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1.
IntroductionThe Intolerance for Smoking Abstinence Discomfort Questionnaire (IDQ-S) assesses distress tolerance specific to nicotine withdrawal. Though developed to assess withdrawal-related distress, the IDQ-S has not been validated among nicotine-deprived, treatment-seeking smokers. The present study extended previous research by examining the predictive utility of the IDQ-S among abstinent, motivated-to-quit smokers.MethodsAbstinent, treatment-seeking smokers completed the IDQ-S Withdrawal Intolerance and Lack of Cognitive Coping scales, assessments of nicotine dependence and reinforcement, and smoking history at baseline. At baseline and at 24-h, 2-week, and 1-month follow-up, participants completed a smoking cue-reactivity task (collection of cue-elicited craving and negative affect), and assessments of cigarettes per day (CPD; daily diaries at follow-up), carbon monoxide (CO), and cotinine.ResultsGreater IDQ-S Withdrawal Intolerance was associated with younger age, higher nicotine dependence and reinforcement, and less smoking years (ps < .03). Greater IDQ-S Lack of Cognitive Coping was associated with less education, lower nicotine dependence and reinforcement, higher baseline CPD, and no prior quit attempts (ps < .04). IDQ-S scales did not significantly predict cue-elicited craving or negative affect, CPD, CO, or cotinine levels at follow-up (ps > .10).ConclusionsWithdrawal intolerance and lack of cognitive coping did not predict smoking outcomes among nicotine-deprived, treatment-seeking smokers, but were associated with smoking characteristics, including nicotine dependence and reinforcement. Withdrawal intolerance and lack of cognitive coping may not be especially useful in predicting craving and smoking behavior, but future studies should replicate the present study's findings and assess the stability of the IDQ-S before forming firm conclusions about its predictive utility.  相似文献   

2.

Background

Smoking menthol cigarettes is more prevalent among African Americans (AA) compared to Whites. Menthol has been found to be inversely related to smoking cessation among AA, yet little is known about the factors associated with menthol smoking among AA light smokers. This study examines baseline demographic, psychological, and smoking factors associated with smoking menthol cigarettes among AA light smokers (≤10 cigarettes per day).

Methods

Participants (n = 540) were enrolled in a double blind, placebo-controlled randomized trial of bupropion in combination with health education counseling for smoking cessation. Bivariate differences between menthol and non-menthol smokers were explored and baseline factors associated with smoking menthol cigarettes were identified.

Results

Participants averaged 46.5 years in age, predominantly female (66.1%), and smoked an average of 8.0 cpd (SD = 2.5). The majority (83.7%) smoked menthol cigarettes. In bivariate analysis, menthol cigarette smokers were younger (mean age: 45 vs. 52 years p < 0.0001), were more likely to be female (68% vs. 52% p = 0.003) and had smoked for shorter duration (28 vs. 34 years p < 0.0001) compared to non-menthol smokers. While depression and withdrawal scores were slightly higher and exhaled carbon monoxide values were lower among menthol smokers, the differences were not statistically significant.

Conclusions

Among AA light smokers, younger individuals and females were more likely to smoke menthol cigarettes and may be more susceptible to the health effects of smoking. Appropriately targeted health education campaigns are needed to prevent smoking uptake in this high-risk population.  相似文献   

3.
IntroductionAlthough quitting motivation predicts smoking cessation, there have been inconsistent findings regarding motivation predicting long-term maintenance of abstinence. Moreover, most such research has been conducted in North America and the United Kingdom. The aim of this study was to examine motivation to quit as a predictor of smoking cessation and of abstinence maintenance in a Spanish sample.MethodThe sample comprised 286 Spanish smokers undergoing psychological treatment for smoking cessation. Motivation to quit was assessed pre-treatment and post-treatment with the Readiness to Quit Ladder. Abstinence post-treatment and at 6 month follow-up was biochemically verified.ResultsParticipants with higher levels of pre-treatment and post-treatment motivation were more likely to be abstinent at the end of the treatment (OR = 1.36) and at 6 month follow-up (OR = 4.88). Among abstainers at the end of the treatment (61.9%), higher levels of motivation to quit post-treatment predicted maintaining abstinence at 6 months (OR = 2.83). Furthermore, participants who failed to quit smoking reported higher levels of motivation to quit post-treatment than they had pretreatment (p < .001).ConclusionsMotivation to quit smoking predicted short and long-term cessation, and also predicted long-term maintenance of abstinence. These results have implications for understanding motivational processes of smoking cessation in general, while extending research to Spanish smokers. They may also help in the design of cessation and relapse-prevention interventions. Specifically, the results suggest that motivational enhancement is important throughout the cessation and maintenance periods.  相似文献   

4.
IntroductionThere has been increased scholarly interest in advancing the study of emotion dysregulation and substance use. However, there is limited study of emotion dysregulation in the context of smoking. The current study examined the emotion dysregulation global construct and sub facets in relation to negative affect reduction expectancies, coping motives, perceived barriers for quitting, and the severity of problems experienced during quit attempts.MethodTreatment seeking smokers (n = 469; 48.2% female, Mage = 36.59, SD = 13.58) enrolled in a smoking cessation trial and completed baseline measures of smoking cognitions and emotion dysregulation.ResultsResults indicated that the emotion dysregulation global score was significantly associated with each of the smoking dependent variables. Additionally, difficulty accessing emotion regulation strategies and difficulty engaging in goal-directed behavior were significantly associated with the dependent variables.ConclusionOverall, this is the first study to evaluate relations between multidimensional facets of emotion dysregulation and clinically relevant smoking variables. Emotion dysregulation may be an important treatment target for changing smoking.  相似文献   

5.
IntroductionEmerging literature suggests that frequency of use of electronic cigarettes (e-cigarettes) may be an important moderating variable in the relationship between e-cigarette use and smoking cessation. However, few studies have focused specifically on treatment-seekers, a group that may differ in important ways from smokers in the general population. This study looks at the relationship between e-cigarette use frequency and abstinence among a sample of treatment-seeking tobacco users.MethodsSeven-month follow-up survey data from N = 2760 treatment-seeking tobacco users who utilized statewide tobacco quitlines in three states were used to assess the relationship between 30-day point prevalence abstinence and e-cigarette use frequency at follow-up. E-cigarette use was examined in two ways. First, we looked at any use in the past 30 days versus no use. Additionally, past 30-day e-cigarette use frequency was categorized into four groups: 0 days, 1–5 days – infrequent, 6–29 days – intermediate, 30 days – daily. Logistic regression models were constructed predicting 30-day point prevalence tobacco abstinence.ResultsBoth infrequent (AOR = 0.35; CI = 0.20–0.59) and intermediate (AOR = 0.50; CI = 0.32–0.80) past 30-day e-cigarette use were associated with lower rates of tobacco abstinence versus no past 30-day use. However, daily e-cigarette users (AOR = 1.16; CI = 0.71–1.70) had similar 30-day abstinence when compared to non-users.ConclusionsResults from this study of treatment-seekers support findings from studies of general population tobacco users that suggest frequency of e-cigarette use is an important moderating variable in the relationship between e-cigarette use and tobacco cessation. Future studies should employ more refined measures of e-cigarette use.  相似文献   

6.
It is widely recognized that smoking is related to abdominal pain and discomfort, as well as gastrointestinal disorders. Research has shown that visceral sensitivity, experiencing anxiety around gastrointestinal sensations, is associated with poorer gastrointestinal health and related health outcomes. Visceral sensitivity also increases anxiety symptoms and mediates the relation with other risk factors, including gastrointestinal distress. No work to date, however, has evaluated visceral sensitivity in the context of smoking despite the strong association between smoking and poor physical and mental health. The current study sought to examine visceral sensitivity as a unique predictor of cigarette dependence, threat-related smoking abstinence expectancies (somatic symptoms and harmful consequences), and perceived barriers for cessation via anxiety symptoms. Eighty-four treatment seeking adult daily smokers (Mage = 45.1 years [SD = 10.4]; 71.6% male) participated in this study. There was a statistically significant indirect effect of visceral sensitivity via general anxiety symptoms on cigarette dependence (b = 0.02, SE = 0.01, Bootstrapped 95% CI [0.006, 0.05]), smoking abstinence somatic expectancies (b = 0.10, SE = 0.03, Bootstrapped 95% CI [0.03, 0.19]), smoking abstinence harmful experiences (b = 0.13, SE = 0.05, Bootstrapped 95% CI [0.03, 0.25]), and barriers to cessation (b = 0.05, SE = 0.06, Bootstrapped 95% CI [0.01, 0.13]). Overall, the present study serves as an initial investigation into the nature of the associations between visceral sensitivity, anxiety symptoms, and clinically significant smoking processes among treatment-seeking smokers. Future work is needed to explore the extent to which anxiety accounts for relations between visceral sensitivity and other smoking processes (e.g., withdrawal, cessation outcome).  相似文献   

7.
Despite the high rate of smoking cessation treatment non-response, relatively little empirical work has examined predictors of treatment non-response. The present study sought to explore the effect of smoking outcome expectancies on treatment response in a sample of treatment-seeking adult daily smokers (N = 182; 53.3% female; Mage = 40.67; SD = 13.63). Results indicated that expectancies for smoking to reduce negative affect were related to an increased likelihood of treatment non-response (OR = 0.73, CI: 0.54, 0.98). These findings remained significant after controlling for sex, presence of Axis I disorder, tobacco-related health problems, tobacco dependence, anxiety sensitivity, and condition assignment as well as other smoking expectancy dimensions. Post hoc analyses revealed that this relation was stronger for smokers in the integrated care condition vs. the standard care condition (Interaction: OR = 1.69, CI: 1.05, 2.73). Additionally, expectancies for smoking to enhance positive affect and provide sensory satisfaction were associated with an increased likelihood of treatment response in the standard care condition. The current findings suggest expectancies that smoking will alleviate negative affect may be a risk factor of smoking cessation treatment non-response. Additionally, findings provide evidence that the relation between smoking expectancies and treatment non-response may differ by smoking cessation treatment.  相似文献   

8.
The construct of relative reinforcing efficacy (RRE) is central to many laboratory and theoretical models of drug abuse, but it has not been widely measured in applied clinical research contexts. The authors used a simulated alcohol purchase task to measure RRE in a sample of 267 college student drinkers. Participants reported their alcohol consumption across a range of prices, and their responses were well-described by a regression equation that has been used to construct demand curves in drug self-administration studies. Several measures of relative reinforcing efficacy were generated, including breakpoint, intensity of demand, elasticity, P-sub(max) (price at which response output is maximized), and O-sub(max) (maximum alcohol expenditures). Demand for alcohol was inelastic across the initial range of prices but became elastic as price increased. Students who reported recent heavy drinking reported significantly greater intensity of demand, O-sub(max), and breakpoint. These results provide initial support for the validity of the RRE indices generated with the alcohol purchase task. These results also provide empirical support for programs that attempt to reduce alcohol abuse by eliminating low-cost access to alcohol.  相似文献   

9.
Rationale  Experimental research is needed in investigating how early smoking abstinence affects relapse risk. Objective  The present study assessed the feasibility of promoting smoking abstinence using once- rather than thrice-daily abstinence monitoring and the relationship between different durations of initial abstinence and changes in smoking preference. Methods  Participants were 34 adult smokers randomized into one of two conditions: 14-day (14C) and 1-day (1C) contingent payment for smoking abstinence. Smoking status and participant ratings were assessed daily; a delay discounting task involving hypothetical money and an inter-temporal choice task involving hypothetical money and cigarettes were administered at baseline and days 7 and 14; a direct test of preference for smoking versus money was assessed on day 14. Results  Once-daily monitoring gained robust experimental control over smoking abstinence. No differences in delay discounting for hypothetical money were observed between the two conditions. Compared to the 1C condition, participants in the 14C condition (1) showed significant increases in the mean percent of delayed hypothetical money over cigarettes choices in the inter-temporal choice task, (2) were significantly less likely to ever choose the smoking option in the direct test of preference for smoking versus money, and (3) reported greater ease of abstaining from smoking and lower nicotine withdrawal and craving. Conclusions  These results offer a more efficient procedure for experimentally promoting smoking abstinence, while providing further evidence that an initial period of sustained abstinence produces a profile of changes consistent with an overall lowering of relapse risk.  相似文献   

10.
In this experiment, we compared behavioral economic measures and measures of the relative reinforcing efficacy of cigarettes and money between-participants. The experiment proceeded in two phases. In the first phase, money and cigarettes were available on separate progressive ratio (PR) schedules when they were solely available. The response requirement for the PR schedule increased across sessions, rather than within a session. In the second phase, money and cigarettes were made concurrently available at some of the response requirements employed during the PR schedule. Measures of (1) PR breakpoint, (2) peak response rate, (3) preference, (4) elasticity and (5) Pmax (the price at which the greatest amount of responding occurs) were compared within participant. Across the PR- and concurrent-schedule conditions, the three measures of reinforcing efficacy (breakpoint, response rate and preference) yielded an inconsistent assessment of the relative reinforcing efficacy of money and cigarettes. The reinforcer that resulted in greater peak response rates varied across subjects, while PR breakpoint was higher for cigarettes in all participants. Further, in concurrent schedules, preferences for cigarettes or money reversed across the response requirements. Behavioral economic analyses suggest that Pmax and elasticity are related to PR breakpoint, and that preference can be predicted from a comparison of the demand curves under single-schedule conditions. Implications for the concept of reinforcing efficacy are discussed.  相似文献   

11.
IntroductionCompared to the general population, smoking rates are 2–4 times higher among individuals with opioid use disorders (OUDs). These smokers also have poor long-term cessation rates, even with pharmacotherapy or other interventions. Low success rates with traditional approaches may prompt smokers with OUDs to try more novel products like electronic cigarettes (ECIGs). This pilot study was designed to examine the feasibility, acceptability, and effect of ECIGs on smoking behavior among smokers with OUD.MethodsParticipants (N = 25) were daily smokers receiving buprenorphine/naloxone for OUD at an outpatient clinic. They were randomized to use a second-generation ECIG (0 or 18 ng/ml nicotine) ad libitum for two weeks while completing assessments via text messaging daily, and also via in-person visits at baseline, end of the two-week intervention, and a 4-week follow-up.ResultsFeasibility was evidenced by high enrollment (93.9%) and retention (70.9%) rates. ECIG adherence was relatively high as measured by self-report (80.6% active, 91.7% placebo), while the average volume of liquid used per week was low (~3 ml). Both ECIG doses produced reductions in self-reported cigarettes per day that were not supported by average carbon monoxide levels. Biologically-confirmed smoking abstinence was observed in 8% of participants.ConclusionsPreliminary results suggest that smokers with OUD are interested in using ECIGs, but their adherence may be less than ideal. Poor medication adherence rates are often observed in this disparate population, and future work should consider the use of other ECIG device types and a combination of methods to verify and quantify ECIG use.  相似文献   

12.
The present study examined the relative contribution of nicotine dependence, self-efficacy, and stages of change variables in predicting the initial abstinence of 102 smokers enrolled in a smoking cessation program. Over half the participants were female, the majority were White, and about half were married or living with a partner Data were collected between 2000 and 2002. When smoking abstinence was defined as having a breath carbon monoxide (CO) level <4 ppm within 24 hours of enrollment in the study, low nicotine dependence and a higher level of contemplation both predicted abstinence. When other potentially confounding variables were included in the analysis, neither nicotine dependence nor contemplation was predictive of abstinence. When abstinence was defined as the number of study baseline days in which the participant had a breath CO level <4 ppm, multiple-regression analysis revealed that self-efficacy predicted abstinence. Self-efficacy remained predictive when other potentially confounding variables were included in the analysis. These results suggest that all three types of constructs are useful in predicting initial smoking abstinence.  相似文献   

13.
BackgroundDistress intolerance (DI), the perceived inability to withstand distress, is implicated in cigarette smoking maintenance. Greater DI may contribute to anticipation of negative outcomes from smoking abstinence, which in turn could contribute to withdrawal symptom severity. The current study aimed to evaluate (1) the association between DI and acute abstinence expectancies and (2) the potential mediating role of abstinence expectancies in the relationship between DI and withdrawal symptom severity.MethodParticipants (n = 444) were daily smokers who reported at least one prior quit attempt, participating in a larger online study on distress and smoking. DI, subjective nicotine withdrawal, and smoking abstinence expectancies were assessed using the Distress Tolerance Scale (DTS), Minnesota Nicotine Withdrawal Scale (MNWS), and Smoking Abstinence Expectancies Questionnaire (SAEQ).ResultsDTS was significantly negatively associated with SAEQ, specifically Negative Mood (r = −0.37, p < .001), Somatic Symptoms (r = −0.47, p < .001), and Harmful Consequences (r = −0.59, p < .001) subscales, but was not associated with Positive Expectancies subscale (r = 0.05, p = .31). Results indicated a significant effect of DTS on withdrawal symptom severity via SAEQ. Follow-up analyses indicated that the indirect effects were driven specifically by SAEQ Negative Mood and Harmful Consequences subscales.DiscussionDI is related to more negative abstinence expectancies, particularly affective aspects of abstinence, which may contribute to the severity of nicotine withdrawal symptoms. This study provides initial evidence of a specific cognitive process that may explain why DI contributes to heightened subjective experience of nicotine withdrawal symptoms.  相似文献   

14.
Divalproex, a GABA agonist, may be a useful agent in the treatment of tobacco dependence. Cue reactivity assessment paradigms are ideally suited to explore basic mechanisms underlying the pharmacological effects of medications that purport to have efficacy for smoking cessation. Our primary goal in the current study was to examine the effects of divalproex on in-treatment reactivity to smoking-relevant and affective cues, and to determine if these reactions were predictive of posttreatment smoking behavior. There were 120 nicotine dependent smokers enrolled in an 8-week double-blind clinical trial and randomly assigned to either divalproex or placebo conditions. Of these, 72 smokers (60% female) who achieved a minimal level of abstinence underwent an in-treatment cue reactivity assessment. Contrary to expectations, divalproex was associated with greater craving and arousal during smoking cue presentation. Divalproex also inhibited cardiovascular response to pleasant cues. Although no significant differences in cessation-related outcomes between divalproex- and placebo-treated participants were observed, cue-elicited craving to smoke predicted end-of-treatment and posttreatment smoking rates. These findings suggest that in-treatment cue reactivity assessment may proactively and dynamically inform ongoing treatment as well as provide a tool for screening potential medications for smoking cessation.  相似文献   

15.

Rationale  

Impulsivity, a multifaceted construct that includes inhibitory control and heightened preference for immediate reward, is central to models of drug use and abuse. Within a self-medication framework, abstinence from smoking may lead to an increase in impulsive behavior and the likelihood of relapse, particularly among persons with disorders (e.g., attention-deficit/hyperactivity disorder, ADHD) and personality traits (e.g., impulsivity) linked to impulsive behavior.  相似文献   

16.
IntroductionDespite previous evidence supporting the use of the Cigarette Purchase Task (CPT) as a valid tool for assessing smoking reinforcement, research assessing how environmental changes affect CPT performance is scarce.AimsThis study addressed for the first time the differential effect of treatment condition [Cognitive Behavioral Treatment (CBT) + Behavioral Activation (BA) versus CBT + BA + Contingency Management (CM)] on cigarette demand among treatment seeking smokers with depressive symptoms. It also sought to assess whether reductions in smoking consumption arranged over the course of an intervention for smoking cessation impact on in-treatment cigarette demand.MethodParticipants were 92 smokers with depressive symptoms from a randomized clinical trial that received eight weeks of either CBT + BA or CBT + BA + CM. Individuals completed the CPT 8 times; the first during the intake visit and the remaining 7 scheduled once a week in midweek sessions. Cotinine samples were collected in each session.ResultsParticipants receiving CBT + BA + CM showed higher reduction in cigarette demand across sessions than participants receiving CBT + BA, although this comparison was only significant for the intensity index (p = .004). Cotinine was positively related to cigarette demand (all p values < .001), although this association became less prominent across sessions. In-treatment cotinine decreases were associated with demand reductions (all p values < .001), but this association was not significant for elasticity.ConclusionsReductions in nicotine intake arranged over the course of an intervention for smoking cessation impact in-treatment cigarette demand.  相似文献   

17.
The present study examined the role of trait worry in predicting smoking-based cognitive processes (motives, expectancies, and beliefs about quitting) in a sample of 286 treatment-seeking, daily smokers (43.7% female; M(age)=37.25; SD=12.83). Consistent with prediction, trait worry was significantly and uniquely associated with smoking outcome expectancies and motives pertaining to negative affect reduction after controlling for other relevant variables such as negative affectivity, gender, smoking rate and tobacco-related disease. Trait worry also was significantly independently related to greater perceived barriers to quitting smoking. The significant effects remained consistent when adjusted for axis I psychopathology. These findings provide initial evidence of the theoretical and clinical importance of trait worry with regard to tobacco-related motives, outcome expectancies, and beliefs about quitting smoking.  相似文献   

18.
To determine whether smokers with a history of depression are differentially susceptible to smoking withdrawal, depressed mood induction and/or hypothalamic-pituitary-adrenal (HPA) axis dysregulation during smoking abstinence, 24 women smokers with and without such a history were studied. During one 5-day interval, participants smoked ad libitum; during a second they abstained. On day 4, the participants were exposed to the Velten mood induction procedure (VMIP). Participants were then instructed to take 1 mg dexamethasone at 11 pm. At 4 pm on day 5, blood samples were withdrawn to determine the cortisol and ACTH response. Despite lower baseline cotinine levels, history-positive participants displayed more pronounced overall withdrawal distress than did history-negative participants, regardless of condition. The VMIP increased depression as well as negative responses on other profile of mood states subscales. Despite many overall group differences, no significant main effects for smoking condition nor interaction effects emerged. All participants evinced cortisol suppression in response to dexamethasone during both conditions, but the degree of suppression did not differ as a function of either abstinence or depression history. In history-positive smokers, however, ACTH levels trended toward overall elevation and showed almost no suppression during abstinence; thus exacerbation of HPA dysregulation in history-positive smokers during smoking abstinence cannot be ruled out.  相似文献   

19.
The current study investigated whether emotion dysregulation (difficulties in the self-regulation of affective states) mediated relationships between anxiety sensitivity (fear of anxiety and related sensations) and cognitive-based smoking processes. Participants (n = 197; 57.5% male; mean age = 38.0 years) were daily smokers recruited as part of a randomized control trial for smoking cessation. Anxiety sensitivity was uniquely associated with all smoking processes. Moreover, emotion dysregulation significantly mediated relationships between anxiety sensitivity and the smoking processes. Findings suggest that emotion dysregulation is an important construct to consider in relationships between anxiety sensitivity and cognitive-based smoking processes among adult treatment-seeking smokers.  相似文献   

20.
RATIONALE: Although adolescent smokers appear to display some of the hallmark features of dependence, the biological and behavioral effects of smoking in this population are poorly understood. OBJECTIVES: This study aimed to define empirically the effects of abstinence and smoking in adolescent smokers, using indices validated in adult smokers. METHODS: Subjects were 16 young novice smokers (five male, 11 female), ages 14-18 years. A modified Stroop task measured the ability to inhibit attention to smoking-related cues; the classic Stroop task measured the ability to inhibit a pre-potent response (i.e. reading a word); a rapid information processing (RIP) task measured vigilance. RESULTS: Abstinence increased and smoking decreased the intrusiveness of smoking cues. Parallel effects were seen in commission errors on the RIP task. These effects were restricted to heavier smokers (>11 cigarettes/day). Subjective withdrawal effects predicted the intrusiveness of smoking words during abstinence. The number of cigarettes smoked per day predicted the beneficial effect of smoking on the classic as well as modified Stroop tasks. The physiological effects of abstinence and smoking predicted RIP performance. CONCLUSIONS: Abstinence impairs and smoking improves inhibitory information processing in young novice smokers in a manner similar to adult smokers. Daily frequency of smoking is a critical moderator of these effects.  相似文献   

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