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Abstract
Background: Research suggests flavor facilitates cigarillo use, but it is unknown if flavor impacts patterns of co-use of cigarillos and cannabis ("co-use"), which is common among young adult smokers. This study's aim was to determine the role of the cigarillo flavor in co-use among young adults. Methods: Data were collected (2020-2021) in a cross-sectional online survey administered to young adults who smoked ≥2 cigarillos/week (N = 361), recruited from 15 urban areas in the United States. A structural equation model was used to assess the relationship between flavored cigarillo use and past 30-day cannabis use (flavored cigarillo perceived appeal and harm as parallel mediators), including several social-contextual covariates (e.g., flavor and cannabis policies). Results: Most participants reported usually using flavored cigarillos (81.8%) and cannabis use in the past 30 days ("co-use") (64.1%). Flavored cigarillo use was not directly associated with co-use (p = 0.90). Perceived cigarillo harm (β = 0.18, 95% CI = 0.06, 0.29), number of tobacco users in the household (β = 0.22, 95% CI = 0.10, 0.33), and past 30-day use of other tobacco products (β = 0.23, 95% CI = 0.15, 0.32) were significantly positively associated with co-use. Living in an area with a ban on flavored cigarillos was significantly negatively associated with co-use (β = -0.12, 95% CI = -0.21, -0.02). Conclusions: Use of flavored cigarillos was not associated with co-use; however, exposure to a flavored cigarillo ban was negatively associated with co-use. Cigar product flavor bans may reduce co-use among young adults or have a neutral impact. Further research is needed to explore the interaction between tobacco and cannabis policy and use of these products.
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Affiliation(s)
- Allison M. Glasser
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, Ohio, 43210, USA
| | - Julianna M. Nemeth
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, Ohio, 43210, USA
| | - Amanda J. Quisenberry
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, 14263, USA
| | - Abigail B. Shoben
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, Ohio, 43210, USA
| | - Erika S. Trapl
- Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, Ohio, 44106, USA
| | - Elizabeth G. Klein
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, Ohio, 43210, USA
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2
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Sharma A, Fix B, Hyland A, Quisenberry AJ, Bansal-Travers M, O'Connor RJ. Differences in demographics and behaviors across two web-based survey platforms: Observations from a study of risk perceptions of heated tobacco products (HTPs). Prev Med Rep 2023; 33:102194. [DOI: 10.1016/j.pmedr.2023.102194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 03/14/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
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3
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Abeyesundere N, Osborn CC, Pike Moore S, Suratkal JP, Kaur M, Otieno C, Quisenberry AJ, Klein EG, Trapl ES. Substitution of flavored cigarillos with menthol cigarettes among young adults in the U.S. Drug Alcohol Depend 2022; 239:109603. [PMID: 35987085 PMCID: PMC10983117 DOI: 10.1016/j.drugalcdep.2022.109603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 08/08/2022] [Accepted: 08/11/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Young adult cigarillo users often cite flavor as a primary reason for initiating and sustaining product use and are more likely to concurrently use other tobacco products such as menthol cigarettes. This study examines substitution with menthol cigarettes among cigarillo users facing a hypothetical ban on flavored cigarillos. METHODS Current young adult (21-28 years) cigarillo users were recruited from October 2020 to April 2021 for an online survey about cigarillo and other tobacco use behaviors. Participants (n = 500) self-reported past or current menthol cigarette experience, and if they would switch to menthol cigarettes if they could not get flavored cigarillos. Logistic regression was used to test differences in switching behaviors by level of experience with menthol cigarettes. RESULTS Most young adult cigarillo users (76.8 %) had ever used a menthol cigarette and 46.6 % reported current use of menthol cigarettes. No participant who had never used menthol cigarettes reported they would switch to menthol cigarettes. Current users were 4.2 times as likely to say they would switch after controlling for demographic characteristics and nicotine dependence. CONCLUSION Most young adult cigarillo users reported they would not switch to menthol cigarettes if flavored cigarillos became unavailable. However, participants who currently use or have used menthol cigarettes were more likely to report their intention to switch products than those who had never used menthol cigarettes. There may be a subsequent increase in menthol cigarette use among past menthol cigarette users if policies restricting flavored tobacco products exclude menthol cigarettes, diluting these policies' intended population health impact.
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Affiliation(s)
- Nichele Abeyesundere
- Department of Population and Quantitative Health Sciences, Prevention Research Center for Healthy Neighborhoods at Case Western Reserve University, Cleveland, OH, the United States of America
| | - Catherine C Osborn
- Department of Population and Quantitative Health Sciences, Prevention Research Center for Healthy Neighborhoods at Case Western Reserve University, Cleveland, OH, the United States of America
| | - Stephanie Pike Moore
- Department of Population and Quantitative Health Sciences, Prevention Research Center for Healthy Neighborhoods at Case Western Reserve University, Cleveland, OH, the United States of America
| | - Jessica P Suratkal
- Department of Population and Quantitative Health Sciences, Prevention Research Center for Healthy Neighborhoods at Case Western Reserve University, Cleveland, OH, the United States of America
| | - Manpreet Kaur
- Department of Population and Quantitative Health Sciences, Prevention Research Center for Healthy Neighborhoods at Case Western Reserve University, Cleveland, OH, the United States of America
| | - Christopher Otieno
- Department of Population and Quantitative Health Sciences, Prevention Research Center for Healthy Neighborhoods at Case Western Reserve University, Cleveland, OH, the United States of America
| | - Amanda J Quisenberry
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, the United States of America
| | - Elizabeth G Klein
- Division of Health Behavior & Health Promotion, The Ohio State University College of Public Health, Columbus, OH, the United States of America
| | - Erika S Trapl
- Department of Population and Quantitative Health Sciences, Prevention Research Center for Healthy Neighborhoods at Case Western Reserve University, Cleveland, OH, the United States of America.
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Glasser AM, Nemeth JM, Quisenberry AJ, Shoben AB, Trapl ES, Klein EG. Cigarillo Flavor and Motivation to Quit among Co-Users of Cigarillos and Cannabis: A Structural Equation Modeling Approach. Int J Environ Res Public Health 2022; 19:5727. [PMID: 35565122 PMCID: PMC9101063 DOI: 10.3390/ijerph19095727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/04/2022] [Accepted: 05/06/2022] [Indexed: 11/16/2022]
Abstract
Flavored cigar restrictions have the potential to benefit public health. Flavor availability facilitates cigarillo use, but it is unknown if flavor impacts patterns of co-use of cigarillos and cannabis, an increasingly prevalent behavior among young adults. Data were collected (2020-2021) in a cross-sectional online survey administered to a convenience sample of young adults who smoked cigarillos from 15 areas with high cigar use prevalence. We assessed the relationship between flavored cigarillo use and motivation to quit cannabis and cigarillo use among past 30-day co-users (N = 218), as well as several covariates (e.g., cigarillo price and flavor/cannabis policy). Flavored cigarillo perceived appeal and harm were hypothesized parallel mediators. Most co-users reported usually using flavored cigarillos (79.5%), which was not significantly associated with motivation to quit cigarillos or cannabis. Perceived cigarillo harm (β = 0.17, 95% CI = 0.00, 0.33), advertising exposure (β = 0.12, 95% CI = 0.00, 0.24), and income (among racial/ethnic minorities; β = -0.13, 95% CI = -0.25, -0.02) were significant predictors of motivation to quit cigarillos. There were no significant predictors of motivation to quit cannabis. Cigarillo flavor was not associated with motivation to quit, so findings could suggest that banning flavors in cigars may have a neutral impact on co-use with cannabis among young adults.
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Affiliation(s)
- Allison M. Glasser
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH 43210, USA; (J.M.N.); (E.G.K.)
| | - Julianna M. Nemeth
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH 43210, USA; (J.M.N.); (E.G.K.)
| | - Amanda J. Quisenberry
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA;
| | - Abigail B. Shoben
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH 43210, USA;
| | - Erika S. Trapl
- Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA;
| | - Elizabeth G. Klein
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH 43210, USA; (J.M.N.); (E.G.K.)
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Diaz D, Quisenberry AJ, Fix BV, Sheffer CE, O'Connor RJ. Stigmatizing attitudes about lung cancer among individuals
who smoke cigarettes. Tob Induc Dis 2022; 20:38. [PMID: 35529324 PMCID: PMC9006129 DOI: 10.18332/tid/146907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/18/2022] [Accepted: 02/23/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Many individuals with lung cancer report experiencing stigma associated with their diagnosis. The objective of this study was to explore how different factors, including smoking status, lung cancer concern, and thoughts on smoking behaviors, were associated with increased stigmatizing attitudes towards people with lung cancer. METHODS In 2015, a Web-based survey was completed by people who currently smoked. Participants (n=1419) aged 18–65 years were randomly assigned to one of three scenarios in which the character who was diagnosed with lung cancer currently, formerly, or never smoked cigarettes. Two aspects of stigma were assessed: blaming the victim and negative attributions about people with lung cancer. RESULTS For blaming the victim and negative attributions, lung cancer stigma differed by scenario (described smoking status, p<0.0001), when adjusting for race, sex, education level, age, income, nicotine dependence, quit intentions, and quit attempts. Higher levels of lung cancer concern were associated with greater blaming the victim (p=0.001), when adjusting for scenario and other significant correlates. CONCLUSIONS The findings suggest that stigmatizing attitudes from people who smoke towards people with lung cancer may be reflective of how they feel about their own smoking habits. We suggest that specific messaging guidelines that avoid an over emphasis on an individual’s smoking status, cessation interventions that address stigma, and screening messages tailored to smoking status, may help to lessen the burden of lung cancer stigma.
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Affiliation(s)
- Destiny Diaz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, United States
| | - Amanda J. Quisenberry
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, United States
| | - Brian V. Fix
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, United States
| | - Christine E. Sheffer
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, United States
| | - Richard J. O'Connor
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, United States
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6
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Quisenberry AJ, Shaw S, Ferketich AK, Corrigan JR. Going Once, Going Twice: Using Willingness-to-Accept Auctions to Promote Smoking Cessation. Nicotine Tob Res 2021; 22:1632-1635. [PMID: 32304211 DOI: 10.1093/ntr/ntaa065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 04/15/2020] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Incentive-based smoking cessation interventions increase quit rates. The optimal incentive, however, is unknown. We used a willingness-to-accept (WTA) auction where smokers submitted bids indicating the incentive they would need to receive for 1 week of smoking cessation. AIMS AND METHODS Smokers ready to quit (n = 35) participated in a WTA auction, naming the amount they needed to be paid to quit for 1 week. Auction winners received an incentive if they successfully quit. All smokers received nicotine replacement therapy and self-help cessation materials. Carbon monoxide concentrations were monitored remotely three times during the week and in person at the final session. RESULTS Participants who smoked their first cigarette within 5 min of waking demanded a significantly larger incentive in exchange for quitting than those who waited (p < .05). About 45% of auction winners quit smoking compared to 20% of nonwinners (p < .05). The cost per quit was $466 among auction winners compared to $894 among nonwinners. CONCLUSIONS WTA auctions may be an effective way to determine the amount smokers need to be paid to quit, which would allow researchers to estimate the most cost-effective payment to offer as part of incentive-based smoking cessation programs. Replication evaluating longer-term cessation outcomes with larger samples is warranted. IMPLICATIONS Incentive-based smoking cessation interventions increase quit rates. However, the optimal incentive is unknown. We found that a WTA auction is a feasible technique for estimating the amount smokers need to be paid to quit. Incentives are a surprisingly cost-effective way to facilitate smoking cessation because they are only paid to those who successfully quit. WTA auctions are a promising tool for determining the incentive that strikes the optimal balance between being large enough to motivate cessation, but small enough that it can be offered to the largest possible population of smokers for a given program budget.
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Affiliation(s)
- Amanda J Quisenberry
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Shreya Shaw
- College of Public Health, The Ohio State University, Columbus, OH
| | - Amy K Ferketich
- College of Public Health, The Ohio State University, Columbus, OH
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7
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Klein EG, Koopman Gonzalez S, Pike Moore S, Bohnert EJ, Quisenberry AJ, Trapl ES. Pulling Your Mask down to Smoke: Qualitative Themes from Young Adults on Nicotine Use during a Pandemic. Subst Use Misuse 2021; 56:437-441. [PMID: 33435783 PMCID: PMC8078211 DOI: 10.1080/10826084.2020.1869264] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Introduction: The COVID-19 pandemic may have resulted in a change in life routines for tobacco users, but little is known about the rationale underlying these changes. Methods: A convenience sample of young adults ages 21-28 (n = 29) were recruited online May-July 2020 to participate in semi-structured interviews about nicotine use behaviors specific to cigarillos and e-cigarettes. Audio-recorded interviews were 60-90 min long and were conducted remotely. Participants were asked opinions and behavioral effects of the COVID-19 pandemic on tobacco use. Verbatim transcripts and field notes from each interview were coded by a trained researcher using a codebook developed using inductive and deductive approaches. Thematic analysis was used to examine product access, use frequency, stress and use triggers. Results: Most current users reported tobacco use stayed the same or increased since the pandemic and attributed this to being home more with greater time/boredom. COVID-19 impacted purchasing behaviors such as purchasing products in greater quantities, through the Internet, or at a different store due to perceived cleanliness. Few reported using tobacco products less frequently and not smoking in public due to the perception of risks associated with smoking and COVID-19, plus having to take off their mask to smoke. Lack of social use modified shared product use, flavors selected, and setting of use. Financial impacts included increased product costs and job loss. Few mentioned wanting to quit due to the pandemic. Discussion: Current tobacco users have experienced major changes in their tobacco use routines during the COVID-19 pandemic.
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Affiliation(s)
| | | | | | | | - Amanda J Quisenberry
- Division of Health Behavior & Health Promotion, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Erika S Trapl
- Case Western Reserve University, Cleveland, Ohio, USA
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Chen-Sankey JC, Mead-Morse EL, Le D, Rose SW, Quisenberry AJ, Delnevo CD, Choi K. Cigar-Smoking Patterns by Race/Ethnicity and Cigar Type: A Nationally Representative Survey Among U.S. Adults. Am J Prev Med 2021; 60:87-94. [PMID: 33341182 PMCID: PMC7755027 DOI: 10.1016/j.amepre.2020.07.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 06/17/2020] [Accepted: 07/16/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Racial/ethnic minorities have a higher prevalence of past 30-day cigar smoking than White, non-Hispanics. Little is known, however, about racial/ethnic differences in advanced cigar-smoking patterns by cigar types. This research explores whether cigar-smoking patterns differ by race/ethnicity and cigar types. METHODS This study used a nationally representative sample of adults (aged ≥18 years; N=28,148) from the Wave 3 survey (2015-2016) of the Population Assessment of Tobacco and Health Study for analysis. Cigar-smoking patterns included past 30-day use, daily use, established use, past 12-month blunt use, use within 30 minutes of waking, and the number of cigars used per day. Weighted multivariable regressions were conducted in 2019 to examine the associations between race/ethnicity and cigar-smoking patterns by cigar types (traditional cigars, cigarillos, and filtered cigars), controlling for covariates. RESULTS Compared with White, non-Hispanics, Black, non-Hispanics were more likely to smoke cigars in the past 30 days (AOR=2.27, 95% CI=2.03, 2.54) and daily (AOR=2.65, 95% CI=1.89, 3.70), have established cigar smoking (AOR=1.95, 95% CI=1.66, 2.29), and smoke blunts in the past 12 months (AOR=2.30, 95% CI=1.84, 2.88). This pattern was generally consistent across cigar types and was especially pronounced for cigarillos. Compared with White, non-Hispanics, Hispanics were more likely to smoke cigars within 30 minutes of waking (AOR=1.50, 95% CI=1.10, 2.06). CONCLUSIONS This study finds that Black, non-Hispanics and Hispanics have more advanced patterns of cigar smoking than White, non-Hispanics. Interventions and policies for minimizing cigar smoking may differentially benefit these populations and reduce disparities.
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Affiliation(s)
- Julia Cen Chen-Sankey
- Intramural Research Program, National Institute on Minority Health and Health Disparities, Bethesda, Maryland.
| | - Erin L Mead-Morse
- School of Medicine, University of Connecticut, Mansfield, Connecticut
| | - Daisy Le
- School of Nursing, George Washington University, Washington, District of Columbia
| | - Shyanika W Rose
- Department of Behavioral Science and Center for Health Equity Transformation, College of Medicine, University of Kentucky, Lexington, Kentucky; Markey Cancer Center, University of Kentucky, Lexington, Kentucky
| | - Amanda J Quisenberry
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Cristine D Delnevo
- Rutgers Center for Tobacco Studies, New Brunswick, New Jersey; Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, New Brunswick, New Jersey; Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Kelvin Choi
- Intramural Research Program, National Institute on Minority Health and Health Disparities, Bethesda, Maryland
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Dermody SS, Heffner JL, Hinds JT, McQuoid J, Quisenberry AJ, Tan ASL, Vogel EA. We are in This Together: Promoting Health Equity, Diversity, and Inclusion in Tobacco Research for Sexual and Gender Minority Populations. Nicotine Tob Res 2020; 22:2276-2279. [PMID: 32335682 PMCID: PMC7733064 DOI: 10.1093/ntr/ntaa070] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 04/20/2020] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Sexual and gender minority (SGM) individuals have higher tobacco use prevalence and consequently higher burden of tobacco-caused diseases, including cancer and cardiovascular disease compared with their heterosexual or cisgender counterparts. Yet, there is a critical gap in research focused on measuring SGM tobacco-related health disparities and addressing unmet needs of SGM individuals in the context of nicotine and tobacco research. AIMS AND METHODS In this commentary, we summarize recommendations discussed during a pre-conference workshop focused on challenges and opportunities in conducting SGM tobacco control research at the 2019 Society for Research on Nicotine and Tobacco Annual Meeting. RESULTS Specifically, we recommend defining and measuring SGM identity in all nicotine and tobacco research routinely, using novel methods to engage a demographically diverse sample of the SGM population, and eliciting SGM community voices in tobacco control research. CONCLUSIONS Addressing these critical research gaps will enable the scientific community to generate the data to fully understand and support SGM individuals in tobacco use prevention and cessation. IMPLICATIONS Tobacco use and its consequences have become increasingly concentrated in disadvantaged groups, including sexual and gender minority (SGM) populations. Through concrete recommendations in this commentary, we aimed to promote health equity, diversity, and inclusion in tobacco research for SGM populations by urging the scientific community to consider expanding efforts to monitor and address tobacco-related health disparities of SGM populations within their respective research programs.
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Affiliation(s)
- Sarah S Dermody
- School of Psychological Science, Oregon State University, Corvallis, OR
| | - Jaimee L Heffner
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Josephine T Hinds
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX
| | - Julia McQuoid
- Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA
| | - Amanda J Quisenberry
- Department of Health Behavior, Division of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Andy S L Tan
- Division of Population Sciences, Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA
| | - Erin A Vogel
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA
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Schneller LM, Li D, Tavárez ZQ, Goniewicz ML, Quisenberry AJ, Xie Z, Rahman I, McIntosh S, O'Connor RJ, Ossip DJ. Flavor Inconsistencies between Flavored Tobacco Products among US Adults. Am J Health Behav 2020; 44:617-630. [PMID: 33121580 DOI: 10.5993/ajhb.44.5.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective: Banning flavors in some tobacco products, while allowing them in others, may shift consumer preferences towards products in which flavors are still allowed. In this study, we examine flavor popularity and inconsistencies in flavor preference across non-cigarette tobacco products among US adults. Methods: We used data from the Population Assessment of Tobacco and Health Study Wave 3 to assess the prevalence of flavor preference for users of non-cigarette tobacco products (N = 9037), as well as flavor inconsistencies between products among polyusers (N = 3183). Results: Most users of flavored tobacco products reported using one flavor category per product. Fruit and tobacco were among the most commonly used flavor categories of ENDS, hookah, traditional cigars, and cigarillo/filtered cigars. Menthol/mint was the most common flavor among snus/smokeless users. Polyusers of ENDS and traditional cigars had the largest inconsistency, where about 68%-76% used different flavors across products. Conversely, polyusers of traditional cigars and cigarillos/filtered cigars had the lowest inconsistency (25%-28%). Conclusions: Flavor preferences differed according to product, suggesting that consumers are not likely to switch across products to maintain a flavor preference. Future research should assess flavor preferences prospectively to improve understanding of the potential benefits of flavor bans.
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Affiliation(s)
- Liane M. Schneller
- Postdoctoral Fellow, the Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, NY;,
| | - Dongmei Li
- Associate Professor, the Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, NY
| | - Zahíra Quiñones Tavárez
- Doctorate Student, Translational Biomedical Science, University of Rochester Medical Center, Rochester, NY
| | - Maciej L. Goniewicz
- Associate Professor of Oncology, Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Amanda J. Quisenberry
- Assistant Professor of Oncology, Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Zidian Xie
- Senior Analyst and Programmer, the Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, NY
| | - Irfan Rahman
- Professor, Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY
| | - Scott McIntosh
- Associate Professor, Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY
| | - Richard J. O'Connor
- Professor of Oncology, Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Deborah J. Ossip
- Professor, Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY
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11
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Carl E, Liskiewicz A, Rivard C, Alberico R, Belal A, Mahoney MC, Quisenberry AJ, Bickel WK, Sheffer CE. Dosing parameters for the effects of high-frequency transcranial magnetic stimulation on smoking cessation: study protocol for a randomized factorial sham-controlled clinical trial. BMC Psychol 2020; 8:42. [PMID: 32357940 PMCID: PMC7193364 DOI: 10.1186/s40359-020-00403-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 04/05/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Despite the considerable success of comprehensive tobacco control efforts, tobacco use remains one of the greatest preventable causes of death and disease today. Over half of all smokers in the US make quit attempts every year, but over 90% relapse within 12 months, choosing the immediate reinforcement of smoking over the long-term benefits of quitting. Conceptual and empirical evidence supports continued investigation of high frequency repetitive transcranial magnetic stimulation (rTMS) of the left dorsolateral prefrontal cortex in reducing relapse and decreasing cigarette consumption. While this evidence is compelling, an optimal dosing strategy must be determined before a long-term efficacy trial can be conducted. The goal of this study is to determine a dosing strategy for 20 Hz rTMS that will produce the best long-term abstinence outcomes with the fewest undesirable effects. METHODS This is a fully crossed, double-blinded, sham-controlled, 3x2x2 randomized factorial study. The three factors are duration (stimulation days: 8, 12, and 16); intensity (900 or 1800 pulses per day); and sham control. Participants (n = 258) will consist of adults (18-65) who are motivated to quit smoking cigarettes and who will be followed for 6 months post-quit. Outcomes include latency to relapse, point prevalence abstinence rates, delay discounting rates, cognitive-behavioral skills acquisition, and multiple measures of potential undesirable effects that impact participant compliance. DISCUSSION This study integrates existing theoretical concepts and methodologies from neuropsychology, behavioral economics, brain stimulation, clinical psychology, and the evidence-based treatment of tobacco dependence in the development of a promising and innovative approach to treat tobacco dependence. This study will establish an optimal dosing regimen for efficacy testing. Findings are expected to have a significant influence on advancing this approach as well as informing future research on clinical approaches that combine rTMS with other evidence-based treatments for tobacco dependence and perhaps other addictions. TRIAL REGISTRATION Clinical Trials NCT03865472 (retrospectively registered). The first participant was fully enrolled on November 26, 2018. Registration was posted on March 7, 2019.
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Affiliation(s)
- Ellen Carl
- Roswell Park Comprehensive Cancer Center, Buffalo, NY, 14203, USA.
| | | | - Cheryl Rivard
- Roswell Park Comprehensive Cancer Center, Buffalo, NY, 14203, USA
| | - Ronald Alberico
- Roswell Park Comprehensive Cancer Center, Buffalo, NY, 14203, USA
| | - Ahmed Belal
- Roswell Park Comprehensive Cancer Center, Buffalo, NY, 14203, USA
| | - Martin C Mahoney
- Roswell Park Comprehensive Cancer Center, Buffalo, NY, 14203, USA
| | | | - Warren K Bickel
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, 24016, USA
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Quisenberry AJ, Pittman J, Goodwin RD, Bickel WK, D'Urso G, Sheffer CE. Smoking relapse risk is increased among individuals in recovery. Drug Alcohol Depend 2019; 202:93-103. [PMID: 31325822 PMCID: PMC6685745 DOI: 10.1016/j.drugalcdep.2019.07.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 07/03/2019] [Accepted: 07/05/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND The prevalence of cigarette smoking among individuals with a history of substance use disorders (SUDs) remains up to four times higher than those without a history of SUDs. More than half of individuals who attain sustained remission from SUDs will die of tobacco-related diseases. The aim of this secondary data analysis was to compare the risk for smoking relapse among smokers with no history of SUDs and smokers in recovery from SUDs after multi-component, cognitive-behavioral treatment for tobacco dependence. METHODS Participants were randomized to receive 6 sessions of multicomponent cognitive-behavioral therapy (adapted for lower socioeconomic groups or standard), 8 weeks of nicotine patches, and were followed for 6 months in the parent randomized clinical trial. Participants passed a urine drug test prior to enrollment. Recovery was assessed at baseline by self-report to the question, "Do consider yourself in recovery from drugs or alcohol?" Relapse was defined as any smoking for 7 consecutive days. RESULTS Participants were primarily lower SES and identified as racial and/or ethnic minorities. Cox proportional hazards models revealed that the risk of smoking relapse following tobacco dependence treatment was greater among smokers in long-term (HR: 1.44; 95% CI: 1.01, 2.05) and short-term (HR: 1.98; 95% CI: 1.30, 3.03) recovery than for smokers with no history of SUDs. CONCLUSIONS Our findings indicate that smokers in recovery from SUDs have 1.5-2 times the risk of relapse than smokers with no history of SUDs. More effective relapse prevention interventions are needed for this vulnerable, high-risk group of smokers.
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Affiliation(s)
- Amanda J Quisenberry
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY, 14203, United States.
| | - Jami Pittman
- College of Liberal Arts & Sciences, Wayne State University, 4841 Cass Avenue, Detroit, MI, 48201, United States
| | - Renee D Goodwin
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, United States; Institute of Implementation in Population Health, The City University of New York, 55 West 125th Street, New York, New York, 10027, United States
| | - Warren K Bickel
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, 2 Riverside Circle, Roanoke, VA, 24016, United States
| | - Giordano D'Urso
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Christine E Sheffer
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY, 14203, United States
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Klein EG, Quisenberry AJ, Shoben AB, Romer D, Peters E. The Influence of Health Numeracy and Health Warning Label Type on Smoking Myths and Quit-Related Reactions. Nicotine Tob Res 2019; 21:974-978. [PMID: 30285145 PMCID: PMC6588388 DOI: 10.1093/ntr/nty207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 09/27/2018] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Health numeracy helps individuals understand risk information, but limited data exist concerning numeracy's role in reactions to varying types of health warning labels (HWLs) for cigarettes. METHODS A nationally representative online panel of adult current smokers received two exposures (1 week apart) to nine HWLs with either text-only or pictorial images with identical mandated text. Following the second exposure, participants (n = 594) rated their beliefs in smoking myths (eg, health-promoting behaviors can undo the risks of smoking) and how much the warnings made them want to quit smoking. Generalized estimating equation regression examined the relation of objective health numeracy and its interaction with HWL type to smoking-myth beliefs and quit-related reactions. RESULTS Health numeracy was not significantly associated with smoking-myth beliefs; the interaction with HWL type was also nonsignificant. Adult smokers with lower health numeracy had higher quit-related reactions than those with higher numeracy following exposure to HWLs. The type of HWL significantly modified numeracy's associations with quit-related reactions; no significant association existed between text-only HWLs and quit-related reactions, whereas among those who viewed the pictorial warnings, lower numeracy was associated with greater quit-related reactions (β = -.23; p < .001). CONCLUSIONS Lower as compared to higher health numeracy was significantly associated with higher quit-related reactions to HWLs and especially with pictorial HWLs. Health numeracy and HWL type were not associated with the endorsement of smoking myths. The role of health numeracy in effectively communicating risks to smokers warrants thoughtful consideration in the development of tobacco HWLs. IMPLICATIONS Health numeracy plays an important role in an individual's ability to understand and respond to health risks. Smokers with lower health numeracy had greater quit-related reactions to pictorial health warnings than those who viewed text-only warning labels. Development and testing of health warning labels should consider health numeracy to most effectively communicate risk to US smokers.
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Affiliation(s)
- Elizabeth G Klein
- Division of Health Behavior & Health Promotion, College of Public Health, Ohio State University, Columbus, OH
| | - Amanda J Quisenberry
- Division of Health Behavior & Health Promotion, College of Public Health, Ohio State University, Columbus, OH
| | - Abigail B Shoben
- Division of Biostatistics, College of Public Health, Ohio State University, Columbus, OH
| | - Dan Romer
- Annenberg Public Policy Center, University of Pennsylvania, Philadelphia, PA
| | - Ellen Peters
- Department of Psychology, Ohio State University, Columbus, OH
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Gaalema DE, Pericot-Valverde I, Bunn JY, Villanti AC, Cepeda-Benito A, Doogan NJ, Keith DR, Kurti AN, Lopez AA, Nighbor T, Parker MA, Quisenberry AJ, Redner R, Roberts ME, Stanton CA, Ades PA, Higgins ST. Tobacco use in cardiac patients: Perceptions, use, and changes after a recent myocardial infarction among US adults in the PATH study (2013-2015). Prev Med 2018; 117:76-82. [PMID: 29746974 PMCID: PMC6195824 DOI: 10.1016/j.ypmed.2018.05.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 04/30/2018] [Accepted: 05/05/2018] [Indexed: 11/29/2022]
Abstract
Smoking status following cardiac events strongly predicts future morbidity and mortality. Using a nationally representative sample of United States adults, aims of this study were (1) to estimate use of, and attitudes towards, tobacco products as a function of level of cardiac risk, and (2) to explore changes in attitudes and tobacco use among adults experiencing a recent myocardial infarction (MI). Data were obtained from the first and second waves of the Population Assessment of Tobacco and Health (PATH) study. Use and attitudes towards tobacco products were examined at Wave 1 among adults with no chronic health condition (n = 18,026), those with risk factors for heart disease (n = 4593), and those who reported ever having had an MI (n = 643). Changes in perceived risk of tobacco and use between the two waves and having an MI in the last 12 months (n = 240) were also examined. Those who reported lifetime MI were more likely to believe that smoking/using tobacco was causing/worsening a health problem. Having had a recent MI event increased perceived tobacco-related risk and attempts at reduction/quitting, but did not significantly impact combusted tobacco cessation/reduction or uptake of non-combusted tobacco products. Sociodemographic characteristics and use of other tobacco products were associated with change in use of tobacco products. Those who have an MI are sensitized to the harm of continued smoking. Nonetheless, having an MI does not predict quitting combusted tobacco use or switching to potentially reduced harm products. Intense intervention is necessary to reduce combusted use in this high-risk population.
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Affiliation(s)
- Diann E Gaalema
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Departments of Psychiatry, University of Vermont, Burlington, VT, USA; Psychological Science, University of Vermont, Burlington, VT, USA.
| | - Irene Pericot-Valverde
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Departments of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Janice Y Bunn
- Medical Biostatistics, University of Vermont, Burlington, VT, USA
| | - Andrea C Villanti
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Departments of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Antonio Cepeda-Benito
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Psychological Science, University of Vermont, Burlington, VT, USA
| | - Nathan J Doogan
- Center of Excellence in Regulatory Tobacco Science, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Diana R Keith
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Departments of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Allison N Kurti
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Departments of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Alexa A Lopez
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA
| | - Tyler Nighbor
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Departments of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Maria A Parker
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Departments of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Amanda J Quisenberry
- Center of Excellence in Regulatory Tobacco Science, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Ryan Redner
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Rehabilitation Institute, Southern Illinois University, Carbondale, IL, USA
| | - Megan E Roberts
- Center of Excellence in Regulatory Tobacco Science, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Cassandra A Stanton
- Westat, Center for Evaluation and Coordination of Training and Research (CECTR) in Tobacco Regulatory Science, Department of Oncology, Georgetown University Medical Center, Washington, DC, USA
| | - Philip A Ades
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Division of Cardiology, University of Vermont College of Medicine, Burlington, VT, USA
| | - Stephen T Higgins
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Departments of Psychiatry, University of Vermont, Burlington, VT, USA; Psychological Science, University of Vermont, Burlington, VT, USA
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15
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Cepeda-Benito A, Doogan NJ, Redner R, Roberts ME, Kurti AN, Villanti AC, Lopez AA, Quisenberry AJ, Stanton CA, Gaalema DE, Keith DR, Parker MA, Higgins ST. Trend differences in men and women in rural and urban U.S. settings. Prev Med 2018; 117:69-75. [PMID: 29627511 PMCID: PMC6173654 DOI: 10.1016/j.ypmed.2018.04.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 02/21/2018] [Accepted: 04/02/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Smoking prevalence is declining at a slower rate in rural than urban settings in the United States (U.S.), and known predictors of smoking do not readily account for this trend difference. Given that socioeconomic and psychosocial determinants of health disparities accumulate in rural settings and that life-course disadvantages are often greater in women than men, we examined whether smoking trends are different for rural and urban men and women. METHOD We used yearly cross-sectional data (n = 303,311) from the U.S. National Survey on Drug Use and Health (NSDUH) from 2007 through 2014 to compare cigarette smoking trends in men and women across rural and urban areas. Current smoking status was modelled using logistic regression controlling for confounding risk factors. RESULTS Regression derived graphs predicting unadjusted prevalence estimates and 95% confidence bands revealed that whereas the smoking trends of rural men, urban men, and urban women significantly declined from 2007 to 2014, the trend for rural women was flat. Controlling for demographic, socioeconomic and psychosocial predictors of smoking did not explain rural women's significantly different trend from those of the other three groups. CONCLUSION Rural women lag behind rural men, urban men and urban women in decreasing smoking, a health disparity finding that supports the need for tobacco control and regulatory policies and interventions that are more effective in reducing smoking among rural women.
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Affiliation(s)
- A Cepeda-Benito
- University of Vermont Center of Tobacco Regulatory Science, University of Vermont, United States; Department of Psychological Science, University of Vermont, United States.
| | - N J Doogan
- Center of Excellence in Regulatory Tobacco Science, College of Public Health, The Ohio State University, United States
| | - R Redner
- University of Vermont Center of Tobacco Regulatory Science, University of Vermont, United States; Rehabilitation Institute, Southern Illinois University, United States
| | - M E Roberts
- Center of Excellence in Regulatory Tobacco Science, College of Public Health, The Ohio State University, United States
| | - A N Kurti
- University of Vermont Center of Tobacco Regulatory Science, University of Vermont, United States; Department of Psychological Science, University of Vermont, United States; Department of Psychiatry, University of Vermont, United States
| | - A C Villanti
- University of Vermont Center of Tobacco Regulatory Science, University of Vermont, United States; Department of Psychiatry, University of Vermont, United States
| | - A A Lopez
- University of Vermont Center of Tobacco Regulatory Science, University of Vermont, United States
| | - A J Quisenberry
- Center of Excellence in Regulatory Tobacco Science, College of Public Health, The Ohio State University, United States
| | - C A Stanton
- Westat, Center for Evaluation and Coordination of Training and Research (CECTR) in Tobacco Regulatory Science, Department of Oncology, Georgetown University Medical Center, United States; Department of Oncology, Georgetown University Medical Center / Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, United States
| | - D E Gaalema
- University of Vermont Center of Tobacco Regulatory Science, University of Vermont, United States; Department of Psychological Science, University of Vermont, United States; Department of Psychiatry, University of Vermont, United States
| | - D R Keith
- University of Vermont Center of Tobacco Regulatory Science, University of Vermont, United States; Department of Psychiatry, University of Vermont, United States
| | - M A Parker
- University of Vermont Center of Tobacco Regulatory Science, University of Vermont, United States; Department of Psychiatry, University of Vermont, United States
| | - S T Higgins
- University of Vermont Center of Tobacco Regulatory Science, University of Vermont, United States; Department of Psychological Science, University of Vermont, United States; Department of Psychiatry, University of Vermont, United States
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16
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Parker MA, Villanti AC, Quisenberry AJ, Stanton CA, Doogan NJ, Redner R, Gaalema DE, Kurti AN, Nighbor T, Roberts ME, Cepeda-Benito A, Higgins ST. Tobacco Product Harm Perceptions and New Use. Pediatrics 2018; 142:peds.2018-1505. [PMID: 30397167 PMCID: PMC6317771 DOI: 10.1542/peds.2018-1505] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/10/2018] [Indexed: 11/24/2022] Open
Abstract
UNLABELLED : media-1vid110.1542/5839992833001PEDS-VA_2018-1505Video Abstract BACKGROUND: Researchers in several studies have examined correlations between tobacco harm perceptions and tobacco use in youth, but none have prospectively addressed the association between harm perceptions and subsequent new use across multiple noncigarette products. METHODS Product-specific absolute and relative harm perceptions for cigarettes, electronic cigarettes (e-cigarettes), cigars, pipes, hookah, and smokeless tobacco were collected at wave 1 (W1) (2013-2014) among youth in the nationally representative US Population Assessment of Tobacco and Health Study (12-17 years of age; n = 10 081). At wave 2 (W2) (2014-2015), product-specific new use was calculated. Adjusted relative risks were used to estimate if harm perceptions at W1 predicted W2 new tobacco use. RESULTS The proportion of youth who endorsed "a lot of harm" was highest for cigarettes (84.8%) and lowest for e-cigarettes (26.6%); the proportion of youth who thought products were "more harmful" than cigarettes was highest for cigars (30.6%) and lowest for e-cigarettes (5.1%). Among youth who had not used those products at W1, product-specific new use at W2 ranged from 9.1% (e-cigarettes) to 0.6% (pipes). Youth who believed that noncombustible tobacco products posed "no or little harm" at W1 were more likely to have tried those products at W2 (P < .05). Youth who viewed e-cigarettes, hookah, and smokeless tobacco as "less harmful" than cigarettes at W1 were more likely to try those tobacco products at W2 (P < .05). CONCLUSIONS Low harm perceptions of noncigarette tobacco products predict new use of these products by youth within the next year. Targeting product-specific harm perceptions may prevent new tobacco use among youth.
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Affiliation(s)
- Maria A. Parker
- Tobacco Center on Regulatory Science, University of
Vermont, Burlington, Vermont
| | - Andrea C. Villanti
- Tobacco Center on Regulatory Science, University of
Vermont, Burlington, Vermont
| | - Amanda J. Quisenberry
- Center of Excellence in Regulatory Tobacco Science,
The Ohio State University, Columbus, Ohio
| | - Cassandra A. Stanton
- Center for Evaluation and Coordination of Training
and Research in Tobacco Regulatory Science, Westat, Rockville, Maryland;,Department of Oncology, Georgetown University Medical
Center, Washington, District of Columbia; and
| | - Nathan J. Doogan
- Center of Excellence in Regulatory Tobacco Science,
The Ohio State University, Columbus, Ohio
| | - Ryan Redner
- Rehabilitation Institute, Southern Illinois
University, Carbondale, Illinois
| | - Diann E. Gaalema
- Tobacco Center on Regulatory Science, University of
Vermont, Burlington, Vermont
| | - Allison N. Kurti
- Tobacco Center on Regulatory Science, University of
Vermont, Burlington, Vermont
| | - Tyler Nighbor
- Tobacco Center on Regulatory Science, University of
Vermont, Burlington, Vermont
| | - Megan E. Roberts
- Center of Excellence in Regulatory Tobacco Science,
The Ohio State University, Columbus, Ohio
| | | | - Stephen T. Higgins
- Tobacco Center on Regulatory Science, University of
Vermont, Burlington, Vermont
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17
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Nighbor TD, Doogan NJ, Roberts ME, Cepeda-Benito A, Kurti AN, Priest JS, Johnson HK, Lopez AA, Stanton CA, Gaalema DE, Redner R, Parker MA, Keith DR, Quisenberry AJ, Higgins ST. Smoking prevalence and trends among a U.S. national sample of women of reproductive age in rural versus urban settings. PLoS One 2018; 13:e0207818. [PMID: 30485376 PMCID: PMC6261597 DOI: 10.1371/journal.pone.0207818] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Accepted: 11/06/2018] [Indexed: 11/19/2022] Open
Abstract
U.S. smoking prevalence is declining at a slower rate in rural than urban settings and contributing to regional health disparities. Cigarette smoking among women of reproductive age is particularly concerning due to the potential for serious maternal and infant adverse health effects should a smoker become pregnant. The aim of the present study was to examine whether this rural-urban disparity impacts women of reproductive age (ages 15-44) including pregnant women. Data came from the ten most recent years of the U.S. National Survey on Drug Use and Health (2007-2016). We estimated prevalence of current smoking and nicotine dependence among women categorized by rural-urban residence, pregnancy status, and trends using chi-square testing and multivariable modeling while adjusting for common risk factors for smoking. Despite overall decreasing trends in smoking prevalence, prevalence was higher among rural than urban women of reproductive age overall (χ2(1) = 579.33, p < .0001) and among non-pregnant (χ2(1) = 578.0, p < .0001) and pregnant (χ2(1) = 79.69, p < .0001) women examined separately. An interaction between residence and pregnancy status showed adjusted odds of smoking among urban pregnant compared to non-pregnant women (AOR = .58, [.53 -.63]) were lower than those among rural pregnant compared to non-pregnant women (AOR = 0.75, [.62 -.92]), consistent with greater pregnancy-related smoking cessation among urban pregnant women. Prevalence of nicotine dependence was also higher in rural than urban smokers overall (χ2(2) = 790.42, p < .0001) and among non-pregnant (χ2(2) = 790.58, p < .0001) and pregnant women examined separately (χ2(2) = 63.69, p < .0001), with no significant changes over time. Associations involving residence and pregnancy status remained significant in models adjusting for covariates (ps < 0.05). Results document greater prevalence of smoking and nicotine dependence and suggest less pregnancy-related quitting among rural compared to urban women, disparities that have potential for direct, multi-generational adverse health impacts.
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Affiliation(s)
- Tyler D. Nighbor
- Vermont Center on Behavior and Health, University of Vermont, Burlington, Vermont, United States of America
- Department of Psychiatry, University of Vermont, Burlington, Vermont, United States of America
| | - Nathan J. Doogan
- Ohio Colleges of Medicine Government Resource Center, The Ohio State University, Columbus, OH, United States of America
| | - Megan E. Roberts
- Ohio Colleges of Medicine Government Resource Center, The Ohio State University, Columbus, OH, United States of America
| | - Antonio Cepeda-Benito
- Vermont Center on Behavior and Health, University of Vermont, Burlington, Vermont, United States of America
- Department of Psychological Science, University of Vermont, Burlington, Vermont, United States of America
| | - Allison N. Kurti
- Vermont Center on Behavior and Health, University of Vermont, Burlington, Vermont, United States of America
- Department of Psychiatry, University of Vermont, Burlington, Vermont, United States of America
- Department of Psychological Science, University of Vermont, Burlington, Vermont, United States of America
| | - Jeff S. Priest
- Medical Biostatistics, University of Vermont, Burlington, Vermont, United States of America
| | - Harley K. Johnson
- Vermont Center on Behavior and Health, University of Vermont, Burlington, Vermont, United States of America
- Department of Psychiatry, University of Vermont, Burlington, Vermont, United States of America
| | - Alexa A. Lopez
- Vermont Center on Behavior and Health, University of Vermont, Burlington, Vermont, United States of America
| | - Cassandra A. Stanton
- Westat, Center for Evaluation and Coordination of Training and Research (CECTR) in Tobacco Regulatory Science, Rockville, Maryland, United States of America
- Department of Oncology, Georgetown University Medical Center, Washington District of Columbia, United States of America
| | - Diann E. Gaalema
- Vermont Center on Behavior and Health, University of Vermont, Burlington, Vermont, United States of America
- Department of Psychiatry, University of Vermont, Burlington, Vermont, United States of America
- Department of Psychological Science, University of Vermont, Burlington, Vermont, United States of America
| | - Ryan Redner
- Vermont Center on Behavior and Health, University of Vermont, Burlington, Vermont, United States of America
- Rehabilitation Institute, Southern Illinois University, Carbondale, Illinois, United States of America
| | - Maria A. Parker
- Vermont Center on Behavior and Health, University of Vermont, Burlington, Vermont, United States of America
- Department of Psychiatry, University of Vermont, Burlington, Vermont, United States of America
| | - Diana R. Keith
- Vermont Center on Behavior and Health, University of Vermont, Burlington, Vermont, United States of America
- Department of Psychiatry, University of Vermont, Burlington, Vermont, United States of America
| | - Amanda J. Quisenberry
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, United States of America
| | - Stephen T. Higgins
- Vermont Center on Behavior and Health, University of Vermont, Burlington, Vermont, United States of America
- Department of Psychiatry, University of Vermont, Burlington, Vermont, United States of America
- Department of Psychological Science, University of Vermont, Burlington, Vermont, United States of America
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18
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Quisenberry AJ, Scott AE, Shoben AB, Ferketich AK, Cooper SE, Berman M, Peters E, Ellen Wewers M, Klein EG. Health Literacy and Attention to Cigarette Health Warning Labels among Rural Smokers. TOB REGUL SCI 2018; 4:38-46. [PMID: 31363489 PMCID: PMC6667177 DOI: 10.18001/trs.4.6.4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES We evaluated the association of health literacy and attention to the pictorial imagery of 9 health warning labels (HWLs) in a tobacco advertisement among rural US smokers. We hypothesized that lower health literacy would be associated with greater visual attention to pictorial portions of HWLs and evaluated the association between health literacy and recall of advertisement elements. METHODS Adult smokers from Appalachian Ohio (N = 180) viewed a pictorial HWL encompassing 20% or 33% of a cigarette advertisement while eye tracking software recorded eye movements toward the advertisement. Health literacy was measured with The Short Test of Functional Health Literacy in Adults. RESULTS Generalized linear regression revealed that every one-unit decrease in health literacy increased viewing time of the pictorial portion of the health warning label by 1.3 percentage points. Logistic regression revealed that the odds of recalling elements of the pictorial portion of the health warning label increased 20% for every one-unit increase in health literacy. CONCLUSIONS Rural smokers with lower health literacy view pictorial portions of health warning labels longer than those with greater health literacy supporting that health literacy is an important consideration in health communications, including future cigarette warning labels.
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Affiliation(s)
| | - Ayanna E Scott
- Ohio State University Center for the Advancement of Team Science, Analytics, and Systems Thinking, Columbus, OH
| | - Abigail B Shoben
- Ohio State University College of Public Health, Center of Excellence in Regulatory Tobacco Science, Columbus, OH
| | - Amy K Ferketich
- Ohio State University College of Public Health, Center of Excellence in Regulatory Tobacco Science, Columbus, OH
| | - Sarah E Cooper
- Ohio State University College of Public Health, Center of Excellence in Regulatory Tobacco Science, Columbus, OH
| | - Micah Berman
- Ohio State University College of Public Health, Center of Excellence in Regulatory Tobacco Science, Columbus, OH
| | - Ellen Peters
- Ohio State University Psychology Department, Center of Excellence in Regulatory Tobacco Science, Columbus, OH
| | - Mary Ellen Wewers
- Ohio State University College of Public Health, Center of Excellence in Regulatory Tobacco Science, Columbus, OH
| | - Elizabeth G Klein
- Ohio State University College of Public Health, Center of Excellence in Regulatory Tobacco Science, Columbus, OH
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19
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Kurti AN, Bunn JY, Villanti AC, Stanton CA, Redner R, Lopez AA, Gaalema DE, Doogan NJ, Cepeda-Benito A, Roberts ME, Phillips JK, Quisenberry AJ, Keith DR, Higgins ST. Patterns of Single and Multiple Tobacco Product Use Among US Women of Reproductive Age. Nicotine Tob Res 2018; 20:S71-S80. [PMID: 30125011 PMCID: PMC6093396 DOI: 10.1093/ntr/nty024] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Accepted: 01/31/2018] [Indexed: 12/21/2022]
Abstract
Introduction Understanding patterns of single and multiple tobacco product use among reproductive-aged women is critical given the potential for adverse health effects on mother and infant should a woman become pregnant. Methods Patterns of tobacco use over a 2-year period were examined among all women (18-44 years) who completed wave 1 (W1) and wave 2 (W2) of the US Population Assessment of Tobacco and Health (PATH, 2013-2014, 2014-2015) Study. We examined the most common patterns of single and multiple tobacco product use in W1, and longitudinal trajectories of women engaged in each of these patterns of use from W1 to W2, among women not pregnant in either wave (n = 7480), not pregnant in W1 and pregnant in W2 (n = 332), and pregnant in W1 and not pregnant in W2 (n = 325). Results The most prevalent patterns of tobacco use in W1 among all three subgroups were using cigarettes alone followed by using cigarettes plus e-cigarettes. In all three subgroups, women using multiple products in W1 were more likely to adopt new use patterns in W2 relative to single-product users, with the new patterns generally involving dropping rather than adding products. The majority of multiple product use included cigarettes, and transitions to single product use typically involved dropping the noncigarette product. The most common trajectory among tobacco users transitioning to or from pregnancy was to use cigarettes alone in W2. Discussion This study contributes new knowledge characterizing tobacco use patterns across time and reproductive events among reproductive-aged women.
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Affiliation(s)
- Allison N Kurti
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT
- Department of Psychiatry, University of Vermont, Burlington, VT
| | - Janice Y Bunn
- Department of Biostatistics, University of Vermont, Burlington, VT
| | - Andrea C Villanti
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT
- Department of Psychiatry, University of Vermont, Burlington, VT
| | - Cassandra A Stanton
- Center for Evaluation and Coordination of Training and Research (CECTR) in Tobacco Regulatory Science, Westat, Rockville, MD
- Department of Oncology, Georgetown University Medical Center, Washington, DC
| | - Ryan Redner
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT
- Rehabilitation Institute, Southern Illinois University, Carbondale, IL
| | - Alexa A Lopez
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT
| | - Diann E Gaalema
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT
- Department of Psychiatry, University of Vermont, Burlington, VT
| | - Nathan J Doogan
- Center for Excellence in Regulatory Tobacco Science, The Ohio State University, Colombus, OH
- College of Public Health, The Ohio State University, Colombus, OH
| | - Antonio Cepeda-Benito
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT
- Department of Psychological Science, University of Vermont, Burlington, VT
| | - Megan E Roberts
- College of Public Health, The Ohio State University, Colombus, OH
| | - Julie K Phillips
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Vermont, Burlington, VT
| | - Amanda J Quisenberry
- Center for Excellence in Regulatory Tobacco Science, The Ohio State University, Colombus, OH
| | - Diana R Keith
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT
- Department of Psychiatry, University of Vermont, Burlington, VT
| | - Stephen T Higgins
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT
- Department of Psychiatry, University of Vermont, Burlington, VT
- Department of Psychological Science, University of Vermont, Burlington, VT
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Doogan NJ, Cooper S, Quisenberry AJ, Brasky TM, Browning CR, Klein EG, Hinton A, Nagaraja HN, Xi W, Wewers ME. The role of travel distance and price promotions in tobacco product purchase quantity. Health Place 2018; 51:151-157. [PMID: 29625358 PMCID: PMC5964010 DOI: 10.1016/j.healthplace.2018.03.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 03/03/2018] [Accepted: 03/28/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Rural Americans are particularly vulnerable to tobacco price reducing promotions are known to be directed to and used by vulnerable populations. Tobacco purchasing decisions, such as unit quantity purchased, may vary by rurality, by price promotion use, and possibly by the interaction between the two. Purchase decisions are likely to affect tobacco use behavior. Therefore, explanation of variation in tobacco purchase quantity by factors associated with rural vulnerability and factors that fall under the regulatory scope of the Tobacco Control Act (TCA) of 2009 could be of value to regulatory proposals intended to equitably benefit public health. METHODS Our sample included 54 combustible tobacco users (298 purchase events) and 27 smokeless tobacco users (112 purchase events), who were asked to report all tobacco purchases on a smartphone application. We used an ecological momentary assessment methodology to collect data about tobacco users' purchasing patterns, including products, quantity purchased, and use of price promotions. A parent cohort study provided relevant data for home-outlet distance calculation and covariates. Our analysis examined associations between our outcome-purchase quantity per purchase event-and distance from participant's home to the nearest outlet, whether a price reducing promotion was used, and the interaction of these two factors. RESULTS Combustible users showed an increased cigarette pack purchase quantity if they lived further from an outlet and used a price promotion (i.e., an interaction effect; RR = 1.70, 95% CI [1.11, 2.62]). Smokeless users purchased more units of snuff when they used price promotions (RR = 1.81, 95% CI [1.02, 3.20]). CONCLUSIONS Regulatory action that imposes restrictions on the availability or use of price promotions could alter the purchasing behavior of rural Americans in such a way that makes it easier to reduce tobacco use or quit. Such action would also restrict flexibility in the price of tobacco products, which is known as a powerful tobacco control lever.
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Affiliation(s)
- Nathan J Doogan
- The Ohio State University College of Public Health, Cunz Hall, 1841 Neil Ave., Columbus, OH 43210, United States.
| | - Sarah Cooper
- The Ohio State University College of Public Health, Cunz Hall, 1841 Neil Ave., Columbus, OH 43210, United States
| | - Amanda J Quisenberry
- The Ohio State University College of Public Health, Cunz Hall, 1841 Neil Ave., Columbus, OH 43210, United States
| | - Theodore M Brasky
- The Ohio State University College of Public Health, Cunz Hall, 1841 Neil Ave., Columbus, OH 43210, United States; The Ohio State University College of Medicine, 370W. 9th Ave., Columbus, OH 43210, United States
| | - Christopher R Browning
- The Ohio State University Department of Sociology, Townshend Hall, 1885 Neil Ave. Mall, Columbus, OH 43210, United States
| | - Elizabeth G Klein
- The Ohio State University College of Public Health, Cunz Hall, 1841 Neil Ave., Columbus, OH 43210, United States
| | - Alice Hinton
- The Ohio State University College of Public Health, Cunz Hall, 1841 Neil Ave., Columbus, OH 43210, United States
| | - Haikady N Nagaraja
- The Ohio State University College of Public Health, Cunz Hall, 1841 Neil Ave., Columbus, OH 43210, United States
| | - Wenna Xi
- The Ohio State University College of Public Health, Cunz Hall, 1841 Neil Ave., Columbus, OH 43210, United States
| | - Mary Ellen Wewers
- The Ohio State University College of Public Health, Cunz Hall, 1841 Neil Ave., Columbus, OH 43210, United States
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21
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Klein EG, Quisenberry AJ, Shoben AB, Cooper S, Ferketich AK, Berman M, Peters E, Wewers ME. Health Warning Labels for Smokeless Tobacco: The Impact of Graphic Images on Attention, Recall, and Craving. Nicotine Tob Res 2018; 19:1172-1177. [PMID: 28339596 DOI: 10.1093/ntr/ntx021] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 01/17/2017] [Indexed: 11/13/2022]
Abstract
Introduction Little research has examined the impacts of graphic health warnings on the users of smokeless tobacco products. Methods A convenience sample of past-month, male smokeless tobacco users (n = 142; 100% male) was randomly assigned to view a smokeless tobacco advertisement with a graphic health warning (GHW) or a text-only warning. Eye-tracking equipment measured viewing time, or dwell time, in milliseconds. Following the advertisement exposure, participants self-reported smokeless tobacco craving and recalled any content in the health warning message (unaided recall). Linear and logistic regression analyses evaluated the proportion of time viewing the GHW, craving, and GHW recall. Results Participants who viewed a GHW spent a significantly greater proportion of their ad viewing time on GHWs (2.87 seconds or 30%), compared to those viewing a text-only warning (2.05 seconds or 24%). Although there were no significant differences by condition in total advertisement viewing duration, those participants viewing a GHW had increased recall of health warning messages compared to the text-only warning (76% had any warning message recall compared to 53%; p < .05). Self-reported craving after advertisement exposure was lower in the GHW compared to text-only condition, but the difference was not statistically significant (a rating of 4.4 vs. 5.3 on a 10-point scale; p = .08). Conclusions GHWs attracted greater attention and greater recall of health warning messages compared to text-only warnings among rural male smokeless tobacco users. Implications Among a sample of rural smokeless tobacco users, GHWs attracted more attention and recall of health warning messages compared to text-only warnings when viewed within smokeless tobacco advertising. These findings provide additional empirical support that GHWs are an effective tobacco control tool for all tobacco products and advertisements.
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Affiliation(s)
| | | | | | - Sarah Cooper
- College of Public Health, Ohio State University, Columbus, OH
| | - Amy K Ferketich
- College of Public Health, Ohio State University, Columbus, OH
| | - Micah Berman
- College of Public Health, Ohio State University, Columbus, OH.,College of Law, Ohio State University, Columbus, OH
| | - Ellen Peters
- College of Arts and Sciences, Ohio State University, Columbus, OH
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22
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Athamneh LN, Stein JS, Quisenberry AJ, Pope D, Bickel WK. The association between parental history and delay discounting among individuals in recovery from addiction. Drug Alcohol Depend 2017; 179:153-158. [PMID: 28780380 PMCID: PMC5599355 DOI: 10.1016/j.drugalcdep.2017.06.037] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 06/13/2017] [Accepted: 06/16/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Family history of addiction is a risk factor for substance use disorders. Delay discounting (DD) is associated with the risk of substance use and dependence, and is predictive of the likelihood of successful abstinence and treatment outcomes; thus, we investigated the extent to which having parents with addiction (parental history of addiction) and number of addicted parents affect DD among individuals in recovery from addiction. METHODS Data from 177 individuals in recovery from addiction from The International Quit and Recovery Registry (IQRR), an ongoing online data collection program that aims to understand addiction and how people succeed in recovery, were included in the analysis. Participants with no, one, or two parents with addiction were compared on measures of DD using an adjusting-amount task. RESULTS Parental history of addiction was significantly associated with delay discounting. After controlling for age and gender, which were significantly different between groups, participants reporting two biological parents with addiction had significantly higher DD rates compared to those reporting one or no parents with addiction. CONCLUSIONS Participants with two parents with addiction had significantly higher rates of discounting compared to those with no or only one parent with addiction. This information can serve as a foundation to better identify and target important subgroups that need additional or non-traditional intervention strategies to address their larger degree of impulsivity and help maintain abstinence or achieve better treatment outcomes.
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Affiliation(s)
- Liqa N. Athamneh
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, 2 Riverside Circle, Roanoke, VA 24016, United States,Graduate Program in Translational Biology, Medicine, and Health, Virginia Tech, 1 Riverside Circle, Roanoke, VA 24016, United States
| | - Jeffrey S. Stein
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, 2 Riverside Circle, Roanoke, VA 24016, United States,Graduate Program in Translational Biology, Medicine, and Health, Virginia Tech, 1 Riverside Circle, Roanoke, VA 24016, United States
| | - Amanda J. Quisenberry
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, 1841 Neil Ave., Columbus, OH, 43210, United States
| | - Derek Pope
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, 2 Riverside Circle, Roanoke, VA 24016, United States
| | - Warren K. Bickel
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, 2 Riverside Circle, Roanoke, VA 24016, United States,Graduate Program in Translational Biology, Medicine, and Health, Virginia Tech, 1 Riverside Circle, Roanoke, VA 24016, United States,Department of Psychology, Virginia Tech, 109 Williams Hall, Blacksburg, VA 24061, United States,Department of Neuroscience, Virginia Tech, 300 Turner Street NW, Blacksburg, VA 24061, United States,Faculty of Health Sciences, Virginia Tech, 1 Riverside Circle, Roanoke, VA 24016, United States,Department of Psychiatry and Behavioral Medicine, Virginia Tech Carilion School of Medicine, 2 Riverside Circle, Roanoke, VA 24016, United States
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23
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Quisenberry AJ, Koffarnus MN, Epstein LH, Bickel WK. The Experimental Tobacco Marketplace II: Substitutability and sex effects in dual electronic cigarette and conventional cigarette users. Drug Alcohol Depend 2017; 178:551-555. [PMID: 28732318 PMCID: PMC5729205 DOI: 10.1016/j.drugalcdep.2017.06.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 05/22/2017] [Accepted: 06/03/2017] [Indexed: 10/19/2022]
Abstract
AIM The aim of the current study was to evaluate tobacco product purchasing in the Experimental: Tobacco Marketplace (ETM) among male and female smokers who also use e-cigarettes. We hypothesized a high substitution profile for e-cigarettes and that males would purchase more Snus than females. METHODS The ETM is an online market used in clinical abuse liability research to mimic real-world purchasing patterns. Tobacco products, including each participant's usual choice of conventional and e-cigarettes, were presented along with a price and description of nicotine content. Participants were endowed with an account balance based on the number of cigarettes and e-cigarettes consumed per week. Each participant was exposed to four ETM sessions in random order during which the price of conventional cigarettes was manipulated. RESULTS Cigarette consumption decreased as price increased. A mixed factor three-way ANOVA revealed a significant main effect of price (i.e., more alternative products were purchased at higher cigarette prices), product (i.e., more e-cigarettes were purchased than gum, lozenges, and Snus), and sex (i.e., males purchased more than females). A significant three-way interaction indicated that males purchased more e-cigarettes, Snus, and dip than females at higher cigarette prices. CONCLUSION This study suggests that the user profile of cigarette smokers is associated with behavioral economic measures of alternative product substitution and indicates that the evaluation of nicotine replacement products should be considered for both males and females separately.
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Affiliation(s)
| | | | - Leonard H Epstein
- University at Buffalo School of Medicine and Biomedical Sciences Buffalo, NY, United States
| | - Warren K Bickel
- Virginia Tech Carilion Research Institute Roanoke, VA, United States.
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Roberts ME, Doogan NJ, Stanton CA, Quisenberry AJ, Villanti AC, Gaalema DE, Keith DR, Kurti AN, Lopez AA, Redner R, Cepeda-Benito A, Higgins ST. Rural Versus Urban Use of Traditional and Emerging Tobacco Products in the United States, 2013-2014. Am J Public Health 2017; 107:1554-1559. [PMID: 28817323 DOI: 10.2105/ajph.2017.303967] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To examine urban-rural differences in US prevalences of traditional and emerging tobacco product use as well as dual or polytobacco use of these products. METHODS Our data were derived from wave 1 (2013-2014) of the Population Assessment of Tobacco and Health (PATH) Study. We estimated weighted prevalences of adult tobacco use across urban-rural geographies and examined prevalences classified by gender, poverty level, and region of the country. RESULTS Nationally, cigarette use and smokeless tobacco use, as well as dual or polytobacco use of traditional products, were more prevalent in rural than in urban areas. Conversely, cigarillo and hookah use and dual or polytobacco use of emerging products were higher in urban areas. There was no significant urban-rural difference in use of e-cigarettes. Gender, poverty, and region of the country did not seem to be driving most urban-rural differences, although differences related to cigarillo use and dual or polytobacco use of emerging products became nonsignificant after control for covariates. CONCLUSIONS Our findings highlight important urban-rural differences in tobacco use. Whether the changing tobacco product landscape will contribute to a continuation of rural health disparities remains to be seen.
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Affiliation(s)
- Megan E Roberts
- Megan E. Roberts, Nathan J. Doogan, and Amanda J. Quisenberry are with the Center of Excellence in Regulatory Tobacco Science, Ohio State University, Columbus. Cassandra A. Stanton is with Westat, Center for Evaluation and Coordination of Training and Research in Tobacco Regulatory Science, Rockville, MD. Andrea C. Villanti, Diann E. Gaalema, Diana R. Keith, Allison N. Kurti, Alexa A. Lopez, Antonio Cepeda-Benito, and Stephen T. Higgins are with the Vermont Center on Tobacco Regulatory Science, University of Vermont, Burlington. Ryan Redner is with the Rehabilitation Institute, Southern Illinois University, Carbondale
| | - Nathan J Doogan
- Megan E. Roberts, Nathan J. Doogan, and Amanda J. Quisenberry are with the Center of Excellence in Regulatory Tobacco Science, Ohio State University, Columbus. Cassandra A. Stanton is with Westat, Center for Evaluation and Coordination of Training and Research in Tobacco Regulatory Science, Rockville, MD. Andrea C. Villanti, Diann E. Gaalema, Diana R. Keith, Allison N. Kurti, Alexa A. Lopez, Antonio Cepeda-Benito, and Stephen T. Higgins are with the Vermont Center on Tobacco Regulatory Science, University of Vermont, Burlington. Ryan Redner is with the Rehabilitation Institute, Southern Illinois University, Carbondale
| | - Cassandra A Stanton
- Megan E. Roberts, Nathan J. Doogan, and Amanda J. Quisenberry are with the Center of Excellence in Regulatory Tobacco Science, Ohio State University, Columbus. Cassandra A. Stanton is with Westat, Center for Evaluation and Coordination of Training and Research in Tobacco Regulatory Science, Rockville, MD. Andrea C. Villanti, Diann E. Gaalema, Diana R. Keith, Allison N. Kurti, Alexa A. Lopez, Antonio Cepeda-Benito, and Stephen T. Higgins are with the Vermont Center on Tobacco Regulatory Science, University of Vermont, Burlington. Ryan Redner is with the Rehabilitation Institute, Southern Illinois University, Carbondale
| | - Amanda J Quisenberry
- Megan E. Roberts, Nathan J. Doogan, and Amanda J. Quisenberry are with the Center of Excellence in Regulatory Tobacco Science, Ohio State University, Columbus. Cassandra A. Stanton is with Westat, Center for Evaluation and Coordination of Training and Research in Tobacco Regulatory Science, Rockville, MD. Andrea C. Villanti, Diann E. Gaalema, Diana R. Keith, Allison N. Kurti, Alexa A. Lopez, Antonio Cepeda-Benito, and Stephen T. Higgins are with the Vermont Center on Tobacco Regulatory Science, University of Vermont, Burlington. Ryan Redner is with the Rehabilitation Institute, Southern Illinois University, Carbondale
| | - Andrea C Villanti
- Megan E. Roberts, Nathan J. Doogan, and Amanda J. Quisenberry are with the Center of Excellence in Regulatory Tobacco Science, Ohio State University, Columbus. Cassandra A. Stanton is with Westat, Center for Evaluation and Coordination of Training and Research in Tobacco Regulatory Science, Rockville, MD. Andrea C. Villanti, Diann E. Gaalema, Diana R. Keith, Allison N. Kurti, Alexa A. Lopez, Antonio Cepeda-Benito, and Stephen T. Higgins are with the Vermont Center on Tobacco Regulatory Science, University of Vermont, Burlington. Ryan Redner is with the Rehabilitation Institute, Southern Illinois University, Carbondale
| | - Diann E Gaalema
- Megan E. Roberts, Nathan J. Doogan, and Amanda J. Quisenberry are with the Center of Excellence in Regulatory Tobacco Science, Ohio State University, Columbus. Cassandra A. Stanton is with Westat, Center for Evaluation and Coordination of Training and Research in Tobacco Regulatory Science, Rockville, MD. Andrea C. Villanti, Diann E. Gaalema, Diana R. Keith, Allison N. Kurti, Alexa A. Lopez, Antonio Cepeda-Benito, and Stephen T. Higgins are with the Vermont Center on Tobacco Regulatory Science, University of Vermont, Burlington. Ryan Redner is with the Rehabilitation Institute, Southern Illinois University, Carbondale
| | - Diana R Keith
- Megan E. Roberts, Nathan J. Doogan, and Amanda J. Quisenberry are with the Center of Excellence in Regulatory Tobacco Science, Ohio State University, Columbus. Cassandra A. Stanton is with Westat, Center for Evaluation and Coordination of Training and Research in Tobacco Regulatory Science, Rockville, MD. Andrea C. Villanti, Diann E. Gaalema, Diana R. Keith, Allison N. Kurti, Alexa A. Lopez, Antonio Cepeda-Benito, and Stephen T. Higgins are with the Vermont Center on Tobacco Regulatory Science, University of Vermont, Burlington. Ryan Redner is with the Rehabilitation Institute, Southern Illinois University, Carbondale
| | - Allison N Kurti
- Megan E. Roberts, Nathan J. Doogan, and Amanda J. Quisenberry are with the Center of Excellence in Regulatory Tobacco Science, Ohio State University, Columbus. Cassandra A. Stanton is with Westat, Center for Evaluation and Coordination of Training and Research in Tobacco Regulatory Science, Rockville, MD. Andrea C. Villanti, Diann E. Gaalema, Diana R. Keith, Allison N. Kurti, Alexa A. Lopez, Antonio Cepeda-Benito, and Stephen T. Higgins are with the Vermont Center on Tobacco Regulatory Science, University of Vermont, Burlington. Ryan Redner is with the Rehabilitation Institute, Southern Illinois University, Carbondale
| | - Alexa A Lopez
- Megan E. Roberts, Nathan J. Doogan, and Amanda J. Quisenberry are with the Center of Excellence in Regulatory Tobacco Science, Ohio State University, Columbus. Cassandra A. Stanton is with Westat, Center for Evaluation and Coordination of Training and Research in Tobacco Regulatory Science, Rockville, MD. Andrea C. Villanti, Diann E. Gaalema, Diana R. Keith, Allison N. Kurti, Alexa A. Lopez, Antonio Cepeda-Benito, and Stephen T. Higgins are with the Vermont Center on Tobacco Regulatory Science, University of Vermont, Burlington. Ryan Redner is with the Rehabilitation Institute, Southern Illinois University, Carbondale
| | - Ryan Redner
- Megan E. Roberts, Nathan J. Doogan, and Amanda J. Quisenberry are with the Center of Excellence in Regulatory Tobacco Science, Ohio State University, Columbus. Cassandra A. Stanton is with Westat, Center for Evaluation and Coordination of Training and Research in Tobacco Regulatory Science, Rockville, MD. Andrea C. Villanti, Diann E. Gaalema, Diana R. Keith, Allison N. Kurti, Alexa A. Lopez, Antonio Cepeda-Benito, and Stephen T. Higgins are with the Vermont Center on Tobacco Regulatory Science, University of Vermont, Burlington. Ryan Redner is with the Rehabilitation Institute, Southern Illinois University, Carbondale
| | - Antonio Cepeda-Benito
- Megan E. Roberts, Nathan J. Doogan, and Amanda J. Quisenberry are with the Center of Excellence in Regulatory Tobacco Science, Ohio State University, Columbus. Cassandra A. Stanton is with Westat, Center for Evaluation and Coordination of Training and Research in Tobacco Regulatory Science, Rockville, MD. Andrea C. Villanti, Diann E. Gaalema, Diana R. Keith, Allison N. Kurti, Alexa A. Lopez, Antonio Cepeda-Benito, and Stephen T. Higgins are with the Vermont Center on Tobacco Regulatory Science, University of Vermont, Burlington. Ryan Redner is with the Rehabilitation Institute, Southern Illinois University, Carbondale
| | - Stephen T Higgins
- Megan E. Roberts, Nathan J. Doogan, and Amanda J. Quisenberry are with the Center of Excellence in Regulatory Tobacco Science, Ohio State University, Columbus. Cassandra A. Stanton is with Westat, Center for Evaluation and Coordination of Training and Research in Tobacco Regulatory Science, Rockville, MD. Andrea C. Villanti, Diann E. Gaalema, Diana R. Keith, Allison N. Kurti, Alexa A. Lopez, Antonio Cepeda-Benito, and Stephen T. Higgins are with the Vermont Center on Tobacco Regulatory Science, University of Vermont, Burlington. Ryan Redner is with the Rehabilitation Institute, Southern Illinois University, Carbondale
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Bickel WK, Snider SE, Quisenberry AJ, Stein JS. Reinforcer Pathology: The Behavioral Economics of Abuse Liability Testing. Clin Pharmacol Ther 2017; 101:185-187. [PMID: 27509043 PMCID: PMC9812002 DOI: 10.1002/cpt.443] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 07/19/2016] [Accepted: 07/26/2016] [Indexed: 01/07/2023]
Abstract
Understanding the abuse liability of novel drugs is critical to understanding the risk these new compounds pose to society. Behavioral economics, the integration of psychology and economics, can be used to predict abuse liability of novel substances. Here, we describe the behavioral economic concept of reinforcer pathology and how it may predict the use of novel drugs in existing drug-users and initiation of use in the drug-naive.
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Affiliation(s)
- W K Bickel
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, Roanoke, Virginia, USA
| | - S E Snider
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, Roanoke, Virginia, USA
| | - A J Quisenberry
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, Roanoke, Virginia, USA
| | - J S Stein
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, Roanoke, Virginia, USA
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26
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Bickel WK, Stein JS, Moody LN, Snider SE, Mellis AM, Quisenberry AJ. Toward Narrative Theory: Interventions for Reinforcer Pathology in Health Behavior. Nebr Symp Motiv 2017; 64:227-267. [PMID: 30351565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Abstract
Rate dependence, a well-known phenomenon in behavioral pharmacology, appears to have declined as a topic of interest, perhaps, as a result of being viewed pertinent to only the preclinical investigation of drugs on schedule-controlled performance. Obstacles to data interpretation due to conflation with regression to the mean also appear to have contributed to the topic's decline. Despite this reduction in exposure, rate dependence is a useful concept and tool that can be used to determine sources of variability, predict therapeutic outcomes, and identify individuals that are most likely to respond therapeutically. Armed with new statistical methods and an understanding of the broad range of conditions under which rate dependence can be observed, we urge researchers to revisit the concept, use the appropriate analysis methods, and to design empirical studies a priori to further explore rate dependence.
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Affiliation(s)
- Amanda J Quisenberry
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, Roanoke, VA
| | - Sarah E Snider
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, Roanoke, VA
| | - Warren K Bickel
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, Roanoke, VA
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Snider SE, Quisenberry AJ, Bickel WK. Order in the absence of an effect: Identifying rate-dependent relationships. Behav Processes 2016; 127:18-24. [PMID: 27001350 PMCID: PMC4868772 DOI: 10.1016/j.beproc.2016.03.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 03/11/2016] [Accepted: 03/18/2016] [Indexed: 01/08/2023]
Abstract
The heterogeneity of group data can obscure a significant effect of an intervention due to differential baseline scores. Instead of discarding the seemingly heterogeneous response set, an orderly lawful relationship could be present. Rate dependence describes a pattern between a baseline and the change in that baseline following some intervention. To highlight the importance of analyzing data from a rate-dependent perspective, we (1) briefly review research illustrating that rate-dependent effects can be observed in response to both drug and non-drug interventions in varied schedules of reinforcement in clinical and preclinical populations; (2) observe that the process of rate-dependence likely requires multiple parts of a system operating simultaneously to evoke differential responding as a function of baseline; and (3) describe several statistical methods for consideration and posit that Oldham's correlation is the most appropriate for rate-dependent analyses. Finally, we propose future applications for these analyses in which the level of baseline behavior exhibited prior to an intervention may determine the magnitude and direction of behavior change and can lead to the identification of subpopulations that would be benefitted. In sum, rate dependence is an invaluable perspective to examine data following any intervention in order to identify previously overlooked results.
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Affiliation(s)
- Sarah E Snider
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, 2 Riverside Circle, Roanoke, VA 24016, USA
| | - Amanda J Quisenberry
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, 2 Riverside Circle, Roanoke, VA 24016, USA
| | - Warren K Bickel
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, 2 Riverside Circle, Roanoke, VA 24016, USA.
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Bickel WK, Quisenberry AJ, Snider SE. Does impulsivity change rate dependently following stimulant administration? A translational selective review and re-analysis. Psychopharmacology (Berl) 2016; 233:1-18. [PMID: 26581504 PMCID: PMC4703435 DOI: 10.1007/s00213-015-4148-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 10/29/2015] [Indexed: 01/19/2023]
Abstract
RATIONALE Rate dependence refers to an orderly relationship between a baseline measure of behavior and the change in that behavior following an intervention. The most frequently observed rate-dependent effect is an inverse relationship between the baseline rate of behavior and response rates following an intervention. A previous report of rate dependence in delay discounting suggests that the discounting of delayed reinforcers, and perhaps, other impulsivity measures, may change rate dependently following acute and chronic administration of potentially therapeutic medications in both preclinical and clinical studies. OBJECTIVE The aim of the current paper was to review the effects of stimulants on delay discounting and other impulsivity tasks. METHODS All studies identified from the literature were required to include (1) an objective measure of impulsivity; (2) administration of amphetamine, methylphenidate, or modafinil; (3) presentation of a pre- and postdrug administration impulsivity measure; and (4) the report of individual drug effects or results in groups split by baseline or vehicle impulsivity. Twenty-five research reports were then reanalyzed for evidence consistent with rate dependence. RESULTS Of the total possible instances, 67 % produced results consistent with rate dependence. Specifically, 72, 45, and 80 % of the data sets were consistent with rate dependence following amphetamine, methylphenidate, and modafinil administration, respectively. CONCLUSIONS These results suggest that rate dependence is a more robust phenomenon than reported in the literature. Impulsivity studies should consider this quantitative signature as a process to determine the effects of variables and as a potential prognostic tool to evaluate the effectiveness of future interventions.
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Affiliation(s)
- W K Bickel
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, Roanoke, VA, 24016, USA.
- Virginia Tech, 2 Riverside Circle, Roanoke, VA, 24016, USA.
| | - A J Quisenberry
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, Roanoke, VA, 24016, USA
| | - S E Snider
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, Roanoke, VA, 24016, USA
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Bickel WK, Snider SE, Quisenberry AJ, Stein JS, Hanlon CA. Competing neurobehavioral decision systems theory of cocaine addiction: From mechanisms to therapeutic opportunities. Prog Brain Res 2015; 223:269-93. [PMID: 26806781 PMCID: PMC5495192 DOI: 10.1016/bs.pbr.2015.07.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Cocaine dependence is a difficult-to-treat, chronically relapsing disorder. Multiple scientific disciplines provide distinct perspectives on this disorder; however, connections between disciplines are rare. The competing neurobehavioral decision systems (CNDS) theory posits that choice results from the interaction between two decision systems (impulsive and executive) and that regulatory imbalance between systems can induce pathology, including addiction. Using this view, we integrate a diverse set of observations on cocaine dependence, including bias for immediacy, neural activity and structure, developmental time course, behavioral comorbidities, and the relationship between cocaine dependence and socioeconomic status. From the CNDS perspective, we discuss established and emerging behavioral, pharmacological, and neurological treatments and identify possible targets for future treatments. The ability of the CNDS theory to integrate diverse findings highlights its utility for understanding cocaine dependence and supports that dysregulation between the decision systems contributes to addiction.
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Affiliation(s)
- Warren K Bickel
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, Roanoke, VA, USA.
| | - Sarah E Snider
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, Roanoke, VA, USA
| | - Amanda J Quisenberry
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, Roanoke, VA, USA
| | - Jeffrey S Stein
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, Roanoke, VA, USA
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Quisenberry AJ, Koffarnus MN, Hatz LE, Epstein LH, Bickel WK. The Experimental Tobacco Marketplace I: Substitutability as a Function of the Price of Conventional Cigarettes. Nicotine Tob Res 2015; 18:1642-8. [PMID: 26470723 DOI: 10.1093/ntr/ntv230] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 10/02/2015] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Behavioral economic studies of nicotine product consumption have traditionally examined substitution between two products and rarely examined substitution with more products. Increasing numbers of tobacco products available for commercial sale leads to more possible cross-product interactions, indicating a need to examine substitution in more complex arrangements that closely mirror the tobacco marketplace. METHODS The experimental tobacco marketplace (ETM) is an experimental online store that displays pictures, information, and prices for several tobacco products. Smokers were endowed with an account balance based on their weekly tobacco purchases. Participants then made potentially real purchases for seven (Experiment 1) or six (Experiment 2) tobacco/nicotine products under four price conditions for conventional cigarettes while prices for other products remained constant. Smokers returned 1 week later to report tobacco/nicotine use and return unused products for a refund. RESULTS In Experiment 1 (n = 22), cigarette purchasing decreased as a function of price. Substitution was greatest for electronic cigarettes and cigarillos and significant for electronic cigarettes. Experiment 2 (n = 34) was a replication of Experiment 1, but with cigarillos unavailable in the ETM. In Experiment 2, cigarette purchases decreased as a function of price. Substitution was robust and significant for electronic cigarettes and Camel Snus. CONCLUSIONS The ETM is a novel, practical assay that mimics the real-world marketplace, and functions as a simple research tool for both researchers and participants. Across the two experiments the product mix in the ETM altered which products functioned as substitutes suggesting complex interactions between purchasing and product availability. IMPLICATIONS This article adds a novel method of collecting purchasing data that mimics real world purchasing to the existing literature. The ETM is a practical avenue by which to study both hypothetical and potentially real purchasing.
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Affiliation(s)
- Amanda J Quisenberry
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, Roanoke, VA
| | - Mikhail N Koffarnus
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, Roanoke, VA
| | - Laura E Hatz
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, Roanoke, VA
| | - Leonard H Epstein
- Department of Pediatrics, University of Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY
| | - Warren K Bickel
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, Roanoke, VA;
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Abstract
Experimental assessments of demand allow the examination of economic phenomena relevant to the etiology, maintenance, and treatment of addiction and other pathologies (e.g., obesity). Although such assessments have historically been resource intensive, development and use of purchase tasks-in which participants purchase 1 or more hypothetical or real commodities across a range of prices-have made data collection more practical and have increased the rate of scientific discovery. However, extraneous sources of variability occasionally produce nonsystematic demand data, in which price exerts either no or inconsistent effects on the purchases of individual participants. Such data increase measurement error, can often not be interpreted in light of research aims, and likely obscure effects of the variable(s) under investigation. Using data from 494 participants, we introduce and evaluate an algorithm (derived from prior methods) for identifying nonsystematic demand data, wherein individual participants' demand functions are judged against 2 general, empirically based assumptions: (a) global, price-dependent reduction in consumption and (b) consistency in purchasing across prices. We also introduce guidelines for handling nonsystematic data, noting some conditions in which excluding such data from primary analyses may be appropriate and others in which doing so may bias conclusions. Adoption of the methods presented here may serve to unify the research literature and facilitate discovery.
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Affiliation(s)
- Jeffrey S Stein
- Addictions Recovery Research Center, Virginia Tech Carilion Research Institute
| | - Mikhail N Koffarnus
- Addictions Recovery Research Center, Virginia Tech Carilion Research Institute
| | - Sarah E Snider
- Addictions Recovery Research Center, Virginia Tech Carilion Research Institute
| | | | - Warren K Bickel
- Addictions Recovery Research Center, Virginia Tech Carilion Research Institute
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Quisenberry AJ, Eddy CR, Patterson DL, Franck CT, Bickel WK. Regret Expression and Social Learning Increases Delay to Sexual Gratification. PLoS One 2015; 10:e0135977. [PMID: 26280349 PMCID: PMC4539230 DOI: 10.1371/journal.pone.0135977] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 07/28/2015] [Indexed: 11/24/2022] Open
Abstract
Objective Modification and prevention of risky sexual behavior is important to individuals’ health and public health policy. This study employed a novel sexual discounting task to elucidate the effects of social learning and regret expression on delay to sexual gratification in a behavioral task. Methods Amazon Mechanical Turk Workers were assigned to hear one of three scenarios about a friend who engages in similar sexual behavior. The scenarios included a positive health consequence, a negative health consequence or a negative health consequence with the expression of regret. After reading one scenario, participants were asked to select from 60 images, those with whom they would have casual sex. Of the selected images, participants chose one image each for the person they most and least want to have sex with and person most and least likely to have a sexually transmitted infection. They then answered questions about engaging in unprotected sex now or waiting some delay for condom-protected sex in each partner condition. Results Results indicate that the negative health outcome scenario with regret expression resulted in delayed sexual gratification in the most attractive and least STI partner conditions, whereas in the least attractive and most STI partner conditions the negative health outcome with and without regret resulted in delayed sexual gratification. Conclusions Results suggest that the sexual discounting task is a relevant laboratory measure and the framing of information to include regret expression may be relevant for prevention of risky sexual behavior.
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Affiliation(s)
- Amanda J. Quisenberry
- Virginia Tech Carilion Research Institute, Roanoke, Virginia, United States of America
| | - Celia R. Eddy
- Virginia Tech Carilion Research Institute, Roanoke, Virginia, United States of America
- Virginia Tech, Department of Statistics, Blacksburg, Virginia, United States of America
| | - David L. Patterson
- Virginia Tech Carilion Research Institute, Roanoke, Virginia, United States of America
| | - Christopher T. Franck
- Virginia Tech Carilion Research Institute, Roanoke, Virginia, United States of America
- Virginia Tech, Department of Statistics, Blacksburg, Virginia, United States of America
| | - Warren K. Bickel
- Virginia Tech Carilion Research Institute, Roanoke, Virginia, United States of America
- * E-mail:
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Bickel WK, Quisenberry AJ, Moody L, Wilson AG. Therapeutic Opportunities for Self-Control Repair in Addiction and Related Disorders: Change and the Limits of Change in Trans-Disease Processes. Clin Psychol Sci 2015; 3:140-153. [PMID: 25664226 PMCID: PMC4314724 DOI: 10.1177/2167702614541260] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Contemporary neuro-economic approaches hypothesize that self-control failure results from drugs annexing normal learning mechanisms that produce pathological reward processing and distort decision-making as a result from the dysregulation of two valuation systems. An emphasis on processes shared across different diseases and disorders is at odds with the contemporary approach that assumes unique disease etiologies and treatments. Studying trans-disease processes can identify mechanisms that operate in multiple disease states and ascertain if factors that influence processes in one disease state may be applicable to all disease states. In this paper we review the dual model of self-control failure, the Competing Neurobehavioral Decision Systems approach, the relationship of delay discounting to the relative control of these two systems, and evidence that the executive system can be strengthened. Future research that could result in more potent interventions for executive system improvement and potential constraints on the repair of self-control failure are discussed.
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Affiliation(s)
| | | | - Lara Moody
- Virginia Tech Carilion Research Institute, Roanoke, VA
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Bickel WK, Moody L, Quisenberry AJ, Ramey CT, Sheffer CE. A Competing Neurobehavioral Decision Systems model of SES-related health and behavioral disparities. Prev Med 2014; 68:37-43. [PMID: 25008219 PMCID: PMC4253853 DOI: 10.1016/j.ypmed.2014.06.032] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 06/24/2014] [Accepted: 06/29/2014] [Indexed: 01/05/2023]
Abstract
We propose that executive dysfunction is an important component relating to the socio-economic status gradient of select health behaviors. We review and find evidence supporting an SES gradient associated with (1) negative health behaviors (e.g., obesity, excessive use of alcohol, tobacco and other substances), and (2) executive dysfunction. Moreover, the evidence supports that stress and insufficient cognitive resources contribute to executive dysfunction and that executive dysfunction is evident among individuals who smoke cigarettes, are obese, abuse alcohol, and use illicit drugs. Collectively these data support the dual system model of cognitive control, referred to here as the Competing Neurobehavioral Decision Systems hypothesis. The implications of these relationships for intervention and social justice considerations are discussed.
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Affiliation(s)
- W K Bickel
- Virginia Tech Carilion Research Institute, Roanoke, VA 24016, USA.
| | - L Moody
- Virginia Tech Carilion Research Institute, Roanoke, VA 24016, USA
| | - A J Quisenberry
- Virginia Tech Carilion Research Institute, Roanoke, VA 24016, USA
| | - C T Ramey
- Virginia Tech Carilion Research Institute, Roanoke, VA 24016, USA
| | - C E Sheffer
- The City College of New York, New York, NY 10031, USA
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Quisenberry AJ, Prisinzano T, Baker LE. Combined effects of modafinil and d-amphetamine in male Sprague-Dawley rats trained to discriminate d-amphetamine. Pharmacol Biochem Behav 2013; 110:208-15. [PMID: 23880213 DOI: 10.1016/j.pbb.2013.07.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 07/09/2013] [Accepted: 07/13/2013] [Indexed: 10/26/2022]
Abstract
Modafinil is a novel wake-promoting drug with FDA approval for the treatment of sleep-related disorders that has recently been investigated as a potential agonist replacement therapy for psychostimulant dependence. Previous research in animals and humans indicates modafinil has a lower abuse liability than traditional psychostimulants, although few studies have carefully assessed modafinil's stimulus properties in combination with other psychostimulants. The current study trained male Sprague-Dawley rats to discriminate subcutaneous injections of 0.3 mg/kg (n=8) or 1.0 mg/kg d-amphetamine (n=8) from saline under an FR 20 schedule of food reinforcement and substitution tests were administered with d-amphetamine (0.03-1.0 mg/kg, s.c.), modafinil (32-256 mg/kg, i.g.), and a low modafinil dose (32 mg/kg, i.g.) in combination with d-amphetamine (0.03-1.0 mg/kg, s.c.) to determine if these drugs have additive effects. The selective D2 dopamine agonist, PNU-91356A, was also tested as a positive control and ethanol and morphine were tested as negative controls. Results indicate that modafinil produced dose-dependent and statistically significant d-amphetamine-lever responding in both groups and nearly complete substitution in animals trained to discriminate 1.0 mg/kg d-amphetamine. Modafinil pretreatment slightly increased the discrimination of low d-amphetamine doses in animals trained to discriminate 0.3 mg/kg d-amphetamine. These results support previous findings that modafinil and d-amphetamine may have additive effects. In consideration of recent interests in modafinil as an agonist treatment for psychostimulant dependence, additional preclinical investigations utilizing other methodologies to examine modafinil in combination with other stimulants, such as behavioral sensitization paradigms or drug self-administration, may be of interest.
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Quisenberry AJ, Prisinzano TE, Baker LE. Modafinil alone and in combination with low dose amphetamine does not establish conditioned place preference in male Sprague-Dawley rats. Exp Clin Psychopharmacol 2013; 21:252-8. [PMID: 23647093 DOI: 10.1037/a0031832] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Modafinil is a novel wake-promoting drug with FDA approval for the treatment of narcolepsy, shift work sleep disorder, and sleep apnea. It is also prescribed for many off-label uses such as ADHD and it is currently being assessed as a treatment for psychostimulant dependence. Previous research assessing the abuse liability of modafinil in animals and humans suggests it is less potent and has a low abuse potential compared to traditional psychomotor stimulants. However, modafinil has not been carefully assessed in combination with other psychostimulant drugs. The current study used an unbiased place conditioning procedure simultaneously with locomotor screening procedures to assess the combined behavioral effects of modafinil and d-amphetamine in adult male Sprague-Dawley rats. Eight 30-min conditioning trials were conducted in a 2 compartment apparatus with distinct visual and tactile cues. Drug and vehicle conditioning trials were alternated with 1 trial per day separated by 24 hr. On drug conditioning trials, rats were administered either modafinil (64 mg/kg, i.g.), d-amphetamine (0.3 or 2.0 mg/kg, s.c.), a combination of modafinil (64 mg/kg) and d-amphetamine (0.3 mg/kg), or vehicle injections. On vehicle conditioning trials, all groups received vehicle injections. Preference for either compartment was assessed by recording time spent in each compartment during a 15-min test conducted 24 hr after the last conditioning trial. Results indicated that this low oral dose of modafinil did not significantly increase locomotor activity or establish conditioned place preference (CPP). Moreover, modafinil did not significantly alter the hyperlocomotor or CPP effects of d-amphetamine. To confirm that modafinil is behaviorally active at this low oral dose, a separate assessment of horizontal and vertical activity was conducted with male Sprague-Dawley rats in an open field apparatus. Results confirmed that modafinil increased locomotor activity relative to vehicle, with increases in vertical activity especially prominent, a measure that was not assessed in place conditioning trials. Although the current results predict a low abuse liability with concurrent use of modafinil and d-amphetamine, additional research with higher dose combinations may be warranted before ruling out the possibility that these drugs could have additive or synergistic effects.
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Lotfizadeh AD, Redner R, Edwards TL, Quisenberry AJ, Baker LE, Poling A. Effects of altering motivation for food in rats trained with food reinforcement to discriminate between d-amphetamine and saline injections. Pharmacol Biochem Behav 2012; 103:168-73. [PMID: 22963928 DOI: 10.1016/j.pbb.2012.08.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Revised: 08/07/2012] [Accepted: 08/28/2012] [Indexed: 11/25/2022]
Abstract
Previous studies have shown that altering motivation typically affects stimulus generalization in animals trained to discriminate exteroceptive stimuli, but few studies have evaluated the effects of manipulating motivation on drug stimuli. In the few published studies, motivation levels were manipulated by arranging different feeding conditions prior to stimulus generalization tests with rats trained to discriminate morphine from vehicle and in pigeons trained to discriminate phencyclidine or pentobarbital from vehicle. In the present study, rats maintained at 80% of free-feeding weights were trained to discriminate between injections of 1.0mg/kg d-amphetamine and saline in a two-lever food-reinforced operant procedure. Generalization tests were then conducted with a range of d-amphetamine doses (0, 0.03, 0.1, and 0.3, 1.0mg/kg) when the rats were not fed before experimental sessions (high motivation) and when they were pre-fed 1g of food (moderate motivation) or their daily ration of food (low motivation) 1h before test sessions. Changing the motivation level significantly affected response rate and latency to the first response in generalizations tests, but did not significantly affect mean percentage of drug-appropriate responding (a continuous measure) or percentage of animals that selected the drug-appropriate lever (a quantal measure). The present findings indicate that manipulating motivation for food minimally impacts d-amphetamine discrimination, however, the range of conditions used to examine the effects of motivating operations on stimulus control by d-amphetamine drugs and other drugs is limited and the topic may warrant further investigation.
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Affiliation(s)
- Amin D Lotfizadeh
- Department of Psychology, Western Michigan University, United States
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