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Upton S, Froeliger B. Regulation of craving and underlying resting-state neural circuitry predict hazard of smoking lapse. Transl Psychiatry 2025; 15:101. [PMID: 40148270 PMCID: PMC11950297 DOI: 10.1038/s41398-025-03319-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2024] [Revised: 02/22/2025] [Accepted: 03/14/2025] [Indexed: 03/29/2025] Open
Abstract
Among individuals with substance use disorders, clinical outcomes may be improved by identifying brain-behavior models that predict drug re/lapse vulnerabilities such as the ability to regulate drug cravings and inhibit drug use. In a sample of nicotine-dependent adult cigarette smokers (N = 213), this laboratory study examined associations between regulation of craving (ROC) efficacy and smoking lapse, utilized functional connectivity multivariate pattern analysis (FC-MVPA) and seed-based connectivity (SBC) analyses to identify resting-state neural circuitry underlying ROC efficacy, and then examined if the identified ROC-mediated circuitry predicted hazard of smoking lapse. Regarding behavior, worse ROC efficacy predicted a greater hazard of smoking lapse. Regarding brain and behavior, FC-MVPA identified 29 brain-wide functional clusters associated with ROC efficacy. Follow-up SBC analyses using 9 of the FC-MVPA-derived clusters identified a total of 64 resting-state edges (i.e., cluster-to-cluster connections) underlying ROC efficacy, 10 of which were also associated with the hazard of smoking lapse. ROC efficacy edges also associated with smoking lapse were largely composed of connections between frontal-striatal-limbic clusters and sensory-motor clusters and better behavioral outcomes were associated with stronger resting-state FC. Findings suggest that both ROC efficacy and underlying resting-state neural circuitry may inform prediction models of re/lapse vulnerabilities and serve as treatment targets for cessation interventions.
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Affiliation(s)
- Spencer Upton
- Department of Psychological Sciences, University of Missouri, Columbia, MO, USA.
| | - Brett Froeliger
- Department of Psychological Sciences, University of Missouri, Columbia, MO, USA
- Department of Psychiatry, University of Missouri, Columbia, MO, USA
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Baek SU, Lee YM, Won JU, Yoon JH. Association of food insecurity with the use of tobacco products and urine cotinine-measured smoking intensity: evidence from a population-based study in South Korea, 2019-2021. Tob Control 2024:tc-2024-058754. [PMID: 39455070 DOI: 10.1136/tc-2024-058754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 08/25/2024] [Indexed: 10/28/2024]
Abstract
INTRODUCTION This study explored the association between food insecurity and tobacco product use and urine cotinine-measured smoking intensity. METHODS This cross-sectional study included 13 705 adults representative of the Korean population. The 18-item Household Food Security Survey Module was administered to the primary food managers in households with the scores applied to household members. The use of three tobacco products-combustible cigarettes, heated tobacco products and electronic cigarettes (e-cigarettes)-was assessed. Based on the urine cotinine level, the smoking status of each participant was classified into one of three groups: non-smoker, low-intensity smoker and high-intensity smoker. Logistic regression analysis was used to determine the association between food insecurity and tobacco product use and urine cotinine-measured smoking intensity. ORs and 95% CIs were estimated. RESULTS Among the survey participants, 3.2% had mild food insecurity and 0.7% had moderate-to-severe food insecurity. Those with mild food insecurity (23.5%, OR: 1.38, 95% CI: 1.01 to 1.89) and those with moderate-to-severe food insecurity (45.1%, OR: 3.36, 95% CI: 1.87 to 6.03) compared with those with non-food insecurity (18.4%) were positively associated with combustible cigarette use. Those with moderate-to-severe food insecurity was positively associated with e-cigarette use (5.5%, OR: 3.49, 95% CI: 1.31 to 9.28). Compared with those with non-food security (7.9%), those with mild food insecurity (14.3%, OR: 1.61, 95% CI: 1.09 to 2.38) and moderate-to-severe food insecurity (22.1%, OR: 2.25, 95% CI: 1.04 to 4.86) were associated with high-intensity smoking. CONCLUSION Food insecurity is associated with both combustible and e-cigarette use. Those with food insecurity are associated with engagement in high-intensity smoking.
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Affiliation(s)
- Seong-Uk Baek
- Graduate School, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
| | - Yu-Min Lee
- Department of Occupational and Environmental Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
- The Institute for Occupational Health, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
| | - Jong-Uk Won
- Department of Occupational and Environmental Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
- The Institute for Occupational Health, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
| | - Jin-Ha Yoon
- The Institute for Occupational Health, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
- Department of Preventive Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
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Nemeth JM, Glasser AM, Macisco J, Hinton A, Wermert A, Patterson JG, Sucaldito A, Gilson C, Kemble H, Garbsch E, Caponi J. Identifying Novel Motivation Phase-Specific Cessation Targets for Youth Experiencing Homelessness in the United States. Nicotine Tob Res 2024; 26:237-244. [PMID: 37725951 PMCID: PMC10803121 DOI: 10.1093/ntr/ntad176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 07/11/2023] [Accepted: 09/18/2023] [Indexed: 09/21/2023]
Abstract
INTRODUCTION Of youth experiencing homelessness (YEH; 14-24 years old), 70%+ smoke combustible, commercial tobacco. Though many have tried to quit, most use ineffective methods. Drop-in centers for YEH are opportune places to link YEH to evidence-based treatment. Using the Phase-Based Model (PBM) for Cessation Research, the aim of this study was to identify "Motivation" phase-specific challenges impacting YEH's willingness to make a quit attempt-the goal of this cessation phase. AIMS AND METHODS Surveys were interview administered with 96 past-week combusted tobacco users accessing drop-in services. Regression models were fit to confirm hypothesized challenges impacting YEH's willingness to quit. RESULTS Moderate nicotine dependence was noted-a key Motivation phase cessation mechanism targeted-and was associated with population challenges including, but not limited to, replacing food with tobacco, accidental oxygen-deprivation events, and smoking to socialize. While 67.1% of participants made a past-year quit attempt, 45.8% expressed 30-day quit interest. Dimensions of coping with housing were associated with quit attempts and quit interest. Quit attempts were also associated with nicotine dependence, working, and smoking to socialize. Whereas, quit interest was associated with less endorsement of smoking to regulate affect and more endorsement to avoid danger. CONCLUSIONS Though common challenges targeted in Motivation phase cessation exist among YEH, other challenges may also need to be addressed to promote quitting. IMPLICATIONS Future research in optimizing evidence-based cessation access for YEH through drop-in centers may consider addressing the challenges of housing, food security, social context, violence, and neurotrauma sequela to bolster YEH willingness to make a quit attempt.
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Affiliation(s)
- Julianna M Nemeth
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA
- The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Allison M Glasser
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA
- Institute for Nicotine and Tobacco Studies, Rutgers University, New Brunswick, NJ, USA
| | - Joseph Macisco
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Alice Hinton
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Amy Wermert
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Joanne G Patterson
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Ana Sucaldito
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA
- Department of Family and Community Medicine and Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Carra Gilson
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA
- Department of Psychology, University of Denver, Denver, CO, USA
| | - Hannah Kemble
- Division of Health Sciences Management and Policy, College of Public Health, The Ohio State University, Columbus, OH, USA
- Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - Ellen Garbsch
- Division of Health Sciences Management and Policy, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Jacob Caponi
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA
- Department of Sociology, University of Michigan, Ann Arbor, MI, USA
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Sloan ME, Sells JR, Vaughan CL, Morris JK, Ortega NE, Sundar S, Soundararajan S, Stangl BL, Gowin J, Chawla S, Diazgranados N, McKee SA, Waters A, Ramchandani VA. Modeling ability to resist alcohol in the human laboratory: A pilot study. DRUG AND ALCOHOL DEPENDENCE REPORTS 2022; 5:100105. [PMID: 36844167 PMCID: PMC9948911 DOI: 10.1016/j.dadr.2022.100105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 09/15/2022] [Accepted: 10/03/2022] [Indexed: 05/25/2023]
Abstract
Background Roughly half of patients with alcohol use disorder prefer non-abstinence based approaches to treatment. However, only individuals who can limit their alcohol use after low-risk consumption are most likely to benefit from these approaches. This pilot study developed a laboratory-based intravenous alcohol self-administration paradigm to determine the characteristics of individuals who could successfully resist consuming alcohol after an initial exposure. Methods Seventeen non-treatment seeking heavy drinkers completed two versions of an intravenous alcohol self-administration paradigm designed to assess impaired control over alcohol use. In the paradigm, participants received a priming dose of alcohol and then entered a 120-min resist phase, in which they received monetary rewards if they resisted self-administering alcohol. We used Cox proportional hazards regression to determine the impact of craving and Impaired Control Scale scores on rate of lapse. Results 64.7% of participants across both versions of the paradigm were unable to resist alcohol for the duration of the session. Craving at baseline (HR = 1.07, 95% CI 1.01-1.13, p = 0.02) and following priming (HR = 1.08, 95% CI 1.02-1.15, p = 0.01) were associated with rate of lapse. Individuals who lapsed endorsed greater attempts to control their drinking over the prior six months compared to individuals who resisted. Conclusions This study provides preliminary evidence that craving may be predictive of risk of lapse in individuals who are trying to limit alcohol intake after consuming a small initial amount of alcohol. Future studies should test this paradigm in a larger and more diverse sample.
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Affiliation(s)
- Matthew E. Sloan
- Addictions Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Division of Neurosciences and Clinical Translation, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada
- Department of Psychological Clinical Science, University of Toronto Scarborough, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Joanna R. Sells
- Department of Medical and Clinical Psychology, Uniformed Services University of Health Science, USA
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, 10 Center Drive, Rm 2-2352, Bethesda, MD 20892, USA
| | - Courtney L. Vaughan
- Department of Medical and Clinical Psychology, Uniformed Services University of Health Science, USA
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, 10 Center Drive, Rm 2-2352, Bethesda, MD 20892, USA
| | - James K. Morris
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, 10 Center Drive, Rm 2-2352, Bethesda, MD 20892, USA
| | - Nancy E. Ortega
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, 10 Center Drive, Rm 2-2352, Bethesda, MD 20892, USA
| | - Sachin Sundar
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, 10 Center Drive, Rm 2-2352, Bethesda, MD 20892, USA
| | - Soundarya Soundararajan
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, 10 Center Drive, Rm 2-2352, Bethesda, MD 20892, USA
| | - Bethany L. Stangl
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, 10 Center Drive, Rm 2-2352, Bethesda, MD 20892, USA
| | - Joshua Gowin
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, 10 Center Drive, Rm 2-2352, Bethesda, MD 20892, USA
- Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Sumedha Chawla
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, 10 Center Drive, Rm 2-2352, Bethesda, MD 20892, USA
| | - Nancy Diazgranados
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | | | - Andrew Waters
- Department of Medical and Clinical Psychology, Uniformed Services University of Health Science, USA
| | - Vijay A. Ramchandani
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, 10 Center Drive, Rm 2-2352, Bethesda, MD 20892, USA
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McKee SA, Verplaetse TL. A novel human laboratory alcohol self-administration paradigm for medication screening: Modeling the ability to resist drinking and heavy drinking. DRUG AND ALCOHOL DEPENDENCE REPORTS 2022; 4:100085. [PMID: 36120181 PMCID: PMC9481061 DOI: 10.1016/j.dadr.2022.100085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 08/01/2022] [Accepted: 08/03/2022] [Indexed: 01/12/2023]
Abstract
Background Human laboratory analogues of drinking behavior provide an efficient, cost-effective mechanistic evaluation of a medication signal on drinking. We developed a novel alcohol self-administration paradigm which models the ability to resist drinking and heavy drinking. Methods We compared a de-escalating schedule of monetary reinforcement (n=16, 50% female) to no schedule (n=16, 50% female) on the ability to resist drinking (i.e., latency to start drinking) and subsequent ad-libitum alcohol consumption of preferred alcoholic beverage in participants with alcohol use disorder (AUD). Participants completed two laboratory sessions designed to model the ability to resist drinking using stress (versus neutral imagery, within-subject factor) as a prime for drinking. Results Participants consumed more alcohol with no schedule (74.2%) versus with the de-escalating reinforcement schedule (40.3%,). The de-escalating schedule reduced alcohol consumption by 49%. Eighty-one percent of participants drank heavily with no schedule and this was reduced with the schedule. Use of the de-escalating schedule also increased the latency to pour and sip the first drink. Participants poured and sipped alcohol faster following stress imagery (vs. neutral), had greater craving, and consumed more alcohol in the first 30 minutes. Conclusions Our novel alcohol self-administration model generated heavy drinking. Over 80% of participants without reinforcement consumed more than 2/3 of their preferred alcoholic beverage designed to increase blood alcohol levels to 0.12 mg% within a 2-hour window. Our model was sensitive to stress, and the de-escalating schedule highlighted stress effects on drinking. Thus, this model is ideal for a cross-over design to test medications for AUD.
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Affiliation(s)
- Sherry A. McKee
- Yale School of Medicine, Dept of Psychiatry, 2 Church St South, Suite 109, New Haven, CT, United States 06519
| | - Terril L. Verplaetse
- Yale School of Medicine, Dept of Psychiatry, 2 Church St South, Suite 109, New Haven, CT, United States 06519
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Menthol Smoking and Nicotine Dependence among Black/African American Women Smokers Living in Low-Resource, Rural Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010877. [PMID: 34682623 PMCID: PMC8535496 DOI: 10.3390/ijerph182010877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/07/2021] [Accepted: 10/13/2021] [Indexed: 12/23/2022]
Abstract
Black/African American women from low-resource, rural communities bear a disproportionate burden of tobacco-related morbidity and mortality. This study examined associations between menthol smoking and socioeconomic deprivation with nicotine dependence and quitting behaviors among Black/African American women cigarette and/or little cigar/cigarillo smokers, aged 18–50 living in low-resource, rural communities. Baseline survey data from a randomized controlled behavioral/intervention trial (#NCT03476837) were analyzed (n = 146). Outcomes included time to first tobacco product (cigarette/little cigar/cigarillo) use within 5 min of waking, Fagerstrom Test for Nicotine Dependence (FTND) score, and ever attempting to quit cigarettes. Socioeconomic deprivation measures included education, income, and receiving supplemental nutritional assistance (SNAP) program benefits. In adjusted regression analyses, menthol smoking was associated with both greater FTND scores and time to first tobacco product use within 5 min of waking, but not ever attempting to quit cigarettes. Regardless of menthol status, only 25.0% of smokers reported that they would quit smoking if menthol cigarettes were banned. The proportion of smokers who smoked their first tobacco product within 5 min of waking increased slightly with greater socioeconomic deprivation. Additional research and targeted efforts are needed to reduce nicotine dependence among Black/African American women smokers living in rural, low-resource communities where access to cessation services is limited.
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Hartmann-Boyce J, Theodoulou A, Farley A, Hajek P, Lycett D, Jones LL, Kudlek L, Heath L, Hajizadeh A, Schenkels M, Aveyard P. Interventions for preventing weight gain after smoking cessation. Cochrane Database Syst Rev 2021; 10:CD006219. [PMID: 34611902 PMCID: PMC8493442 DOI: 10.1002/14651858.cd006219.pub4] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Most people who stop smoking gain weight. This can discourage some people from making a quit attempt and risks offsetting some, but not all, of the health advantages of quitting. Interventions to prevent weight gain could improve health outcomes, but there is a concern that they may undermine quitting. OBJECTIVES To systematically review the effects of: (1) interventions targeting post-cessation weight gain on weight change and smoking cessation (referred to as 'Part 1') and (2) interventions designed to aid smoking cessation that plausibly affect post-cessation weight gain (referred to as 'Part 2'). SEARCH METHODS Part 1 - We searched the Cochrane Tobacco Addiction Group's Specialized Register and CENTRAL; latest search 16 October 2020. Part 2 - We searched included studies in the following 'parent' Cochrane reviews: nicotine replacement therapy (NRT), antidepressants, nicotine receptor partial agonists, e-cigarettes, and exercise interventions for smoking cessation published in Issue 10, 2020 of the Cochrane Library. We updated register searches for the review of nicotine receptor partial agonists. SELECTION CRITERIA Part 1 - trials of interventions that targeted post-cessation weight gain and had measured weight at any follow-up point or smoking cessation, or both, six or more months after quit day. Part 2 - trials included in the selected parent Cochrane reviews reporting weight change at any time point. DATA COLLECTION AND ANALYSIS Screening and data extraction followed standard Cochrane methods. Change in weight was expressed as difference in weight change from baseline to follow-up between trial arms and was reported only in people abstinent from smoking. Abstinence from smoking was expressed as a risk ratio (RR). Where appropriate, we performed meta-analysis using the inverse variance method for weight, and Mantel-Haenszel method for smoking. MAIN RESULTS Part 1: We include 37 completed studies; 21 are new to this update. We judged five studies to be at low risk of bias, 17 to be at unclear risk and the remainder at high risk. An intermittent very low calorie diet (VLCD) comprising full meal replacement provided free of charge and accompanied by intensive dietitian support significantly reduced weight gain at end of treatment compared with education on how to avoid weight gain (mean difference (MD) -3.70 kg, 95% confidence interval (CI) -4.82 to -2.58; 1 study, 121 participants), but there was no evidence of benefit at 12 months (MD -1.30 kg, 95% CI -3.49 to 0.89; 1 study, 62 participants). The VLCD increased the chances of abstinence at 12 months (RR 1.73, 95% CI 1.10 to 2.73; 1 study, 287 participants). However, a second study found that no-one completed the VLCD intervention or achieved abstinence. Interventions aimed at increasing acceptance of weight gain reported mixed effects at end of treatment, 6 months and 12 months with confidence intervals including both increases and decreases in weight gain compared with no advice or health education. Due to high heterogeneity, we did not combine the data. These interventions increased quit rates at 6 months (RR 1.42, 95% CI 1.03 to 1.96; 4 studies, 619 participants; I2 = 21%), but there was no evidence at 12 months (RR 1.25, 95% CI 0.76 to 2.06; 2 studies, 496 participants; I2 = 26%). Some pharmacological interventions tested for limiting post-cessation weight gain (PCWG) reduced weight gain at the end of treatment (dexfenfluramine, phenylpropanolamine, naltrexone). The effects of ephedrine and caffeine combined, lorcaserin, and chromium were too imprecise to give useful estimates of treatment effects. There was very low-certainty evidence that personalized weight management support reduced weight gain at end of treatment (MD -1.11 kg, 95% CI -1.93 to -0.29; 3 studies, 121 participants; I2 = 0%), but no evidence in the longer-term 12 months (MD -0.44 kg, 95% CI -2.34 to 1.46; 4 studies, 530 participants; I2 = 41%). There was low to very low-certainty evidence that detailed weight management education without personalized assessment, planning and feedback did not reduce weight gain and may have reduced smoking cessation rates (12 months: MD -0.21 kg, 95% CI -2.28 to 1.86; 2 studies, 61 participants; I2 = 0%; RR for smoking cessation 0.66, 95% CI 0.48 to 0.90; 2 studies, 522 participants; I2 = 0%). Part 2: We include 83 completed studies, 27 of which are new to this update. There was low certainty that exercise interventions led to minimal or no weight reduction compared with standard care at end of treatment (MD -0.25 kg, 95% CI -0.78 to 0.29; 4 studies, 404 participants; I2 = 0%). However, weight was reduced at 12 months (MD -2.07 kg, 95% CI -3.78 to -0.36; 3 studies, 182 participants; I2 = 0%). Both bupropion and fluoxetine limited weight gain at end of treatment (bupropion MD -1.01 kg, 95% CI -1.35 to -0.67; 10 studies, 1098 participants; I2 = 3%); (fluoxetine MD -1.01 kg, 95% CI -1.49 to -0.53; 2 studies, 144 participants; I2 = 38%; low- and very low-certainty evidence, respectively). There was no evidence of benefit at 12 months for bupropion, but estimates were imprecise (bupropion MD -0.26 kg, 95% CI -1.31 to 0.78; 7 studies, 471 participants; I2 = 0%). No studies of fluoxetine provided data at 12 months. There was moderate-certainty that NRT reduced weight at end of treatment (MD -0.52 kg, 95% CI -0.99 to -0.05; 21 studies, 2784 participants; I2 = 81%) and moderate-certainty that the effect may be similar at 12 months (MD -0.37 kg, 95% CI -0.86 to 0.11; 17 studies, 1463 participants; I2 = 0%), although the estimates are too imprecise to assess long-term benefit. There was mixed evidence of the effect of varenicline on weight, with high-certainty evidence that weight change was very modestly lower at the end of treatment (MD -0.23 kg, 95% CI -0.53 to 0.06; 14 studies, 2566 participants; I2 = 32%); a low-certainty estimate gave an imprecise estimate of higher weight at 12 months (MD 1.05 kg, 95% CI -0.58 to 2.69; 3 studies, 237 participants; I2 = 0%). AUTHORS' CONCLUSIONS Overall, there is no intervention for which there is moderate certainty of a clinically useful effect on long-term weight gain. There is also no moderate- or high-certainty evidence that interventions designed to limit weight gain reduce the chances of people achieving abstinence from smoking.
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Affiliation(s)
- Jamie Hartmann-Boyce
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Annika Theodoulou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Amanda Farley
- Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK
| | - Peter Hajek
- Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Deborah Lycett
- Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | - Laura L Jones
- Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK
| | - Laura Kudlek
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Laura Heath
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Anisa Hajizadeh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Blanco-Gandia MC, Montagud-Romero S, Rodríguez-Arias M. Binge eating and psychostimulant addiction. World J Psychiatry 2021; 11:517-529. [PMID: 34631457 PMCID: PMC8475000 DOI: 10.5498/wjp.v11.i9.517] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 05/13/2021] [Accepted: 07/27/2021] [Indexed: 02/06/2023] Open
Abstract
Many of the various factors, characteristics, and variables involved in the addictive process can determine an individual’s vulnerability to develop drug addiction. Hedonic eating, based on pleasure rather than energy needs, modulates the same reward circuits, as do drugs of abuse. According to the last report of the World Health Organization, the worldwide obesity rate has more than doubled since 1980, reaching especially critical levels in children and young people, who are overexposed to high-fat, high-sugar, energy-dense foods. Over the past few decades, there has been an increase in the number of studies focused on how eating disorders can lead to the development of drug addiction and on the comorbidity that exists between the two disorders. Herein, we review the most recent research on the subject, focusing especially on animal models of binge eating disorders and drug addiction. The complex profile of patients with substance use and binge eating disorders requires an integrated response to dually diagnosed patients. Nutritional patterns should be considered an important variable in the treatment of substance use disorders, and future studies need to focus on specific treatments and interventions in individuals who show a special vulnerability to shift from one addiction to the other.
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Affiliation(s)
| | | | - Marta Rodríguez-Arias
- Department of Psychobiology, Facultad de Psicología, Universitat de Valencia, Valencia 46010, Spain
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Sheira LA, Frongillo EA, Hahn J, Palar K, Riley ED, Wilson TE, Adedimeji A, Merenstein D, Cohen M, Wentz EL, Adimora AA, Ofotokun I, Metsch L, Turan JM, Tien PC, Weiser SD. Relationship between food insecurity and smoking status among women living with and at risk for HIV in the USA: a cohort study. BMJ Open 2021; 11:e054903. [PMID: 34489299 PMCID: PMC8422493 DOI: 10.1136/bmjopen-2021-054903] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES People living with HIV (PLHIV) in the USA, particularly women, have a higher prevalence of food insecurity than the general population. Cigarette smoking among PLHIV is common (42%), and PLHIV are 6-13 times more likely to die from lung cancer than AIDS-related causes. This study sought to investigate the associations between food security status and smoking status and severity among a cohort of predominantly low-income women of colour living with and without HIV in the USA. DESIGN Women enrolled in an ongoing longitudinal cohort study from 2013 to 2015. SETTING Nine participating sites across the USA. PARTICIPANTS 2553 participants enrolled in the Food Insecurity Sub-Study of the Women's Interagency HIV Study, a multisite cohort study of US women living with HIV and demographically similar HIV-seronegative women. OUTCOMES Current cigarette smoking status and intensity were self-reported. We used cross-sectional and longitudinal logistic and Tobit regressions to assess associations of food security status and changes in food security status with smoking status and intensity. RESULTS The median age was 48. Most respondents were African-American/black (72%) and living with HIV (71%). Over half had annual incomes ≤US$12 000 (52%). Food insecurity (44%) and cigarette smoking (42%) were prevalent. In analyses adjusting for common sociodemographic characteristics, all categories of food insecurity were associated with greater odds of current smoking compared with food-secure women. Changes in food insecurity were also associated with increased odds of smoking. Any food insecurity was associated with higher smoking intensity. CONCLUSIONS Food insecurity over time was associated with smoking in this cohort of predominantly low-income women of colour living with or at risk of HIV. Integrating alleviation of food insecurity into smoking cessation programmes may be an effective method to reduce the smoking prevalence and disproportionate lung cancer mortality rate particularly among PLHIV.
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Affiliation(s)
- Lila A Sheira
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, California, USA
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, University of South Carolina System, Columbia, South Carolina, USA
| | - Judith Hahn
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, California, USA
| | - Kartika Palar
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, California, USA
| | - Elise D Riley
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, California, USA
| | - Tracey E Wilson
- Community Health Sciences, School of Public Health, State University of New York Downstate Medical Center, Brooklyn, New York, USA
| | - Adebola Adedimeji
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Daniel Merenstein
- Family Medicine, Georgetown University Medical Center, Washington, District of Columbia, USA
| | - Mardge Cohen
- Medicine, John H Stroger Hospital of Cook County, Chicago, Illinois, USA
| | - Eryka L Wentz
- School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Adaora A Adimora
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Lisa Metsch
- Sociomedical Sciences, Columbia University Mailman School of Public Health, New York City, New York, USA
| | - Janet M Turan
- Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Phyllis C Tien
- Department of Medicine, University of California, San Francisco, California, USA
- Department of Veteran Affairs Medical Center, San Francisco, California, USA
| | - Sheri D Weiser
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, California, USA
- Center for AIDS Prevention Studies, University of California, San Francisco, California, USA
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10
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Pericot-Valverde I, Heo M, Litwin AH, Niu J, Gaalema DE. Modeling the effect of stress on vaping behavior among young adults: A randomized cross-over pilot study. Drug Alcohol Depend 2021; 225:108798. [PMID: 34091155 PMCID: PMC8504555 DOI: 10.1016/j.drugalcdep.2021.108798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 02/24/2021] [Accepted: 04/04/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Laboratory models have been useful in identifying the motivational processes underlying tobacco use. This pilot study aimed at (1)validating a human laboratory model initially developed for smokers to e-cigarette users; (2)applying this model to examine the effects of stress on the reinforcing value of nicotine among young adults. METHODS Using a randomized cross-over design, young e-cigarette users (n = 30) who were nicotine deprived were exposed to a stress or a non-stress task, and then engaged in a laboratory task assessing vaping's reward value on two separate days. During the first part of the task, participants had the option of initiating an e-cigarette self-administration session or delaying initiation for up to 50 min in exchange for money. During the second part of the task, participants chose between vaping or receiving money. The length of the delay and the number of e-cigarette uses consumed were the primary outcomes. Craving and puff topography were secondary outcomes. RESULTS There was no difference in the length of time that participants were able to refrain from vaping in the stress and control task (p = .90). Participants purchased and consumed more puffs after being exposed to the stress task compared to the control task (p<.001), puff topography and craving were unaffected. CONCLUSIONS Exposure to a stressor did not undermine the ability to resist vaping among deprived e-cigarette users (first part), but it influenced the number of uses purchased once users decided to vape (second part). This study evidences that these two parts of the task for assessing reward value are differentially sensitive to the stress manipulation.
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Affiliation(s)
- Irene Pericot-Valverde
- School of Health Research, Clemson University, Greenville, SC, USA; Prisma Health, Department of Medicine, Greenville, SC, USA; Department of Public Health Science, Clemson University, Clemson, SC, USA.
| | - Moonseong Heo
- Department of Public Health Science, Clemson University, Clemson, SC, USA.
| | - Alain H Litwin
- School of Health Research, Clemson University, Greenville, SC, USA; Prisma Health, Department of Medicine, Greenville, SC, USA; Department of Medicine, University of South Carolina School of Medicine, Greenville, SC, USA.
| | - Jiajing Niu
- School of Mathematical and Statistical Sciences, Clemson University, Clemson, SC, USA.
| | - Diann E Gaalema
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Departments of Psychology and Psychiatry, University of Vermont, Burlington, VT, USA.
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11
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Lydon-Staley D, MacLean R, Falk E, Bassett D, Wilson S. The feasibility of an in-scanner smoking lapse paradigm to examine the neural correlates of lapses. Addict Biol 2021; 26:e13001. [PMID: 33508880 PMCID: PMC8225575 DOI: 10.1111/adb.13001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 11/13/2020] [Accepted: 01/02/2021] [Indexed: 11/28/2022]
Abstract
Quitting smoking is notoriously difficult. Models of nicotine dependence posit that strength of cognitive control contributes to maintaining smoking abstinence during smoking cessation attempts. We examine the role for large-scale functional brain systems associated with cognitive control in smoking lapse using a novel adaption of a well-validated behavioral paradigm. We use data from 17 daily smokers (five females) after 12 h of smoking abstinence. Participants completed up to 10 sequential 5-min functional magnetic resonance imaging (fMRI) runs, within a single scanning session. After each run, participants decided whether to stay in the scanner in order to earn additional money or to terminate the session in order to smoke a cigarette (i.e., lapse) and forego additional monetary reward. Cox regression results indicate that decreased segregation of the default mode system from the frontoparietal system undermines the ability to resist smoking. This study demonstrates the feasibility of modifying an established behavioral model of smoking lapse behavior for use in the neuro imaging environment, and it provides initial evidence that this approach yields valuable information regarding fine-grained, time-varying changes in patterns of neural activity in the moments leading up to a decision to smoke. Specifically, results lend support to the hypothesis that the time-varying interplay between large-scale functional brain systems associated with cognitive control is implicated in smoking lapse behavior.
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Affiliation(s)
- D.M. Lydon-Staley
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
| | - R.R. MacLean
- VA Connecticut Healthcare System, West Haven, CT
- Yale University School of Medicine, New Haven, CT
| | - E.B. Falk
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA
- Department of Psychology, University of Pennsylvania, Philadelphia, PA
- Wharton Marketing Department, University of Pennsylvania, Philadelphia, PA
| | - D.S. Bassett
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA
- Department of Electrical & Systems Engineering, School of Engineering & Applied Science, University of Pennsylvania, Philadelphia, PA
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Department of Physics & Astronomy, College of Arts & Sciences, University of Pennsylvania, Philadelphia, PA
- The Santa Fe Institute, Sante Fe, NM
| | - S.J. Wilson
- Department of Psychology, The Pennsylvania State University, University Park, PA
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12
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Converging vulnerability factors for compulsive food and drug use. Neuropharmacology 2021; 196:108556. [PMID: 33862029 DOI: 10.1016/j.neuropharm.2021.108556] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 03/29/2021] [Accepted: 04/03/2021] [Indexed: 12/12/2022]
Abstract
Highly palatable foods and substance of abuse have intersecting neurobiological, metabolic and behavioral effects relevant for understanding vulnerability to conditions related to food (e.g., obesity, binge eating disorder) and drug (e.g., substance use disorder) misuse. Here, we review data from animal models, clinical populations and epidemiological evidence in behavioral, genetic, pathophysiologic and therapeutic domains. Results suggest that consumption of highly palatable food and drugs of abuse both impact and conversely are regulated by metabolic hormones and metabolic status. Palatable foods high in fat and/or sugar can elicit adaptation in brain reward and withdrawal circuitry akin to substances of abuse. Intake of or withdrawal from palatable food can impact behavioral sensitivity to drugs of abuse and vice versa. A robust literature suggests common substrates and roles for negative reinforcement, negative affect, negative urgency, and impulse control deficits, with both highly palatable foods and substances of abuse. Candidate genetic risk loci shared by obesity and alcohol use disorders have been identified in molecules classically associated with both metabolic and motivational functions. Finally, certain drugs may have overlapping therapeutic potential to treat obesity, diabetes, binge-related eating disorders and substance use disorders. Taken together, data are consistent with the hypotheses that compulsive food and substance use share overlapping, interacting substrates at neurobiological and metabolic levels and that motivated behavior associated with feeding or substance use might constitute vulnerability factors for one another. This article is part of the special issue on 'Vulnerabilities to Substance Abuse'.
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13
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Cole CA, Powers S, Tomko RL, Froeliger B, Valafar H. Quantification of Smoking Characteristics Using Smartwatch Technology: Pilot Feasibility Study of New Technology. JMIR Form Res 2021; 5:e20464. [PMID: 33544083 PMCID: PMC7895644 DOI: 10.2196/20464] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 12/22/2020] [Accepted: 01/13/2021] [Indexed: 02/02/2023] Open
Abstract
Background While there have been many technological advances in studying the neurobiological and clinical basis of tobacco use disorder and nicotine addiction, there have been relatively minor advances in technologies for monitoring, characterizing, and intervening to prevent smoking in real time. Better understanding of real-time smoking behavior can be helpful in numerous applications without the burden and recall bias associated with self-report. Objective The goal of this study was to test the validity of using a smartwatch to advance the study of temporal patterns and characteristics of smoking in a controlled laboratory setting prior to its implementation in situ. Specifically, the aim was to compare smoking characteristics recorded by Automated Smoking PerceptIon and REcording (ASPIRE) on a smartwatch with the pocket Clinical Research Support System (CReSS) topography device, using video observation as the gold standard. Methods Adult smokers (N=27) engaged in a video-recorded laboratory smoking task using the pocket CReSS while also wearing a Polar M600 smartwatch. In-house software, ASPIRE, was used to record accelerometer data to identify the duration of puffs and interpuff intervals (IPIs). The recorded sessions from CReSS and ASPIRE were manually annotated to assess smoking topography. Agreement between CReSS-recorded and ASPIRE-recorded smoking behavior was compared. Results ASPIRE produced more consistent number of puffs and IPI durations relative to CReSS, when comparing both methods to visual puff count. In addition, CReSS recordings reported many implausible measurements in the order of milliseconds. After filtering implausible data recorded from CReSS, ASPIRE and CReSS produced consistent results for puff duration (R2=.79) and IPIs (R2=.73). Conclusions Agreement between ASPIRE and other indicators of smoking characteristics was high, suggesting that the use of ASPIRE is a viable method of passively characterizing smoking behavior. Moreover, ASPIRE was more accurate than CReSS for measuring puffs and IPIs. Results from this study provide the foundation for future utilization of ASPIRE to passively and accurately monitor and quantify smoking behavior in situ.
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Affiliation(s)
- Casey Anne Cole
- Department of Computer Science and Engineering, University of South Carolina, Columbia, SC, United States
| | - Shannon Powers
- Department of Psychological Sciences, University of Missouri-Columbia, Columbia, MO, United States.,Department of Psychology, University of Denver, Denver, CO, United States
| | - Rachel L Tomko
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Brett Froeliger
- Department of Psychological Sciences, University of Missouri-Columbia, Columbia, MO, United States.,Department of Psychiatry, University of Missouri-Columbia, Columbia, MO, United States
| | - Homayoun Valafar
- Department of Computer Science and Engineering, University of South Carolina, Columbia, SC, United States
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14
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Zhang X, Wang S, Liu Y, Chen H. More restriction, more overeating: conflict monitoring ability is impaired by food-thought suppression among restrained eaters. Brain Imaging Behav 2020; 15:2069-2080. [PMID: 33033984 DOI: 10.1007/s11682-020-00401-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2020] [Indexed: 11/30/2022]
Abstract
Numerous studies have shown that restrained eating is not an effective weight loss strategy. Restrained eaters often suppress their desires and thoughts about tasty food, which makes it more difficult to control themselves in subsequent eating behavior. The ego depletion impairs conflict monitoring abilities. Therefore, this study explored the effects of food thoughts suppression on restrained eaters' conflict monitoring. Therefore, this study used functional magnetic resonance imaging (fMRI) methods to explore changes in the activity of brain regions involved in conflict monitoring when restrained eaters choose between high- and low-calorie foods after either suppressing or not suppressing thoughts about food. The results showed that, compared to the control condition, after suppression of such thoughts, restrained eaters chose more high-calorie foods and displayed decreased activity in the dorsal anterior cingulate cortex-an important region in charge of conflict monitoring. At the same time, the functional coupling of the dorsal anterior cingulate cortex and the precuneus increased. Our findings suggest that restrained eaters' suppression of thoughts about tasty food could lead to a decline in their ability to monitor conflicts between current behaviors and goals, which in turn leads to unhealthy eating behavior.
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Affiliation(s)
- Xuemeng Zhang
- School of Psychology, Southwest University, No. 2 Tiansheng road, Beibei district, Chongqing, 400715, China
- Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, China
| | - Shaorui Wang
- School of Psychology, Southwest University, No. 2 Tiansheng road, Beibei district, Chongqing, 400715, China
- Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, China
| | - Yong Liu
- School of Psychology, Southwest University, No. 2 Tiansheng road, Beibei district, Chongqing, 400715, China
- Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, China
| | - Hong Chen
- School of Psychology, Southwest University, No. 2 Tiansheng road, Beibei district, Chongqing, 400715, China.
- Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, China.
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15
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The Transdiagnostic Nature of Cravings: Smoking Cessation and Food Craving in Pregnancy. Midwifery 2020; 87:102730. [PMID: 32434103 DOI: 10.1016/j.midw.2020.102730] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 03/08/2020] [Accepted: 04/10/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Smoking cessation prior to pregnancy is strongly encouraged due to the adverse effects of tobacco use on the developing fetus, but appears to also increase risk of excess gestational weight gain (GWG). Smoking cessation has previously been shown to cause weight gain in non-pregnant individuals, in part due to an increase in food craving frequency. Food craving frequency in pregnancy is a known predictor of excess GWG, but has not yet been examined in relation to pre-pregnancy smoking status. This study sought to test the hypothesis that pre-pregnancy smoking cessation elevates excess GWG risk via an increase in food craving frequency. METHODS Pregnant women (n = 82) completed measures of pre-pregnancy tobacco use and current general and specific food cravings. Gestational weight gain was calculated based on participant self-report of pre-pregnancy weight and data on weight prior to delivery culled from medical records. RESULTS Pre-pregnancy tobacco use was associated with significantly greater food craving frequency in pregnancy (p = .05), specifically for high-fat and fast-foods (both p < .05), compared to women who did not smoke. Emotional and physiological aspects of cravings accounted for 35% of the variance in excess GWG (p < .03). CONCLUSIONS Pre-pregnancy smoking appears predictive of food raving frequency in pregnancy and could thus contribute to excess GWG risk. Findings highlight the importance of incorporating strategies for managing cravings into behavioral interventions promoting healthy GWG for women endorsing pre-pregnancy tobacco use.
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16
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Fasting may increase incentive signaling for nonfood rewards. Nutr Res 2020; 77:43-53. [PMID: 32315894 DOI: 10.1016/j.nutres.2020.02.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 02/21/2020] [Accepted: 02/27/2020] [Indexed: 11/22/2022]
Abstract
During acute energy deprivation, hunger signaling mechanisms support homeostasis by enhancing incentive for food. There is some evidence (primarily based on nonhuman experiments) that fasting heightens incentive signaling for nonfood reward as well. We hypothesized that, consistent with results from research in rodent and nonhuman primates, human participants would evidence increased incentive-related brain activity for nonfood rewards during fast (relative to satiety) and that this increase would be heightened when available rewards were immediate. To assess these possibilities, healthy participants with body mass index between 18 and 29 kg/m2 completed a task which engaged participants in opportunities to win immediate and delayed money (Monetary Incentive Delay Task) during 2 neuroimaging sessions (1 postprandial, 1 fasted). Analyses of participants (N = 18 included, body mass index 22.12± 2.72, age 21.39± 3.52) focused on brain activity during the incentive window of the task. Region of interest, as well as whole-brain analyses, supported the hypothesized increase in incentive signaling during fasting in regions that included caudate and putamen. No evidence of interaction was observed between fasting and the effect of reward immediacy or reward magnitude. Although provisional given the modest sample size, these results suggest that acute fasting can heighten incentive signaling for nonfood rewards.
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17
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Gass JC, Tiffany ST. Assessment of the Choice Behavior Under Cued Conditions (CBUCC) paradigm as a measure of motivation to smoke under laboratory conditions. Addiction 2020; 115:302-312. [PMID: 31390087 DOI: 10.1111/add.14771] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 04/24/2019] [Accepted: 07/26/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS The Choice Behavior under Cued Conditions (CBUCC) task uses three indices of tobacco use (consumption, money spent to access a cigarette and latency to reach for a cigarette) to assess motivation to smoke under laboratory conditions. Initial research with this procedure has shown that it can evince cue-specific craving and differential responding for smoking versus a neutral cue. This study aimed to replicate these findings and assess the interaction of cue-specific craving and behavior with abstinence prior to testing. DESIGN A mixed repeated-measures between-groups factorial design was used. Participants attended a morning laboratory session in which they were randomized to remain abstinent or smoke as usual (between-groups factor) and returned in the afternoon to complete CBUCC. In this, participants were exposed to 40 experimental trials. In each trial they were exposed to a cigarette or water cue behind a movable glass door (repeated-measures factor). SETTING University at Buffalo, New York, USA. PARTICIPANTS Participants were 106 daily non-treatment-seeking cigarette smokers, data from 102 were used. MEASUREMENTS On each of 40 trials, participants rated cigarette craving, and behavioral measures from the CBUCC (money spent, latency to access the cue, puff duration) were recorded. FINDINGS Craving and CBUCC behavioral measures showed high internal reliability across trials (Cronbach alphas ranged from 0.88 to 0.98). Craving and money spent were higher in trials with the cigarette cue than the water cue (F(1100) = 45.49, P < 0.001 and F(1100) = 116.26, P < 0.001). Other CBUCC measures did not show a significant effect of cue type. The difference in spending between cigarette and water cues was larger for abstinent participants than non-abstinent participants (F(1100) = 5.0, P = 0.03). Other CBUCC measures did not show a significant interaction between abstinence and cue type. Craving on smoking trials was significantly correlated with cigarette spending (r = 0.54, P < 0.001) in the non-abstinence condition but not in the abstinence condition. CONCLUSIONS Craving and 'money spent' in the Choice Behavior under Cued Conditions task (CBUCC) appears to be responsive to cigarette versus water cues, and money spent appears to show greater difference in responsiveness to cigarette than water cues after abstinence.
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Affiliation(s)
- Julie C Gass
- Department of Psychology, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Stephen T Tiffany
- Department of Psychology, University at Buffalo, State University of New York, Buffalo, NY, USA
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18
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Lycett D, Aveyard P, Farmer A, Lewis A, Munafò M. Referral to Slimming World in UK Stop Smoking Services (SWISSS) versus stop smoking support alone on body weight in quitters: results of a randomised controlled trial. BMJ Open 2020; 10:e032271. [PMID: 31988226 PMCID: PMC7045045 DOI: 10.1136/bmjopen-2019-032271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Most people who stop smoking gain weight. Dietary modification may seem an obvious solution, but food restriction may increase cigarette craving and smoking relapse. TRIAL DESIGN An unblinded parallel randomised controlled trial. METHODS Participants were adult smokers with a body mass index greater or equal to 23 kg/m2. Setting was National Health Service commissioned Stop Smoking Services, interventions were referral to a commercial weight management programme, plus stop smoking support (treatment group), compared with stop smoking support alone (control group). Objective was to compare weight change between interventions in smoking abstainers and not abstinent rates in all. Primary outcome was change in weight (kg) at 12 weeks. Randomisation sequence was computer generated and concealed until allocation. RESULTS Seventy-six participants were recruited, 37 were randomised to the treatment group and 39 to the control group. Change in weight was analysed in long-term abstainers (13 treatment, 14 control) only because the aim was to prevent weight gain associated with smoking cessation. Abstinence was analysed on an intention-to-treat basis (37 treatment, 39 control). At 12 weeks weight gain was less in the treatment than the control group with an adjusted mean difference of -2.3 kg 95% CI (-4.4 to -0.1). Craving scores were lower (Mood and Physical Symptoms Scale craving domain -1.6 (-2.7 to -0.5)) and quit rates were higher in the treatment than the control group (32% vs 21%), although the trial was not powered to superiority in cravings and quit rates. No adverse events or side effects were reported. CONCLUSION In people who are obese and want to quit smoking, these data provide modest encouragement that providing weight management at the time of quitting may be helpful. Those who are not obese, but who are informed about potential weight gain during their quit attempt, were uninterested in a weight management programme. TRIAL REGISTRATION NUMBER ISRCTN65705512.
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Affiliation(s)
- Deborah Lycett
- Faculty of Health and Life Sciences, Coventry University, Coventry, West Midlands, UK
| | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire, UK
| | - Andrew Farmer
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire, UK
| | - Amanda Lewis
- Population Health Sciences Bristol Medical School, University of Bristol, Bristol, UK
| | - Marcus Munafò
- School of Experimental Psychology, University of Bristol, Bristol, UK
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Powers JM, LaRowe LR, Heckman BW, Ditre JW. Pain characteristics and nicotine deprivation as predictors of performance during a laboratory paradigm of smoking cessation. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2019; 34:341-350. [PMID: 31750703 DOI: 10.1037/adb0000532] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Although smokers with co-occurring pain report expectations for experiencing greater nicotine withdrawal and difficulty quitting, limited work has examined the role of pain in cessation-related outcomes. The goal of this study was to examine clinically relevant pain characteristics (pain persistence, pain intensity, pain-related disability) as predictors of withdrawal and smoking lapse/relapse outcomes using a laboratory paradigm of cessation. Participants (N = 120 daily cigarette smokers; 48% male; Mage = 36.17, SD = 12.16; MCigarettes Per Day = 20.51, SD = 6.99) were randomized to either nondeprived or 12-hr nicotine deprivation conditions prior to an experimental study visit. Upon arrival to the laboratory, participants completed measures of pain characteristics and nicotine withdrawal symptoms. Primary outcomes included nicotine withdrawal scores and analogues of smoking lapse (latency to initiating smoking) and relapse (number of cigarettes smoked). We hypothesized that smokers with greater pain persistence, pain intensity, and pain-related disability would endorse more severe nicotine withdrawal and greater lapse/relapse behavior, and that these positive associations would be stronger among those who were nicotine deprived. Results indicated that, above and beyond the effect of nicotine deprivation, persistent pain predicted more severe nicotine withdrawal, and that greater pain-related disability predicted quicker latency to lapse during the laboratory paradigm. Contrary to expectation, nicotine deprivation did not moderate effects of pain characteristics on withdrawal or lapse/relapse outcomes. Clinical implications include that different pain processes may influence different cessation outcomes, and that smokers in pain may benefit from the provision of pharmacological aids to better control withdrawal symptoms. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Cortland CI, Shapiro JR, Guzman IY, Ray LA. The ironic effects of stigmatizing smoking: combining stereotype threat theory with behavioral pharmacology. Addiction 2019; 114:1842-1848. [PMID: 31140666 DOI: 10.1111/add.14696] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 10/01/2018] [Accepted: 05/17/2019] [Indexed: 12/01/2022]
Abstract
AIMS Public service announcements often create media messages intended to stigmatize negative behaviors to reduce and prevent these behaviors. Drawing on social and cognitive psychology, we hypothesize that stigmatizing messages can create stereotype threat would be associated with shorter latency to first cigarette in the laboratory compared to the control condition. DESIGN A double-blind, randomized, controlled trial in which participants completed two smoking lapse tasks, one at baseline and one post-intervention/control. SETTING An experimental psychopharmacology laboratory in the western United States. PARTICIPANTS A community sample of non-treatment-seeking daily smokers (n = 77) received either a stereotype threat (n = 39) or neutral/control (n = 38) message. INTERVENTION Participants received either a stereotype threat message that stigmatized smoking or a control message. MEASUREMENTS The primary outcome measure was participants' ability to delay smoking during the smoking lapse task in the experimental session FINDINGS: The difference in delay time during the experimental session at the point where 50% of each group had smoked was 3 minutes. Cox proportional hazard models revealed that participants in the stereotype threat group were significantly less able to delay initiating smoking compared to the control group (hazard ratio = 0.504, P = 0.010, 95% confidence interval = 0.30, 0.85), after controlling for baseline latency to smoke. CONCLUSIONS Messages that elicit negative stereotypes of smokers operated as 'smoking-promoting messages' in the context of our controlled laboratory investigation.
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Affiliation(s)
- Clarissa I Cortland
- Department of Psychology, The University of California, Los Angeles, CA, USA
| | - Jenessa R Shapiro
- Department of Psychology, The University of California, Los Angeles, CA, USA
| | - Iris Y Guzman
- Department of Psychology, The University of California, Los Angeles, CA, USA
| | - Lara A Ray
- Department of Psychology, The University of California, Los Angeles, CA, USA
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Effects of the Nicotinic Partial Agonist Varenicline on Smoking Lapse Behaviour in Schizophrenia. CANADIAN JOURNAL OF ADDICTION 2019. [DOI: 10.1097/cxa.0000000000000052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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De La Garza R, Shuman SL, Yammine L, Yoon JH, Salas R, Holst M. A Pilot Study of E-Cigarette Naïve Cigarette Smokers and the Effects on Craving After Acute Exposure to E-Cigarettes in the Laboratory. Am J Addict 2019; 28:361-366. [PMID: 31066987 DOI: 10.1111/ajad.12895] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 03/27/2019] [Accepted: 04/14/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Recent surveys confirm continued increases in the use of electronic-cigarettes (e-cigarettes) in adolescents and adults. Users often state that e-cigarettes reduce tobacco craving and withdrawal symptoms in addition to their smoking. Data from laboratory studies and clinical trials have confirmed these statements, though there are inconsistencies in the outcomes. In this pilot study, we set out to evaluate the effects of e-cigarettes, as compared to the participants' own cigarettes, on baseline craving and smoking severity. METHODS Using a within-subjects, placebo-controlled study design, 15 tobacco-dependent, e-cigarette naïve participants sustained abstinence overnight. They completed distinct phases of this protocol during four separate study sessions. Participants were randomized to an e-cigarette device containing one of three doses of nicotine (0, 18, or 36 mg/ml) or their own cigarette. Each study visit was ~3 hours long and separated by at least 7 days. Visits included assessments of craving and smoking severity. RESULTS The data showed that after 10 puffs in both the Own cigarette and e-cigarette conditions, breath carbon monoxide levels increased significantly in the former but not the latter. Questionnaire of Smoking Urges and Choices to Smoke scores were not statistically different across groups after two distinct bouts of 10 puffs each. Additionally, E-cigarette Perceptions Questionnaire responses were not significantly different according to dose. CONCLUSION AND SCIENTIFIC SIGNIFICANCE This experiment provides data demonstrating that e-cigarettes did not reduce craving or smoking severity in e-cigarette naïve users. However, since this was a pilot study, the conclusions that can be drawn are limited. (Am J Addict 2019;28:361-366).
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Affiliation(s)
- Richard De La Garza
- Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | - Samuel L Shuman
- Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | - Luba Yammine
- Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | - Jin Ho Yoon
- Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | - Ramiro Salas
- Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | - Manuela Holst
- Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, Texas
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Ovarian Hormones and Transdermal Nicotine Administration Independently and Synergistically Suppress Tobacco Withdrawal Symptoms and Smoking Reinstatement in the Human Laboratory. Neuropsychopharmacology 2018; 43:828-837. [PMID: 28905874 PMCID: PMC5809791 DOI: 10.1038/npp.2017.216] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 09/08/2017] [Accepted: 09/10/2017] [Indexed: 12/19/2022]
Abstract
Modeling intra-individual fluctuations in estradiol and progesterone may provide unique insight into the effects of ovarian hormones on the etiology and treatment of nicotine dependence. This randomized placebo-controlled laboratory study tested the independent and interactive effects of intra-individual ovarian hormone variation and nicotine on suppression of tobacco withdrawal symptoms and smoking behavior. Female smokers randomized to 21 mg nicotine (TNP; n=37) or placebo (PBO; n=43) transdermal patch following overnight abstinence completed three sessions occurring during hormonally distinct menstrual cycle phases. At each session, participants provided saliva for hormone assays and completed repeated self-report measures (ie, tobacco withdrawal symptoms, smoking urge, and negative affect (NA)) followed by an analog smoking reinstatement task for which participants could earn money to delay smoking and subsequently purchase cigarettes to smoke. Higher (vs lower) progesterone levels were associated with greater reductions in NA. Higher (vs lower) progesterone levels and progesterone to estradiol ratios were associated with reducing smoking urges over time to a greater extent with TNP compared to PBO. There was an interaction between Patch and estradiol on NA. With TNP, higher-than-usual estradiol was associated with greater decreases in NA. However with PBO, lower-than-usual estradiol was associated with greater decreases in NA. These results suggest that the effects of TNP on mood- and smoking-related outcomes may vary depending on the ovarian hormone levels.
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Boyraz G, Cherry ML, Cherry MA, Aarstad-Martin S, Cloud C, Shamp LM. Posttraumatic Stress, Coping Flexibility, and Risky Drinking Among Trauma-Exposed Male and Female College Students: The Mediating Effect of Delay of Gratification. Subst Use Misuse 2018; 53:508-520. [PMID: 28857646 DOI: 10.1080/10826084.2017.1342658] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND The co-occurence of posttraumatic stress (PTS) and risky drinking has been demonstrated in diverse populations, including college students. However, the mechanisms underlying this co-occurrence, as well as the protective factors that may reduce risky drinking among trauma-exposed college students have yet to be fully understood in the literature. OBJECTIVES The present study builds upon self-regulation theories and previous empirical work to determine whether the effects of PTS and coping flexibility on risky drinking were mediated by delay of gratification among trauma-exposed college students. In addition, the potential moderating effect of gender on these relationships was examined. METHODS Participants included 624 trauma-exposed college students (68.4% female) attending a public university in the southeast region of the United States. Data were collected through an online survey. The hypothesized model was examined using a multigroup structural equation modeling approach. RESULTS As hypothesized, PTS had a significant, positive indirect effect on risky drinking through delay of gratification; however, the effect of PTS on delay of gratification was stronger for males than for females. Results also indicated that the indirect effect of coping flexibility on risky drinking through delay of gratification was significant and negative for males and females. Conclusions/Importance: The findings of this study suggest that delay of gratification might be an important mechanism underlying the co-occurrence of PTS and risky drinking. In addition, our results highlight the potential benefits of coping flexibility for college students coping with PTS.
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Affiliation(s)
- Güler Boyraz
- a Department of Psychology and Behavioral Sciences , Louisiana Tech University , Ruston , Louisiana , USA
| | - Megan L Cherry
- a Department of Psychology and Behavioral Sciences , Louisiana Tech University , Ruston , Louisiana , USA
| | - Marcus A Cherry
- a Department of Psychology and Behavioral Sciences , Louisiana Tech University , Ruston , Louisiana , USA
| | - Samantha Aarstad-Martin
- a Department of Psychology and Behavioral Sciences , Louisiana Tech University , Ruston , Louisiana , USA
| | - Cody Cloud
- a Department of Psychology and Behavioral Sciences , Louisiana Tech University , Ruston , Louisiana , USA
| | - Lindsey M Shamp
- a Department of Psychology and Behavioral Sciences , Louisiana Tech University , Ruston , Louisiana , USA
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Kim JE, Flentje A, Tsoh JY, Riley ED. Cigarette Smoking among Women Who Are Homeless or Unstably Housed: Examining the Role of Food Insecurity. J Urban Health 2017; 94:514-524. [PMID: 28589340 PMCID: PMC5533665 DOI: 10.1007/s11524-017-0166-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Smoking prevalence remains high among individuals who are homeless, partly due to stressors related to homelessness. Beyond housing insecurity, homelessness involves financial stresses and unmet subsistence needs. In particular, food insecurity contributes to negative health outcomes and other health risks. This study examined associations between food insecurity severity and smoking among homeless and marginally housed women in San Francisco, California. We used data from 247 women from a longitudinal cohort study. Generalized estimating equations were used to estimate longitudinal associations between study factors and smoking based on data from five biannual assessment points between 2009 and 2012. The longitudinal adjusted odds of smoking were higher among severely food insecure individuals compared to those who were not food insecure (AOR = 1.68, 95% CI [1.02, 2.78]), while associations with other study factors, including demographics, time, HIV status, mental health, and substance use (except marijuana use), did not reach levels of significance. Similar adjusted longitudinal results were observed when food insecurity was the dependent variable and smoking an independent variable, suggesting the possibility of a bidirectional association. Considering unmet needs, such as food and hunger, may improve comprehensive smoking cessation strategies targeting individuals for whom mainstream tobacco control efforts have not been effective. Similarly, offering improved access to smoking cessation resources should be considered in efforts to address food insecurity among individuals experiencing homelessness.
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Affiliation(s)
- Jin E Kim
- University of California San Francisco, San Francisco, CA, USA.
| | - Annesa Flentje
- University of California San Francisco, San Francisco, CA, USA
| | - Janice Y Tsoh
- University of California San Francisco, San Francisco, CA, USA
| | - Elise D Riley
- University of California San Francisco, San Francisco, CA, USA
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26
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Affiliation(s)
- Brett M. Millar
- Health Psychology & Clinical Science Doctoral Program, The Graduate Center, City University of New York (CUNY), New York, NY, USA
- Center for HIV/AIDS Educational Studies & Training (CHEST), Hunter College, CUNY, New York, NY, USA
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Heckman BW, MacQueen DA, Marquinez NS, MacKillop J, Bickel WK, Brandon TH. Self-control depletion and nicotine deprivation as precipitants of smoking cessation failure: A human laboratory model. J Consult Clin Psychol 2017; 85:381-396. [PMID: 28333537 PMCID: PMC5364802 DOI: 10.1037/ccp0000197] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The need to understand potential precipitants of smoking relapse is exemplified by relapse rates as high as 95%. The Self-Control Strength model, which proposes that self-control is dependent upon limited resources and susceptible to fatigue, may offer insight into relapse processes. The current study tested the hypothesis that self-control depletion (SCD), produced from engagement in emotional suppression, would serve as a novel antecedent for cessation failure, as indexed by a validated laboratory analogue of smoking lapse and relapse. We also examined whether SCD effects interacted with those of a well-established relapse precipitant (i.e., nicotine deprivation). Craving and behavioral economic indices (delay discounting and demand) were tested as hypothesized mechanisms for increased cessation failure. Ultimately, a moderated mediation model was used to test nicotine deprivation as a hypothesized moderator of SCD effects. METHOD We used a 2 × 2 (12-hr deprivation vs. no deprivation; SCD vs. no SCD) factorial between-subjects design (N = 128 smokers). RESULTS The primary hypothesis of the study was supported, as SCD increased lapse behavior (p = .04). Nicotine deprivation significantly increased craving, cigarette demand, delay discounting, and lapse behavior. No main effects were found for SCD on putative mediators (i.e., craving, demand, and discounting), but the SCD and deprivation manipulations interacted upon craving (p = .04). The moderated mediation model was significant. SCD was found to increase craving among nicotine deprived smokers, which mediated effects on lapse behavior. CONCLUSIONS SCD appears to play an important role in smoking relapse and may be a viable target for intervention. (PsycINFO Database Record
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Affiliation(s)
- Bryan W Heckman
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina
| | | | | | - James MacKillop
- Department of Psychiatry & Behavioural Neurosciences, Peter Boris Centre for Addictions Research, McMaster University
| | - Warren K Bickel
- Department of Psychiatry and Behavioral Medicine, Virginia Tech Carilion Research Institute
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Murphy CM, Owens MM, Sweet LH, MacKillop J. The substitutability of cigarettes and food: A behavioral economic comparison in normal weight and overweight or obese smokers. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2016; 30:857-867. [PMID: 27736143 DOI: 10.1037/adb0000223] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Obesity and cigarette smoking contribute to a multitude of preventable deaths in the United States and eating and smoking behavior may influence each other. The field of behavioral economics integrates principles from psychology and economics and permits systematic examination of how commodities interrelate with one another. Using this framework, the current study evaluated the effects of rising food and cigarette prices on consumption to investigate their substitutability and their relationship to BMI and associated variables. Behavioral economics categorizes commodities as substitutable when the consumption of one increases as a function of a price increase in the other. Smokers (N = 86) completed a 2-part hypothetical task in which money was allocated to purchase cigarettes and fast-food-style reinforcers (e.g., hamburgers, ice cream) at various prices. Results indicated that food and cigarettes were not substitutes for one another (cross-price elasticity coefficients < .20). Food purchases were independent of cigarette price, whereas cigarette purchases decreased as food price rose. Cross-price elasticity coefficients were significantly associated with confidence in one's ability to control weight without smoking (rs = -.23 and .29), but not BMI (rs = .04 and .04) or postcessation weight concerns (rs = -.05 and .12). Perceived ability to manage weight without cigarettes may influence who substitutes food for cigarettes when quitting. In addition, given observed decreases in purchases of both commodities as food prices increased, these findings imply that greater taxation of fast-food-style reinforcers could potentially reduce consumption of these foods and also cigarettes among smokers. (PsycINFO Database Record
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Affiliation(s)
| | - Max M Owens
- Department of Psychology, University of Georgia
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Schepis TS, Tapscott BE, Krishnan-Sarin S. Stress-related increases in risk taking and attentional failures predict earlier relapse to smoking in young adults: A pilot investigation. Exp Clin Psychopharmacol 2016; 24:110-9. [PMID: 26901590 PMCID: PMC4795968 DOI: 10.1037/pha0000066] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Substantial evidence links greater impulsivity and stress exposure to poorer smoking cessation outcomes. Results from adolescents also indicate that stress-related change in risk taking can impede cessation attempts. We investigated the effects of stress-related change in impulsivity, risk taking, attention and nicotine withdrawal, and craving in young adult smokers on time to smoking relapse in a relapse analogue paradigm. Twenty-six young adult smokers (50% women; mean age: 20.9 ± 1.8) were exposed to a stress imagery session followed by a contingency management-based relapse analogue paradigm. Participants smoked at least 5 cigarettes daily, with a mean baseline carbon monoxide (CO) level of 13.7 (± 5.1) ppm. Repeated measures analysis of variance (ANOVA) and paired t tests examined stress induction validity and Cox regressions of proportional hazards examined the effects of stress-related changes in nicotine withdrawal, nicotine craving, attention, impulsivity, and risk taking on time to relapse. While stress-related change in impulsivity, nicotine craving and withdrawal did not predict time to relapse (all ps > .10), greater stress-related increases in reaction time (RT) variability (p = .02) were predictive of shorter time to relapse, with trend-level findings for inattention and risk taking. Furthermore, changes in stress-related risk taking affected outcome in women more than in men, with a significant relationship between stress-related change in risk taking only in women (p = .026). Smoking cessation attempts in young adults may be adversely impacted by stress-related increases in risk taking and attentional disruption. Clinicians working with young adults attempting cessation may need to target these stress-related impairments by fostering more adaptive coping and resilience.
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Affiliation(s)
- Ty S. Schepis
- Texas State University, Department of Psychology, San Marcos, Texas, USA
| | - Brian E. Tapscott
- University of Rhode Island, Department of Psychology, Kingston, Rhode Island, USA
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Leventhal AM, Trujillo M, Ameringer KJ, Tidey JW, Sussman S, Kahler CW. Anhedonia and the relative reward value of drug and nondrug reinforcers in cigarette smokers. JOURNAL OF ABNORMAL PSYCHOLOGY 2015; 123:375-86. [PMID: 24886011 DOI: 10.1037/a0036384] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Anhedonia-a psychopathologic trait indicative of diminished interest, pleasure, and enjoyment-has been linked to use of and addiction to several substances, including tobacco. We hypothesized that anhedonic drug users develop an imbalance in the relative reward value of drug versus nondrug reinforcers, which could maintain drug use behavior. To test this hypothesis, we examined whether anhedonia predicted the tendency to choose an immediate drug reward (i.e., smoking) over a less immediate nondrug reward (i.e., money) in a laboratory study of non-treatment-seeking adult cigarette smokers. Participants (N = 275, ≥10 cigarettes/day) attended a baseline visit that involved anhedonia assessment followed by 2 counterbalanced experimental visits: (a) after 16-hr smoking abstinence and (b) nonabstinent. At both experimental visits, participants completed self-report measures of mood state followed by a behavioral smoking task, which measured 2 aspects of the relative reward value of smoking versus money: (1) latency to initiate smoking when delaying smoking was monetarily rewarded and (2) willingness to purchase individual cigarettes. Results indicated that higher anhedonia predicted quicker smoking initiation and more cigarettes purchased. These relations were partially mediated by low positive and high negative mood states assessed immediately prior to the smoking task. Abstinence amplified the extent to which anhedonia predicted cigarette consumption among those who responded to the abstinence manipulation, but not the entire sample. Anhedonia may bias motivation toward smoking over alternative reinforcers, perhaps by giving rise to poor acute mood states. An imbalance in the reward value assigned to drug versus nondrug reinforcers may link anhedonia-related psychopathology to drug use.
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Affiliation(s)
- Adam M Leventhal
- Department of Preventive Medicine, University of Southern California Keck School of Medicine
| | - Michael Trujillo
- Department of Preventive Medicine, University of Southern California Keck School of Medicine
| | - Katherine J Ameringer
- Department of Preventive Medicine, University of Southern California Keck School of Medicine
| | - Jennifer W Tidey
- Center for Alcohol and Addiction Studies, Brown University School of Public Health
| | - Steve Sussman
- Department of Preventive Medicine, University of Southern California Keck School of Medicine
| | - Christopher W Kahler
- Center for Alcohol and Addiction Studies, Brown University School of Public Health
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Heggen E, Svendsen M, Klemsdal TO, Tonstad S. Low Carbohydrate and Moderately Fat-Reduced Diets Similarly Affected Early Weight Gain in Varenicline-Treated Overweight or Obese Smokers. Nicotine Tob Res 2015; 18:1440-8. [PMID: 26242289 DOI: 10.1093/ntr/ntv164] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 07/21/2015] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Weight gain is common when stopping smoking. This study compared the effect of advising smokers to follow a diet low in carbohydrates versus a usual fat-reduced diet on weight gain and nicotine withdrawal. METHODS In a randomized clinical trial, 122 men and women smokers with body mass index 25-40kg/m(2) were assigned low-carbohydrate versus moderately fat-reduced diets. Within a week thereafter all participants started treatment with a 12-week course of varenicline 10 days prior to the target quit date. Brief dietary and motivational counseling was given at all visits. Self-reported abstinence was validated. RESULTS Protein intake in the low-carbohydrate versus fat-reduced diets was 26.4% of total energy versus 20.0%, fat 38.2% versus 30.1%, and carbohydrates 29.0% versus 41.7% (all P < .001). Mean weight changes for the low-carbohydrate versus fat-reduced groups were -1.2 (SD 2.2) versus -0.5 (SD 2.0) kg, -0.2 (SD 3.3) versus 0.5 (SD 2.6) kg, and 2.2 (SD 4.5) versus 2.1 (SD 3.9) kg at 4, 12, and 24 weeks after the target quit date, respectively (not statistically significant). Smoking abstinence rates did not differ between diets. In the combined groups, point prevalence abstinence rates were 71.0% at 12 weeks and 46.3% at 24 weeks. The Minnesota Nicotine Withdrawal Symptoms score was lower in the fat-reduced group compared with the low-carbohydrate group at weeks 4 and 12. CONCLUSIONS In overweight or obese smokers using varenicline a low-carbohydrate diet was no better than a fat-reduced diet in reducing weight gain but may result in more severe nicotine withdrawal symptoms. Compared to previous studies, cessation rates with varenicline were not impaired by dietary counseling. IMPLICATIONS The study implies that a popular low-carbohydrate diet does not result in greater weight loss than a moderately fat-reduced diet in overweight and obese smokers who are attempting to quit smoking with the aid of varenicline. Dietary counseling combined with varenicline treatment did not appear to unfavorably influence quit rates compared to previous studies in smokers not selected for overweight or obesity. Notably, the withdrawal symptoms score was lower in the fat-reduced dietary group than the low-carbohydrate group, suggesting a venue for further study.
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Affiliation(s)
- Eli Heggen
- Section for Preventive Cardiology, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Mette Svendsen
- Section for Preventive Cardiology, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Tor Ole Klemsdal
- Section for Preventive Cardiology, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Serena Tonstad
- Section for Preventive Cardiology, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
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Roseberry AG. Acute fasting increases somatodendritic dopamine release in the ventral tegmental area. J Neurophysiol 2015; 114:1072-82. [PMID: 26084913 DOI: 10.1152/jn.01008.2014] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 06/11/2015] [Indexed: 11/22/2022] Open
Abstract
Fasting and food restriction alter the activity of the mesolimbic dopamine system to affect multiple reward-related behaviors. Food restriction decreases baseline dopamine levels in efferent target sites and enhances dopamine release in response to rewards such as food and drugs. In addition to releasing dopamine from axon terminals, dopamine neurons in the ventral tegmental area (VTA) also release dopamine from their soma and dendrites, and this somatodendritic dopamine release acts as an autoinhibitory signal to inhibit neighboring VTA dopamine neurons. It is unknown whether acute fasting also affects dopamine release, including the local inhibitory somatodendritic dopamine release in the VTA. In these studies, I have tested whether fasting affects the inhibitory somatodendritic dopamine release within the VTA by examining whether an acute 24-h fast affects the inhibitory postsynaptic current mediated by evoked somatodendritic dopamine release (D2R IPSC). Fasting increased the contribution of the first action potential to the overall D2R IPSC and increased the ratio of repeated D2R IPSCs evoked at short intervals. Fasting also reduced the effect of forskolin on the D2R IPSC and led to a significantly bigger decrease in the D2R IPSC in low extracellular calcium. Finally, fasting resulted in an increase in the D2R IPSCs when a more physiologically relevant train of D2R IPSCs was used. Taken together, these results indicate that fasting caused a change in the properties of somatodendritic dopamine release, possibly by increasing dopamine release, and that this increased release can be sustained under conditions where dopamine neurons are highly active.
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Affiliation(s)
- Aaron G Roseberry
- Department of Biology, Center for Obesity Reversal, and Neuroscience Institute, Georgia State University, Atlanta, Georgia
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A preliminary study assessment of the nutritional status of alcohol dependent inpatients – cigarette smokers and non-smokers. ALCOHOLISM AND DRUG ADDICTION 2014. [DOI: 10.1016/s0867-4361(14)70025-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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Langdon KJ, Leventhal AM. Posttraumatic stress symptoms and tobacco abstinence effects in a non-clinical sample: evaluating the mediating role of negative affect reduction smoking expectancies. J Psychopharmacol 2014; 28:1009-17. [PMID: 25142407 PMCID: PMC4407802 DOI: 10.1177/0269881114546708] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The relation between posttraumatic stress symptoms and smoking is well documented but poorly understood. The present investigation sought to evaluate the impact of posttraumatic stress symptoms on subjective and behavioral tobacco abstinence effects both directly and indirectly through negative affect reduction smoking outcome expectancies. Participants included 275 (68.7% male; Mage =43.9, 10+ cig/day) adult non-treatment seeking smokers, who attended two counterbalanced laboratory sessions (16 h of smoking deprivation vs ad libitum smoking), during which they completed self-report measures of withdrawal symptoms and mood followed by a smoking lapse task in which they could earn money for delaying smoking and purchase cigarettes to smoke. Results supported a mediational pathway whereby higher baseline symptoms of posttraumatic stress predicted greater endorsement of expectancies that smoking will effectively reduce negative affect, which in turn predicted greater abstinence-provoked exacerbations in nicotine withdrawal symptoms and negative affect. Posttraumatic stress symptoms also predicted number of cigarettes purchased independent of negative affect reduction expectancies, but did not predict delaying smoking for money. Findings highlight tobacco abstinence effects as a putative mechanism underlying posttraumatic stress disorder (PTSD)-smoking comorbidity, indicate an important mediating role of beliefs for smoking-induced negative affect reduction, and shed light on integrated treatment approaches for these two conditions.
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Affiliation(s)
- Kirsten J Langdon
- National Center for PTSD, Women's Health Sciences Division, VA Boston Healthcare System, Boston, MA, USA Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Adam M Leventhal
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Zvolensky MJ, Farris SG, Guillot CR, Leventhal AM. Anxiety sensitivity as an amplifier of subjective and behavioral tobacco abstinence effects. Drug Alcohol Depend 2014; 142:224-30. [PMID: 25015688 PMCID: PMC4127105 DOI: 10.1016/j.drugalcdep.2014.06.023] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 05/01/2014] [Accepted: 06/17/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Anxiety sensitivity, a transdiagnostic cognitive vulnerability factor described as an amplifier of negative emotional states, is implicated in the maintenance of cigarette smoking and cessation difficulties. The current study aimed to examine the role of anxiety sensitivity in predicting abstinence-induced changes in nicotine withdrawal, smoking urges and smoking behavior during an experimental relapse analogue task (RAT). METHOD Participants were 258 non-treatment seeking smokers (M [SD] age=44.0 [10.73]; 69.8% male). Participants attended two counterbalanced experimental sessions including smoking deprivation (16 h of smoking abstinence) and smoking as usual. The Minnesota Nicotine Withdrawal Scale (MNWS) and Brief Questionnaire of Smoking Urges (QSU) were completed at each session in addition to the RAT. Hierarchical regressions were conducted to examine the predictive impact of anxiety sensitivity on withdrawal and urges during smoking deprivation. Follow-up mediational analyses were conducted to examine whether abstinence-induced withdrawal and urges mediated responding during the RAT. RESULTS Anxiety sensitivity amplified the effects of experimentally manipulated acute abstinence on subjective nicotine withdrawal symptoms and smoking urges. Additionally, higher levels of anxiety sensitivity indirectly predicted shorter latency to smoking initiation after deprivation during the RAT through the effects of greater abstinence-induced nicotine withdrawal and smoking urges. Anxiety sensitivity was unrelated to increased smoking during the RAT, although this may be partially attributed to the type of laboratory assessment employed. CONCLUSIONS Elevated anxiety sensitivity appears to impact initiation of smoking after nicotine deprivation through the effects of abstinence-induced withdrawal and smoking urges.
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Affiliation(s)
- Michael J Zvolensky
- University of Houston, Department of Psychology, Fred J. Heyne Building, Suite 104, Houston, TX 77204, USA; The University of Texas MD Anderson Cancer Center, Department of Behavioral Science, 1155 Pressler Street, Houston, TX 77030, USA.
| | - Samantha G Farris
- The University of Texas MD Anderson Cancer Center, Department of Behavioral Science, 1155 Pressler Street, Houston, TX 77030, USA
| | - Casey R Guillot
- University of Southern California Keck School of Medicine, Department of Preventive Medicine, 2250 Alcazar, St, CSC 240, Los Angeles, CA 90033, USA
| | - Adam M Leventhal
- University of Southern California Keck School of Medicine, Department of Preventive Medicine, 2250 Alcazar, St, CSC 240, Los Angeles, CA 90033, USA; University of Southern California, Department of Psychology, 2250 Alcazar, St, CSC 240, Los Angeles, CA 90033, USA
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Day AM, Kahler CW, Spillane NS, Metrik J, Rohsenow DJ. Length of smoking deprivation moderates the effects of alcohol administration on urge to smoke. Addict Behav 2014; 39:976-9. [PMID: 24556154 DOI: 10.1016/j.addbeh.2014.01.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Revised: 01/23/2014] [Accepted: 01/29/2014] [Indexed: 11/29/2022]
Abstract
Although smoking deprivation is often used in laboratory studies to induce urges to smoke cigarettes, the optimal length of deprivation has not been established. Previous research showed that overnight abstinence from cigarettes led to high baseline urge to smoke that potentially masked alcohol's acute effects on urge to smoke (Kahler et al., 2012). The current study examined whether alcohol's effects on smoking urge were more pronounced when a shorter length of smoking deprivation was used (i.e., 3h instead of overnight abstinence). Using a balanced placebo design for alcohol administration, we found that participants experienced a significant increase in self-reported urge to smoke when administered alcohol after a 3-h smoking deprivation (n=32), whereas this effect was smaller and nonsignificant when smokers were required to be abstinent overnight (n=96). Research on factors that heighten smoking urges may find stronger effects if a 3-h deprivation is used compared to using overnight abstinence.
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Affiliation(s)
- Anne M Day
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box G-S121-4, Providence, RI, 02912, United States.
| | - Christopher W Kahler
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box G-S121-4, Providence, RI, 02912, United States
| | - Nichea S Spillane
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box G-S121-4, Providence, RI, 02912, United States
| | - Jane Metrik
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box G-S121-4, Providence, RI, 02912, United States; Providence Veterans Affairs Medical Center, Providence, RI 02908, United States
| | - Damaris J Rohsenow
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box G-S121-4, Providence, RI, 02912, United States; Providence Veterans Affairs Medical Center, Providence, RI 02908, United States
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Factors associated with weight changes in successful quitters participating in a smoking cessation program. Addict Behav 2014; 39:239-45. [PMID: 24140303 DOI: 10.1016/j.addbeh.2013.10.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 09/03/2013] [Accepted: 10/01/2013] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To identify possible predictors of post-cessation weight gain in smoking abstainers. PATIENTS AND METHODS A sample of 607 successful abstainers seen at the Centre for Tobacco-Dependent in Prague, Czech Republic, between 2005 and 2010, was included in this analysis. This sample was followed up for 1year and included 47.9% women (N=291) with the mean age of 48years (18-85). FINDINGS Post-cessation weight gain occurred in 88.6% of the 607 abstainers. The mean weight gain after one year post-quit was 5.1kg (95% confidence interval 4.7-5.5kg). Baseline characteristics associated with increased weight gain included a higher baseline smoking rate (p<0.001), more severe cigarette dependence (p=0.003), less physical activity (p=0.008), and a report of increased appetite on the baseline assessment of withdrawal symptoms (p<0.001). CONCLUSIONS Smokers who are more dependent and have minimal physical activity are at increased risk for post-cessation weight gain. For these smokers, incorporating interventions targeting the weight issue into tobacco dependence treatment is recommended. Further research should be done to identify reasons for this important quitting complication.
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Stein KF, Chen DG(D, Corte C, Keller C, Trabold N. Disordered eating behaviors in young adult Mexican American women: prevalence and associations with health risks. Eat Behav 2013; 14:476-83. [PMID: 24183140 PMCID: PMC5731461 DOI: 10.1016/j.eatbeh.2013.08.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 07/23/2013] [Accepted: 08/07/2013] [Indexed: 11/30/2022]
Abstract
Recent research has shown that disordered eating behaviors are as prevalent in heterogenous samples of Latinas living in the U.S. as in non-Hispanic white women, yet less is known about the prevalence in women of Mexican origin. The primary purpose of this study is to report the prevalence and associations among DE behaviors and health risk of alcohol, tobacco use and obesity in a sample of N = 472 young adult college enrolled Mexican American (MA) women living in the United States. This report focuses on baseline data from a 12-month repeated measures longitudinal study. Ecological momentary assessment (EMA) was used to capture the prevalence of disordered eating and health risk behaviors in the context of everyday activities. Disordered eating behaviors including purging, binge eating, fasting and exercise were reported by approximately 15% of the sample. Food/calorie restricting, was the most prevalent behavior reported by 48% of the sample and along with binge eating was a positive predictor of BMI. Fasting was the only disordered eating behavior associated with tobacco use. These findings suggest that subclinical levels of DE behaviors are prevalent in a community sample of women of Mexican origin and are associated with health risks of tobacco use and higher BMI. Early identification of DE behaviors and community-based interventions targeting MA women may help reduce disparities associated with overweight and obesity in this population.
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Affiliation(s)
- Karen Farchaus Stein
- University of Rochester, School of Nursing, 601 Elmwood Avenue, Box SON, Rochester, NY 14642, USA.
| | - Ding-Geng (Din) Chen
- University of Rochester, School of Nursing, 601 Elmwood Avenue, Box SON Rochester, NY 14642 USA
| | - Colleen Corte
- University of Illinois, Chicago, School of Nursing, 845 South Damen Avenue (MC 802) Chicago, IL 60612 USA
| | - Colleen Keller
- Arizona State University, College of Nursing and Health Innovation, 500 N. 3 Street, Phoenix, AZ 85004 USA
| | - Nicole Trabold
- University of Rochester, School of Nursing, 601 Elmwood Avenue, Box SON Rochester, NY 14642 USA
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Elman I, Borsook D, Volkow ND. Pain and suicidality: insights from reward and addiction neuroscience. Prog Neurobiol 2013; 109:1-27. [PMID: 23827972 PMCID: PMC4827340 DOI: 10.1016/j.pneurobio.2013.06.003] [Citation(s) in RCA: 156] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 06/03/2013] [Accepted: 06/18/2013] [Indexed: 01/09/2023]
Abstract
Suicidality is exceedingly prevalent in pain patients. Although the pathophysiology of this link remains unclear, it may be potentially related to the partial congruence of physical and emotional pain systems. The latter system's role in suicide is also conspicuous during setbacks and losses sustained in the context of social attachments. Here we propose a model based on the neural pathways mediating reward and anti-reward (i.e., allostatic adjustment to recurrent activation of the reward circuitry); both are relevant etiologic factors in pain, suicide and social attachments. A comprehensive literature search on neurobiology of pain and suicidality was performed. The collected articles were critically reviewed and relevant data were extracted and summarized within four key areas: (1) physical and emotional pain, (2) emotional pain and social attachments, (3) pain- and suicide-related alterations of the reward and anti-reward circuits as compared to addiction, which is the premier probe for dysfunction of these circuits and (4) mechanistically informed treatments of co-occurring pain and suicidality. Pain-, stress- and analgesic drugs-induced opponent and proponent states of the mesolimbic dopaminergic pathways may render reward and anti-reward systems vulnerable to sensitization, cross-sensitization and aberrant learning of contents and contexts associated with suicidal acts and behaviors. These findings suggest that pain patients exhibit alterations in the brain circuits mediating reward (depressed function) and anti-reward (sensitized function) that may affect their proclivity for suicide and support pain and suicidality classification among other "reward deficiency syndromes" and a new proposal for "enhanced anti-reward syndromes". We suggest that interventions aimed at restoring the balance between the reward and anti-reward networks in patients with chronic pain may help decreasing their suicide risk.
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Affiliation(s)
- Igor Elman
- Providence VA Medical Center and Cambridge Health Alliance, Harvard Medical School, 26 Central Street, Somerville, MA 02143, USA.
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Acker J, MacKillop J. Behavioral economic analysis of cue-elicited craving for tobacco: a virtual reality study. Nicotine Tob Res 2013; 15:1409-16. [PMID: 23322768 PMCID: PMC3715390 DOI: 10.1093/ntr/nts341] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Accepted: 12/11/2012] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Subjective craving is a prominent construct in the study of tobacco motivation; yet, the precise measurement of tobacco craving poses several difficulties. A behavioral economic approach to understanding drug motivation imports concepts and methods from economics to improve the assessment of craving. METHODS Using an immersive virtual reality (VR) cue reactivity paradigm, this study tested the hypothesis that, compared with neutral cues, tobacco cues would result in significant increases in subjective craving and diverse aspects of demand for tobacco in a community sample of 47 regular smokers. In addition, the study examined these motivational indices in relation to a dual-component delay and cigarette consumption self-administration paradigm. RESULTS In response to the VR tobacco cues, significant increases were observed for tobacco craving and the demand indices of Omax (i.e., maximum total expenditure toward cigarettes) and Breakpoint (i.e., price at which consumption is completely suppressed), whereas a significant decrease was observed for Elasticity (i.e., lower cigarette price sensitivity). Continuous analyses revealed trend-level inverse associations between Omax and Intensity in relation to delay duration and significant positive associations between subjective craving, Omax, and Elasticity in relation to the number of cigarettes purchased. CONCLUSIONS The results from this study provide further evidence for the utility of behavioral economic concepts and methods in understanding smoking motivation. These data also reveal the incremental contribution of behavioral economic indices beyond subjective craving in predicting in vivo cigarette consumption. Relationships to previous studies and methodological considerations are discussed.
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Affiliation(s)
- John Acker
- Department of Psychology, University of Georgia, Athens, GA;
| | - James MacKillop
- Department of Psychology, University of Georgia, Athens, GA;
- Department of Behavioral and Social Sciences, Brown University, Providence, RI
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Leeman RF, Corbin WR, Nogueira C, Krishnan-Sarin S, Potenza MN, O'Malley SS. A human alcohol self-administration paradigm to model individual differences in impaired control over alcohol use. Exp Clin Psychopharmacol 2013; 21:303-14. [PMID: 23937598 PMCID: PMC4131292 DOI: 10.1037/a0033438] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We developed an alcohol self-administration paradigm to model individual differences in impaired control. The paradigm includes moderate drinking guidelines meant to model limits on alcohol consumption, which are typically exceeded by people with impaired control. Possible payment reductions provided a disincentive for excessive drinking. Alcohol use above the guideline, despite possible pay reductions, was considered to be indicative of impaired control. Heavy-drinking 21- to 25-year-olds (n = 39) were randomized to an experimental condition including the elements of the impaired control paradigm or to a free-drinking condition without these elements. Alcohol self-administration was compared between these two conditions to establish the internal validity of the experimental paradigm. In both conditions, participants self-administered beer and nonalcoholic beverages for 3 hours in a bar setting with 1-3 other participants. Experimental condition participants self-administered significantly fewer beers and drank to lower blood-alcohol concentrations (BACs) on average than those in the free-drinking condition. Experimental condition participants were more likely than free-drinking condition participants to intersperse nonalcoholic beverages with beer and to drink at a slower pace. Although experimental condition participants drank more moderately than those in the free-drinking condition overall, their range of drinking was considerable (BAC range = .024-.097), with several participants drinking excessively. A lower initial subjective response to alcohol and earlier age of alcohol use onset were associated with greater alcohol self-administration in the experimental condition. Given the variability in response, the impaired control laboratory paradigm may have utility for preliminary tests of novel interventions in future studies and for identifying individual differences in problem-drinking risk.
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Affiliation(s)
- Robert F Leeman
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, USA.
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Pang RD, Leventhal AM. Sex differences in negative affect and lapse behavior during acute tobacco abstinence: a laboratory study. Exp Clin Psychopharmacol 2013; 21:269-76. [PMID: 23834551 PMCID: PMC3962304 DOI: 10.1037/a0033429] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Heightened negative affect during acute tobacco abstinence in women relative to men could be an important factor underlying sex differences in smoking motivation. However, little controlled experimental work addresses this hypothesis. The current study investigated sex differences in withdrawal-related negative affect, time to start smoking on a lab analogue smoking lapse task, and the interrelation between sex, withdrawal-related negative affect, and smoking lapse behavior. Following a baseline session, current smokers (women: n = 68, men: n = 131) attended two counterbalanced lab sessions (16 hours smoking abstinence and ad libitum smoking) during which they completed self-report measures of mood and withdrawal symptoms followed by a laboratory analogue smoking lapse task. In this task participants are monetarily rewarded for delaying smoking. Performance on this task serves as an analogue model of smoking lapse behavior by measuring smoker's capability to resist temptation to smoke under conditions where abstinence is advantageous. Females showed greater abstinence induced increases in composite negative affect as well as several particular negative affect states (i.e., POMS Anger, Anxiety, Depression, and Confusion, ps < .05) but no differences in abstinence induced changes in other forms of affect or craving. Females also exhibited marginally greater abstinence induced decreases in their willingness to delay smoking for money (p = .10), which was mediated by abstinence induced increases in anger (p < .05). These results suggest that differential sensitivity to abstinence induced negative affect, particularly anger, could underlie sex specific smoking patterns. Negative affect during tobacco abstinence may be an important factor for understanding and treating nicotine addiction in women.
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Affiliation(s)
- Raina D Pang
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA 90033, USA.
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Lycett D, Aveyard P, Farmer A, Lewis A, Munafò M. Slimming World in Stop Smoking Services (SWISSS): study protocol for a randomized controlled trial. Trials 2013; 14:182. [PMID: 23782870 PMCID: PMC3698185 DOI: 10.1186/1745-6215-14-182] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Accepted: 05/28/2013] [Indexed: 12/23/2022] Open
Abstract
Background Quitting smokers gain weight. This deters some from trying to stop smoking and may explain the increased incidence of type 2 diabetes after cessation. Dieting when stopping smoking may be counterproductive. Hunger increases cravings for smoking and tackling two behaviours together may undermine quitting success. A meta-analysis of randomized controlled trials (RCTs) showed individualized dietary support may prevent weight gain, although there is insufficient evidence whether it undermines smoking cessation. Commercial weight management providers (CWMPs), such as Slimming World, provide individualized dietary support for National Health Service (NHS) patients; however, there is no evidence that they can prevent cessation-related weight gain. Our objective is to determine whether attending Slimming World from quit date, through referral from NHS Stop Smoking Services, is more effective than usual care at preventing cessation-related weight gain. Methods This RCT will examine the effectiveness of usual cessation support plus referral to Slimming World compared to usual cessation support alone. Healthy weight, overweight and obese adult smokers attending Stop Smoking Services will be included. The primary outcome is weight change in quitters 12 weeks post-randomization. Multivariable linear regression analysis will compare weight change between trial arms and adjust for known predictors of cessation-related weight gain. We will recruit 320 participants, with 160 participants in each arm. An alpha error rate of 5% and 90% power will detect a 2 kg (SD = 2.5) difference in weight gain at 12 weeks, assuming 20% remain abstinent by then. Discussion This trial will establish whether referral to the 12-week Slimming World programme plus usual care is an effective intervention to prevent cessation-related weight gain. If so, we will seek to establish whether weight control comes at the expense of a successful quit attempt in a further non-inferiority trial. Positive results from both these trials would provide a potential solution to cessation-related weight gain, which could be rolled out across England within Stop Smoking Services to better meet the needs of 0.75 million smokers stopping with NHS support every year. Trial registration Current Controlled Trials ISRCTN65705512
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Affiliation(s)
- Deborah Lycett
- Department of Health Professions, Faculty of Health and Life Sciences RC131, Coventry University, Priory Street, Coventry CV1 5FB, UK.
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Sweitzer MM, Denlinger RL, Donny EC. Dependence and withdrawal-induced craving predict abstinence in an incentive-based model of smoking relapse. Nicotine Tob Res 2012; 15:36-43. [PMID: 22513801 DOI: 10.1093/ntr/nts080] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Understanding factors that render some individuals more vulnerable to smoking relapse during the early stages of a quit attempt is critical to tailoring treatment efforts. Development of laboratory models of relapse can provide a framework for identifying underlying mechanisms that may contribute to vulnerability. Here, we explored predictors of abstinence in a novel incentive-based model of relapse. METHODS Fifty-six nontreatment seeking daily smokers completed several nicotine dependence measures prior to participating in a 1-week abstinence incentive test. During the abstinence procedure, participants earned monetary reinforcement for each biochemically verified day of abstinence according to a descending schedule of reinforcement. RESULTS Compliance with the procedure was excellent. All but 3 participants were able to initiate abstinence; nearly 70% lapsed as incentives were reduced. Scores on the Fagerström Test for Nicotine Dependence (FTND), number of cigarettes smoked per day, and self-reported craving on the first day of abstinence each independently predicted time to lapse. The single item of time to first cigarette in the morning on the FTND significantly predicted time to lapse, even when controlling for other significant predictors just listed. The Nicotine Dependence Syndrome Scale (NDSS) and Wisconsin Inventory of Smoking Dependence Motives did not predict lapse, but the NDSS did predict reinitiation of abstinence among those experiencing an initial lapse. CONCLUSIONS These findings partially replicate those of previous full-scale clinical trials and support the feasibility and validity of an incentive-based model of relapse. The time-limited and laboratory-based nature of this model has the potential to further investigations of underlying mechanisms contributing to relapse.
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Affiliation(s)
- Maggie M Sweitzer
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA.
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MacKillop J, Brown CL, Stojek MK, Murphy CM, Sweet L, Niaura RS. Behavioral economic analysis of withdrawal- and cue-elicited craving for tobacco: an initial investigation. Nicotine Tob Res 2012; 14:1426-34. [PMID: 22416117 DOI: 10.1093/ntr/nts006] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION The role of craving in nicotine dependence remains controversial and may be a function of measurement challenges. The current study used behavioral economic approach to test the hypotheses that subjective craving from acute withdrawal and exposure to tobacco cues dynamically increases the relative value of cigarettes. METHODS Using a 2 (1-hr/12-hr deprivation) × 2 (neutral/tobacco cues) within-subjects design, 33 nicotine dependent adults completed 2 laboratory sessions. Assessment included subjective craving and behavioral economic indices of cigarette demand, namely Intensity (i.e., cigarette consumption at zero cost), O(max) (i.e., maximum total expenditure), Breakpoint (i.e., highest acceptable price for cigarettes), P(max) (i.e., price at which consumption becomes sensitive to price), and elasticity (i.e., price sensitivity). Behavioral economic indices were generated using a Cigarette Purchase Task in which participants selected between cigarettes for a subsequent 2-hr self-administration period and money. RESULTS Main effects of deprivation and tobacco cues were present for subjective craving and multiple behavioral economic indices of cigarette demand. Interestingly, deprivation significantly increased Breakpoint (p ≤ .01) and P(max) (p ≤ .05) and had trend-level effects on Intensity and O(max) (p ≤ .10); whereas cues significantly reduced elasticity (p ≤ .01), reflecting lower sensitivity to increasing prices. Heterogeneous associations were evident among the motivational variables but with aggregations suggesting variably overlapping motivational channels. CONCLUSIONS These findings further support a behavioral economic approach to craving and a multidimensional conception of acute motivation for addictive drugs. Methodological considerations, including potential order effects, and the need for further refinement of these findings are discussed.
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Affiliation(s)
- James MacKillop
- Department of Psychology, University of Georgia, Athens, GA 30602, USA.
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Blunted vagal reactivity predicts stress-precipitated tobacco smoking. Psychopharmacology (Berl) 2012; 220:259-68. [PMID: 21938416 PMCID: PMC3260347 DOI: 10.1007/s00213-011-2473-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Accepted: 08/28/2011] [Indexed: 12/26/2022]
Abstract
RATIONALE Long-term smoking can lead to changes in autonomic function, including decreased vagal tone and altered stress responses. One index of the inability to adapt to stress may be blunted vagal reactivity. Stress is a primary mechanism involved in relapse to smoking, but mechanisms leading to stress-precipitated relapse are not well understood. OBJECTIVES Using an experimental paradigm of stress-precipitated smoking behavior, we examined whether autonomic reactivity mediates the relationship between stress and smoking. High-frequency heart rate variability (HF-HRV), a putative measure of vagal tone, and the ratio of low-to-high frequency HRV (LF/HF), a measure of sympathovagal balance, were assessed. METHODS Using a within-subjects design, 32 nicotine-dependent, 15-h abstinent smokers (a subgroup from McKee et al. (J Psychopharmacol 25(4):490-502, 2011)) were exposed to individualized script-driven imagery of stressful and relaxing scenarios and assessed on the ability to resist smoking and subsequent ad-lib smoking. HRV was monitored throughout each laboratory session (maximum 60 min following imagery). RESULTS As expected, stress and ad-lib smoking additively decreased HF-HRV and increased LF/HF. Blunted stress-induced HF-HRV responses reflecting decreased vagal reactivity were associated with less time to initiate smoking and increased craving relief and reinforcement from smoking. These relationships were specific to HF-HRV following stress as neither baseline HF-HRV, HF-HRV following relaxing imagery, or LF/HF predicted smoking behavior. CONCLUSIONS The current findings are the first to experimentally demonstrate that stress-precipitated decreased vagal reactivity predicts the ability to resist smoking. Findings suggest that strategies that normalize vagal reactivity in early abstinent smokers may lead to improved smoking cessation outcomes.
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Farley AC, Hajek P, Lycett D, Aveyard P. Interventions for preventing weight gain after smoking cessation. Cochrane Database Syst Rev 2012; 1:CD006219. [PMID: 22258966 DOI: 10.1002/14651858.cd006219.pub3] [Citation(s) in RCA: 111] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Most people who stop smoking gain weight. There are some interventions that have been designed to reduce weight gain when stopping smoking. Some smoking cessation interventions may also limit weight gain although their effect on weight has not been reviewed. OBJECTIVES To systematically review the effect of: (1) Interventions targeting post-cessation weight gain on weight change and smoking cessation.(2) Interventions designed to aid smoking cessation that may also plausibly affect weight on post-cessation weight change. SEARCH METHODS Part 1 - We searched the Cochrane Tobacco Addiction Group's Specialized Register and CENTRAL in September 2011.Part 2 - In addition we searched the included studies in the following "parent" Cochrane reviews: nicotine replacement therapy (NRT), antidepressants, nicotine receptor partial agonists, cannabinoid type 1 receptor antagonists and exercise interventions for smoking cessation published in Issue 9, 2011 of the Cochrane Library. SELECTION CRITERIA Part 1 - We included trials of interventions that were targeted at post-cessation weight gain and had measured weight at any follow up point and/or smoking cessation six or more months after quit day.Part 2 - We included trials that had been included in the selected parent Cochrane reviews if they had reported weight gain at any time point. DATA COLLECTION AND ANALYSIS We extracted data on baseline characteristics of the study population, intervention, outcome and study quality. Change in weight was expressed as difference in weight change from baseline to follow up between trial arms and was reported in abstinent smokers only. Abstinence from smoking was expressed as a risk ratio (RR). We used the most rigorous definition of abstinence available in each trial. Where appropriate, we performed meta-analysis using the inverse variance method for weight and Mantel-Haenszel method for smoking using a fixed-effect model. MAIN RESULTS Part 1: Some pharmacological interventions tested for limiting post cessation weight gain (PCWG) resulted in a significant reduction in WG at the end of treatment (dexfenfluramine (Mean difference (MD) -2.50 kg, 95% confidence interval (CI) -2.98 to -2.02, 1 study), phenylpropanolamine (MD -0.50 kg, 95% CI -0.80 to -0.20, N=3), naltrexone (MD -0.78 kg, 95% CI -1.52 to -0.05, N=2). There was no evidence that treatment reduced weight at 6 or 12 months (m). No pharmacological intervention significantly affected smoking cessation rates.Weight management education only was associated with no reduction in PCWG at end of treatment (6 or 12m). However these interventions significantly reduced abstinence at 12m (Risk ratio (RR) 0.66, 95% CI 0.48 to 0.90, N=2). Personalised weight management support reduced PCWG at 12m (MD -2.58 kg, 95% CI -5.11 to -0.05, N=2) and was not associated with a significant reduction of abstinence at 12m (RR 0.74, 95% CI 0.39 to 1.43, N=2). A very low calorie diet (VLCD) significantly reduced PCWG at end of treatment (MD -3.70 kg, 95% CI -4.82 to -2.58, N=1), but not significantly so at 12m (MD -1.30 kg, 95% CI -3.49 to 0.89, N=1). The VLCD increased chances of abstinence at 12m (RR 1.73, 95% CI 1.10 to 2.73, N=1). There was no evidence that cognitive behavioural therapy to allay concern about weight gain (CBT) reduced PCWG, but there was some evidence of increased PCWG at 6m (MD 0.74, 95% CI 0.24 to 1.24). It was associated with improved abstinence at 6m (RR 1.83, 95% CI 1.07 to 3.13, N=2) but not at 12m (RR 1.25, 95% CI 0.83 to 1.86, N=2). However, there was significant statistical heterogeneity.Part 2: We found no evidence that exercise interventions significantly reduced PCWG at end of treatment (MD -0.25 kg, 95% CI -0.78 to 0.29, N=4) however a significant reduction was found at 12m (MD -2.07 kg, 95% CI -3.78 to -0.36, N=3).Both bupropion and fluoxetine limited PCWG at the end of treatment (bupropion MD -1.12 kg, 95% CI -1.47 to -0.77, N=7) (fluoxetine MD -0.99 kg, 95% CI -1.36 to -0.61, N=2). There was no evidence that the effect persisted at 6m (bupropion MD -0.58 kg, 95% CI -2.16 to 1.00, N=4), (fluoxetine MD -0.01 kg, 95% CI -1.11 to 1.10, N=2) or 12m (bupropion MD -0.38 kg, 95% CI -2.00 to 1.24, N=4). There were no data on WG at 12m for fluoxetine.Overall, treatment with NRT attenuated PCWG at the end of treatment (MD -0.69 kg, 95% CI -0.88 to -0.51, N=19), with no strong evidence that the effect differed for the different forms of NRT. There was evidence of significant statistical heterogeneity caused by one study which reported a 4.3 kg reduction in PCWG due to NRT. With this study removed, the difference in weight change at end of treatment was -0.45 kg (95% CI -0.66 to -0.27, N=18). There was no evidence of an effect on PCWG at 12m (MD -0.42 kg, 95% CI -0.92 to 0.08, N=15).We found evidence that varenicline significantly reduced PCWG at end of treatment (MD -0.41 kg, 95% CI -0.63 to -0.19, N=11), but this effect was not maintained at 6 or 12m. Three studies compared the effect of bupropion to varenicline. Participants taking bupropion gained significantly less weight at the end of treatment (-0.51 kg (95% CI -0.93 to -0.09 kg), N=3). Direct comparison showed no significant difference in PCWG between varenicline and NRT. AUTHORS' CONCLUSIONS Although some pharmacotherapies tested to limit PCWG show evidence of short-term success, other problems with them and the lack of data on long-term efficacy limits their use. Weight management education only, is not effective and may reduce abstinence. Personalised weight management support may be effective and not reduce abstinence, but there are too few data to be sure. One study showed a VLCD increased abstinence but did not prevent WG in the longer term. CBT to accept WG did not limit PCWG and may not promote abstinence in the long term. Exercise interventions significantly reduced weight in the long term, but not the short term. More studies are needed to clarify whether this is an effect of treatment or a chance finding. Bupropion, fluoxetine, NRT and varenicline reduce PCWG while using the medication. Although this effect was not maintained one year after stopping smoking, the evidence is insufficient to exclude a modest long-term effect. The data are not sufficient to make strong clinical recommendations for effective programmes to prevent weight gain after cessation.
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Affiliation(s)
- Amanda C Farley
- Primary Care Clinical Sciences, University of Birmingham, Birmingham, UK
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Hogarth L. The role of impulsivity in the aetiology of drug dependence: reward sensitivity versus automaticity. Psychopharmacology (Berl) 2011; 215:567-80. [PMID: 21301818 PMCID: PMC3090566 DOI: 10.1007/s00213-011-2172-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2010] [Accepted: 01/07/2011] [Indexed: 12/04/2022]
Abstract
RATIONALE Impulsivity has long been known as a risk factor for drug dependence, but the mechanisms underpinning this association are unclear. Impulsivity may confer hypersensitivity to drug reinforcement which establishes higher rates of instrumental drug-seeking and drug-taking behaviour, or may confer a propensity for automatic (non-intentional) control over drug-seeking/taking and thus intransigence to clinical intervention. METHOD The current study sought to distinguish these two accounts by measuring Barratt Impulsivity and craving to smoke in 100 smokers prior to their completion of an instrumental concurrent choice task for tobacco (to measure the rate of drug-seeking) and an ad libitum smoking test (to measure the rate of drug-taking-number of puffs consumed). RESULTS The results showed that impulsivity was not associated with higher rates of drug-seeking/taking, but individual differences in smoking uptake and craving were. Rather, nonplanning impulsivity moderated (decreased) the relationship between craving and drug-taking, but not drug-seeking. CONCLUSIONS These data suggest that whereas the uptake of drug use is mediated by hypervaluation of the drug as an instrumental goal, the orthogonal trait nonplanning impulsivity confers a propensity for automatic control over well-practiced drug-taking behaviour.
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Affiliation(s)
- Lee Hogarth
- School of Psychology, University of Nottingham, University Park, Nottingham, UK.
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Donny EC, Caggiula AR, Weaver MT, Levin ME, Sved AF. The reinforcement-enhancing effects of nicotine: implications for the relationship between smoking, eating and weight. Physiol Behav 2011; 104:143-8. [PMID: 21549139 DOI: 10.1016/j.physbeh.2011.04.043] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2011] [Revised: 04/22/2011] [Accepted: 04/26/2011] [Indexed: 01/19/2023]
Abstract
Concerns about body weight represent an important barrier to public health efforts aimed at reducing smoking. Epidemiological studies have found that current smokers weigh less than non-smokers, smoking cessation results in weight gain, and weight restriction is commonly cited as a reason for smoking. The mechanisms underlying the relationship between smoking and weight are complex and may involve a number of factors including changes in caloric intake, physical activity, metabolic rate, and lipogenesis. Amongst these possible mechanisms, nicotine-induced enhancement of food reinforcement may be particularly important. In this paper, we first review data from our laboratory that highlight two distinct ways in which nicotine impacts reinforced behavior: 1) by acting as a primary reinforcer; and 2) by directly (non-associatively) enhancing the reinforcing effects of other stimuli. We then elaborate on the reinforcement-enhancing effects of nicotine as they pertain to behaviors and stimuli related to food. Data from both laboratory animals and humans support the assertion that nicotine enhances the reinforcing efficacy of food and suggest that the influence of these effects on eating may be most important after nicotine cessation when nicotine's effects on satiety subside. Finally, we discuss the theoretical and clinical implications of this perspective for understanding and addressing the apparent tradeoff between smoking and weight gain. Better understanding of the mechanisms underlying the reinforcement-enhancing effects of nicotine broadly, and the effects on food reinforcement per se, may aid in the development of new treatments with better long term outcomes.
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Affiliation(s)
- Eric C Donny
- Department of Psychology, University of Pittsburgh, 210 S. Bouquet Street, Pittsburgh, PA 15260, USA.
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Gold MS. From bedside to bench and back again: a 30-year saga. Physiol Behav 2011; 104:157-61. [PMID: 21530563 DOI: 10.1016/j.physbeh.2011.04.027] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2011] [Revised: 04/19/2011] [Accepted: 04/20/2011] [Indexed: 01/09/2023]
Abstract
My work (Mark S. Gold) began in the 70s looking for the mechanisms of drug reinforcement and withdrawal. Through observation and experience, drugs of abuse and the drive for food appeared to be quite related. As pioneered by Bart Hoebel, food can become an object of desire and act in most respects as a drug of abuse. The Gold lab is investigating working models for pathological attachment to eating and food addiction. New pharmacological treatments which interfere with food reinforcement may be the next step.
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Affiliation(s)
- Mark S Gold
- Department of Psychiatry, College of Medicine, University of Florida, Gainesville, FL 32611, USA.
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