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Bar-Zeev Y, Shahab L. Society for Research on Nicotine and Tobacco - Europe Debate: Nicotine Use is Hardly Rational. Nicotine Tob Res 2024; 26:954-956. [PMID: 38366689 DOI: 10.1093/ntr/ntae028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 02/02/2024] [Indexed: 02/18/2024]
Affiliation(s)
- Yael Bar-Zeev
- Braun School of Public Health and Community Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Lion Shahab
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
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McNally GP, Jean-Richard-Dit-Bressel P. A Cognitive Pathway to Persistent, Maladaptive Choice. Eur Addict Res 2024; 30:233-242. [PMID: 38865985 DOI: 10.1159/000538103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 02/27/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND Correctly recognising that alcohol or other substances are causing problems is a necessary condition for those problems to spur beneficial behaviour change. Yet such recognition is neither immediate nor straightforward. Recognition that one's alcohol or drug use is causing negative consequences often occurs gradually. Contemporary addiction neuroscience has yet to make progress in understanding and addressing these recognition barriers, despite evidence that a lack of problem recognition is a primary impediment to seeking treatment. SUMMARY Based on our recent empirical work, this article shows how recognition barriers can emerge from dual constraints on how we learn about the negative consequences of our actions. One constraint is imposed by the characteristics of negative consequences themselves. A second constraint is imposed by the characteristics of human cognition and information processing. In some people, the joint action of these constraints causes a lack of correct awareness of the consequences of their behaviour and reduced willingness to update that knowledge and behaviour when confronted with counterevidence. KEY MESSAGES This "cognitive pathway" can drive persistent, maladaptive choice.
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Affiliation(s)
- Gavan P McNally
- School of Psychology, UNSW, Sydney, New South Wales, Australia
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McNally GP, Jean-Richard-Dit-Bressel P, Millan EZ, Lawrence AJ. Pathways to the persistence of drug use despite its adverse consequences. Mol Psychiatry 2023; 28:2228-2237. [PMID: 36997610 PMCID: PMC10611585 DOI: 10.1038/s41380-023-02040-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 03/10/2023] [Accepted: 03/15/2023] [Indexed: 04/01/2023]
Abstract
The persistence of drug taking despite its adverse consequences plays a central role in the presentation, diagnosis, and impacts of addiction. Eventual recognition and appraisal of these adverse consequences is central to decisions to reduce or cease use. However, the most appropriate ways of conceptualizing persistence in the face of adverse consequences remain unclear. Here we review evidence that there are at least three pathways to persistent use despite the negative consequences of that use. A cognitive pathway for recognition of adverse consequences, a motivational pathway for valuation of these consequences, and a behavioral pathway for responding to these adverse consequences. These pathways are dynamic, not linear, with multiple possible trajectories between them, and each is sufficient to produce persistence. We describe these pathways, their characteristics, brain cellular and circuit substrates, and we highlight their relevance to different pathways to self- and treatment-guided behavior change.
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Affiliation(s)
- Gavan P McNally
- School of Psychology, UNSW Sydney, Sydney, NSW, 2052, Australia.
| | | | - E Zayra Millan
- School of Psychology, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - Andrew J Lawrence
- Florey Institute of Neuroscience and Mental Health, Parkville, VIC, 3010, Australia
- Florey Department of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, 3010, Australia
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Okoli CTC, Seng S. Factors Associated with the Initial Sensations of Smoking among Smokers with Mental Illness. Issues Ment Health Nurs 2019; 40:798-804. [PMID: 31188699 DOI: 10.1080/01612840.2019.1595794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
People with mental illnesses (MI) have a disproportionate smoking prevalence and associated disease burden. Smoking initiation among people with MI is poorly understood. However, the sensations experienced during smoking initiation predict continued smoking and nicotine dependence. Yet, few studies have examined the initial experiences of smoking among people with MI. Thus, the aim of this study was to explore factors associated with the initial sensations of smoking in people with MI. Smokers in an inpatient psychiatric facility (n = 123) were surveyed. Data obtained included information on demographics, smoking and secondhand smoke (SHS) exposure, psychiatric diagnoses, and sensations of initial smoking. Spearman correlations explored associations among initial smoking sensation variables; and binary logistic regression analyses examined the associations between study variables and groupings derived from initial sensations (i.e., "pleasant + buzz," "unpleasant + buzz," and "all" sensations). The most frequently reported initial smoking sensation was feeling dizzy (87%) and there were low to moderate correlations between unpleasant (e.g., cough, sick, nervous) and pleasant (e.g., good, relaxed) sensations. In logistic regression analyses, having higher perceived SHS exposure was significantly associated with the "pleasant + buzz" sensation grouping; and lower past week SHS exposure was associated with the "unpleasant + buzz" sensation grouping; but, no variables were associated with "all" sensation group. Initial smoking sensations are an uncharted avenue of exploration in understanding smoking initiation among people with MI. SHS exposure may be an important factor associated with the report of both unpleasant and pleasant initial sensations. Future studies are needed to further explore initial sensations in relation to the context of smoking initiation among people with MI.
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Affiliation(s)
| | - Sarret Seng
- University of Kentucky College of Nursing , Lexington , Kentucky , USA
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Navarro MA, Stalgaitis CA, Walker MW, Wagner DE. Youth peer crowds and risk of cigarette use: The effects of dual peer crowd identification among hip hop youth. Addict Behav Rep 2019; 10:100204. [PMID: 31388555 PMCID: PMC6675938 DOI: 10.1016/j.abrep.2019.100204] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 07/09/2019] [Accepted: 07/13/2019] [Indexed: 11/25/2022] Open
Abstract
Introduction Recent research has found that the Hip Hop peer crowd has a strong link to risky health behaviors, including tobacco use. The current study expands on previous research on the Hip Hop peer crowd by investigating the nuances of the effects on cigarette risk that Hip Hop identification has in combination with other peer crowds. Methods Targeted social media advertisements were used to recruit youth to complete an online survey. Participants (n = 4681) self-reported peer crowd identification via the I-Base Survey™, and cigarette smoking status. Smoking status was compared between peer crowd groups consisting of participants who had identification with only one peer crowd, and those who had identification with the Hip Hop peer crowd and one other crowd (i.e., Hip Hop dual peer crowd identification). Results Significant differences in cigarette status were observed among the dual and single peer crowd groups. Specifically, differences in cigarette Non-susceptible Non-triers and Experimenters demonstrated that youth who identified as Mainstream Only were at lowest risk while youth who identified as Hip Hop/Alternative had the highest rates of cigarette experimentation. There were no differences between peer crowd groups on proportions of Susceptible Non-triers. Conclusions Examining dual peer crowd identifications provides a nuanced understanding of risk. Dual identification with Hip Hop seems to have differential effects compared to solo identification with other crowds, whereby Hip Hop identification may increase cigarette experimentation when combined with another peer crowd. Findings demonstrate the potential of considering multiple peer crowd identification to inform public education campaign development. Peer crowds have previously investigated the Hip Hop peer crowd in isolation. FDA's multicultural youth tobacco education campaign tailors messages Hip Hop peer crowd. Data comes from the first nationally-recruited sample of youth peer crowd and smoking. Peer crowds had differential levels of risk based on dual membership. Hip Hop peer crowd targeting should consider the effects of other peer crowds.
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Affiliation(s)
- Mario A Navarro
- Center for Tobacco Products, Food and Drug Administration (FDA), 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
| | | | - Matthew W Walker
- Center for Tobacco Products, Food and Drug Administration (FDA), 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
| | - Dana E Wagner
- Rescue Agency, 2437 Morena Boulevard, San Diego, CA 92110, USA
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The Hip Hop peer crowd: An opportunity for intervention to reduce tobacco use among at-risk youth. Addict Behav 2018; 82:28-34. [PMID: 29477904 DOI: 10.1016/j.addbeh.2018.02.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 01/03/2018] [Accepted: 02/09/2018] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Peer crowds, peer groups with macro-level connections and shared norms that transcend geography and race/ethnicity, have been linked to risky health behaviors. Research has demonstrated that Hip Hop peer crowd identification, which is common among multicultural youth, is associated with increased risk of tobacco use. To address this, the FDA Center for Tobacco Products created Fresh Empire, the first national tobacco education campaign tailored for Hip Hop youth aged 12-17 who are multicultural (Hispanic, African American, Asian-Pacific Islander, or Multiracial). As part of campaign development, peer crowd (Hip Hop, Mainstream, Popular, Alternative, Country) and cigarette smoking status were examined for the first time with a nationally recruited sample. METHODS Youth were recruited via targeted social media advertisements. Participants aged 13-17 (n = 5153) self-reported peer crowd identification via the I-Base Survey™ and cigarette smoking status. Differences in smoking status by peer crowd were examined using chi-square and followed up with z-tests to identify specific differences. RESULTS Alternative youth were most at risk of cigarette smoking, followed by Hip Hop. Specifically, Hip Hop youth were significantly less likely to be Non-susceptible Non-triers than Popular, Mainstream, and Country youth, and more likely to be Experimenters than Popular and Mainstream youth. CONCLUSIONS Representative studies show that Alternative is relatively small compared to other high-risk crowds, such as the Hip Hop peer crowd. The current research underscores the potential utility of interventions tailored to larger at-risk crowds for campaigns like Fresh Empire.
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Borkowski EL, Leal WE. The Euphoric Sensations of Cigarettes: Exploring How Operant Conditioning May Be the Missing Link in the Theoretical Understanding of Antidrug Policies. JOURNAL OF DRUG ISSUES 2018. [DOI: 10.1177/0022042618774838] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aims to examine how positive and negative reinforcers during an individual’s first few cigarettes (cigarette initiation experiences) are associated with adulthood smoking behavior. Respondents from the Add Health were asked about subjective feelings during their first few cigarettes. Using ordinary least squares (OLS) and logistic regression, we examine the differential effects of positive and negative cigarette initiation experiences on 30-day cigarette use in adulthood and lifetime nicotine dependence. The results indicate that all measures of positive cigarette initiation experiences are positively associated with both cigarette measures; however, the opposite is not true of negative cigarette initiation experiences. The results highlight the misconceptions of antidrug policies aimed at punishment of users, by indicating that positive experiences influence later cigarette use more than negative experiences. These findings suggest that drug policies and initiatives aimed at punishment may be misguided and could benefit from adopting operant conditioning concepts that emphasize reinforcements.
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Symptoms during Adolescents' First Use of Cigarettes and E-Cigarettes: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14101260. [PMID: 29053574 PMCID: PMC5664761 DOI: 10.3390/ijerph14101260] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 10/11/2017] [Accepted: 10/16/2017] [Indexed: 11/16/2022]
Abstract
Symptoms adolescents experience during their first time using a cigarette predict their current use, but little is known regarding the symptoms experienced during first e-cigarette use. We conducted a pilot study to understand the symptoms adolescents experience when they first tried cigarettes and e-cigarettes and the associations between these symptoms and current use. Participants were 41 adolescents in two U.S. cities who had tried cigarettes or e-cigarettes. We asked adolescents to recall the symptoms they experienced during their first cigarette or e-cigarette and categorized symptoms as negative (felt bad, coughing/chest pain, bad taste, upset stomach, dizzy/lightheaded) or positive (felt relaxed, rush/buzz). Adolescents reported fewer negative symptoms for first e-cigarette than first cigarette use (all p < 0.05). Current cigarette smoking was associated with endorsing fewer negative symptoms (OR = 0.49, 95% CI = [0.25, 0.95]) and more positive symptoms (OR = 7.11, 95% CI = [1.47, 34.33]) at first cigarette use. First e-cigarette use symptoms were not associated with current e-cigarette use. Adolescents reported fewer negative symptoms from first e-cigarette than from first cigarette, and e-cigarette symptoms did not influence use as they do for cigarettes. Additional research is needed to confirm these findings in longitudinal studies.
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Ferreira HR, Rosa EF, Antunes JLF, Duarte DA, Imparato JCP, Pannuti CM, Mendes FM. Prolonged pacifier use during infancy and smoking initiation in adolescence: evidence from a historical cohort study. Eur Addict Res 2015; 21:33-8. [PMID: 25358513 DOI: 10.1159/000365351] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 06/19/2014] [Indexed: 11/19/2022]
Abstract
AIM To investigate the association between prolonged pacifier use during childhood and smoking in adolescence and early adulthood. METHODS A historical cohort study including patients from a dental private office was designed. Dental records were used, which contained complete data about sucking habits from 314 children (2-10 years of age) who had attended a private dental office from 1988 to 1994 in Ibiá, Brazil. Then, we collected data about the smoking habits from 261 subjects who were successfully contacted again from 2004 to 2006. Our outcome variable was smoking, and subjects who had smoked more than 100 cigarettes during their lifetime were classified as smokers. Poisson regression analysis matched the association between oral habits and smoking. Incidence rate ratios (IRR) and 95% confidence intervals (95% CI) were calculated. The level of significance was set at 5%. RESULTS We observed a statistically significant association between prolonged pacifier use (more than 24 months) and smoking (IRR = 4.48; 95% CI 2.32-8.65). Breastfeeding, in contrast, was a protective factor (IRR = 0.64; 95% CI 0.42-0.96). CONCLUSIONS Prolonged pacifier use during childhood is positively associated with smoking initiation in adolescence and early adulthood.
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Affiliation(s)
- Helenice R Ferreira
- Division of Pediatric Dentistry, Cruzeiro do Sul University, São Paulo, Brazil
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Wellman RJ, DiFranza JR, O'Loughlin J. Recalled first reactions to inhaling nicotine predict the level of physical dependence. Drug Alcohol Depend 2014; 143:167-72. [PMID: 25108583 DOI: 10.1016/j.drugalcdep.2014.07.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 07/15/2014] [Accepted: 07/16/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND The level of physical dependence is a measure of addiction that correlates highly with addiction-associated changes in brain structure. We sought to determine whether age at first inhalation and initial reactions to inhaling nicotine are related to level of physical dependence in early adulthood. METHODS Young adults (n=312; mean age=24 years; 51% female) from the Nicotine Dependence in Teens study who had smoked at least once in the preceding three months completed self-report questionnaires in 2011-12. We assessed level of physical dependence with three validated self-report items assessing 'wanting,' 'craving' and 'needing' triggered by nicotine deprivation. Survey items assessed smoking behavior, including age at first inhalation, and recalled first reactions to inhaling nicotine. RESULTS After adjusting for covariates, experiencing relaxation, heart racing/pounding, rush or "buzz" (OR=1.45; 95% CI: 1.08, 1.94) and dizziness (OR=1.58; 95% CI: 1.15, 2.18) at first nicotine inhalation were associated with an increased odds of being at a higher level of physical dependence in young adulthood; the association for experiencing relaxation (OR=1.78; 95% CI: 1.20, 2.64) and heart racing/pounding (OR=1.51; 95% CI: 1.00, 2.28) persisted after additionally controlling for all other first reactions. Neither age at first inhalation nor unpleasant first reactions predicted level of physical dependence. CONCLUSIONS In accordance with prior research, our findings suggest that smokers who are particularly sensitive to the pleasant, "buzz-related" and generally arousing effects of nicotine may be more likely to attain higher levels of physical dependence.
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Affiliation(s)
- Robert J Wellman
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, Massachusetts, 01655, USA
| | - Joseph R DiFranza
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, Massachusetts, 01655, USA.
| | - Jennifer O'Loughlin
- Department of Social and Preventive Medicine, University of Montréal, 3875 St. Urbain, 1st Floor, Montreal, Quebec, H2W 1V1, Canada; Centre de recherche du Centre Hospitalier de l'Université de Montréal, Tour St-Antoine, 850 St-Denis, Montreal, Quebec, H2X 0A9, Canada; Institut national de santé publique du Québec, 945 Wolfe Avenue, Quebec (QC) G1V 5B3, Canada
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Schuck K, Otten R, Engels RCME, Kleinjan M. Initial responses to the first dose of nicotine in novel smokers: the role of exposure to environmental smoking and genetic predisposition. Psychol Health 2014; 29:698-716. [PMID: 24446757 DOI: 10.1080/08870446.2014.884222] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Sensitivity to initial smoking constitutes an early predictor of the risk of dependence. We investigated the role of exposure to smoking (by parents, siblings, and peers) and reward-related candidate gene polymorphisms (OPRM1 A118G, DRD2 TaqlA and DRD4 bp VNTR) in adolescents' responses to initial smoking. METHODS We used cross-sectional survey data and saliva samples from 171 Dutch students who had never inhaled on a cigarette (mean age: 13.9 years). The outcome measure was adolescents' self-reported responses to initial smoking. RESULTS Exposure to peer smoking was associated with increased liking (OR = 1.74, CI = 1.13-2.70) and more pleasant sensations (β = .21, p = .01). Exposure to maternal smoking was associated with less unpleasant sensations (β = -.20, p = .01). Adolescents carrying the G-variant of the OPRM1 A118G polymorphism were more likely to report liking (OR = 2.50, CI = 1.09-5.73) and adolescents homozygous for the C-variant of the DRD2 TaqlA polymorphism reported less unpleasant sensations (β = .18, p = .04). CONCLUSION Although preliminary, these findings suggest that exposure to environmental smoking and polymorphisms in the OPRM1 and DRD2 gene may affect initial sensitivity to nicotine, an early phenotype of the risk of dependence. In the future, collaborative efforts to combine data from multiple studies in meta-analyses are needed to improve accuracy of estimated effects in genetic studies.
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Affiliation(s)
- Kathrin Schuck
- a Behavioural Science Institute, Radboud University Nijmegen , Nijmegen , The Netherlands
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Zabor EC, Li Y, Thornton LM, Shuman MR, Bulik CM, Lichtenstein P, Pedersen NL, Sullivan PF, Furberg H. Initial reactions to tobacco use and risk of future regular use. Nicotine Tob Res 2013; 15:509-17. [PMID: 22949572 PMCID: PMC3612000 DOI: 10.1093/ntr/nts180] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Accepted: 06/27/2012] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Studies suggest that initial smoking pleasure influences future smoking behavior. We investigated how initial reactions to cigarettes or Swedish smokeless tobacco (snus) were associated with future use among 10,708 adults from the Swedish Twin Registry. METHODS The Early Smoking Experience questionnaire captured physiologic reactions to initial tobacco use. Binary recursive partitioning (BRP) identified combinations of initial reactions predictive of regular tobacco use. Analyses, stratified by sex, were conducted separately among those who experimented with only cigarettes (EC), only snus (ES), and both products (EC+S). RESULTS Among EC, 39.8% of men and 43.7% of women became smokers, while among ES, 78.6% of men and 53.7% of women became snus users. Among EC+S, 31.3% of men and 20.0% of women became dual users. BRP identified different reactions as predictive of future smoking for men (buzz) and women (dizziness, difficulty inhaling). No initial reaction predicted future snus use among men, but pleasant sensations, later age at first use, and relaxation predicted future snus use for women. Among EC+S, future exclusive use of either product was associated with a favorable initial reaction to that product. Dual users experienced higher prevalence of pleasant reactions and lower prevalence of unpleasant reactions in response to both products. CONCLUSIONS Our findings support that those who progress to regular tobacco use may be sensitive to the rewarding effects of nicotine but suggest that initial reactions differ by tobacco type. A high proportion of men became regular snus users regardless of initial reactions.
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Affiliation(s)
- Emily Craig Zabor
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
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Okoli C, Greaves L, Fagyas V. Sex differences in smoking initiation among children and adolescents. Public Health 2013; 127:3-10. [DOI: 10.1016/j.puhe.2012.09.015] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2011] [Revised: 04/04/2012] [Accepted: 09/27/2012] [Indexed: 11/16/2022]
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