Search

Introduction: The ability to update reward and punishment contingencies is a fundamental aspect of effective decision-making, requiring the ability to successfully adapt to the changing demands of one's environment. In the case of nicotine addiction, research has predominantly focused on reward- and punishment-based learning processes among current smokers relative to non-smokers, whereas less is known about these processes in former smokers.Methods: In a total sample of 105 students, we used the Probabilistic Selection Task to examine differences in reinforcement learning among 41 current smokers, 29 ex-smokers, and 35 non-smokers. The PST was comprised of a training and test phase that allowed for the comparison of learning from positive versus negative feedback.Results: The test phase of the Probabilistic Selection Task significantly predicted smoking status. Current and non-smokers were classified with moderate accuracy, whereas ex-smokers were typically misclassified as smokers. Lower rates of learning from rewards were associated with an increased likelihood of being a smoker or an ex-smoker compared with being a non-smoker. Higher rates of learning from punishment were associated with an increased likelihood of being a smoker relative to non-smoker. However, learning from punishment did not predict ex-smoker status.Conclusions: Current smokers and ex-smokers were less likely to learn from rewards, supporting the hypothesis that deficient reward processing is a feature of chronic addiction. In addition, current smokers were more sensitive to punishment than ex-smokers, contradicting some recent findings. [ABSTRACT FROM AUTHOR]

Introduction Suboptimal decision-making is a feature in the initiation and maintenance of substance use, often manifested in choosing for short-term benefits rather than long-term gain, and the failure to display cognitive flexibility, respectively. Studies of nicotine users typically focus on characterizing those who are already addicted; less is known about decision-making in former smokers. Methods Non- ( n = 21), former daily- ( n = 23) and current daily smokers ( n = 24), completed the contingency-shifting variant Iowa Gambling Task (csIGT), in which the reward and punishment contingencies of the decks are systematically varied after 100 trials of the ‘standard’ IGT. Scores on the standard blocks of the csIGT provided an index of emotion-based decision-making, while the contingency-shifting blocks assessed flexible decision-making. Subjective ratings were also recorded at 20-trial intervals. Results Both current and former smokers showed significantly impaired performance relative to non-smokers when making decisions during the standard blocks of the csIGT. Both former and non-smokers' awareness of the reward/punishment contingencies was significantly higher than those of current smokers at the end of the standard IGT. Both former and non-smokers had significantly better performance on the contingency shifting blocks, relative to current smokers. Conclusions The findings indicate that both current and former smokers display a suboptimal pattern of decision-making than non-smokers during the standard IGT. However, with respect to the ability to change behavior following reversed contingencies, former smokers are more similar to non-smokers than to current smokers. Former smokers were also more aware of the contingencies than current smokers. [ABSTRACT FROM AUTHOR]

Introduction Smoking related stimuli are known to increase both subjective craving and heart rate in smokers; however, little is currently known about the effects of such stimuli in former smokers. Methods Subjective craving and heart rate were measured in 38 never smokers, 20 former smokers, and 30 current smokers exposed to video clips containing neutral and smoking related cues. Results Compared with neutral cues, smoking cues significantly increased both heart rate and self-reported craving in current smokers, while in former smokers smoking cues were associated with a significant decrease in heart rate as well as with a relatively diminished increase in subjective craving. Neither craving nor heart rate was impacted by the smoking cues in never smokers. Conclusions Findings suggest that while smoking related stimuli continue to elicit modest subjective cravings in former smokers, there appears to be a marked change in the typical physiological response associated with such stimuli. [ABSTRACT FROM AUTHOR]

Aims ‘Categorical self-labels’ (e.g. thinking of oneself as a smoker or non-smoker) are important aspects of identity that can have a fundamental influence on behaviour. To explore the role identity aspects relating to smoking can play in smoking cessation and relapse, this study assessed the prospective associations between taking on a non-smoker identity following quitting and long-term abstinence. Methods A representative sample of 574 ex-smokers in England who quit smoking in the past year was followed-up at three ( N = 179) and six months ( N = 163). Post-quit identity relating to smoking (‘I still think of myself as a smoker’ or ‘I think of myself as a non-smoker’), and demographic and smoking-related characteristics were assessed at baseline. Self-reported smoking abstinence was assessed at follow-ups. Results Non-smoker identity was reported by 80.3% (95%CI 76.8–83.4) of recent ex-smokers. Younger age ( p = 0.017) and longer abstinence ( p < 0.001) were independently associated with a post-quit non-smoker identity. After adjusting for covariates, non-smoker identity ( p = 0.032) and length of abstinence at baseline ( p < 0.001) were associated with continued abstinence at three month follow-up, and baseline length of abstinence ( p = 0.003) predicted continued abstinence at six months. Conclusions The majority of people who quit smoking recently consider themselves as non-smokers. Younger people and those who have been abstinent for longer are more likely to take on a non-smoker identity. Ex-smokers who make this mental transition following a quit attempt appear more likely to remain abstinent in the medium term than those who still think of themselves as smokers. [ABSTRACT FROM AUTHOR]

Introduction Previous research has demonstrated that chronic cigarette smoking and major depressive disorder (MDD) are each associated with cognitive decrements. Further, these conditions co-occur commonly, though mechanisms in the comorbid condition are poorly understood. There may be distinct, additive, or overlapping factors underlying comorbid cigarette smoking and MDD. The present study investigated the impact of smoking and MDD on executive function and emotion processing. Methods Participants (N = 198) were grouped by diagnostic category (MDD and healthy controls, HC) and smoking status (ever-smokers, ES and never-smokers, NS). Participants completed the Facial Emotion Perception Test (FEPT), a measure of emotional processing, and the parametric Go/No-go task (PGNG), a measure of executive function. Results FEPT performance was analyzed using ANCOVA with accuracy and reaction time as separate dependent variables. Repeated measures MANCOVA was conducted for PGNG with performance measure and task level as dependent variables. Analyses for each task included diagnostic and smoking group as independent variables, and gender was controlled for. Results for FEPT reveal that lower overall accuracy was found for ES relative to NS, though MDD did not differ from HC. Post-hoc analyses revealed that ES were poorer at identifying happy and sad, but not fearful or angry, faces. For PGNG, poorer performance was observed in MDD relative to HC in response time to Go targets, but there were no differences for ES and NS. Interaction of diagnosis and smoking group was not observed for performance on either task. Conclusions The results of this study provide preliminary evidence for distinctive cognitive decrements in smokers and individuals with depression. [ABSTRACT FROM AUTHOR]

With the declining sales of cigarettes, the tobacco industry has been promoting other forms of combustible and smokeless tobacco to current and former cigarette smokers. Exposure to the promotion of tobacco products has been shown to vary by income level. We combined the 2006 through 2011 National Surveys on Drug Use and Health to compare the prevalence and patterns of other tobacco use (cigar, snuff, and chewing tobacco) between current and former cigarette smokers by income level. Other tobacco use was minimal among females and among male non-smokers. Approximately a third of both current and former male cigarette smokers reported past-year other tobacco use. Overall, current smokers were more likely than former smokers to have used cigars (adjusted odds ratio (AOR) 1.69, 95% CI 1.50-1.92) or snuff (AOR 1.14, 95% CI 1.01-1.28) in the past year. The association of smoking status with other tobacco use differed by income level (interaction term p-value<0.001). Among lower income groups, current smokers were more likely to use cigars and snuff compared to former smokers. Among the highest income group, former smokers were just as likely to use smokeless tobacco as current smokers. The differing patterns of use of other tobacco between current and former smokers by income level highlight a need for studies to understand the motivations for the use of these products and their role in smoking cessation. [ABSTRACT FROM AUTHOR]

Background: E-cigarettes may be effective smoking cessation aids and their use by smokers has been growing rapidly. It is important to observe and assess natural patterns in the use of e-cigarettes whilst experimental data accumulates. This paper reports the prevalence of e-cigarette awareness, beliefs and usage, including brand choice, and characterises the socio-demographic and smoking profile associated with current use, among the general population of smokers and recent ex-smokers. Methods: Data were obtained from 3538 current and 579 recent ex-smokers in a cross-sectional online survey of a national sample of smokers in Great Britain in November and December 2012. Differences between current and recent ex-smokers in the prevalence of e-cigarette awareness, beliefs and usage were examined and the socio-demographic and smoking profile associated with current use of e-cigarettes was assessed in a series of simple and multiple logistic regressions. Results: Ninety-three percent of current and recent ex-smokers (n=3841) were aware of e-cigarettes. Approximately a fifth (n=884) were currently using e-cigarettes, whilst just over a third (n=1507) had ever used them. Sixty-seven percent of the sample (n=2758) believed e-cigarettes to be less harmful than cigarettes; however, almost a quarter (n=994) remained unsure. Among both current and recent ex-smokers, the most popular reasons for using were health, cutting down and quitting (each >80%) and 38% used the brand ‘E-lites’. Among current smokers who were aware of but had never used e-cigarettes, approximately half (n=1040) were interested in using them in the future. Among current smokers, their use was associated with higher socio-economic status (OR=1.48, 95%CI=1.25–1.75), smoking more cigarettes (OR=1.02, 95%CI=1.01–1.03) and having a past-year quit attempt (OR=2.82, 95%CI=2.38–3.34). Conclusions: There is a near universal awareness of e-cigarettes and their use appears to be common among smokers in Great Britain although a quarter of all smokers are unsure as to whether e-cigarettes are less harmful than cigarettes. E-lites – a brand that delivers a low dose of nicotine – is the most popular. E-cigarette users appear to have higher socio-economic status, to smoke more cigarettes per day and to have attempted to quit in the past year. [Copyright &y& Elsevier]

Abstract: Objective: To assess behavior change over 12months in users of e-cigarettes (“vapers”). Methods: Longitudinal Internet survey, 2011 to 2013. Participants were enrolled on websites dedicated to e-cigarettes and smoking cessation. We assessed use of e-cigarettes and tobacco among the same cohort at baseline, after one month (n =477) and one year (n =367). Results: Most participants (72%) were former smokers, and 76% were using e-cigarettes daily. At baseline, current users had been using e-cigarettes for 3months, took 150 puffs/day on their e-cigarette and used refill liquids containing 16mg/ml of nicotine, on average. Almost all the daily vapers at baseline were still vaping daily after one month (98%) and one year (89%). Of those who had been vaping daily for less than one month at baseline, 93% were still vaping daily after one month, and 81% after one year. In daily vapers, the number of puffs/day on e-cigarettes remained unchanged between baseline and one year. Among former smokers who were vaping daily at baseline, 6% had relapsed to smoking after one month and also 6% after one year. Among dual users (smokers who were vaping daily at baseline), 22% had stopped smoking after one month and 46% after one year. In dual users who were still smoking at follow-up, cigarette consumption decreased by 5.3 cig/day after one month (from 11.3 to 6.0 cig./day, p =0.006), but remained unchanged between baseline and 1-year follow-up. Conclusions: E-cigarettes may contribute to relapse prevention in former smokers and smoking cessation in current smokers. [Copyright &y& Elsevier]

Abstract: Background: Most smokers who quit smoking gain weight. There are some interventions designed to limit weight gain following smoking cessation. Objective: To conduct a systematic review to evaluate if combination pharmacological therapy interventions for smoking cessation are effective in reducing post-cessation weight gain. Methods: The following databases were researched: Medline, PubMed, PsycINFO, CENTRAL and EMBASE. Detailed inclusion and exclusion criteria were specified a priori before conducting abstract and full text screening. Included studies were required to: (1) report data on combination pharmacotherapy including at least one FDA-approved smoking cessation medication; (2) report outcome measure of weight change from baseline to the end of follow up; (3) incorporate a minimum of 2-week follow-up; (4) recruit adult smokers. Studies were excluded if they had (1) behavioral interventions; (2) sample size of <30; (3) switching medications; or (4) they were not written in English. Abstracts and the full texts were reviewed independently by two investigators. Inclusion of studies was decided by a third independent investigator in case of disagreement between the two primary investigators. Results: Out of 1873 studies identified, 1083 studies were included for abstract screening. Finally, 12 studies met the eligibility criteria after full text screening of 242 studies. Seven studies showed that participants in the combined therapy group had less post-cessation weight gain than those in the group of individual drugs or placebo. Four studies did not report differential weight gain measures by treatment groups. Only one study showed that post-treatment weight gain in the combined therapy group was more than the monotherapy group, although the result was not statistically significant. Conclusions: Seven out of twelve studies indicated that combination smoking cessation medications had less post-cessation weight gain than monotherapy or placebo in short term. Long term weight gain was not well documented by most of the studies and future research is warranted. [Copyright &y& Elsevier]

Objective: While the majority of women quit smoking either before or during pregnancy, 60 to 80% relapse in the postpartum period. The objective of this research was to examine postpartum women who quit smoking during their pregnancies and to determine the predictive factors for relapse in the postpartum period by identifying different subgroups that predict risk of relapse. Method: One hundred forty four postpartum women who were abstinent at the time of delivery were recruited. Data regarding the Acquisition Stage of Change, Decisional Balance and Situational Temptations to Smoke were assessed in the immediate postpartum period. Based on their intention to remain abstinent, 121 women identified in the acquisition-Precontemplation (aPC) group comprised the study sample. Smoking status was assessed again at 2months postpartum. Results: A cluster analysis was performed to idenitfy subgroups of the acquisition-Precontemplation (aPC) group. Four subgroups were identified and were labeled Most Protected, Ambivalent, Risk Denial, and High Risk. Logistic regression was performed to establish external validity of the clusters. The clusters and exclusive breastfeeding were the only statistically significant variables associated with relapse at 2months postpartum. Conclusions: The results confirmed the clusters identified in previous prevention research with both adolescents and postpartum women, The cluster profiles can serve to guide the development of a tailored intervention program. [Copyright &y& Elsevier]

Abstract: Introduction: Accurately assessing quit attempt history is important to develop population estimates of cessation and to increase our understanding of smoking trajectories. Thus, the current study investigated failure to report quit attempts as a function of length of quit attempt by time since quit attempt over the past year. Methods: The present study used data from the Smoking Toolkit Study, a series of population-based surveys of smokers and recent ex-smokers in England aged 16years and older. Among the 11,772 smokers identified at baseline (24.4% of the total sample), this study focused on the 4234 participants (36.0% of current smokers) who reported between one and three quit attempts in the past year. Results: There was a strong trend for quit attempts that lasted for shorter periods of time to fail to be reported. After three months, 90.1% of those lasting less than one day, 63.7% of those lasting between a day a one week, and 38.9% of those lasting between one week and one month failed to be reported. Conclusion: A large proportion of unsuccessful quit attempts fail to be reported, particularly if they only last a short time or occurred longer ago. Therefore, population estimates of quit attempts based on retrospective data may be considerable underestimates and estimates of the success of quit attempts may be overestimates. Future research is needed to establish whether there is differential reporting of quit attempts as a function of features of attempts such as use of cessation aids. [Copyright &y& Elsevier]

Abstract: Helping smokers quit is important as smoking is the number one preventable cause of death in the U.S. Smoking activates the mesolimbic dopamine reward system which is also responsible for pleasure associated with other behaviors, including engaging in novel, exciting and/or challenging (i.e., self-expanding) events. We hypothesized that the reward activation achieved by experiencing self-expanding events can supplant the reinforcement normally provided by smoking and can thus facilitate quitting. We investigated this hypothesis among 74 current and 66 former smokers who reported the self-expanding events they experienced for the 2months prior to their most successful or final, quit attempt, respectively. Former smokers, compared to current smokers, reported significantly more self-expanding events and that the events were more helpful to their quitting. For current smokers, there was a significant moderate-to-large positive correlation between number of self-expanding events and number of days subsequently abstained from smoking. The results support the proposition that experiencing self-expanding activities or events can be beneficial for smoking abstinence. [Copyright &y& Elsevier]

Abstract: Objectives: There is a need to better understand the prevalence of use of pharmaceutical aids among former smokers, and explore concerns that those former smokers may have had about using such products. This paper examines the use of various cessation aids and strategies as well as reasons for not using cessation aids among a nationally representative sample of former smokers from Canada. Methods: Using data from the 2006 Canadian Tobacco Use Monitoring Survey (CTUMS), univariate analyses were performed to examine the use of different cessation aids, strategies to quit smoking, and reasons for not using cessation aids among former smokers who had quit in the previous two years. Results: In 2006, over one in four Canadians (27.1% or about 7.2million persons) aged 15 and older was a former smoker. Overall, female former smokers were more likely to report that they reduced their consumption of cigarettes as a quitting strategy, whereas male former smokers were more likely to report using a pharmacological aids when quitting. Among reasons given for not using cessation aids, lack of trust that these products would work was the most common (15.4%), following by issue of cost (8.5%), concern about possible side effects (5.8%) and lack of information about products (1.8%). Conclusion: These results suggest that men and women use different approaches to quit smoking. Our findings provide new insight which could be used to target cessation programs to the individuals where they are most likely to be effective. [Copyright &y& Elsevier]

Abstract: Very little is known about the association between cigarette use and perceived level of meaning in life, although the connection of other addictive behaviors with the feeling of meaninglessness has been widely investigated. The aim of the present study was to examine the relationship between life meaning and smoking status in a large national representative sample. A total of 12,643 people were interviewed in the Hungarostudy 2002 survey, representing the Hungarian population according to gender, age, and sub-regions of the country. Multinomial logistic regression analysis showed that meaning in life scores significantly differentiated between current and never smokers, as well as between current and former smokers. In addition, the difference in life meaning scores between never and ex-smokers was insignificant, and gender did not interact with life meaning in relation to smoking status. Further research is needed to clarify the nature and mediators of the observed relationship between life meaning and smoking in order to better understand the role of existential concerns in cigarette use. [Copyright &y& Elsevier]

We explored the performance of the Fagerström Test for Nicotine Dependence (FTND) in a sample of 1378 daily smokers and 1058 ex-smokers who participated in a survey study of the Netherlands Twin Register. FTND scores were higher for smokers than for ex-smokers. Nicotine dependence level was not associated with age. FTND score was highly correlated with the maximum number of cigarettes smoked (even after excluding the item ‘number of cigarettes per day’ from FTND), but the FTND score showed a low correlation with age of first cigarette and total number of years smoked. In a subsample of smokers (n=143) and ex-smokers (n=181) the test–retest correlations for the FTND were high. In general, the performance of the FTND in ex-smokers was comparable with that in smokers. These findings suggest the FTND to be a valuable tool for studies of nicotine dependence in large epidemiological samples. [Copyright &y& Elsevier]

The impulsivity levels were evaluated and compared in smoking, nonsmoking, and ex-smoking abstinent alcoholics (N=400) in a French alcohol detoxification center. Impulsivity was measured using the Barratt Impulsiveness Scale, French version (BIS 10). The BIS scores correlated inversely with age. Gender had no effect on impulsivity scores, while impulsivity was associated with smoking. Adding age as a covariate, however, eliminated or moderated the association, with three exceptions: (1) among males, heavy smokers were more impulsive than nonsmokers and medium smokers; (2) on the nonplanning subscale, heavy smokers were more impulsive than all other groups, and (3) current smokers were more impulsive than ex-smokers. Elevated impulsivity levels appear to be an obstacle to smoking cessation. In addition, stopping smoking may diminish impulsivity levels in alcoholics. Routine testing of impulsivity in current alcoholic smokers might predict who might successfully become an ex-smoker. [Copyright &y& Elsevier]

To investigate the possibility that specific symptom patterns contribute differentially to excess depression among smokers, we analyzed Center for Epidemiological Studies—Depression (CES-D) and subscale scores in 931 women current smokers (CS), ex-smokers (ES), and never-smokers (NS). After adjusting for differences in age, education, and marital status, significant group differences were found for the CES-D overall and for Depressed Affect, Anhedonia, and Somatic Features, but not Interpersonal Distress. Both CS and ES scored significantly higher than NS on most measures, whereas differences between CS and ES failed to reach significance. CS were significantly more likely than NS to be taking antidepressants. Alcohol intake also showed significant group differences, with CS>ES>NS, suggesting that the link between current smoking and alcohol intake is mediated by factors other than depression, since CS and ES were comparably depressed. We conclude that studying specific symptom patterns may elucidate the smoking–depression link. Our observation that ES and CS exhibit similar levels of depressive symptomatology further suggests that interventions for depressed smokers need to take into account the likely persistence of depression following cessation. [Copyright &y& Elsevier]

Background: Research has suggested that smokers who quit smoking and continue to identify themselves as a smoker versus a non-smoker are at greater risk of relapse. This study examines the relationship between post-quit smoker identities and relapse risk of former smokers in Australia and the UK comparing those who still identified as a smoker with firm choice to no longer smoke versus those not expressing a firm choice. Cross-country differences were examined.Methods: Data analysed came from 544 former smokers (quit 1 month or more) who participated in the Australian and UK Waves 9 (2013) and 10 (2014) of the International Tobacco Control (ITC) surveys. Post-quit smoker identities were assessed at baseline and smoking relapse at follow-up.Results: Baseline self-reported smoker identity independently predicted smoking relapse at 12-month follow-up (p < .01). Compared with the subgroup who identified themselves as smokers trying to quit, those who identified themselves as smokers who had chosen to no longer smoke (OR = 0.01, 95% CI = 0.01-0.25, p < .001), ex-smokers (OR = 0.05, CI = 0.01-0.25, p < .001) or non-smokers (OR = 0.07, CI = 0.02-0.37, p < .001) were less likely to relapse at follow-up. No cross-country differences were found.Conclusions: Following quitting, smokers who maintained a smoker identity with a firm choice to no longer smoke or adopted a non-smoker or ex-smoker identity were less likely to relapse than those who failed to do so, suggesting that a clear rule/commitment to not smoke and/or a shift to a non-smoking identity may be protective of relapse. [ABSTRACT FROM AUTHOR]

Aims: In Australia, sales of nicotine containing electronic cigarettes (also known as e-cigarette) are banned unless approved as a therapeutic good. The aims of this study were to estimate the prevalence of e-cigarette use and its correlates in Australia using a nationally representative survey., Method: We analysed data from the largest drug use survey in Australia (the National Drug Strategy Household Survey [NDSHS]; N = 22,354)., Results: We estimated that 227,000 Australians (1.2% of the population) were current e-cigarettes users, and 97,000 (0.5%) used them daily. Individuals who were male, younger, had higher level of psychological distress, and smoked were more likely to use electronic cigarettes. Among smokers, an intention to quit and reduction in smoking was associated with experimentation and daily use of e-cigarette, but not with occasional use. Recent quitting was associated with daily use., Conclusion: Overall, the prevalence of e-cigarette use was low in 2016 in Australia. Smoking status was the strongest correlates of e-cigarette use. Patterns of vaping were differentialy associated with an intention to quit smoking, smoking reduction and recent quitting. Some smokers may attempt to use e-cigarettes to cut-down their tobacco use, and those who vaped daily were mostly likely to be recent quitters., (Copyright © 2019. Published by Elsevier Ltd.)

Introduction: Use of electronic nicotine delivery systems (ENDS) has increased markedly. We examined how current ENDS users differ in perceptions of tobacco and ENDS-related health risks as a function of cigarette smoking status., Methods: We classified 1329 current ENDS users completing a national online survey based on cigarette smoking status, and employed linear and logistic regression to assess group differences in perceptions of tobacco-related health risks., Results: The sample consisted of 38% Current Cigarette Smokers, 40% Former Cigarette Smokers, and 22% Non-Smokers. Our targeted recruitment strategy yielded a balance of key descriptive variables across participants. Significant differences were observed in race, employment and marital status across cigarette smoking status, but not in gender, education, income, or sexual orientation. Participants reported considerable perceived knowledge about health risks associated with tobacco use, but less regarding ENDS use. Current Smokers rated ENDS use as riskier than Non-Smokers, and considered cigarette use less risky for both users and bystanders. Current Smokers were more likely to perceive cardiovascular diseases, diabetes and cancer as the health risks associated with ENDS use. Former Smokers were more likely to perceive such risks with traditional tobacco use. Further, regardless of smoking status, perceived knowledge about the health risks of tobacco or ENDS use was positively associated with perceived likelihood of high risks of cardiovascular diseases and cancer., Conclusions: Among current ENDS users, there were significant differences in perceived health risks based on cigarette smoking history. Improved health messaging can be achieved when cigarette smoking status is taken into account., (Copyright © 2018 Elsevier Ltd. All rights reserved.)