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Jones DR, Potter LN, Lam CY, Schlechter CR, Nahum-Shani I, Fagundes C, Wetter DW. Examining Links Between Distinct Affective States and Tobacco Lapse During a Cessation Attempt Among African Americans: A Cohort Study. Ann Behav Med 2024; 58:506-516. [PMID: 38740389 PMCID: PMC11185091 DOI: 10.1093/abm/kaae020] [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] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Affect states are posited to play a pivotal role in addiction-related processes, including tobacco lapse (i.e., smoking during a quit attempt), and distinct affective states (e.g., joy vs. happiness) may differentially influence lapse likelihood. However, few studies have examined the influence of distinct affective states on tobacco lapse. PURPOSE This study examines the influence of 23 distinct affect states on tobacco lapse among a sample of tobacco users attempting to quit. METHODS Participants were 220 adults who identified as African American (50% female, ages 18-74). Ecological momentary assessment was used to assess affect and lapse in real-time. Between and within-person associations testing links between distinct affect states and lapse were examined with multilevel modeling for binary outcomes. RESULTS After adjusting for previous time's lapse and for all other positive or negative affect items, results suggested that at the between-person level, joy was associated with lower odds of lapse, and at the within-person level, attentiveness was associated with lower odds of lapse. Results also suggested that at the between-person level, guilt and nervous were associated with higher odds of lapse, and at the within-person level, shame was associated with higher odds of lapse. CONCLUSIONS The present study uses real-time, real-world data to demonstrate the role of distinct positive and negative affects on momentary tobacco lapse. This work helps elucidate specific affective experiences that facilitate or hinder the ability to abstain from tobacco use during a quit attempt.
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Affiliation(s)
- Dusti R Jones
- Center for Health Outcomes and Population Equity (HOPE), Huntsman Cancer Institute and the University of Utah, Salt Lake City, USA
| | - Lindsey N Potter
- Center for Health Outcomes and Population Equity (HOPE), Huntsman Cancer Institute and the University of Utah, Salt Lake City, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, USA
| | - Cho Y Lam
- Center for Health Outcomes and Population Equity (HOPE), Huntsman Cancer Institute and the University of Utah, Salt Lake City, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, USA
| | - Chelsey R Schlechter
- Center for Health Outcomes and Population Equity (HOPE), Huntsman Cancer Institute and the University of Utah, Salt Lake City, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, USA
| | - Inbal Nahum-Shani
- Institute for Social Research, University of Michigan, Ann Arbor, USA
- Center for Methodologies for Adapting and Personalizing Prevention, Treatment, and Recovery Services for SUD and HIV (MAPS Center), University of Michigan, Ann Arbor, USA
| | | | - David W Wetter
- Center for Health Outcomes and Population Equity (HOPE), Huntsman Cancer Institute and the University of Utah, Salt Lake City, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, USA
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Santiago-Torres M, Mull KE, Sullivan BM, Kwon D, Nollen NL, Zvolensky MJ, Bricker JB. Efficacy and utilization of an acceptance and commitment therapy-based smartphone application for smoking cessation among Black adults: secondary analysis of the iCanQuit randomized trial. Addiction 2022; 117:760-771. [PMID: 34890104 PMCID: PMC9798432 DOI: 10.1111/add.15721] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 10/11/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND AIMS Black adults who smoke are less likely to seek treatment and to succeed in quitting compared with other racial groups. The lack of efficacious and engaging trials for smoking cessation further contributes to this disparity. This study explored whether an acceptance and commitment therapy (ACT)-based smartphone application (iCanQuit) was more efficacious for smoking cessation than a United States Clinical Practice Guidelines (USCPG)-based smartphone application (QuitGuide) among Black adults. DESIGN Secondary analysis of a two-arm randomized trial with 12-month follow-up. SETTING United States (US). PARTICIPANTS A total of 554 Black adults who smoke daily were recruited from 34 US states and enrolled between May 2017 and September 2018. INTERVENTIONS Participants were randomized to receive iCanQuit (n = 274) or QuitGuide (n = 280) for 12 months. MEASUREMENTS Smoking cessation outcomes were measured at 3, 6, and 12 months. The primary outcome was self-reported complete-case 30-day point prevalence abstinence (PPA) at 12 months. Secondary outcomes were 7-day PPA, missing-as-smoking imputation, multiple imputation, prolonged abstinence, and cessation of all tobacco products at 12 months. Study retention, treatment engagement, and change in ACT-based processes were also compared between arms. FINDINGS Study retention was 89% at 12 months and did not differ by arm (P > 0.05). The complete-case 30-day PPA was 28% for iCanQuit versus 20% for QuitGuide at 12 months (odds ratio [OR] = 1.60; 95% confidence interval [CI] = 1.03, 2.46). Similar associations were observed for the missing-as-smoking imputation, although non-significant (25% iCanQuit vs 18% QuitGuide; OR = 1.50; 95% CI = 0.98, 2.30). iCanQuit vs QuitGuide participants were significantly more engaged with iCanQuit application as measured by the number of logins from baseline to 6 months (incidence rate ratio = 3.26; 95% CI = 2.58, 4.13). Increased acceptance of cues to smoke mediated the effect of treatment on cessation (indirect effect: OR = 0.20; 95% CI = 0.05, 0.29). CONCLUSIONS Among Black adults, an acceptance and commitment therapy-based smartphone application appeared to be more efficacious and engaging for smoking cessation than the United States Clinical Practice Guidelines-based QuitGuide application.
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Affiliation(s)
- Margarita Santiago-Torres
- Division of Public Health Sciences, Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Kristin E. Mull
- Division of Public Health Sciences, Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Brianna M. Sullivan
- Division of Public Health Sciences, Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Diana Kwon
- Division of Public Health Sciences, Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Nicolle L. Nollen
- Department of Preventive Medicine, University of Kansas School of Medicine, Kansas City, KS, USA
| | - Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA
- HEALTH Institutive, University of Houston, Houston, TX, USA
- MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Jonathan B. Bricker
- Division of Public Health Sciences, Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Psychology, University of Washington, Seattle, WA, USA
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Fontanari AMV, Churchill S, Schneider MA, Soll B, Costa AB, Lobato MIR. Tobacco use among transgender and gender non-binary youth in Brazil. CIENCIA & SAUDE COLETIVA 2021; 26:5281-5292. [PMID: 34787219 DOI: 10.1590/1413-812320212611.3.35272019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 12/20/2019] [Indexed: 11/22/2022] Open
Abstract
Transgender and gender non-binary youth are particularly vulnerable to tobacco smoking and susceptible to smoking adverse health outcomes. That is, they are in special risk to start smoking and, after starting, they may face worse outcomes when comparing to their cisgender peers. Therefore, the present study aims to evaluate factors associated with tobacco use among transgender and gender non-binary youth. Brazilian youth aged 16 to 25 who identify as transgender or gender non-binary answered an online questionnaire. Poisson regression with robust variance was run to predict smoking cigarettes based on individual and environmental factors. 14.1% of 206 youth reported smoking cigarettes daily, whereas 9.3% of participants reported smoking e-cigarettes occasionally. Drug use, lack of social support, deprivation, discrimination, the wait for medical gender-affirming procedures and being outside school were associated with smoking cigarettes. Contextual and individual factors should be further explored in causal analysis and taken into consideration when planning smoking prevention and cessation interventions for transgender and gender non-binary youth.
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Affiliation(s)
- Anna Martha Vaitses Fontanari
- Departamento de Psiquiatria, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. R. Ramiro Barcelos 2350, Santa Cecilia. 90035-903 Porto Alegre RS Brasil.
| | | | - Maiko Abel Schneider
- Departamento de Psiquiatria, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. R. Ramiro Barcelos 2350, Santa Cecilia. 90035-903 Porto Alegre RS Brasil.
| | - Bianca Soll
- Departamento de Psiquiatria, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. R. Ramiro Barcelos 2350, Santa Cecilia. 90035-903 Porto Alegre RS Brasil.
| | | | - Maria Inês Rodrigues Lobato
- Departamento de Psiquiatria, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. R. Ramiro Barcelos 2350, Santa Cecilia. 90035-903 Porto Alegre RS Brasil.
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Liautaud MM, Kechter A, Bello MS, Guillot CR, Oliver JA, Banks DE, D’Orazio LM, Leventhal AM. Anhedonia in tobacco withdrawal among African-American smokers. Exp Clin Psychopharmacol 2021; 29:511-523. [PMID: 34110886 PMCID: PMC8511043 DOI: 10.1037/pha0000474] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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
Anhedonia-diminished interest and pleasure in response to rewards-may be a symptom of tobacco withdrawal that is understudied in priority populations. This experiment investigated the magnitude and correlates of various dimensions of anhedonia during tobacco withdrawal among African-American (AA) smokers-a population subject to health disparities. AA smokers (N = 607; ≥ 10 cigarettes/day, 37.8% female, M[SD] age = 50.0[10.6] years) completed self-report measures assessing expected pleasure from (i.e., consummatory anhedonia) and desire to engage in (i.e., anticipatory anhedonia) various types of hypothetically experienced rewards at counterbalanced 16-hr tobacco deprived and nondeprived lab visits. Other tobacco withdrawal symptom measures (e.g., craving, negative affect, hunger) were also assessed. Tobacco deprivation most robustly increased scores on a composite measure of consummatory anhedonia directed toward various reward domains (i.e., hobbies, sensory experiences, social activities; d = .32, p < .001). Deprivation modestly increased consummatory and anticipatory anhedonia directed toward sexual rewards (ds = .09-.12, ps < .02), did not significantly change anhedonia toward food rewards, and decreased anhedonia directed toward psychoactive drug rewards (i.e., increased desire for and pleasure from drugs; ds = -.21 to -.19, ps < .001). Deprivation-induced changes in anhedonia were modestly correlated with other withdrawal symptoms (average |r|s = .04-.23) and were amplified among participants with higher nicotine dependence and lower positive affect-related traits (|β|s = .10-.12, ps < .01). Some dimensions of anhedonia may be genuine expressions of acute tobacco withdrawal in AA smokers. Applying multi-dimensional anhedonia conceptualizations might advance basic knowledge and treatment of tobacco use disorder, improve smoking cessation outcomes, and address tobacco-related health disparities facing AA smokers. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | - Afton Kechter
- University of Southern California, Department of Preventive Medicine
| | | | | | - Jason A. Oliver
- Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences
| | - Devin E. Banks
- University of Missouri Saint Louis, Department of Psychological Sciences
| | | | - Adam M. Leventhal
- University of Southern California, Department of Preventive Medicine
- University of Southern California, Department of Psychology
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Frost-Pineda K, Heck JD, Curtin GM. Measures of dependence in menthol and nonmenthol smokers - A comprehensive narrative review. J Addict Dis 2020; 38:122-142. [PMID: 32286199 DOI: 10.1080/10550887.2020.1727286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Introduction. More than a decade ago, concerns were raised that menthol in cigarettes might enhance addiction to smoking. This article provides a comprehensive review of published studies examining cigarette dependence among menthol and nonmenthol smokers. The purpose of the review is to evaluate the scientific evidence to determine if menthol increases cigarette dependence. Materials and Methods. The published literature was searched in 2019 for studies that provide evidence on cigarette dependence among menthol compared to nonmenthol smokers. Included in this review are published studies that compare menthol and nonmenthol smokers based on widely accepted and validated measures of dependence, or other established predictors of dependence (age of smoking initiation [first cigarette]/age of progression [regular/daily smoking]) and indicators of dependence (smoking frequency, cigarettes smoked per day, time to first cigarette after waking, night waking to smoke, smoking duration). Results and Conclusion. Based on a review of the available studies, including those with adjusted results and large representative samples, reliable and consistent empirical evidence supports a conclusion that menthol smokers are not more dependent than nonmenthol smokers and thus menthol in cigarettes does not increase dependence.
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Pang RD, Bello MS, Liautaud MM, Weinberger AH, Leventhal AM. Gender Differences in Negative Affect During Acute Tobacco Abstinence Differ Between African American and White Adult Cigarette Smokers. Nicotine Tob Res 2020; 21:1072-1078. [PMID: 29917091 DOI: 10.1093/ntr/nty122] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 06/12/2018] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Prior studies have found heightened negative affect following tobacco abstinence in women compared to men. However, experimental work addressing whether these findings generalize across racial groups is scarce. This study investigated whether race (non-Hispanic White vs. non-Hispanic African American) moderated gender differences in abstinence-induced negative affect and smoking behavior. METHODS Data were collected from 2010 to 2017 from two separate laboratory studies investigating experimentally manipulated tobacco abstinence. Following a baseline session, adult daily smokers (≥10 cigarettes/day; women: n = 297, 83.8% non-Hispanic African American; men: n = 492, 86.2% non-Hispanic African American) attended two counterbalanced lab sessions (16 hours abstinent vs. non-abstinent) and completed self-report measures of negative affect followed by a laboratory analogue smoking reinstatement task. RESULTS We found a gender × race interaction for several negative affect states and composite negative affect (βs = -.12 to -.16, Ps < .05). Analyses stratified by race showed that non-Hispanic White women compared to non-Hispanic White men exhibited greater abstinence-induced increases in anger, anxiety, and composite negative affect (βs = -.20 to -.29, Ps < .05). No significant gender differences in abstinence-induced negative affect were found for non-Hispanic African American smokers (βs = .00 to - .04, Ps > .05). CONCLUSION These findings suggest that negative affect during acute tobacco abstinence may be a clinically important and intervenable factor that can inform cessation interventions specifically for non-Hispanic White women smokers. Further empirical exploration of mechanisms underlying interactions of gender and race in tobacco addiction may benefit smoking cessation efforts in non-Hispanic African American women smokers. IMPLICATIONS This study contributes to a scant body of research examining the intersectional influence of race and gender on abstinence-induced negative affect-a central, motivationally prepotent feature of tobacco withdrawal. Using a laboratory-based design to experimentally manipulate abstinence, we provide evidence of a gender × race interaction on negative affect-related withdrawal. Our findings suggest that gender differences in abstinence-induced negative affect observed among non-Hispanic White smokers may not generalize to non-Hispanic African American smokers, highlighting the need for future work to address potential mechanisms underlying the racially discrepant impact of gender on affective tobacco withdrawal.
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Affiliation(s)
- Raina D Pang
- Department of Preventive Medicine, Keck School of Medicine at University of Southern California, Los Angeles, CA
| | - Mariel S Bello
- Department of Psychology, University of Southern California, Los Angeles, CA
| | - Madalyn M Liautaud
- Department of Preventive Medicine, Keck School of Medicine at University of Southern California, Los Angeles, CA
| | - Andrea H Weinberger
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, NY.,Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Adam M Leventhal
- Department of Preventive Medicine, Keck School of Medicine at University of Southern California, Los Angeles, CA.,Department of Psychology, University of Southern California, Los Angeles, CA
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Kelly ME, Guillot CR, Quinn EN, Lucke HR, Bello MS, Pang RD, Leventhal AM. Anxiety sensitivity in relation to cigarette smoking and other substance use in African American smokers. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2020; 34:669-679. [PMID: 32162964 DOI: 10.1037/adb0000573] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Anxiety sensitivity (AS)-fearfulness of anxiety symptoms-has been implicated in the etiology of emotional disorders (e.g., depressive and anxiety disorders) and linked to cigarette smoking and other substance use (SU). However, studies examining AS in relation to SU primarily have been conducted with racially/ethnically heterogeneous or mostly European American samples. Hence, this cross-sectional study involving secondary analysis of baseline data focused on investigating associations of AS with cigarette smoking and other SU in a sample of 630 non-treatment-seeking African American smokers (37.3% female; M age = 49.6 years; M cigarettes smoked per day = 15.4). After screening out individuals with non-nicotine substance dependence, participants reported their demographics, AS, dysphoria symptoms (i.e., depression and anxiety symptoms), and SU. In regression analyses controlling for dysphoria symptoms, age, education level, income level, and years of regular smoking, AS was positively associated with tobacco withdrawal severity (β = .12, p = .007), overall smoking motives (β = .17, p < .001), alcohol use problems (β = .12, p = .005), and other (non-nicotine, nonalcohol) SU problems (β = .16, p < .001). Though lacking the passage of time between assessments needed to provide strong evidence of mediation, unplanned analyses further revealed indirect associations of AS with several SU variables through dysphoria symptoms. Current findings are consistent with those found in prior samples and suggest that AS is similarly related to SU in African Americans, who may benefit from interventions that have been helpful in improving AS, dysphoria symptoms, and SU in other groups. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | | | | | | | - Mariel S Bello
- Department of Psychology, University of Southern California
| | - Raina D Pang
- Department of Preventive Medicine, University of Southern California Keck School of Medicine
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Hughes JR. The Diversity of Nicotine and Tobacco Research. Nicotine Tob Res 2018; 20:1161-1162. [PMID: 29878240 DOI: 10.1093/ntr/nty100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 05/14/2018] [Indexed: 11/12/2022]
Affiliation(s)
- John R Hughes
- Department of Psychiatry, Vermont Center on Behavior and Health, Burlington, VT
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