the within-subjects level. Overall, results suggest that associations between positive affect and negative affect may be different in South Korean smokers than in Western smokers, and that there are robust associations between both negative and positive affect and craving.
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Affiliation(s)
- R.G. Gunter
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - E.H. Szeto
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - S. Suh
- Department of Psychology, Sungshin Women’s University, Seoul, Republic of Korea
| | - Y. Kim
- Department of Preventive Medicine, University of Southern California, CA, USA
| | - S-H. Jeong
- School of Media & Communication, Korea University, Seoul, Republic of Korea
| | - A.J. Waters
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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Tran TPT, Park J, Park E, Shin SH, Paek YJ, Kim YH, Lim MK. Effect of Additional Motivational Interviewing on Smoking Abstinence for 1-Year among Korean Adolescents: Results from A Comparative Retrospective Study in Quitline. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218025. [PMID: 33142682 PMCID: PMC7662252 DOI: 10.3390/ijerph17218025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/28/2020] [Accepted: 10/28/2020] [Indexed: 11/16/2022]
Abstract
The aim of this study was to evaluate the effect of additional motivational enhancement through telephone-based counseling on short- and long-term smoking abstinence among Korean adolescents. METHODS A comparative retrospective study was conducted based on the longitudinal follow up in Quitline from 2010 to 2017. A total of 533 and 178 adolescent smokers voluntarily participated in the 1-year quitting counseling only (group A, who were ready to quit) and the additional 4-week motivational interviewing before 1-year quitting counseling (group B, who were ambivalent about quitting), respectively. The outcomes were self-reported continuous abstinence at 30-day, 6-month, and 1-year follow up. Logistic regression was applied to estimate the effect of potential factors, including motivational enhancement, on cessation outcome. RESULTS At baseline, adolescents in group B had a lower motivation to quit than those in group A (p < 0.001). The successful quit rates at 30-day, 6-month, and 1-year follow up were 37.2%, 12.8%, and 11.4% in group A and 33.7%, 15.2%, and 11.2% in group B, respectively. After adjusting factors as appropriate, successful quit rates in group B were not significantly different from the rates in group A. Higher self-efficacy increased the successful quit rate at 30-day, 6-month, and 1-year follow up, similar in subgroup analysis by gender. Never-drinking showed significant association with 30-day successful quit in the whole population and among boys. The lower number of smoking triggers was associated with an increased 30-day successful quit rate among boys only. CONCLUSIONS Counseling for motivational enhancement could be a promising approach for better quitting outcomes. Improving self-efficacy and eliminating smoking triggers should be continuously strengthened during the quitting process.
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Affiliation(s)
- Thi Phuong Thao Tran
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea; (T.P.T.T.); (J.P.)
| | - Jinju Park
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea; (T.P.T.T.); (J.P.)
| | - Eunjung Park
- Division of Cancer Prevention & Early Detection, National Cancer Control Institute, National Cancer Center, Goyang 10408, Korea; (E.P.); (S.H.S.)
| | - Sang Hwa Shin
- Division of Cancer Prevention & Early Detection, National Cancer Control Institute, National Cancer Center, Goyang 10408, Korea; (E.P.); (S.H.S.)
| | - Yu-Jin Paek
- Department of Family Medicine, Health Promotion Center, Hallym University Sacred Heart Hospital, Anyang 14068, Korea;
| | - Yun Hee Kim
- Department of Nursing, Pukyong National University, Busan 48513, Korea;
| | - Min Kyung Lim
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea; (T.P.T.T.); (J.P.)
- Division of Cancer Prevention & Early Detection, National Cancer Control Institute, National Cancer Center, Goyang 10408, Korea; (E.P.); (S.H.S.)
- Correspondence: ; Tel.: +82-31-920-2016; Fax: +82-31-920-2929
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Ali R, Zhang Z, Bux Soomro M, Gogan ICW, Soomro HR. Tobacco control via quick response code and mobile health technologies: Empirical-evidence of the health belief model theory. HUMAN SYSTEMS MANAGEMENT 2020. [DOI: 10.3233/hsm-190629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Rahib Ali
- School of Management Science and Economy, Harbin Institute of Technology, Heilongjiang, China
| | - Ziqiong Zhang
- School of Management Science and Economy, Harbin Institute of Technology, Heilongjiang, China
| | - Muhammad Bux Soomro
- Computer Science Department, Shaheed Zulfikar Ali Bhutto Institute of Science and Technology, Larkana Campus, Pakistan
| | | | - Habib Rehman Soomro
- Management Sciences Department, Shaheed Zulfikar Ali Bhutto Institute of Science and Technology, Larkana Campus, Pakistan
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Do you have a "moment" to text? Symptom evaluation using ecological momentary assessment and text messaging in women with HIV. ACTA ACUST UNITED AC 2020; 26:1363-1365. [PMID: 31663983 DOI: 10.1097/gme.0000000000001451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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17
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Abstract
This chapter reviews the array of methods used in contemporary research on population-level research on substance use and its consequences. We argue that there are critical questions that can best - or in some cases, only - be addressed at the level of a population. We then describe the major categories of data collection methods used in population research, including surveys, ecological momentary assessment, administrative data, audit methods, and unobtrusive assessment of substance use. Two categories of measures are then discussed: measures of an individual's use of substances and related problems and measures of harm to others caused by one's use. We then review factors that may be considered causes or correlates of substance use and consequences, including both individual and environmental factors. We close with a few thoughts on the accumulation of knowledge and its translation to policy and practice.
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Dimoff JD, Sayette MA, Levine JM. Experiencing cigarette craving with a friend: A shared reality analysis. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2019; 33:721-729. [PMID: 31621342 PMCID: PMC6889042 DOI: 10.1037/adb0000519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cigarette craving predicts relapse to smoking, which remains the leading cause of preventable death in the United States. Understanding why individuals smoke has important clinical implications and is a research priority. Nonlaboratory studies reveal that social factors, such as the presence of other people, are associated with self-reported craving, yet laboratory smoking research has largely ignored these factors by testing participants in isolation. In this study, a shared reality framework was used to evaluate social processes that may change when smokers experience craving while in the presence of a smoking friend versus in social isolation. Sixty pairs of smoking friends (n = 120) arrived together at the laboratory following a required 5 hr of smoking abstinence. One preselected (target) participant then underwent an in vivo smoking cue-exposure craving induction with their friend either present or in another room, completing an unrelated task. Target participants who were together with their friend while craving experienced a greater sense of similarity and felt closer to their friend than did those who were alone. Furthermore, in the together condition, shared Duchenne smiles (using the Facial Action Coding System) were associated with targets' ratings of perceived similarity to their friend. Though social context did not influence affect or urge to smoke, urge was associated with targets' ratings of similarity in the together, but not the alone condition. Results highlight the potential social utility of craving (satisfying epistemic and relational goals) and highlight the need for increased laboratory research on smoking that includes a social context. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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19
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Smoking-Cessation Acceptance Via Mobile Health and Quick Response Code Technologies: Empirical Evidence of a Pilot Study from China and Pakistan. CURRENT PSYCHOLOGY 2019. [DOI: 10.1007/s12144-019-00479-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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20
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Rubin LF, Haaga DAF, Pearson JL, Gunthert KC. Depression as a moderator of the prospective relationship between mood and smoking. Health Psychol 2019; 39:99-106. [PMID: 31682148 DOI: 10.1037/hea0000816] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Affective features of depression are uniquely involved in the depression-smoking relationship, and it follows that smokers with depression are likely to use cigarettes to alleviate negative affect. However, most ecological momentary assessment (EMA) studies demonstrate no relationship between mood and smoking, in general. Conversely, a small number of experimental studies suggest there is an association between mood and smoking and that the relationship is dependent on levels of depression. Researchers have yet to examine the impact of depression on the relationship between mood and smoking using EMA methodology. Accordingly, the aim of this study was to explore the relationship between depression, mood, and ad lib smoking among adults in "real time." METHOD Participants included 96 adult daily smokers (53% female, 67% non-Hispanic Black; age, M = 40.76, SD = 12.42) who completed baseline ratings of depressive symptoms and 7 consecutive days of in vivo data collection focused on cigarette smoking and associated mood and craving ratings. RESULTS Results indicated that depression moderates the prospective relationship between mood and smoking (even when controlling for craving), such that participants with higher levels of depressive symptoms smoke more cigarettes in response to an improvement in mood (relative to their average mood), whereas participants with lower levels of depressive symptoms smoke more in response to worsening mood states (relative to their average mood). CONCLUSIONS Attempting to maintain better mood may be a motivating factor for smoking among depressed individuals. These findings may be helpful in tailoring smoking cessation treatment programs for people exhibiting depressive symptoms. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | | | - Jennifer L Pearson
- Schroeder Institute for Tobacco Research and Policy Studies, Truth Initiative
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21
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Berg CJ, Haardörfer R, Payne JB, Getachew B, Vu M, Guttentag A, Kirchner TR. Ecological momentary assessment of various tobacco product use among young adults. Addict Behav 2019; 92:38-46. [PMID: 30579116 DOI: 10.1016/j.addbeh.2018.12.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 12/07/2018] [Accepted: 12/10/2018] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Young adults are at high risk for using traditional and novel tobacco products. However, little is known about daily/weekly use patterns or psychosocial triggers for using various tobacco products. METHODS This ecological momentary assessment (EMA) study examined timing, tobacco cravings, affect, social context, and other substance use (alcohol, marijuana) in relation to use of cigarettes, electronic nicotine delivery systems (ENDS), and any tobacco product (i.e., cigarettes, ENDS, cigars, hookah), respectively. We also examined interactions between these predictors, sex, and race/ethnicity. From a longitudinal study of 3418 18-25 year-olds from seven Georgia colleges/universities, we recruited 72 reporting current tobacco use to participate in the 21-day EMA study; 43 participated, of which 31 completed ≥66% assessments and were analyzed. Cravings, affect, social context, and substance use were assessed daily across four four-hour windows. RESULTS Of the 31 participants, average age was 21.10 years (SD = 1.95), 45.2% were female, and 71.0% non-Hispanic White; 71.0% used cigarettes, 58.1% ENDS, 38.7% cigars, and 25.8% hookah (25.6% used one product, 46.5% two, 27.9% ≥ three). Predictors of cigarette use included higher anxiety, greater odds of marijuana and alcohol use, and higher boredom levels among women. Predictors of ENDS use included being non-White and greater odds of marijuana use, as well as higher tobacco cravings among women and higher boredom among men. Predictors of any tobacco product use included being non-White, higher boredom levels, and greater odds of marijuana and alcohol use. CONCLUSIONS Distinct interventions may be needed to address use of differing tobacco products among young adults.
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Affiliation(s)
- Carla J Berg
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, United States; Winship Cancer Institute, Emory University, 1365 Clifton Rd NE, Atlanta, GA 30322, United States.
| | - Regine Haardörfer
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, United States
| | - Jackelyn B Payne
- Winship Cancer Institute, Emory University, 1365 Clifton Rd NE, Atlanta, GA 30322, United States
| | - Betelihem Getachew
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, United States
| | - Milkie Vu
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, United States
| | - Alexandra Guttentag
- College of Global Public Health, New York University, 715 Broadway, 12th Floor New York, NY 10003, United States
| | - Thomas R Kirchner
- College of Global Public Health, New York University, 715 Broadway, 12th Floor New York, NY 10003, United States
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Dvorak RD, Waters AJ, MacIntyre JM, Gwaltney CJ. Affect, craving, and cognition: An EMA study of ad libitum adolescent smoking. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2018; 32:583-594. [PMID: 30211581 PMCID: PMC6137814 DOI: 10.1037/adb0000392] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Reducing smoking among adolescents is a public health priority. Affect, craving, and cognitive processes have been identified as predictors of smoking in adolescents. The current study examined associations between implicit attitude for smoking (assessed via the positive-negative valence implicit association test) and affect, craving, and smoking assessed using ecological momentary assessment (EMA). Adolescent smokers (n = 154; Mage = 16.57, SD = 1.12) completed a laboratory assessment of implicit smoking attitudes and carried a palm-top computer for several days while smoking ad libitum. During EMA, they recorded affect, craving, and smoking behavior. Data were analyzed using a multilevel path analysis. At the between-subjects level, more positive implicit smoking attitude was indirectly associated with smoking rate via craving. This association was moderated by positive affect, such that it was stronger for those with greater traitlike positive affect. At the event (within-subject) level, implicit attitude potentiated associations between stress and craving and between positive affect and craving. Individuals with a more positive implicit attitude exhibited more robust indirect associations between momentary stress-positive affect and smoking. In sum, a more positive implicit attitude to smoking was associated with overall levels of craving and smoking and might have potentiated momentary affect-craving associations. Interventions that modify implicit attitude may be an approach for reducing adolescent smoking. (PsycINFO Database Record
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Mead EL, Chen JC, Kirchner TR, Butler J, Feldman RH. An Ecological Momentary Assessment of Cigarette and Cigar Dual Use Among African American Young Adults. Nicotine Tob Res 2018; 20:S12-S21. [PMID: 30125017 PMCID: PMC6093372 DOI: 10.1093/ntr/nty061] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Accepted: 03/28/2018] [Indexed: 11/25/2022]
Abstract
Introduction The dual use of cigarettes and cigars among African American young adults is a significant public health issue. Patterns of and reasons for dual use are difficult to capture using traditional self-report methods. This study used ecological momentary assessment (EMA) to characterize patterns of dual smoking and examine the personal and environmental predictors of cigarette and cigar smoking among African American young adult dual users (ages 18-29) in real-time. Methods For 14 days, 64 participants smoked ad libitum and were prompted four times daily to record their smoking, craving, emotions, social smoking, and environment via text message on their mobile phones. The odds of single product and dual use were examined using adjusted generalized estimating equations. Results Participants smoked an average of 7.9 cigarettes and 4.2 cigars per day. Cigarettes and cigars were smoked as frequently during periods of dual use as they were during periods of single product use. Cigarette craving was positively associated with cigarette-only smoking (OR: 1.07), whereas cigar craving was positively associated with cigar-only smoking (OR: 1.43) and dual use (OR: 1.08). Cigars had the greatest odds of dual use when with others (OR: 4.69) and in others' homes (OR: 4.33). Cigarettes had the greatest odds of being smoked while alone (OR: 1.57). Conclusions EMA was useful for capturing variable smoking patterns and predictors. In this study population, cigarettes and cigars appeared to be smoked additively, and cigars smoked socially. These findings can inform future interventions addressing dual use in this high priority population. Implications This is the first study to use EMA to examine naturalistic patterns and predictors of multiple tobacco use in real-time. African American young adults smoked cigarettes and cigars during periods of dual use as frequently as during periods of single product use. This suggests that most use was additive (one product smoked in addition to another) and less often as substitution (one product smoked instead of another). Social smoking and craving were strongly associated with cigar smoking in single and dual use periods. This study suggests the need for cessation messaging specifically targeted to reduce dual use in this population.
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Affiliation(s)
- Erin L Mead
- University of Connecticut Health, School of Medicine, Farmington, CT
- University of Maryland, School of Public Health, Department of Behavioral and Community Health, Tobacco Center of Regulatory Science, College Park, MD
| | - Julia Cen Chen
- University of Maryland, School of Public Health, Department of Behavioral and Community Health, College Park, MD
| | | | - James Butler
- University of Maryland Center for Health Equity, School of Public Health, Department of Behavioral and Community Health, College Park, MD
| | - Robert H Feldman
- University of Maryland, School of Public Health, Department of Behavioral and Community Health, Tobacco Center of Regulatory Science, College Park, MD
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Predictors of craving and substance use among patients with alcohol, tobacco, cannabis or opiate addictions: Commonalities and specificities across substances. Addict Behav 2018; 83:123-129. [PMID: 29428330 DOI: 10.1016/j.addbeh.2018.01.041] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 01/25/2018] [Accepted: 01/31/2018] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Craving has been proposed as a major contributor to addiction relapse and the influence of mood on craving and substance use has been extensively documented. However, information is lacking concerning the extent to which the magnitude of these effects may vary according to different types of substances. The aim of the present study was to compare the prospective links between emotions, craving and substance use in four groups of patients beginning treatment for alcohol, tobacco, cannabis, or opiate addiction. METHODS Ecological Momentary Assessment (EMA) was used over a two-week period. Data were analyzed using hierarchical linear modeling (HLM). RESULTS 159 participants were recruited (67.3% male; M = 36.7 years). The average response rate to the EMA assessments was 83.1%. The findings confirmed the strong predictive role of craving intensity on substance use reported at the next assessment of the day among the alcohol (γ = 0.224; p = .018), tobacco (γ = 0.133; p = .013) and cannabis groups (γ = 0.266; p = .019), but not for opiates (γ = 0.098; p = .142). Craving intensity was itself predicted by greater anxious mood (γ = 0.108; p = 0,029) and event negativity (γ = 0.107; p = .003) among tobacco patients, lower sad mood among cannabis patients (γ = -0.248; p = 0,002), and lower event negativity among opiate patients (γ = -0.201; p = .002). CONCLUSION While these results support the benefit of targeting craving in addiction treatment regardless of substance type, the substance-specific emotional risk factors for craving identified in this study may provide important insights for the development of personalized treatment strategies.
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Effects of anxiety and mood disorders on craving and substance use among patients with substance use disorder: An ecological momentary assessment study. Drug Alcohol Depend 2018; 187:242-248. [PMID: 29684892 DOI: 10.1016/j.drugalcdep.2018.03.008] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Revised: 03/05/2018] [Accepted: 03/06/2018] [Indexed: 02/01/2023]
Abstract
BACKGROUND Despite recognition of the negative impact of psychiatric comorbidity on addictive disorders, the mechanisms underlying this association remain poorly understood. The present investigation applied mobile technologies to examine the effect of comorbid mood or anxiety disorders on craving intensity and substance use within the natural conditions of daily life. METHODS A total of 159 participants were recruited from a French outpatient addiction clinic and completed two weeks of computerized ambulatory monitoring of daily life experiences using Ecological Momentary Assessment (EMA). Patients described in real-time their emotional states, craving intensity, and substance use. Current mood and/or anxiety disorders were diagnosed according to DSM-IV criteria. The main substances of dependence were alcohol (n = 48), tobacco (n = 43), cannabis (n = 35), or opiates (n = 33). RESULTS Craving intensity strongly predicted substance use reported over subsequent hours of the day both in groups with (OR = 1.13, p = .009, n = 95) and without (OR = 1.20, p = .002, n = 64) current comorbid psychiatric disorders. Current comorbid mood and/or anxiety disorders were associated with higher craving intensity (γ coef = 0.632, SE = 0.254, p = .014) and consequently more frequent substance use (γ coef = 0.162, SE = 0.052, p = .003). A portion of increased substance use associated with current mood and/or anxiety disorders was independent of increases in craving intensity. CONCLUSIONS Attention to craving management is particularly important for patients with substance use disorders and comorbid mood and/or anxiety disorders, but additional interventions are also needed that address other mechanisms through which these disorders lead to an increase in substance use frequency, independently from craving.
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Exploring online communication about cigarette smoking among Twitter users who self-identify as having schizophrenia. Psychiatry Res 2017; 257:479-484. [PMID: 28841509 PMCID: PMC5877400 DOI: 10.1016/j.psychres.2017.08.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 06/13/2017] [Accepted: 08/01/2017] [Indexed: 12/19/2022]
Abstract
Novel approaches are needed to address elevated tobacco use among people with schizophrenia. This exploratory study examined the frequency, timing, and type of communication about tobacco-related content on Twitter among users who self-identify as having schizophrenia compared with users from the general population. Over a 200-day period from January to July 2016, Twitter users who self-identify as having a schizophrenia spectrum disorder (n = 203) and a randomly selected group of general population control users (n = 173) posted 1,544,122 tweets. Communication frequency did not differ between groups. Tweets containing tobacco-related keywords were extracted. Twitter users with schizophrenia posted significantly more tweets containing any tobacco-related terms (mean = 3.74; SD = 16.3) compared with control users (mean = 0.82; SD = 1.8). A significantly greater proportion of Twitter users with schizophrenia (45%; n = 92) posted tweets containing any tobacco terms compared with control users (30%; n = 52). Schizophrenia users showed significantly greater odds of tweeting about tobacco compared with control users (OR = 1.99; 95% CI 1.29-3.07). These findings suggest that online communication about tobacco may parallel real world trends of elevated tobacco use observed among people with schizophrenia. By showing that Twitter users who self-identify as having schizophrenia discuss tobacco-related content online, popular social media could inform smoking cessation efforts targeting this at-risk group.
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Conklin CA, Soreca I, Kupfer DJ, Cheng Y, Salkeld RP, Mumma JM, Jakicic JM, Joyce CJ. Exercise attenuates negative effects of abstinence during 72 hours of smoking deprivation. Exp Clin Psychopharmacol 2017; 25:265-272. [PMID: 28682103 PMCID: PMC5567790 DOI: 10.1037/pha0000128] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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
Exercise is presumed to be a potentially helpful smoking cessation adjunct reputed to attenuate the negative effects of deprivation. The present study examined the effectiveness of moderate within-session exercise to reduce 4 key symptoms of smoking deprivation during 3 72-hr nicotine abstinence blocks in both male and female smokers. Forty-nine (25 male, 24 female) sedentary smokers abstained from smoking for 3 consecutive days on 3 separate occasions. At each session, smokers' abstinence-induced craving, cue-induced craving, negative mood, and withdrawal symptom severity were assessed prior to and after either exercise (a.m. exercise, p.m. exercise) or a sedentary control activity (magazine reading). Abstinence-induced craving and negative mood differed as a function of condition, F(2, 385) = 21, p < .0001; and, F(2, 385) = 3.38, p = .03. Planned contrasts revealed no difference between a.m. and p.m. exercise, but exercise overall led to greater pre-post reduction in abstinence-induced craving, t(385) = 6.23, p < .0001, effect size Cohen's d = 0.64; and negative mood, t(385) = 2.25, p = .03, d = 0.23. Overall exercise also led to a larger pre-post reduction in cue-induced craving in response to smoking cues, F(2, 387) = 8.94, p = .0002; and withdrawal severity, F(2, 385) = 3.8, p = .02. Unlike the other 3 measures, p.m. exercise reduced withdrawal severity over control, t(385) = 2.64, p = .009, d = 0.27, whereas a.m. exercise did not. The results support the clinical potential of exercise to assist smokers in managing common and robust negative symptoms experienced during the first 3 days of abstinence. (PsycINFO Database Record
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Affiliation(s)
| | | | | | - Yu Cheng
- Department of Statistics, University of Pittsburgh
| | | | - Joel M Mumma
- Department of Psychiatry, University of Pittsburgh
| | - John M Jakicic
- Department of Health and Physical Activity, University of Pittsburgh
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Burke LE, Shiffman S, Music E, Styn MA, Kriska A, Smailagic A, Siewiorek D, Ewing LJ, Chasens E, French B, Mancino J, Mendez D, Strollo P, Rathbun SL. Ecological Momentary Assessment in Behavioral Research: Addressing Technological and Human Participant Challenges. J Med Internet Res 2017; 19:e77. [PMID: 28298264 PMCID: PMC5371716 DOI: 10.2196/jmir.7138] [Citation(s) in RCA: 143] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 02/03/2017] [Accepted: 02/19/2017] [Indexed: 12/22/2022] Open
Abstract
Background Ecological momentary assessment (EMA) assesses individuals’ current experiences, behaviors, and moods as they occur in real time and in their natural environment. EMA studies, particularly those of longer duration, are complex and require an infrastructure to support the data flow and monitoring of EMA completion. Objective Our objective is to provide a practical guide to developing and implementing an EMA study, with a focus on the methods and logistics of conducting such a study. Methods The EMPOWER study was a 12-month study that used EMA to examine the triggers of lapses and relapse following intentional weight loss. We report on several studies that informed the implementation of the EMPOWER study: (1) a series of pilot studies, (2) the EMPOWER study’s infrastructure, (3) training of study participants in use of smartphones and the EMA protocol and, (4) strategies used to enhance adherence to completing EMA surveys. Results The study enrolled 151 adults and had 87.4% (132/151) retention rate at 12 months. Our learning experiences in the development of the infrastructure to support EMA assessments for the 12-month study spanned several topic areas. Included were the optimal frequency of EMA prompts to maximize data collection without overburdening participants; the timing and scheduling of EMA prompts; technological lessons to support a longitudinal study, such as proper communication between the Android smartphone, the Web server, and the database server; and use of a phone that provided access to the system’s functionality for EMA data collection to avoid loss of data and minimize the impact of loss of network connectivity. These were especially important in a 1-year study with participants who might travel. It also protected the data collection from any server-side failure. Regular monitoring of participants’ response to EMA prompts was critical, so we built in incentives to enhance completion of EMA surveys. During the first 6 months of the 12-month study interval, adherence to completing EMA surveys was high, with 88.3% (66,978/75,888) completion of random assessments and around 90% (23,411/25,929 and 23,343/26,010) completion of time-contingent assessments, despite the duration of EMA data collection and challenges with implementation. Conclusions This work informed us of the necessary preliminary steps to plan and prepare a longitudinal study using smartphone technology and the critical elements to ensure participant engagement in the potentially burdensome protocol, which spanned 12 months. While this was a technology-supported and -programmed study, it required close oversight to ensure all elements were functioning correctly, particularly once human participants became involved.
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Affiliation(s)
- Lora E Burke
- Department of Health & Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, PA, United States.,Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, United States
| | - Saul Shiffman
- University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Edvin Music
- Department of Health & Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, PA, United States.,University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Mindi A Styn
- Department of Health & Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, PA, United States.,University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Andrea Kriska
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, United States
| | - Asim Smailagic
- Institute for Complex Engineered Systems, Carnegie Mellon University, Pittsburgh, PA, United States
| | - Daniel Siewiorek
- Human Computer Interaction Institute, Carnegie Mellon University, Pittsburgh, PA, United States
| | - Linda J Ewing
- University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Eileen Chasens
- Department of Health & Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, PA, United States
| | - Brian French
- Department of Epidemiology and Biostatistics, University of Georgia College of Public Health, Athens, GA, United States
| | - Juliet Mancino
- University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Dara Mendez
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, United States
| | - Patrick Strollo
- University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Stephen L Rathbun
- Department of Epidemiology and Biostatistics, University of Georgia College of Public Health, Athens, GA, United States
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Chiamulera C, Ferrandi E, Benvegnù G, Ferraro S, Tommasi F, Maris B, Zandonai T, Bosi S. Virtual Reality for Neuroarchitecture: Cue Reactivity in Built Spaces. Front Psychol 2017; 8:185. [PMID: 28243216 PMCID: PMC5303754 DOI: 10.3389/fpsyg.2017.00185] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 01/30/2017] [Indexed: 11/24/2022] Open
Affiliation(s)
- Cristiano Chiamulera
- Neuropsychopharmacology Lab, Sezione Farmacologia, Università di Verona Verona, Italy
| | - Elisa Ferrandi
- Neuropsychopharmacology Lab, Sezione Farmacologia, Università di Verona Verona, Italy
| | - Giulia Benvegnù
- Neuropsychopharmacology Lab, Sezione Farmacologia, Università di Verona Verona, Italy
| | - Stefano Ferraro
- Neuropsychopharmacology Lab, Sezione Farmacologia, Università di VeronaVerona, Italy; Altair Robotics Laboratory, Department of Computer Science, Università di VeronaVerona, Italy
| | - Francesco Tommasi
- Neuropsychopharmacology Lab, Sezione Farmacologia, Università di Verona Verona, Italy
| | - Bogdan Maris
- Altair Robotics Laboratory, Department of Computer Science, Università di Verona Verona, Italy
| | - Thomas Zandonai
- Experimental Psychology Department, Faculty of Psychology, Mind, Brain and Behaviour Research Center, University of Granada Granada, Spain
| | - Sandra Bosi
- Italian League against Cancer (LILT) Reggio Emilia, Italy
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Dumortier A, Beckjord E, Shiffman S, Sejdić E. Classifying smoking urges via machine learning. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2016; 137:203-213. [PMID: 28110725 PMCID: PMC5289882 DOI: 10.1016/j.cmpb.2016.09.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Revised: 08/12/2016] [Accepted: 09/20/2016] [Indexed: 05/30/2023]
Abstract
BACKGROUND AND OBJECTIVE Smoking is the largest preventable cause of death and diseases in the developed world, and advances in modern electronics and machine learning can help us deliver real-time intervention to smokers in novel ways. In this paper, we examine different machine learning approaches to use situational features associated with having or not having urges to smoke during a quit attempt in order to accurately classify high-urge states. METHODS To test our machine learning approaches, specifically, Bayes, discriminant analysis and decision tree learning methods, we used a dataset collected from over 300 participants who had initiated a quit attempt. The three classification approaches are evaluated observing sensitivity, specificity, accuracy and precision. RESULTS The outcome of the analysis showed that algorithms based on feature selection make it possible to obtain high classification rates with only a few features selected from the entire dataset. The classification tree method outperformed the naive Bayes and discriminant analysis methods, with an accuracy of the classifications up to 86%. These numbers suggest that machine learning may be a suitable approach to deal with smoking cessation matters, and to predict smoking urges, outlining a potential use for mobile health applications. CONCLUSIONS In conclusion, machine learning classifiers can help identify smoking situations, and the search for the best features and classifier parameters significantly improves the algorithms' performance. In addition, this study also supports the usefulness of new technologies in improving the effect of smoking cessation interventions, the management of time and patients by therapists, and thus the optimization of available health care resources. Future studies should focus on providing more adaptive and personalized support to people who really need it, in a minimum amount of time by developing novel expert systems capable of delivering real-time interventions.
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Affiliation(s)
- Antoine Dumortier
- Department of Electrical and Computer Engineering, University of Pittsburgh, Benedum Hall, Pittsburgh, PA 15260, USA
| | - Ellen Beckjord
- Department of Psychiatry, University of Pittsburgh, 5115 Centre Avenue, Suite 140, Pittsburgh, PA 15232, USA
| | - Saul Shiffman
- Department of Psychology, University of Pittsburgh, 510 BELPB, 130 N. Bellefield Avenue, Pittsburgh, PA 15260, USA
| | - Ervin Sejdić
- Department of Electrical and Computer Engineering, University of Pittsburgh, Benedum Hall, Pittsburgh, PA 15260, USA.
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Dragone D, Manaresi F, Savorelli L. Obesity and Smoking: can we Kill Two Birds with one Tax? HEALTH ECONOMICS 2016; 25:1464-1482. [PMID: 26395977 DOI: 10.1002/hec.3231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 04/08/2015] [Accepted: 08/13/2015] [Indexed: 06/05/2023]
Abstract
The debate on tobacco and fat taxes often treats smoking and eating as independent behaviors. However, the available evidence shows that they are interdependent, which implies that policies against smoking or obesity may have larger scope than expected. To address this issue, we propose a dynamic rational model where eating, smoking, and physical exercise are simultaneous choices that jointly affect body weight and addiction to smoking. Focusing on direct and cross-price effects, we study the impact of tobacco and food taxes, and we show that in both cases a single policy tool can reduce both smoking and body weight. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Davide Dragone
- Dipartimento di Scienze Economiche, University of Bologna, Bologna, Italy.
| | - Francesco Manaresi
- Bank of Italy, Structural Economic Analysis - Labour Market Division, Rome, Italy
| | - Luca Savorelli
- School of Economics & Finance, University of St Andrews, St Andrews, UK
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Borzekowski DLG, Chen JC. Tobacco cues in India: An ecological momentary assessment. Tob Induc Dis 2016; 14:16. [PMID: 27147939 PMCID: PMC4855761 DOI: 10.1186/s12971-016-0081-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 04/18/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Tobacco use in India is a major health concern; however, little is known about the influence of tobacco-related social and environmental cues on tobacco use. This study uses ecological momentary assessment (EMA) to examine real-time tobacco use and exposure to social and environmental cues. METHODS In Hyderabad and Kolkata, participants were recruited, and an EMA application was installed on their mobile phones. Momentary prompts (MP) were randomly used to collect real-time information and end-of-day (EOD) prompts gathered retrospective information on daily basis. Besides personal tobacco use, the surveys asked about exposure to social (e.g., presence of others using tobacco) and environmental cues (e.g., visual and olfactory stimuli). Using the data aggregation approach, bivariate and multivariate analyses were performed to examine the association of tobacco use and cue exposure. Moderating roles of participants' socio-demographic characteristics were also tested to gain an in-depth understanding of the relationship. RESULTS Among the 205 participants, around a third (MP, 33.7 %; EOD, 37.6 %) used tobacco at least once during the study period. Tobacco-related social and environmental cues related were commonly reported. In the bivariate models, tobacco use was associated with gender, age, and all the examined social and environmental cues except for seeing restrictions on tobacco use. In the multivariate models, tobacco use was associated with age, gender, seeing others using tobacco, and seeing restrictions on tobacco use. Seeing others in one's immediate group using tobacco was the strongest predictor of tobacco use in both MP and EOD assessments. Gender and age did not moderate the relationship between cue exposure and tobacco use, although males reported higher tobacco use and cue exposure in general. CONCLUSIONS This research provides data on the ubiquity of social and environmental tobacco cues in India. The EMA approach was feasible and informative. Future cessation interventions and advocacy efforts should address the high prevalence of tobacco use and exposure to pro-tobacco use cues especially among Indian males. Health education campaigns for promoting tobacco use restrictions in private places as well as changing the norms of tobacco use in social settings are recommended.
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Affiliation(s)
- Dina L G Borzekowski
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, #2364 SPH Building, Valley Drive, College Park, MD 20742 USA
| | - Julia Cen Chen
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, #2364 SPH Building, Valley Drive, College Park, MD 20742 USA
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Ecological momentary assessment of affect and craving in patients in treatment for prescription opioid dependence. Brain Res Bull 2016; 123:94-101. [PMID: 26876756 DOI: 10.1016/j.brainresbull.2016.01.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 01/21/2016] [Accepted: 01/22/2016] [Indexed: 11/21/2022]
Abstract
Low positive affect (PA) is likely to contribute to risk of relapse; however, it has received relatively little attention in clinical research. This study examined the associations among positive affect, negative affect (NA), and craving in medically withdrawn patients using ecological momentary assessment (EMA). Participants (n=73) provided reports of their PA, NA, and craving 4 times a day for an average of 10.47 (SD=3.80) days. Person- and day-level associations between PA, NA, and craving were examined using multilevel models. A significant interaction emerged between person- and day-level PA such that PA on the day level was negatively associated with craving for individuals experiencing low mean PA throughout the study. No significant interaction emerged between person- and day-level NA. The main effects for both person- and day-level NA were significant. Individuals experiencing high NA throughout the study experienced higher craving overall and on days when NA was higher than usual, craving was also higher. Results suggest that high person- and day-level NA may directly contribute to the risk for relapse via increased craving, whereas low day- level PA may contribute to risk for relapse among individuals exhibiting low person-level PA via increased craving on days with lower than average levels of PA for those individuals. Given that there is a paucity of research relating low PA to craving, continued investigation into how and when low PA creates risk for relapse is warranted.
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Shiffman S, Li X, Dunbar MS, Tindle HA, Scholl SM, Ferguson SG. Does laboratory cue reactivity correlate with real-world craving and smoking responses to cues? Drug Alcohol Depend 2015; 155:163-9. [PMID: 26277429 PMCID: PMC4581999 DOI: 10.1016/j.drugalcdep.2015.07.673] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 07/04/2015] [Accepted: 07/25/2015] [Indexed: 01/25/2023]
Abstract
BACKGROUND Laboratory cue reactivity (CR) assessments are used to assess smokers' responses to cues. Likewise, EMA recording is used to characterize real-world response to cues. Understanding the relationship between CR and EMA responses addresses the ecological validity of CR. METHODS In 190 daily smokers not currently quitting, craving and smoking responses to cues were assessed in laboratory CR and by real-world EMA recording. Separate CR sessions involved 5 smoking-relevant cues (smoking, alcohol, negative affect, positive affect, smoking prohibitions), and a neutral cue. Subjects used EMA to monitor smoking situations for 3 weeks, completing parallel situational assessments (presence of others smoking, alcohol consumption, negative affect, positive affect, and smoking prohibitions, plus current craving) in smoking and non-smoking occasions (averaging 70 and 60 occasions each). Analyses correlated CR craving and smoking cue responses with EMA craving and smoking correlations with similar cues. RESULTS Although some cues did not show main effects on average craving or smoking, a wide range of individual differences in response to cues was apparent in both CR and EMA data, providing the necessary context to assess their relationship. Laboratory CR measures of cue response were not correlated with real-world cue responses assessed by EMA. The average correlation was 0.03; none exceeded 0.32. One of 40 correlations examined was significantly greater than 0. CONCLUSIONS Laboratory CR measures do not correlate with EMA-assessed craving or smoking in response to cues, suggesting that CR measures are not accurate predictors of how smokers react to relevant stimuli in the real world.
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Affiliation(s)
- Saul Shiffman
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15213, USA.
| | - Xiaoxue Li
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Michael S Dunbar
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Hilary A Tindle
- Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Sarah M Scholl
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15213, USA
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Rojewski AM, Morean ME, Toll BA, McKee SA, Krishnan-Sarin S, Green BG, Bartoshuk LM, O’Malley SS. The Yale Craving Scale: Development and psychometric properties. Drug Alcohol Depend 2015; 154:158-66. [PMID: 26183404 PMCID: PMC4834029 DOI: 10.1016/j.drugalcdep.2015.06.040] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 06/01/2015] [Accepted: 06/19/2015] [Indexed: 01/16/2023]
Abstract
INTRODUCTION The current study presents a psychometric evaluation of the Yale Craving Scale (YCS), a novel measure of craving for cigarettes and alcohol, respectively. The YCS is the first craving measure to use a generalized Labeled Magnitude Scale (gLMS) as the scoring format, which facilitates between-group comparisons of subjective craving and eliminates ceiling effects by assessing the full range of imaginable sensation intensities. METHODS Psychometric evaluations of the YCS for use with cigarettes (YCS Smoking) and alcohol (YCS Drinking) included assessments of latent factor structure, internal consistency, ceiling effects, and test-criterion relationships. Study samples included 493 treatment-seeking smokers and 213 heavy drinkers. RESULTS Factor analyses of the 5-item YCS Smoking and Drinking scores confirmed a 1-factor scale. The YCS Smoking and Drinking scores evidenced: (1) good internal consistency, (2) scalar measurement invariance within several subgroups (e.g., smoking/drinking status; nicotine/alcohol dependence), (3) convergent relationships with extant craving measures, and (4) concurrent relationships with smoking/drinking outcomes. CONCLUSIONS These results suggest that the YCS represents a psychometrically sound scale for assessing smoking and drinking urges in dependent populations.
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Affiliation(s)
- Alana M. Rojewski
- Medical University of South Carolina, Department of Public Health Sciences, 135 Cannon Street, MSC 835, Charleston, SC 29425, USA,Yale School of Medicine, Department of Psychiatry, 1 Long Wharf Drive, Box 18, New Haven, CT 06511, USA
| | - Meghan E. Morean
- Oberlin College, 120W. Lorain St., Oberlin, OH 44074, USA,Yale School of Medicine, Department of Psychiatry, CMHC, 34 Park Street, New Haven, CT 06519, USA,Corresponding author at: Oberlin College, 120W. Lorain St., Oberlin, OH 44074, USA. (M.E. Morean)
| | - Benjamin A. Toll
- Medical University of South Carolina, Department of Public Health Sciences, 135 Cannon Street, MSC 835, Charleston, SC 29425, USA,Yale Cancer Center, USA,Smilow Cancer Hospital at Yale-New Haven, and Medical University of South Carolina, Department of Public Health Sciences, 135 Cannon Street, MSC 835, Charleston, SC, 29425, USA
| | - Sherry A. McKee
- Yale School of Medicine, Department of Psychiatry, 2 Church Street South, Suite 109, New Haven, CT 06519 USA
| | - Suchitra Krishnan-Sarin
- Yale School of Medicine, Department of Psychiatry, CMHC, 34 Park Street, New Haven, CT 06519, USA
| | - Barry G. Green
- The John B. Pierce Laboratory, 290 Congress Avenue, New Haven, CT, 06519, USA,Yale School of Medicine, Department of Surgery, 310 Cedar Street, New Haven, CT, 06510, USA
| | - Linda M. Bartoshuk
- The University of Florida, Food Science and Human Nutrition, 572 Newell Dr., P.O. Box 110370, Gainesville, FL, 32611-0370, USA
| | - Stephanie S. O’Malley
- Medical University of South Carolina, Department of Public Health Sciences, 135 Cannon Street, MSC 835, Charleston, SC 29425, USA,Yale School of Medicine, Department of Psychiatry, 1 Long Wharf Drive, Box 18, New Haven, CT 06511, USA,Oberlin College, 120W. Lorain St., Oberlin, OH 44074, USA,Yale School of Medicine, Department of Psychiatry, CMHC, 34 Park Street, New Haven, CT 06519, USA,Yale Cancer Center, USA,Smilow Cancer Hospital at Yale-New Haven, and Medical University of South Carolina, Department of Public Health Sciences, 135 Cannon Street, MSC 835, Charleston, SC, 29425, USA,Yale School of Medicine, Department of Psychiatry, 2 Church Street South, Suite 109, New Haven, CT 06519 USA,The John B. Pierce Laboratory, 290 Congress Avenue, New Haven, CT, 06519, USA,Yale School of Medicine, Department of Surgery, 310 Cedar Street, New Haven, CT, 06510, USA,The University of Florida, Food Science and Human Nutrition, 572 Newell Dr., P.O. Box 110370, Gainesville, FL, 32611-0370, USA
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Juengst SB, Graham KM, Pulantara IW, McCue M, Whyte EM, Dicianno BE, Parmanto B, Arenth PM, Skidmore ERD, Wagner AK. Pilot feasibility of an mHealth system for conducting ecological momentary assessment of mood-related symptoms following traumatic brain injury. Brain Inj 2015; 29:1351-61. [PMID: 26287756 DOI: 10.3109/02699052.2015.1045031] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This study assessed pilot feasibility and validity of a mobile health (mHealth) system for tracking mood-related symptoms after traumatic brain injury (TBI). DESIGN A prospective, repeated measures design was used to assess compliance with daily ecological momentary assessments (EMA) conducted via a smartphone application over an 8-week period. METHODS An mHealth system was developed specifically for individuals with TBI and utilized previously validated tools for depressive and anxiety symptoms (Patient Health Questionnaire-9, Generalized Anxiety Disorder-7). Feasibility was assessed in 20 community-dwelling adults with TBI via an assessment of compliance, satisfaction and usability of the smartphone applications. The authors also developed and implemented a clinical patient safety management mechanism for those endorsing suicidality. RESULTS Participants correctly completed 73.4% of all scheduled assessments, demonstrating good compliance. Daily assessments took <2 minutes to complete. Participants reported high satisfaction with smartphone applications (6.3 of 7) and found them easy to use (6.2 of 7). Comparison of assessments obtained via telephone-based interview and EMA demonstrated high correlations (r = 0.81-0.97), supporting the validity of conducting these assessments via smartphone application in this population. CONCLUSIONS EMA conducted via smartphone demonstrates initial feasibility among adults with TBI and presents numerous opportunities for long-term monitoring of mood-related symptoms in real-world settings.
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Affiliation(s)
- Shannon B Juengst
- a Department of Physical Medicine & Rehabilitation , School of Medicine
| | - Kristin M Graham
- b Department of Rehabilitation Science & Technology , School of Health and Rehabilitation Sciences
| | - I Wayan Pulantara
- c Department of Health Information Management , School of Health and Rehabilitation Sciences
| | - Michael McCue
- b Department of Rehabilitation Science & Technology , School of Health and Rehabilitation Sciences
| | - Ellen M Whyte
- a Department of Physical Medicine & Rehabilitation , School of Medicine .,d Department of Psychiatry
| | - Brad E Dicianno
- a Department of Physical Medicine & Rehabilitation , School of Medicine .,b Department of Rehabilitation Science & Technology , School of Health and Rehabilitation Sciences
| | - Bambang Parmanto
- c Department of Health Information Management , School of Health and Rehabilitation Sciences
| | - Patricia M Arenth
- a Department of Physical Medicine & Rehabilitation , School of Medicine
| | - Elizabeth R D Skidmore
- a Department of Physical Medicine & Rehabilitation , School of Medicine .,e Department of Occupational Therapy , School of Health and Rehabilitation Sciences
| | - Amy K Wagner
- a Department of Physical Medicine & Rehabilitation , School of Medicine .,f Center for Neuroscience , and.,g Safar Center for Resuscitation Research, University of Pittsburgh , Pittsburgh , PA , USA
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Emotion differentiation and intensity during acute tobacco abstinence: A comparison of heavy and light smokers. Addict Behav 2015; 47:70-3. [PMID: 25885662 DOI: 10.1016/j.addbeh.2015.03.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2014] [Revised: 02/04/2015] [Accepted: 03/29/2015] [Indexed: 11/22/2022]
Abstract
The ability to recognize and label discrete emotions, termed emotion differentiation, is particularly pertinent to overall emotion regulation abilities. Patterns of deficient emotion differentiation have been associated with mood and anxiety disorders but have yet to be examined in relation to nicotine dependence. This study employed ecological momentary assessment to examine smokers' subjective experience of discrete emotions during 24-h of forced tobacco abstinence. Thirty daily smokers rated their emotions up to 23 times over the 24-hour period, and smoking abstinence was biologically verified. From these data, we computed individual difference measures of emotion differentiation, overall emotion intensity, and emotional variability. As hypothesized, heavy smokers reported poorer negative emotion differentiation than light smokers (d=0.55), along with more intense negative emotion (d=0.97) and greater negative emotion variability (d=0.97). No differences were observed in positive emotion differentiation. Across the sample, poorer negative emotion differentiation was associated with greater endorsement of psychological motives to smoke, including negative and positive reinforcement motives, while positive emotion differentiation was not.
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Bujarski S, Roche DJ, Sheets ES, Krull JL, Guzman I, Ray LA. Modeling naturalistic craving, withdrawal, and affect during early nicotine abstinence: A pilot ecological momentary assessment study. Exp Clin Psychopharmacol 2015; 23:81-9. [PMID: 25844632 PMCID: PMC4388058 DOI: 10.1037/a0038861] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [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
Despite the critical role of withdrawal, craving, and positive affect (PA) and negative affect (NA) in smoking relapse, relatively little is known about the temporal and predictive relationship between these constructs within the first day of abstinence. This pilot study aims to characterize dynamic changes in withdrawal, craving, and affect over the course of early abstinence using ecological momentary assessment. Beginning immediately after smoking, moderate and heavy smoking participants (n = 15 per group) responded to hourly surveys assessing craving, withdrawal, NA, and PA. Univariate and multivariate multilevel random coefficient modeling was used to describe the progression of craving, withdrawal/NA, and PA and to test correlations between these constructs at the subject level over the course of early abstinence. Heavy smokers reported greater craving from 1-4 hr of abstinence and greater withdrawal/NA after 3 or more hours as compared with moderate smokers. Level of withdrawal/NA was strongly positively associated with craving, and PA was negatively correlated with craving; however, the temporal dynamics of these correlations differed substantially. The association between withdrawal/NA and craving decreased over early abstinence, whereas the reverse was observed for PA. These findings can inform experimental studies of nicotine abstinence as well as their clinical applications to smoking cessation efforts. In particular, these results help to elucidate the role of PA in nicotine abstinence by demonstrating its independent association with nicotine craving over and above withdrawal/NA. If supported by future studies, these findings can refine experimental methods and clinical approaches for smoking cessation.
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Affiliation(s)
- Spencer Bujarski
- University of California Los Angeles, Department of Psychology, Los Angeles, CA, USA
| | - Daniel J.O. Roche
- University of California Los Angeles, Department of Psychology, Los Angeles, CA, USA
| | - Erin S. Sheets
- Colby College, Department of Psychology, Waterville, ME, USA
| | - Jennifer L. Krull
- University of California Los Angeles, Department of Psychology, Los Angeles, CA, USA
| | - Iris Guzman
- University of California Los Angeles, Department of Psychology, Los Angeles, CA, USA
| | - Lara A. Ray
- University of California Los Angeles, Department of Psychology, Los Angeles, CA, USA
- University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences, United States, Los Angeles, CA, USA
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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: 215] [Impact Index Per Article: 23.9] [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.
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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.
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Racicot S, McGrath JJ. Development and psychometric properties of the Social Smoking Situations (S(3)) Scale: an enhanced measure of social exposure to smoking during adolescence. Addict Behav 2015; 41:256-62. [PMID: 25452074 DOI: 10.1016/j.addbeh.2014.10.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2014] [Revised: 10/13/2014] [Accepted: 10/17/2014] [Indexed: 11/28/2022]
Abstract
Common questions of exposure to smoking, such as number of parents, siblings, or friends who smoke, fail to capture the contexts in which the exposure occurs. This study developed the Social Smoking Situations (S(3)) Scale to more precisely measure contextual exposure to smoking during adolescence. Informed by the cue-reactivity literature and using informal focus groups, items of contextual exposure to smoking were generated for three categories of smokers: parents, siblings, and peers. Participants (N=761; Mage=15.6, SD=1.3; 61.4% female) were recruited as part of the AdoQuest Study in Montreal, QC. Principal components analysis was used to identify the component structure of the parent, sibling, and peer versions of the S(3) Scale. S(3) scores were computed subsequently to test their association with smoking behavior and smoking expectancies. Further, S(3) scores were compared with common questions (i.e., number of smokers) via univariate modeling to determine which would generate larger estimates of effect size when predicting smoking behavior and smoking expectancies. Overall, S(3) scores generated larger estimates than common questions; this finding was consistent across the parent (ORavg: 2.59 vs. 1.36), sibling (ORavg: 3.44 vs. 1.59), and peer (ORavg: 3.89 vs. 1.38) versions. The S(3) Scale is a new psychometrically sound instrument that may provide a more robust measurement of social exposure to smoking during adolescence. Importantly, it has the potential to strengthen prevention programming and intervention efforts aimed at adolescents, as it could depict a more precise portrait of the individual and contextual sources of social exposure to smoking.
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Affiliation(s)
- Simon Racicot
- Pediatric Public Health Psychology Laboratory, Department of Psychology, Concordia University, 7141 Sherbrooke Street West, Montréal, Québec, H4B 1R6, Canada
| | - Jennifer J McGrath
- Pediatric Public Health Psychology Laboratory, Department of Psychology, Concordia University, 7141 Sherbrooke Street West, Montréal, Québec, H4B 1R6, Canada.
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Cohn A, Brandon T, Armeli S, Ehlke S, Bowers M. Real-time patterns of smoking and alcohol use: an observational study protocol of risky-drinking smokers. BMJ Open 2015; 5:e007046. [PMID: 25564150 PMCID: PMC4289730 DOI: 10.1136/bmjopen-2014-007046] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Despite the strong relationship between smoking and health-related consequences, very few smokers quit. Heavy drinking is a significant risk factor for health consequences, and is implicated in persistent smoking and less success at quitting smoking. Self-efficacy (SE) to abstain from smoking is an important determinant of smoking outcomes and may link alcohol use to poor quit rates. Even though research has demonstrated a strong association between drinking and smoking, and the multiplicative effect of these substances on cancer-related, heavy-drinking smokers has been largely ignored in the literature. Further, research has not taken advantage of innovative methods, such as ecological momentary assessment, to capture the impact of daily factors on smoking cessation outcomes in this particular group. The proposed study identifies daily changing factors that impede or promote SE and future smoking cessation efforts in risky-drinking smokers. METHODS AND ANALYSIS This is an observational study of 84 regular smokers (≥10 cigarettes per day) who drink at risky levels, report a desire to quit in the next 6 months, and show no evidence of psychiatric disturbance, severe history of alcohol withdrawal or drug dependence (excluding nicotine and caffeine). Participants report on their smoking, alcohol consumption and SE related to smoking twice a day for 28 days using interactive voice response (IVR) surveys. Multilevel regression and path models will examine within-person daily associations among drinking, smoking and SE, and how these variables predict the likelihood of future smoking behaviour at 1 and 6 months follow-up. ETHICS AND DISSEMINATION This protocol was approved by an accredited Institutional Review Board. The findings will help us understand the factors that promote or impede smoking cessation among a high-risk group of smokers (heavy-drinking smokers) and will be disseminated through peer-reviewed journal articles and presentations at national conferences.
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Affiliation(s)
- Amy Cohn
- Schroeder Institute, Washington DC, USA
| | - Thomas Brandon
- Moffitt Cancer Center, University of South Florida, Tampa, Florida, USA
| | - Stephen Armeli
- Department of Psychology, Fairleigh Dickinson University, Teaneck, New Jersey, USA
| | - Sarah Ehlke
- Schroeder Institute for Tobacco Research and Policy Studies, Legacy, Washington DC, USA
| | - Molly Bowers
- Schroeder Institute for Tobacco Research and Policy Studies, Legacy, Washington DC, USA
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Wagner AK. A Rehabilomics framework for personalized and translational rehabilitation research and care for individuals with disabilities: Perspectives and considerations for spinal cord injury. J Spinal Cord Med 2014; 37:493-502. [PMID: 25029659 PMCID: PMC4166184 DOI: 10.1179/2045772314y.0000000248] [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: 10/31/2022] Open
Abstract
Despite many people having similar clinical presentation, demographic factors, and clinical care, outcome can differ for those sustaining significant injury such as spinal cord injury (SCI) and traumatic brain injury (TBI). In addition to traditional demographic, social, and clinical factors, variability also may be attributable to innate (including genetic, transcriptomic proteomic, epigenetic) biological variation that individuals bring to recovery and their unique response to their care and environment. Technologies collectively called "-omics" enable simultaneous measurement of an enormous number of biomolecules that can capture many potential biological contributors to heterogeneity of injury/disease course and outcome. Due to the nature of injury and complex disease, and its associations with impairment, disability, and recovery, rehabilitation does not lend itself to a singular "protocolized" plan of therapy. Yet, by nature and by necessity, rehabilitation medicine operates as a functional model of "Personalized Care". Thus, the challenge for successful programs of translational rehabilitation care and research is to identify viable approaches to examine broad populations, with varied impairments and functional limitations, and to identify effective treatment responses that incorporate personalized protocols to optimize functional recovery. The Rehabilomics framework is a translational model that provides an "-omics" overlay to the scientific study of rehabilitation processes and multidimensional outcomes. Rehabilomics research provides novel opportunities to evaluate the neurobiology of complex injury or chronic disease and can be used to examine methods and treatments for person-centered care among populations with disabilities. Exemplars for application in SCI and other neurorehabilitation populations are discussed.
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Affiliation(s)
- Amy K. Wagner
- Correspondence to: Amy K. Wagner, MD Department of Physical Medicine and Rehabilitation, Safar Center for Resuscitation Research, University of Pittsburgh, 3471 5th Avenue Suite 202, Pittsburgh, PA 15213, USA.
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Treloar HR, Piasecki TM, McCarthy DE, Baker TB. Relations Among Caffeine Consumption, Smoking, Smoking Urge, and Subjective Smoking Reinforcement in Daily Life. JOURNAL OF CAFFEINE RESEARCH 2014; 4:93-99. [PMID: 25229011 DOI: 10.1089/jcr.2014.0007] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Caffeine consumption and cigarette smoking tend to occur within the same individuals and at the same time. One potential explanation for this co-use is that caffeine consumption increases subjective smoking reinforcement. Electronic diaries were used to collect momentary reports of smoking, caffeine consumption, temptation/urge to smoke, and subjective smoking reinforcement in 74 prequit smokers. Momentary reports of caffeine consumption and smoking were associated, replicating previous findings. These results remained significant when contextual factors (time of day, weekday/weekend, presence of others, presence of others smoking, location, and past hour alcohol consumption) were covaried. Caffeine consumption was also associated with positive cigarette appraisals and reports of strong temptation/urge to smoke and urge reduction from the prior cigarette. Under the conditions of caffeine consumption versus at other times, smokers were significantly more likely to report their last cigarette as producing a rush/buzz, being pleasant, relaxing, and tasting good. The effects for temptation/urge to smoke and rush/buzz varied as a function of latency since smoking. Caffeine consumption increased reports of urge to smoke and rush/buzz only when smoking occurred more than 15 minutes prior to the diary entry. Findings suggest that caffeine consumption influences some aspects of smoking motivation or affects memorial processing of smoking reinforcement.
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Affiliation(s)
- Hayley R Treloar
- Department of Psychological Sciences, University of Missouri , Columbia, Missouri
| | - Thomas M Piasecki
- Department of Psychological Sciences, University of Missouri , Columbia, Missouri
| | - Danielle E McCarthy
- Department of Psychology, Rutgers, The State University of New Jersey , Piscataway, New Jersey
| | - Timothy B Baker
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health , Madison, Wisconsin
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Teo SSH, Tan NC, Ngoh ASH, Swah TS, Chen Z, Tai BC. Smoking Behaviour of Asthmatic Patients in Primary Care: A Cross-Sectional Study. PROCEEDINGS OF SINGAPORE HEALTHCARE 2014. [DOI: 10.1177/201010581402300204] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: One-third of adult asthma patients smoke cigarettes despite smoking being a known trigger of asthma exacerbation. This study aims to describe the behaviour of asthmatic patients who smoke and explore the reasons why they continue to smoke cigarettes even when unwell. Methods: A cross-sectional questionnaire survey was conducted on adult asthma patients at primary care clinics in Singapore. One hundred and seventy-four asthmatic smokers (AS) of four ethnic groups, both genders, aged 21–50 years were recruited. Demographic data and smoking characteristics, reasons for smoking, and experiences during their attempts to quit were collected and analysed using the statistical software STATA version 12. Results: The median age of AS was 30 years. Seventy-five percent were males and mostly Malays (58%). Seventy-one percent had at least secondary education. Eighty-six percent started smoking before 20 years old. Ninety-eight percent smoked less than 10 sticks per day and 51% smoked ≤5 pack-years. Thirty-eight percent smoked within 5 minutes of awakening. AS cited reasons such as stress relief (79%), peer pressure (36%), influence from family members who smoke (40%), think better (35%), staying alert (57%), and relaxed (53%). Although 77% believed smoking worsened their asthma, they continued to smoke. Restlessness (43%), mood swings (27%), difficulties in concentration (25%) and irritability (24%) were common symptoms encountered in those who attempted to quit. About 44% did not refrain from smoking even when they were ill. Conclusion: Adult asthmatic smokers continued cigarette smoking to relieve stress, maintain mental alertness and avoid withdrawal symptoms. Implementing a programme to address smoking behaviour and withdrawal symptoms is paramount towards successful smoking cessation.
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Affiliation(s)
| | | | | | - Teck Sin Swah
- Department of Clinical Services, SingHealth Polyclinics, Singapore
| | - Zhaojin Chen
- Investigational Medicine Unit, National University Health System, Singapore
| | - Bee Choo Tai
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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Shiffman S. Commentary on Heckman et al. (2013): Negative affect increases craving-Questions about the relationship of affect, craving and smoking. Addiction 2013; 108:2079-80. [PMID: 24237897 DOI: 10.1111/add.12363] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Saul Shiffman
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA.
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Brief psycho-education affects circadian variability in nicotine craving during cessation. Drug Alcohol Depend 2013; 132:283-9. [PMID: 23478153 DOI: 10.1016/j.drugalcdep.2013.02.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Revised: 02/12/2013] [Accepted: 02/14/2013] [Indexed: 11/23/2022]
Abstract
BACKGROUND Nicotine cravings are a key target of smoking cessation interventions. Cravings demonstrate circadian variation during abstinence, often peaking during the morning and evening hours. Although some research has also shown diurnal variation in the efficacy of nicotine replacement medications, little research has examined how brief psychosocial interventions affect temporal patterns of craving during abstinence. The present study examined the impact of two brief psycho-education interventions on circadian variations in cravings during a 24-h period. METHOD 176 adult smokers interested in quitting participated in two lab sessions. During the first session, participants received (a) mindfulness psycho-education that encouraged acceptance of cravings as a normal, tolerable part of quitting that people should not expect to perfectly control, (b) standard cessation psycho-education, or (c) no psycho-education. Half the sample initiated a cessation attempt the following day. Dependent variables were assessed using ecological momentary assessment (24-h of monitoring, immediately after first lab session) and questionnaires four days later. RESULTS Partially consistent with hypotheses, both forms of psycho-education were associated with differential diurnal variation in cravings during cessation. Relative to those receiving no psycho-education, standard smoking cessation psycho-education decreased morning cravings. Psycho-education encouraging acceptance of cravings was associated with lower craving in both the morning and evening, albeit only among successfully abstinent smokers. CONCLUSIONS Results demonstrate that brief non-pharmacological interventions can affect circadian craving patterns during smoking cessation. Further investigation of mechanisms of change and of the impact of psycho-education on cessation outcomes is warranted.
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Veilleux JC, Conrad M, Kassel JD. Cue-induced cigarette craving and mixed emotions: a role for positive affect in the craving process. Addict Behav 2013; 38:1881-9. [PMID: 23380484 DOI: 10.1016/j.addbeh.2012.12.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Revised: 09/28/2012] [Accepted: 12/07/2012] [Indexed: 11/17/2022]
Abstract
Craving is an important component of nicotine addiction, and extant research has demonstrated a clear link between cue-induced craving and negative affect, with mixed results in the positive affect domain. The current study was designed to test the idea that cue-reactive craving might be associated with a mixed emotional process, or the simultaneous experience of positive and negative affect. Participants were 86 non-deprived regular smokers and tobacco chippers who provided simultaneous ratings of positive and negative affect during cue exposure to pleasant, unpleasant, neutral and cigarette cues. Results indicated that self-reported craving was elevated in response to cigarette cues compared to other valenced cue types and craving was higher to pleasant cues than either neutral or unpleasant cues. Mixed emotional responses were higher to cigarette cues than other cue types. In addition, mixed emotional responses to cigarette cues predicted craving even after controlling for smoker type, difficulties regulating negative emotion, baseline craving level and mixed emotional responses to neutral cues. As the first study to investigate mixed emotions and cigarette craving, our results highlight the importance of examining the relationship between cue-reactive craving and emotional response using models of emotion that allow for measurement of nuanced emotional experience. In addition, our findings suggest that positive affect processes may indeed play a role in craving among non-deprived smokers.
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Affiliation(s)
- Jennifer C Veilleux
- Department of Psychological Science, University of Arkansas, Fayetteville, AR 72701, USA.
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Shiffman S, Dunbar M, Kirchner T, Li X, Tindle H, Anderson S, Scholl S. Smoker reactivity to cues: effects on craving and on smoking behavior. JOURNAL OF ABNORMAL PSYCHOLOGY 2013; 122:264-80. [PMID: 22708884 PMCID: PMC3988583 DOI: 10.1037/a0028339] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We assessed craving and smoking in response to smoking-relevant cues. Two hundred seven daily smokers viewed images related to 1 of 6 cue sets (cigarettes, positive and negative affect, alcohol, smoking prohibitions, and neutral cues) in separate sessions. Compared with neutral cues, cigarette cues significantly increased craving, and positive affect cues significantly decreased craving. When subjects were then allowed to smoke during continuing cue exposure, cues did not affect the likelihood of smoking or the amount smoked (number of cigarettes, number of puffs, puff time, or increased carbon monoxide). However, craving intensity predicted likelihood of smoking, latency to smoke, and amount smoked, with craving increases after cue exposure making significant independent contributions. Some craving effects were curvilinear, suggesting that they are subject to thresholds and might not be observed under some circumstances.
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Affiliation(s)
- Saul Shiffman
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15213, USA.
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Perriot J, Underner M, Peiffer G, Le Houezec J, Samalin L, Schmitt A, de Chazeron I, Doly-Kuchcik L. Le sevrage tabagique des « fumeurs difficiles ». Rev Mal Respir 2012; 29:448-61. [PMID: 22542404 DOI: 10.1016/j.rmr.2011.09.048] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Accepted: 09/21/2011] [Indexed: 02/05/2023]
Affiliation(s)
- J Perriot
- Dispensaire Émile-Roux, centre de lutte antituberculeux (CLAT 63), centre de tabacologie, 11 rue Vaucanson, Clermont-Ferrand, France.
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Caldwell B, Sumner W, Crane J. A systematic review of nicotine by inhalation: is there a role for the inhaled route? Nicotine Tob Res 2012; 14:1127-39. [PMID: 22377934 DOI: 10.1093/ntr/nts009] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION A considerable minority of adults remain addicted to smoking cigarettes despite substantial education and public health efforts. Nicotine replacement therapies have only modest long-term quit rates. The pulmonary route of nicotine delivery has advantages over other routes. However, there are regulatory and technical barriers to the development of pulmonary nicotine delivery devices, and hence, none are commercially available. Current knowledge about pulmonary nicotine delivery is scattered throughout the literature and other sources such as patent applications. This review draws together what is currently known about pulmonary nicotine delivery and identifies potential ways that deep lung delivery can be achieved with a simple portable device. AIMS To systematically review clinical trials of nicotine inhalers, determine whether they delivered nicotine via the lung, and identify ways that pulmonary delivery of medicinal nicotine might be achieved and the technical issues involved. METHODS Systematic search of Medline and Embase. RESULTS Thirty-eight trials met the inclusion criteria. Cough, reflex interruption of smooth inspiration, and throat scratch limited the usefulness of nicotine inhalers. The pharmacokinetic profiles of portable nicotine inhalers were inferior to smoking, but among commercially available products, electronic cigarettes are currently the most promising. CONCLUSIONS Pulmonary nicotine delivery might be maximized by use of nicotine salts, which have a more physiological pH than pure nicotine, by ensuring the mass of the particles is optimal for alveolar absorption, and by adding flavoring agents. Metered-dose inhalers potentially can deliver nicotine more efficiently than other nicotine products, facilitating smoking cessation and improving smokers' lives.
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Affiliation(s)
- Brent Caldwell
- Department of Medicine, University of Otago, 23a Mein Street, Newtown, Wellington 6021, New Zealand.
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