Adolescents' behavioral and neural responses to e-cigarette advertising

Neural responses to gaming content on social media in young adults

Excessive gaming can impair both mental and physical health, drawing widespread public and clinical attention, especially among young generations. People are now more exposed to gaming-related content on social media than before, and this exposure may have a significant impact on their behavior. However, the neural mechanisms underlying this effect remain unexplored. Using functional magnetic resonance imaging (fMRI), this study aimed to investigate the neural activity induced by gaming-related content on social media among young adults casually playing online games. While being assessed by fMRI, the participants watched gaming-related videos and neutral (nongaming) videos on social media. The gaming-related cues significantly activated several brain areas, including the medial prefrontal cortex, posterior cingulate cortex, hippocampus, thalamus, superior/middle temporal gyrus, precuneus and occipital regions, compared with the neutral cues. Additionally, the participants' gaming desire levels positively correlated with a gaming-related cue-induced activation in the left orbitofrontal cortex and the right superior temporal gyrus. These findings extend previous studies on gaming cues and provide useful information to elucidate the effects of gaming-related content on social media in young adults. Continued research using real-world gaming cues may help improve our understanding of promoting gaming habits and provide support to individuals vulnerable to gaming addiction.

Altered spontaneous neurological activity in methamphetamine use disorders and its association with cognitive function

BACKGROUND

Methamphetamine (MA) is a widely used and detrimental drug, yet the precise mechanisms by which MA affects cognitive function remain unclear. This study aims to investigate the relationship between cognitive function and brain functional imaging in individuals with MA use disorder (MUD).

METHODS

This study involved 45 patients diagnosed with MUD and 43 healthy controls (HC). Cognitive function assessment utilized the MATRICS Consensus Cognitive Battery, and functional data were acquired using a 3.0 Tesla magnetic resonance imaging scanner.

RESULTS

The MUD group exhibited lower regional homogeneity (ReHo) values in the bilateral postcentral, the left superior temporal, and the left lingual regions compared to the HC group. Additionally, the MUD group displayed higher amplitude of low-frequency fluctuation (ALFF) values in the bilateral fusiform and the left putamen compared to the HC group, along with lower ALFF values in the bilateral postcentral cortices and the left middle cingulate cortex compared to the HC group (all p < 0.05, with false discovery rate corrected). Linear regression analysis revealed a positive correlation between the ReHo value in the right postcentral cortex and the neuropsychology assessment battery-mazes test (p = 0.014). Furthermore, the ALFF value in the left putamen showed negative correlations with the scores of the digit-symbol coding test (p = 0.027), continuous performance test (p = 0.037), and battery-mazes test (p = 0.024).

CONCLUSION

Patients with MUD exhibit altered brain spontaneous neurological activities, and the intensity of spontaneous neurological activity in the left putamen is strongly associated with cognitive function.

Explicit and implicit effects of gaming content on social media on the behavior of young adults

Excessive gameplay can have negative effects on both mental and physical health, especially among young people. Nowadays, social media platforms are bombarding users with gaming-related content daily. Understanding the effect of this content on people's behavior is essential to gain insight into problematic gaming habits. However, this issue is yet to be studied extensively. In this study, we examined how gaming-related content on social media affects young adults explicitly and implicitly. We studied 25 healthy young adults (average age 21.5 ± 2.2) who played online games casually and asked them to report their gaming desire. We also conducted an implicit association test (IAT) to measure their implicit attitudes toward gaming-related content. We also investigated the relationship between these measures and various psychological factors, such as personality traits, self-efficacy, impulsiveness, and cognitive flexibility. The results revealed that participants had a higher explicit gaming desire when exposed to gaming-related cues on social media than neutral cues. They also had a robust positive implicit attitude toward gaming-related content on social media. Explicit gaming desire was positively correlated with neuroticism levels. Furthermore, the IAT effect was negatively correlated with self-efficacy and cognitive flexibility levels. However, there were no significant correlations between explicit gaming desire/IAT effect and impulsiveness levels. These findings suggest that gaming-related content on social media can affect young adults' behavior both explicitly and implicitly, highlighting the need for further research to prevent gaming addiction in vulnerable individuals.

How Do Adolescent Smoking Prevention Interventions Work in Different Contextual Settings? A Qualitative Comparative Study Between the UK and Colombia

BACKGROUND

Adolescent smoking is associated with significant health and social risks. Previous research has demonstrated the effectiveness of interventions based on behavior change theories in preventing adolescent smoking uptake. However, evidence from the theory-based perspective of evaluation is limited, especially for how such complex interventions work, and how they work when implemented in different contextual settings.

METHOD

A comparative qualitative analysis was conducted to explore various influences on behavior change among participants taking part in two smoking prevention interventions in Northern Ireland and Bogotá. Twenty-seven focus groups were conducted in 12 schools (6 in Northern Ireland and 6 in Bogota, n = 195 pupils participated; aged 11-15 years). The Theoretical Domains Framework guided a content analysis of the data.

RESULTS

We found similarities across settings in terms of knowledge, skills, and beliefs related to smoking or vaping behavior change, as well as differences in contextual resources and social influence. Different environmental resources included availability to purchase tobacco products in the neighborhoods and previous information about tobacco risk. Participants in both interventions perceived behavioral change outcomes related to personal skills and intention to not smoke or vape.

CONCLUSION

These findings have highlighted how both individual factors and contextual resources influence behavior change for smoking prevention in practice. Local contextual factors and social influences affecting pupils should be taken into account in the implementation and evaluation of health behavior change interventions. In particular, this study supports using social and contextual influence strategies in interventions to reduce the onset of adolescent smoking and vaping.

Distinct resting-state functional connectivity patterns of Anterior Insula affected by smoking in mild cognitive impairment

Smoking is a modifiable risk factor for Alzheimer's disease (AD). The insula plays a vital role in both smoking and cognition. However, the smoking effects on insula-related networks in cognitively normal controls (CN) and mild cognitive impairment (MCI) patients remain unknown. We identified 129 CN (85 non-smokers and 44 smokers) and 83 MCI (54 non-smokers and 29 smokers). Each underwent neuropsychological assessment and MRI (structural and resting-state functional). Seed-based functional analyses in the anterior and posterior insula were performed to calculate the functional connectivity (FC) with voxels in the whole brain. Mixed-effect analyses were performed to explore the interactive effects on smoking and cognitive status. Associations between FC and neuropsychological scales were assessed. Mixed-effect analyses revealed the FC differences between the right anterior insula (RAI) with the left middle temporal gyrus (LMTG) and that with the right inferior parietal lobule (RIPL) (p < 0.01, cluster level < 0.05, two-tailed, gaussian random field correction). The FC of RAI in both LMTG and RIPL sees a significant decrease in MCI smokers (p < 0.01). Smoking affects insula FC differently between MCI and CN, and could decrease the insula FC in MCI patients. Our study provides evidence of neural mechanisms between smoking and AD.

Exploring the mechanistic pathways of how social network influences social norms in adolescent smoking prevention interventions

We know little about how smoking prevention interventions might leverage social network structures to enhance protective social norms. In this study we combined statistical and network science methods to explore how social networks influence social norms related to adolescent smoking in school-specific settings in Northern Ireland and Colombia. Pupils (12-15 years old) participated in two smoking prevention interventions in both countries (n = 1344). A Latent Transition Analysis identified three groups characterized by descriptive and injunctive norms towards smoking. We employed a Separable Temporal Random Graph Model to analyze homophily in social norms and conducted a descriptive analysis of the changes in the students' and their friends' social norms over time to account for social influence. The results showed that students were more likely to be friends with others who had social norms against smoking. However, students with social norms favorable towards smoking had more friends with similar views than the students with perceived norms against smoking, underlining the importance of network thresholds. Our results support the notation that the ASSIST intervention takes advantage of friendship networks to leverage greater change in the students' smoking social norms than the Dead Cool intervention, reiterating that social norms are subject to social influence.

Consumer Behaviour to Be Considered in Advertising: A Systematic Analysis and Future Agenda

In the past decade, neurophysiological and physiological tools have been used to explore consumer behaviour toward advertising. The studies into brain processes (e.g., emotions, motivation, reward, attention, perception, and memory) toward advertising are scant, and remain unclear in the academic literature. To fill the gap in the literature, this study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol to extract relevant articles. It extracted and analysed 76 empirical articles from the Web of Science (WoS) database from 2009-2020. The findings revealed that the inferior frontal gyrus was associated with pleasure, while the middle temporal gyrus correlated with displeasure of advertising. Meanwhile, the right superior-temporal is related to high arousal and the right middle-frontal-gyrus is linked to low arousal toward advertisement campaigns. The right prefrontal-cortex (PFC) is correlated with withdrawal behaviour, and the left PFC is linked to approach behaviour. For the reward system, the ventral striatum has a main role in the reward system. It has also been found that perception is connected to the orbitofrontal cortex (OFC) and ventromedial (Vm) PFC. The study's findings provide a profound overview of the importance of brain processes such as emotional processes, reward, motivation, cognitive processes, and perception in advertising campaigns such as commercial, social initiative, and public health.

Connectome-based predictive modelling of smoking severity in smokers

The functional connectivity within and between networks could provide a framework to characterize the neurobiological mechanism of nicotine addiction. This study examined the brain regions that were functionally connected in response to smoking cues and established the brain-behaviour relationships in smokers. Sixty-seven male smokers were enrolled and scanned while performing the cue-reactivity and Stroop task. A whole-brain analysis approach, connectome-based predictive modelling (CPM), was conducted on the data from the cue-reactivity task to identify the networks that could predict the smoking severity with the Shen atlas as templates. Then, the brain-behaviour relationships were verified in a different brain state (Stroop task). CPM identified the smoking severity-related network, as indicated by a significant correlation between predicted and actual smoking severity scores (r = 0.31, p = 0.02). Identified networks mainly involved the canonical networks implicated in the reward process (motor/sensory network and salience network) and executive control (frontoparietal network). Network strength in the Stroop task marginally significantly predicted smoking severity scores (r = 0.23, p = 0.06), partially replicating the brain-behaviour relationship. The CPM results identified the whole-brain neural network related to smoking severity, which was cross-validated by the AAL and Shen atlas. These findings contribute to more profound insights into neural substrates underlying the smoking severity.

The development and validation of an electronic nicotine delivery system (ENDS) image cue stimulus set

RATIONALE

Responsiveness to drug-related cues assesses drug reward in research studies. There are currently no validated visual image cues related to electronic nicotine delivery systems (ENDS), thus, this study aimed to develop and validate affective ENDS image cues.

METHODS

ENDS users and non-vaping individuals in the United States and Canada were recruited via Amazon MTurk. A total of 120 ENDS-related images and 56 neutral images, matched for visual similarity, were assessed. These images were either selected from public databases or were photographed by study staff. Closely adhering to the International Affective Picture System procedure, each participant rated 66 images one-by-one on dimensions of valence, arousal, dominance, and desire-to-vape where higher scores indicated greater feelings of happiness, excitement, loss of control, and desire to vape.

RESULTS

After excluding patterned responses, the data from 926 participants (610 ENDS users, and 316 non-vaping controls) were analyzed. When viewing ENDS-related images, desire-to-vape scores were correlated with valence (r = 0.55, p < 0.0005), arousal (r = 0.72, p < 0.0005), and dominance (r = 0.58, p < 0.0005) scores. Images that elicited greater desires to vape also elicited greater feelings of happiness and excitement, but less perceived control. Correlations between arousal and valence (r = 0.42, p < 0.0005) and dominance (r = 0.71, p < 0.0005) suggest that images that increased feelings of excitement also increased happiness and decreased perceived control.

CONCLUSIONS

Correlational findings of the affective ENDS-related images were similar to those of previous studies validating collections of tobacco and alcohol picture cues, supporting the future use of these stimuli in ENDS research.

Time for a paradigm shift: The adolescent brain in addiction treatment

OBJECTIVE

One route to improve adolescent addiction treatment outcomes is to use translational approaches to help identify developmental neuroscience mechanisms that undergird active treatment ingredients and advance adolescent behavior change.

METHODS

This sample included 163 adolescents (ages 15-19) randomized to motivational interviewing (MI) vs. brief adolescent mindfulness (BAM). Youth completed an fMRI paradigm assessing adolescent brain response to therapist language (complex reflection vs. mindful; complex reflection vs. confront; mindful vs. confront) at pre- (prior to the completion of the full intervention) and post-treatment (at 3-month follow-up) and behavioral measures at 3, 6 and 12 months.

RESULTS

Youth in both treatment groups showed significant problem drinking reductions at 3 and 6 months, but MI youth demonstrated significantly better treatment outcomes than BAM youth at 12 months. We observed several significant treatment group differences (MI > BAM) in neural response to therapist language, including at pre-treatment when examining complex reflection vs. mindful, and complex reflection vs. confront (e.g., superior temporal gyrus, lingual gyrus); and at post-treatment when examining mindful vs. confront (e.g., supplementary motor area; middle frontal gyrus). When collapsed across treatment groups (MI + BAM), we observed significant differences by time, with youth showing a pattern of brain change in response to complex reflection vs. mindful, and complex reflection vs. confront (e.g., precuneus; postcentral gyrus). There was no evidence of a significant group × time interaction. However, brain change in response to therapist language (complex reflection vs. confront) in regions such as middle frontal gyrus, was associated with reductions in problem drinking at 12 months. Yet, few treatment group differences were observed.

CONCLUSIONS

These data underscore the need to better understand therapist language and it's impact on the developing brain, in order to inform and aggregate the most impactful elements of addiction treatment for future treatment development for adolescents.

Individual Differences in Brain Responses: New Opportunities for Tailoring Health Communication Campaigns

Prevention neuroscience investigates the brain basis of attitude and behavior change. Over the years, an increasingly structurally and functionally resolved "persuasion network" has emerged. However, current studies have only identified a small handful of neural structures that are commonly recruited during persuasive message processing, and the extent to which these (and other) structures are sensitive to numerous individual difference factors remains largely unknown. In this project we apply a multi-dimensional similarity-based individual differences analysis to explore which individual factors-including characteristics of messages and target audiences-drive patterns of brain activity to be more or less similar across individuals encountering the same anti-drug public service announcements (PSAs). We demonstrate that several ensembles of brain regions show response patterns that are driven by a variety of unique factors. These results are discussed in terms of their implications for neural models of persuasion, prevention neuroscience and message tailoring, and methodological implications for future research.

Technological advancements and opportunities in Neuromarketing: a systematic review

Neuromarketing has become an academic and commercial area of interest, as the advancements in neural recording techniques and interpreting algorithms have made it an effective tool for recognizing the unspoken response of consumers to the marketing stimuli. This article presents the very first systematic review of the technological advancements in Neuromarketing field over the last 5 years. For this purpose, authors have selected and reviewed a total of 57 relevant literatures from valid databases which directly contribute to the Neuromarketing field with basic or empirical research findings. This review finds consumer goods as the prevalent marketing stimuli used in both product and promotion forms in these selected literatures. A trend of analyzing frontal and prefrontal alpha band signals is observed among the consumer emotion recognition-based experiments, which corresponds to frontal alpha asymmetry theory. The use of electroencephalogram (EEG) is found favorable by many researchers over functional magnetic resonance imaging (fMRI) in video advertisement-based Neuromarketing experiments, apparently due to its low cost and high time resolution advantages. Physiological response measuring techniques such as eye tracking, skin conductance recording, heart rate monitoring, and facial mapping have also been found in these empirical studies exclusively or in parallel with brain recordings. Alongside traditional filtering methods, independent component analysis (ICA) was found most commonly in artifact removal from neural signal. In consumer response prediction and classification, Artificial Neural Network (ANN), Support Vector Machine (SVM) and Linear Discriminant Analysis (LDA) have performed with the highest average accuracy among other machine learning algorithms used in these literatures. The authors hope, this review will assist the future researchers with vital information in the field of Neuromarketing for making novel contributions.

Adolescent Substance Use and the Brain: Behavioral, Cognitive and Neuroimaging Correlates

Adolescence is an important ontogenetic period that is characterized by behaviors such as enhanced novelty-seeking, impulsivity, and reward preference, which can give rise to an increased risk for substance use. While substance use rates in adolescence are generally on a decline, the current rates combined with emerging trends, such as increases in e-cigarette use, remain a significant public health concern. In this review, we focus on the neurobiological divergences associated with adolescent substance use, derived from a cross-sectional, retrospective, and longitudinal studies, and highlight how the use of these substances during adolescence may relate to behavioral and neuroimaging-based outcomes. Identifying and understanding the associations between adolescent substance use and changes in cognition, mental health, and future substance use risk may assist our understanding of the consequences of drug exposure during this critical window.

People in E-Cigarette Ads Attract More Attention: An Eye-Tracking Study

OBJECTIVES

Minimally regulated electronic cigarettes (e-cigarette) advertising may be one potential factor driving the increasing prevalence of young adult e-cigarette use. Using eye-tracking, the current study examined which e-cigarette advertising features were the most appealing to young adults as a first step to examine how e-cigarette advertising may be regulated.

METHODS

Using a within-subjects design, 30 young adults (M age = 20.0 years) viewed e-cigarette ads in a laboratory. Ad features or areas of interest (AOIs) included: 1) brand logo, 2) product descriptor, and 3) people. During ad viewing, eye-tracking measured participants' dwell time and time to first fixation for each AOI as well as each ad brand. Harm perceptions pre- and post-viewing were measured.

RESULTS

Participants spent the longest dwell time on people (M = 2701 ms), then product descriptors (M = 924 ms), then brand logos (M = 672 ms; ps < .001). They also fixated fastest on AOIs in that order. Participant sex significantly impacted dwell time of ad brand, and harm perceptions decreased after viewing the ads (ps < .05).

CONCLUSIONS

This study provides initial evidence about which e-cigarette ad features may appeal most to young adults and may be useful when designing evidence-based policy.

E-Cigarette Marketing and Communication: How E-Cigarette Companies Market E-Cigarettes and the Public Engages with E-cigarette Information

Introduction

Given the lack of regulation on marketing of electronic cigarettes (e-cigarettes) in the United States and the increasing exchange of e-cigarette-related information online, it is critical to understand how e-cigarette companies market e-cigarettes and how the public engages with e-cigarette information.

Methods

Results are from a systematic review of peer-reviewed literature on e-cigarettes via a PubMed search through June 1, 2017. Search terms included: "e-cigarette*" or "electronic cigarette" or "electronic cigarettes" or "electronic nicotine delivery" or "vape" or "vaping." Experimental studies, quasi-experimental studies, observational studies, qualitative studies, and mixed methods studies providing empirical findings on e-cigarette marketing and communication (ie, nonmarketing communication in the public) were included.

Results

One hundred twenty-four publications on e-cigarette marketing and communication were identified. They covered topics including e-cigarette advertisement claims/promotions and exposure/receptivity, the effect of e-cigarette advertisements on e-cigarette and cigarette use, public engagement with e-cigarette information, and the public's portrayal of e-cigarettes. Studies show increases in e-cigarette marketing expenditures and online engagement through social media over time, that e-cigarettes are often framed as an alternative to combustible cigarettes, and that e-cigarette advertisement exposure may be associated with e-cigarette trial in adolescents and young adults.

Discussion

Few studies examine the effects of e-cigarette marketing on perceptions and e-cigarette and cigarette use. Evidence suggests that exposure to e-cigarette advertisements affects perceptions and trial of e-cigarettes, but there is no evidence that exposure affects cigarette use. No studies examined how exposure to e-cigarette communication, particularly misleading or inaccurate information, impacts e-cigarette, and tobacco use behaviors.

Implications

The present article provides a comprehensive review of e-cigarette marketing and how the public engages with e-cigarette information. Studies suggest an association between exposure to e-cigarette marketing and lower harm perceptions of e-cigarettes, intention to use e-cigarettes, and e-cigarette trial, highlighting the need to for advertising regulations that support public health goals. Findings from this review also present the methodological limitations of the existing research (primarily due to cross-sectional and correlational analyses) and underscore the need for timely, rigorous research to provide an accurate understanding of e-cigarette marketing and communication and its impact on e-cigarette and tobacco product use.

Survey of the effect of viewing an online e-cigarette advertisement on attitudes towards cigarette and e-cigarette use in adults located in the UK and USA: a cross-sectional study

OBJECTIVES

This study explored the potential for e-cigarette advertisements to (1) enhance attitudes towards cigarettes and/or (2) reduce barriers to e-cigarettes uptake. The study tested whether exposure to an online electronic cigarette advertisement changed attitudes towards cigarettes and e-cigarettes in smokers, non-smokers, e-cigarette users and dual users (smokers who also use e-cigarettes).

DESIGN

Cross-sectional study SETTING: Online survey PARTICIPANTS: Adults (n=964) aged 18 to 65 years old (M=36 years, SD=11.6) from the UK and USA. Participants were grouped into current non-smokers, e-cigarette users, dual users and smokers.

INTERVENTIONS

Participants viewed 1 of 15 randomly assigned online e-cigarette advertisements.

PRIMARY MEASURES

Three single seven-point Likert scales measuring health, desirability, social acceptability were completed pre and post advertisement exposure.

RESULTS

Post exposure all smoking groups showed a decrease or no change in how socially acceptable or desirable they rated cigarettes. Paradoxically, dual users rated cigarettes as being significantly healthier after viewing the advertisement (p=0.01) while all other smoking group ratings remained the same. There was an increase or no change in how all smoking groups perceived the healthiness and desirability of e-cigarettes CONCLUSIONS: We observed no evidence that exposure to an e-cigarette advertisement renormalises or encourages smoking in smokers, non-smokers or e-cigarette users. However, there is some indication that viewing an e-cigarette advertisement may increase duals users' perceptions of the health of smoking.

The top-down regulation from the prefrontal cortex to insula via hypnotic aversion suggestions reduces smoking craving

Hypnosis has been shown to have treatment effects on nicotine addiction. However, the neural basis of these effects is poorly understood. This preliminary study investigated the neural mechanisms of hypnosis-based treatment on cigarette smoking, specifically, whether the hypnosis involves a top-down or bottom-up mechanism. Two groups of 45 smokers underwent a smoking aversion suggestion and viewed smoking-related pictures and neutral pictures. One group underwent functional magnetic resonance imaging scanning twice (control and hypnotic states), whereas the other group underwent two electroencephalograph sessions. Our study found that self-reported smoking craving decreased in both groups following hypnosis. Smoking cue-elicited activations in the right dorsal lateral prefrontal cortex (rDLPFC) and left insula (lI) and the functional connectivity between the rDLPFC and lI were increased in the hypnotic state compared with the control state. The delta band source waveforms indicated the activation from 390 to 862 ms at the rDLPFC and from 490 to 900 ms at the lI was significantly different between the smoking and neutral conditions in the hypnotic state, suggesting the activation in the rDLPFC preceded that in the lI. These results suggest that the decreased smoking craving via hypnotic aversion suggestions may arise from the top-down regulation of the rDLPFC to the lI. Our findings provide novel neurobiological evidence for understanding the therapeutic effects of hypnosis on nicotine addiction, and the prefrontal-insula circuit may serve as an imaging biomarker to monitor the treatment efficacy noninvasively.

A fMRI study on the impact of advertising for flavored e-cigarettes on susceptible young adults

BACKGROUND

E-cigarettes are sold in flavors such as "skittles," "strawberrylicious," and "juicy fruit," and no restrictions are in place on marketing e-cigarettes to youth. Sweets/fruits depicted in e-cigarette advertisements may increase their appeal to youth and interfere with health warnings. This study tested a brain biomarker of product preference for sweet/fruit versus tobacco flavor e-cigarettes, and whether advertising for flavors interfered with warning labels.

METHODS

Participants (N = 26) were college-age young adults who had tried an e-cigarette and were susceptible to future e-cigarette use. They viewed advertisements in fMRI for sweet/fruit and tobacco flavor e-cigarettes, menthol and regular cigarettes, and control images of sweets/fruits/mints with no tobacco product. Cue-reactivity was measured in the nucleus accumbens, a brain biomarker of product preference. Advertisements randomly contained warning labels, and recognition of health warnings was tested post-scan. Visual attention was measured using eye-tracking.

RESULTS

There was a significant effect of e-cigarette condition (sweet/tobacco/control) on nucleus accumbens activity, that was not found for cigarette condition (menthol/regular/control). Nucleus accumbens activity was greater for sweet/fruit versus tobacco flavor e-cigarette advertisements and did not differ compared with control images of sweets and fruits. Greater nucleus accumbens activity was correlated with poorer memory for health warnings.

CONCLUSIONS

These and exploratory eye-tracking findings suggest that advertising for sweet/fruit flavors may increase positive associations with e-cigarettes and/or override negative associations with tobacco, and interfere with health warnings, suggesting that one way to reduce the appeal of e-cigarettes to youth and educate youth about e-cigarette health risks is to regulate advertising for flavors.