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To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.addbeh.2006.05.021 Byline: Jason D. Robinson (a), Paul M. Cinciripini (a), Stephen T. Tiffany (b), Brian L. Carter (a), Cho Y. Lam (a), David W. Wetter (c) Keywords: Nicotine; Gender differences; Startle; Affect; Smoking deprivation Abstract: Men and women may differ in their sensitivity to the mood-modulating properties of nicotine. Male and female adult smokers were exposed to four sessions crossing two nicotine deprivation conditions (12-h deprived vs. nondeprived) with two drug conditions (nicotine vs. placebo nasal spray). Acoustic probes elicited startle eyeblink responses while viewing affective and cigarette-related slides. In-session mood ratings were collected to gauge self-reported negative affect, positive affect, and craving. Nicotine nasal spray reduced startle amplitude in both men and women following 12-h deprivation compared with smoking nondeprivation. During nondeprivation, nicotine nasal spray increased startle amplitude in women compared with placebo spray, whereas no difference was found for men. The startle results suggest that both men and women are responsive to the hedonic properties of nicotine. Author Affiliation: (a) Department of Behavioral Science, The University of Texas M. D. Anderson Cancer Center, P.O. Box 301439, Unit 1330, Houston, TX 77230, United States (b) University of Utah School of Medicine, 410 Chipeta Way, Room 222, Salt Lake City, UT 84108, United States (c) Department of Health Disparities Research, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Unit 125, Houston, TX 77030, United States

The proportion of DSM-IV-based threshold and subthreshold depressive disorders is assessed. The results suggest that investigation of the prevalence of depression in community samples of pregnant smokers is warranted, as depression may present a major obstacle in pregnant women's efforts to quit smoking.

The association between education level and smoking status in a community-based sample of working adults is examined. It was found that there was a strong educational gradient in smoking status.

Latine adults who smoke have a low probability of receiving evidence-based smoking cessation interventions. Acceptance and Commitment Therapy (ACT) has shown to be efficacious for treating tobacco dependence, but its usefulness for Latine populations is just emerging and has not been studied in the context of a culturally tailored treatment. This single-arm study evaluated the feasibility of recruitment and retention, and treatment acceptability of the PRESENT Wellness Program: a culturally relevant ACT-based smoking cessation treatment for Latine adults who also experience psychological distress. Secondary objectives were the examination of smoking rates and levels of depression, anxiety, and psychological inflexibility (ACT core target) among Latine adults. Taking place during the COVID-19 pandemic, the treatment entailed 8 sessions delivered via telehealth (1 in-person/video and 7 by phone), and nicotine patches. Participants (N = 23) completed baseline assessments and follow-ups 1-week post-end of treatment (EOT) and 2-months post EOT. Most participants were women (70%), ranging from young adult to middle-aged, born in the US (57%), working full time (52.2%), and reporting financial strain (70%). Average number of sessions completed was 5.5. Follow-up rates were 61% at both follow-ups. The program was acceptable as indicated by quantitative and qualitative measures. Point-prevalence smoking abstinence was 35% at both follow-ups. Participants reported an average decline across time [% or M(SD)] in all secondary measures, as follows: everyday smoking [Baseline = 87%; 1-wk post EOT = 13%; 2 mo post EOT = 8.7%]; depression [Baseline = 13.7(6.3); 1-wk post EOT = 9.9 (6.6); 2 mo post EOT = 7.4 (5.8)]; anxiety [Baseline = 12.7 (5.4); 1-wk post EOT = 9.7 (6.4); 2 mo post EOT = 8.1 (5.2)]; and psychological inflexibility [Baseline = 50.6 (7.2); 1-wk post EOT = 33.0 (10.7); 2 mo post EOT = 32.6 (12.4)]. The current study observed that implementation of an acceptance-based smoking cessation treatment delivered in a hybrid mode is feasible and acceptable for English-speaking Latine persons. The PRESENT Wellness Program shows promise to address smoking and behavioral health challenges in the Latine community. Replication and expansion of the study is warranted, including the linguistic adaptation and evaluation of the program among Spanish-preferring Latine persons who smoke. • Telehealth ACT-based intervention was feasible among Latine people who smoke. • Latine individuals achieved 35% smoking abstinence after ACT-based intervention. • Depression, anxiety & psychological inflexibility decreased after the intervention. [ABSTRACT FROM AUTHOR]

This article examines the relationship between alcohol use and smoking behavior. An analysis of demographic characteristics, alcohol consumption, and tobacco use is presented.

Scheduled reduced smoking is a promising approach in manipulating smoking behavior prior to quitting, thus enhancing cessation rates. Compared to gradual reduction and abrupt quitting or 'cold turkey' techniques, scheduled reduced smoking exhibited superior abstinence rates. It has been found to improve adaptation to nonsmoking and minimize vulnerability to relapse, as gleaned from pattern of results observed for abstinence, withdrawal, negative affect and smoking urges.

The progression of smoking in a cohort of 321 low-level and occasional smokers is investigated. The results showed that over the course of 4 years, 45% of low-level and occasional users had become nonsmokers, 35% became occasional smokers, and 20% became daily smokers.

Abstract: Over 10years ago, Baer and colleagues proposed the integration of skills training and motivational strategies for the treatment of substance abuse. Since that time, several studies evaluating the efficacy of such hybrid approaches have been published, but few have been efficacious. Motivation and Problem Solving (MAPS) is a comprehensive, dynamic, and holistic intervention that incorporates empirically supported cognitive behavioral and social cognitive theory–based treatment strategies within an overarching motivational framework, and has been demonstrated to be effective in a randomized clinical trial focused on the prevention of postpartum smoking relapse. MAPS was designed to be applicable to not only relapse prevention but also the cessation of substance use, and is relevant for individuals regardless of their motivation to change. MAPS views motivation as dynamically fluctuating from moment to moment throughout the behavior change process, and comprehensively addresses multiple issues important to the individual and relevant to change through the creation of a wellness program. As a result, we believe that MAPS enhances the likelihood that individuals will successfully achieve and maintain abstinence from substance use, and that its comprehensive focus on addressing diverse and salient issues enhances both engagement in treatment and its applicability in modifying other health risk behaviors. The current paper introduces MAPS, distinguishes it from other hybrid and stage-based substance use treatments, and provides detailed information and clinical text regarding how MAPS is specifically and uniquely implemented to address key mechanisms relevant to quitting smoking and maintaining abstinence. [Copyright &y& Elsevier]

Ambulatory assessment of smoking behavior has greatly advanced our knowledge of the smoking cessation process. The current article first provides a brief overview of ecological momentary assessment for smoking cessation and highlights some of the primary advantages and scientific advancements made from this data collection method. Next, a discussion of how certain data collection tools (i.e., smoking topography and carbon monoxide detection) that have been traditionally used in lab-based settings are now being used to collect data in the real world. The second half of the paper focuses on the use of wearable wireless sensors to collect data during the smoking cessation process. Details regarding how these sensor-based technologies work, their application to newer tobacco products, and their potential to be used as intervention tools are discussed. Specific focus is placed on the opportunity to utilize novel intervention approaches, such as Just-In-Time Adaptive Interventions, to intervene upon smoking behavior. Finally, a discussion of some of the current challenges and limitations related to using sensor-based tools for smoking cessation are presented, along with suggestions for future research in this area. [ABSTRACT FROM AUTHOR]

Background: Smartphone apps can provide real-time, tailored interventions for smoking cessation. The current study examines the effectiveness of a smartphone-based smoking cessation application that assessed risk for imminent smoking lapse multiple times per day and provided messages tailored to current smoking lapse risk and specific lapse triggers.Methods: Participants (N=59) recruited from a safety-net hospital smoking cessation clinic completed phone-based ecological momentary assessments (EMAs) 5 times/day for 3 consecutive weeks (1week pre-quit, 2weeks post-quit). Risk for smoking lapse was estimated in real-time using a novel weighted lapse risk estimator. With each EMA, participants received messages tailored to current level of risk for imminent smoking lapse and self-reported presence of smoking urge, stress, cigarette availability, and motivation to quit. Generalized linear mixed model analyses determined whether messages tailored to specific lapse risk factors were associated with greater reductions in these triggers than messages not tailored to specific triggers.Results: Overall, messages tailored to smoking urge, cigarette availability, or stress corresponded with greater reductions in those triggers than messages that were not tailored to specific triggers (p's=0.02 to <0.001). Although messages tailored to stress were associated with greater reductions in stress than messages not tailored to stress, the association was non-significant (p=0.892) when only moments of high stress were included in the analysis.Conclusions: Mobile technology can be used to conduct real-time smoking lapse risk assessment and provide tailored treatment content. Findings provide initial evidence that tailored content may impact users' urge to smoke, stress, and cigarette availability. [ABSTRACT FROM AUTHOR]

Background Although individuals with psychiatric disorders are disproportionately affected by cigarette smoking, few outpatient mental health treatment facilities offer smoking cessation services. In this paper, we describe the development of a smartphone-assisted mindfulness smoking cessation intervention with contingency management (SMI-CM), as well as the design and methods of an ongoing pilot randomized controlled trial (RCT) targeting smokers receiving outpatient psychiatric treatment. We also report the results of an open-label pilot feasibility study. Methods In phase 1, we developed and pilot-tested SMI-CM, which includes a smartphone intervention app that prompts participants to practice mindfulness, complete ecological momentary assessment (EMA) reports 5 times per day, and submit carbon monoxide (CO) videos twice per day. Participants earned incentives if submitted videos showed CO ≤ 6 ppm. In phase 2, smokers receiving outpatient treatment for mood disorders are randomized to receive SMI-CM or enhanced standard treatment plus non-contingent CM (EST). Results The results from the pilot feasibility study ( N = 8) showed that participants practiced mindfulness an average of 3.4 times/day (≥ 3 min), completed 72.3% of prompted EMA reports, and submitted 68.0% of requested CO videos. Participants reported that the program was helpful overall ( M = 4.85/5) and that daily mindfulness practice was helpful for both managing mood and quitting smoking ( Ms = 4.50/5). Conclusions The results from the feasibility study indicated high levels of acceptability and satisfaction with SMI-CM. The ongoing RCT will allow evaluation of the efficacy and mechanisms of action underlying SMI-CM for improving cessation rates among smokers with mood disorders. [ABSTRACT FROM AUTHOR]

Tobacco and alcohol use are linked behaviors that individually and synergistically increase the risk for negative health consequences. This study was a two-group, randomized clinical trial evaluating the efficacy of a behavioral intervention, "Motivation And Problem Solving Plus" (MAPS+), designed to concurrently address smoking cessation and the reduction of at-risk drinking. Targeted interventions may promote coaction, the likelihood that changing one behavior (smoking) increases the probability of changing another behavior (alcohol use). Puerto Ricans (N=202) who were smokers and at-risk drinkers were randomized to standard MAPS treatment focused exclusively on smoking cessation (S-MAPS), or MAPS+, focused on cessation and at-risk drinking reduction. Drinking outcomes included: number of at-risk drinking behaviors, heavy drinking, binge drinking, and drinking and driving. MAPS+ did not have a significant main effect on reducing at-risk drinking relative to S-MAPS. Among individuals who quit smoking, MAPS+ reduced the number of drinking behaviors, the likelihood of meeting criteria for heavy drinking relative to S-MAPS, and appeared promising for reducing binge drinking. MAPS+ did not improve drinking outcomes among individuals who were unsuccessful at quitting smoking. MAPS+ showed promise in reducing at-risk drinking among Puerto Rican smokers who successfully quit smoking, consistent with treatment enhanced coaction. Integrating an alcohol intervention into cessation treatment did not reduce engagement in treatment, or hinder cessation outcomes, and positively impacted at-risk drinking among individuals who quit smoking. Findings of coaction between smoking and drinking speak to the promise of multiple health behavior change interventions for substance use treatment and chronic disease prevention. [ABSTRACT FROM AUTHOR]

Smoking cessation treatments that are easily accessible and deliver intervention content at vulnerable moments (e.g., high negative affect) have great potential to impact tobacco abstinence. The current study examined the feasibility and acceptability of a multi-component Just-In-Time Adaptive Intervention (JITAI) for smoking cessation. Daily smokers interested in quitting were consented to participate in a 6-week cessation study. Visit 1 occurred 4 days pre-quit, Visit 2 was on the quit day, Visit 3 occurred 3 days post-quit, Visit 4 was 10 days post-quit, and Visit 5 was 28 days post-quit. During the first 2 weeks (Visits 1-4), the JITAI delivered brief mindfulness/motivational strategies via smartphone in real-time based on negative affect or smoking behavior detected by wearable sensors. Participants also attended 5 in-person visits, where brief cessation counseling (Visits 1-4) and nicotine replacement therapy (Visits 2-5) were provided. Outcomes were feasibility and acceptability; biochemically-confirmed abstinence was also measured. Participants (N = 43) were 58.1 % female (AgeMean = 49.1, mean cigarettes per day = 15.4). Retention through follow-up was high (83.7 %). For participants with available data (n = 38), 24 (63 %) met the benchmark for sensor wearing, among whom 16 (67 %) completed at least 60 % of strategies. Perceived ease of wearing sensors (Mean = 5.1 out of 6) and treatment satisfaction (Mean = 3.6 out of 4) were high. Biochemically-confirmed abstinence was 34 % at Visit 4 and 21 % at Visit 5. Overall, the feasibility of this novel multi-component intervention for smoking cessation was mixed but acceptability was high. Future studies with improved technology will decrease participant burden and better detect key intervention moments. [ABSTRACT FROM AUTHOR]

In the midst of the COVID-19 pandemic, many research and clinical teams have transitioned their projects to a remote-based format, weighing the pros and cons of making such a potentially disruptive decision. One key aspect of this decision is related to the patient population, with underserved populations possibly benefiting from the increased reach of telehealth, while also encountering technology barriers that may limit accessibility. Early in the pandemic, our team shifted a group-based, smoking cessation and alcohol modification treatment trial to a remote-based format. Our population included individuals who concurrently wanted to quit smoking and modify their alcohol use. This paper describes technical and logistical considerations of transitioning from in-person to remote-based delivery for group-based treatment, including the impact upon study staff, group facilitators, participants, and the institution. Remotely-delivered group treatment may be valuable not only in response to pandemic-related restrictions, but it may also offer an alternative treatment-delivery modality with independent benefits in terms of population reach, costs, and pragmatics for clients, staff, and institutions. [ABSTRACT FROM AUTHOR]

Abstract: Background: Prominent theories of drug use underscore the importance of considering the inter-relationships (e.g., reciprocal relations, indirect effects) of determinants of drug use behavior. In the area of smoking, few studies have examined multiple determinants of cessation in this way, and in prospective analyses. The current study is an examination of the prospective cross-lagged relationships among five intrapersonal determinants of cessation. Methods: Data from a longitudinal cohort study on racial differences in the process of smoking cessation were used to examine reciprocal relations among abstinence motivation, abstinence self-efficacy, positive affect, negative affect, and craving. Each of these five measures assessed on the quit day were regressed onto the same measures assessed 1–2 weeks pre-quit. The relationships of these variables at quit day with 1-week post-quit abstinence from smoking were also examined. Results: When the five variables were examined simultaneously in a cross-lagged path analysis, motivation and self-efficacy, and self-efficacy and positive affect showed cross-lagged relations. Only self-efficacy on the quit day uniquely predicted 1-week post quit abstinence. There were significant indirect effects of motivation and positive affect on cessation via self-efficacy. Conclusions: The current study reaffirms the importance of motivation and self-efficacy in smoking cessation, and suggests that positive affect may play a role in smoking cessation. [Copyright &y& Elsevier]

Abstract: Background: Although studies have shown a cross-sectional link between discrimination and smoking, the prospective influence of discrimination on smoking cessation has yet to be evaluated. Thus, the purpose of the current study was to determine the influence of everyday and major discrimination on smoking cessation among Latinos making a quit attempt. Methods: Participants were 190 Spanish speaking smokers of Mexican Heritage recruited from the Houston, TX metropolitan area who participated in the study between 2009 and 2012. Logistic regression analyses were conducted to evaluate the associations of everyday and major discrimination with smoking abstinence at 26 weeks post-quit. Results: Most participants reported at least some everyday discrimination (64.4%), and at least one major discrimination event (56%) in their lifetimes. Race/ethnicity/nationality was the most commonly perceived reason for both everyday and major discrimination. Everyday discrimination was not associated with post-quit smoking status. However, experiencing a greater number of major discrimination events was associated with a reduced likelihood of achieving 7-day point prevalence smoking abstinence, OR=.51, p =.004, and continuous smoking abstinence, OR=.29, p =.018, at 26 weeks post-quit. Conclusions: Findings highlight the high frequency of exposure to discrimination among Latinos, and demonstrate the negative impact of major discrimination events on a smoking cessation attempt. Efforts are needed to attenuate the detrimental effects of major discrimination events on smoking cessation outcomes. [Copyright &y& Elsevier]

Although over 70% of homeless individuals smoke, few studies have examined the effectiveness of smoking cessation interventions in this vulnerable population. The purpose of this pilot study was to compare the effectiveness of shelter-based smoking cessation clinic usual care (UC) to an adjunctive contingency management (CM) treatment that offered UC plus small financial incentives for smoking abstinence. Sixty-eight homeless individuals in Dallas, Texas (recruited in 2012) were assigned to UC (n =58) or UC plus financial incentives (CM; n =10) groups and were followed for 5 consecutive weeks (1 week pre-quit through 4 weeks post-quit). A generalized linear mixed model regression analysis was conducted to compare biochemically-verified abstinence rates between groups. An additional model examined the interaction between time and treatment group. The participants were primarily male (61.8%) and African American (58.8%), and were 49 years of age on average. There was a significant effect of treatment group on abstinence overall, and effects varied over time. Follow-up logistic regression analyses indicated that CM participants were significantly more likely than UC participants to be abstinent on the quit date (50% vs. 19% abstinent) and at 4 weeks post-quit (30% vs. 1.7% abstinent). Offering small financial incentives for smoking abstinence may be an effective way to facilitate smoking cessation in homeless individuals. [Copyright &y& Elsevier]

Background: Because smoking has a profound impact on socioeconomic disparities in illness and death, it is crucial that vulnerable populations of smokers be targeted with treatment. The U.S. Public Health Service recommends that all patients be asked about their smoking at every visit and that smokers be given brief advice to quit and referred to treatment.Purpose: Initiatives to facilitate these practices include the 5A's (ask, advise, assess, assist, arrange) and Ask-Advise-Refer (AAR). Unfortunately, primary care referrals are low, and most smokers referred fail to enroll. This study evaluated the efficacy of the Ask-Advise-Connect (AAC) approach to linking smokers with treatment in a large, safety net public healthcare system.Design: The study design was a pair-matched group-randomized trial with two treatment arms.Setting/participants: Ten safety net clinics in Houston TX.Intervention: Clinics were randomized to AAC (n=5; intervention) or AAR (n=5; control). Licensed vocational nurses (LVNs) were trained to assess and record the smoking status of all patients at all visits in the electronic health record. Smokers were given brief advice to quit. In AAC, the names and phone numbers of smokers who agreed to be connected were sent electronically to the Texas quitline daily, and patients were proactively called by the quitline within 48 hours. In AAR, smokers were offered a quitline referral card and encouraged to call on their own. Data were collected between June 2010 and March 2012 and analyzed in 2012.Main Outcome Measures: The primary outcome was impact, defined here as the proportion of identified smokers that enrolled in treatment.Results: The impact (proportion of identified smokers who enrolled in treatment) of AAC (14.7%) was significantly greater than the impact of AAR (0.5%), t(4)=14.61, p=0.0001, OR=32.10 (95% CI=16.60, 62.06).Conclusions: The AAC approach to aiding smoking cessation has tremendous potential to reduce tobacco-related health disparities. [ABSTRACT FROM AUTHOR]

Smoking is the leading preventable cause of death and disability in the U.S. Empirical evidence suggests that engaging in evidence-based self-regulatory strategies (e.g., behavioral substitution, mindful attention) can improve smokers' ability to resist craving and build self-regulatory skills. However, poor engagement represents a major barrier to maximizing the impact of self-regulatory strategies. This paper describes the protocol for Mobile Assistance for Regulating Smoking (MARS) – a research study designed to inform the development of a mobile health (mHealth) intervention for promoting real-time, real-world engagement in evidence-based self-regulatory strategies. The study will employ a 10-day Micro-Randomized Trial (MRT) enrolling 112 smokers attempting to quit. Utilizing a mobile smoking cessation app, the MRT will randomize each individual multiple times per day to either: (a) no intervention prompt; (b) a prompt recommending brief (low effort) cognitive and/or behavioral self-regulatory strategies; or (c) a prompt recommending more effortful cognitive or mindfulness-based strategies. Prompts will be delivered via push notifications from the MARS mobile app. The goal is to investigate whether, what type of, and under what conditions prompting the individual to engage in self-regulatory strategies increases engagement. The results will build the empirical foundation necessary to develop a mHealth intervention that effectively utilizes intensive longitudinal self-report and sensor-based assessments of emotions, context and other factors to engage an individual in the type of self-regulatory activity that would be most beneficial given their real-time, real-world circumstances. This type of mHealth intervention holds enormous potential to expand the reach and impact of smoking cessation treatments. [ABSTRACT FROM AUTHOR]

Abstract: The current study utilized regression analyses to explore the relationships among demographic and linguistic indicators of acculturation, gender, and tobacco dependence among Spanish-speaking Latino smokers in treatment. Additionally, bootstrapping analyses were used to examine the role of dependence as a mediator of the relationship between indicators of acculturation and cessation. Indicators of time spent in the United States were related to indicators of physical dependence. Preferred media language was related to a multidimensional measure of dependence. Gender did not impact the relationships between acculturation indicators and dependence. A multidimensional measure of dependence significantly mediated the relationship between preferred media language and cessation. Future research would benefit from consideration of acculturation and multidimensional measures of dependence when studying smoking cessation among Latinos, and from further examination of factors accounting for relationships among acculturation, dependence, and cessation. [Copyright &y& Elsevier]

Abstract: In this study, we examined the relationship between the level of daily cigarette consumption and the startle response to affective and cigarette-related cues among treatment-seeking smokers. Before receiving any behavioral or pharmacological treatment, 136 smokers attended a baseline laboratory session, during which we recorded their reflexive eyeblink responses to acoustic startle probes while they were viewing pleasant, unpleasant, neutral, and cigarette-related pictures. We found that 1) cigarette-related and pleasant pictures similarly reduced the startle magnitude compared to neutral pictures; 2) the magnitude of startle modulation rendered by pleasant or unpleasant pictures did not differ among light, moderate, and heavy smokers; and 3) startle attenuation by cigarette-related pictures was greater in heavy smokers than in light smokers. These results suggest that similar to pleasant stimuli, cigarette-related cues are motivationally salient for smokers, and that this salience increases with nicotine dependence. [Copyright &y& Elsevier]

Abstract: African Americans suffer disproportionately from the adverse health consequences of smoking, and also report substantially lower socioeconomic status than Whites and other racial/ethnic groups in the U.S. Although socioeconomic disadvantage is known to have a negative influence on smoking cessation rates and overall health, little is known about the influence of socioeconomic status on smoking cessation specifically among African Americans. Thus, the purpose of the current study was to characterize the impact of several individual- and area-level indicators of socioeconomic status on smoking cessation among African Americans. Data were collected as part of a smoking cessation intervention study for African American smokers (N = 379) recruited from the Houston, Texas, metropolitan area, who participated in the study between 2005 and 2007. The separate and combined influences of individual-level (insurance status, unemployment, education, and income) and area-level (neighborhood unemployment, education, income, and poverty) indicators of socioeconomic status on continuous smoking abstinence were examined across time intervals using continuation ratio logit modeling. Individual-level analyses indicated that unemployment was significantly associated with reduced odds of smoking abstinence, while higher income was associated with greater odds of abstinence. However, only unemployment remained a significant predictor of abstinence when unemployment and income were included in the model together. Area-level analyses indicated that greater neighborhood unemployment and poverty were associated with reduced odds of smoking abstinence, while greater neighborhood education was associated with higher odds of abstinence. However, only neighborhood unemployment remained significantly associated with abstinence status when individual-level income and unemployment were included in the model. Overall, findings suggest that individual- and area-level unemployment have a negative impact on smoking cessation among African Americans. Addressing unemployment through public policy and within smoking cessation interventions, and providing smoking cessation treatment for the unemployed may have a beneficial impact on tobacco-related health disparities. [Copyright &y& Elsevier]

Abstract: Background: Negative affect is an important predictor of smoking behavior, and many smokers believe that smoking reduces negative affect. However, it is unclear whether such beliefs, known as negative reinforcement smoking outcome expectancies (NRSOE), are associated with changes in negative affect in response to nicotine deprivation and administration. Methods: Smokers (N =114) participated in 4 sessions that balanced overnight smoking deprivation (12-h deprived vs. ad lib) and nasal spray administration (nicotine vs. placebo). Corrugator supercilii (COR) EMG, skin conductance (SCR), and in-session ratings were collected while the participants viewed affective, cigarette-related, and neutral slides. Retrospective questionnaire data were collected prior to slide viewing. NRSOE were determined using the Smoking Consequences Questionnaire – Adult Nicotine Affect Reduction scale (SCQ-NAR). Results: High scores on the SCQ-NAR were associated with smaller COR EMG to unpleasant slides following nicotine nasal spray administration compared to placebo spray, regardless of overnight deprivation. Smokers who had high scores on the SCQ-NAR had smaller SCR, following nicotine nasal spray administration compared to placebo spray, but only after overnight deprivation. The in-session ratings and retrospective questionnaire measures indicated that smokers who had high scores on the SCQ-NAR experienced greater negative affect and craving, and less positive affect, than smokers with low scores on the SCQ-NAR, regardless of nicotine exposure. Conclusions: Our questionnaire results suggest that while smokers who have high NRSOE self-report greater overall levels of negative affect and craving, while the psychophysiological data suggest that such smokers may experience negative affect reduction when blindly administered a dose of nicotine. [Copyright &y& Elsevier]

Background: Recent cross-sectional evidence suggests that the effect of depression on smoking prevalence and quit ratios differs by race/ethnicity. Purpose: This study prospectively examined the main and interactive effects of race/ethnicity and depressive symptoms on smoking cessation during a specific quit attempt among smokers receiving cessation treatment. Methods: Data from a longitudinal study of smokers in treatment were examined using continuation ratio logit modeling. Continuous abstinence across Weeks 1, 2, and 4 post-quit was the outcome variable. Data were collected between March 2005 and November 2007, and the current study analyses were conducted in April 2010. Results: Depressive symptoms predicted significantly lower cessation rates for whites and African Americans. In contrast, among Latinos there was no relationship between depression and cessation. Conclusions: This research is the first to prospectively demonstrate a racially/ethnically differentiated effect of depressive symptoms on smoking cessation, and it has implications for targeted smoking-cessation treatments as it indicates that depression may not be a key treatment target for Latinos. [ABSTRACT FROM AUTHOR]

Abstract: Subjective social status (SSS) reflects an individual''s perception of her/his relative position in the social hierarchy. However, little is known about culturally-relevant, multilevel predictors of low SSS among low socioeconomic status (SES), minority populations. The goal of this study was to identify individual- and neighborhood-level variables predicting SSS among 297 Spanish-speaking Latino immigrant smokers living in several locations in Texas, with an emphasis on the association of SSS with acculturative and socioeconomic variables. Participants were recruited and enrolled through the National Cancer Institute''s Cancer Information Service from August 2002 to March 2004. Determinants of SSS were explored using a series of linear regressions. In analyses adjusting for demographics (including objective indicators of SES), speaking Spanish at home and work and living in economically disadvantaged neighborhoods, respectively, were associated with low SSS. However, in analyses including demographics, acculturation, and neighborhood characteristics, only income, education, and acculturation remained associated with SSS. Consistent with results from a previous study in the area (), less acculturation predicted low SSS among immigrant Latino smokers. However, unlike previous research, these associations were maintained after controlling for SES. Results suggest that the density of less acculturated Latinos within economically deprived neighborhoods might account for the disappearance of neighborhood effects in the final model. [Copyright &y& Elsevier]

Abstract: The majority of smoking cessation research has focused on heavy smokers. African Americans (AA) are less likely than the general population to be heavy smokers. Thus, little is known about the smoking and psychosocial characteristics of lighter AA smokers. The present study compared the baseline demographic, smoking, and psychosocial characteristics of light (5–10 cigarettes per day; n =86) and moderate to heavy (>10 cigarettes per day; n =286) AA smokers enrolled in a smoking cessation clinical trial. Results indicated no differences between groups on demographic variables. However, light smokers (LS) were less dependent on smoking, reported more previous quit attempts, and had higher self-efficacy to quit than moderate to heavy smokers (MHS). On a measure of withdrawal, LS reported less pre-quit craving and less difficulty concentrating than MHS. In addition, LS reported lower perceived stress, fewer symptoms of depression, and greater positive affect than AA MHS. These findings highlight important similarities and differences between AA LS and MHS, and have implications for the treatment of AA smokers. [Copyright &y& Elsevier]

Abstract: Research suggests that there are racial disparities in smoking behaviors, cessation rates, mortality, and morbidity. However, little is known regarding racial differences in affect regulation by smoking. The purpose of this study was to examine racial differences in the effects of nicotine deprivation and administration on smokers'' startle responding to smoking and affective cues. 104 African American (AA) and Caucasian American (CA) smokers completed 4 laboratory sessions crossing nicotine deprivation (12-hour deprived vs. nondeprived) with nicotine nasal spray (active vs. placebo). Participants viewed affective (positive, neutral, and negative) and smoking slides while startle probes were administered. The results showed that relative to placebo, AA smokers given nicotine spray exhibited significantly lower startle responses when they were exposed to smoking cues and CA smokers given nicotine spray exhibited significantly lower startle responses when they were exposed to negative and neutral cues. Although nicotine suppresses startle responding in both AA and CA smokers, the effect is modulated by different cue conditions, suggesting that there may be racial differences in components of smoking motivation. [Copyright &y& Elsevier]

Abstract: The Implicit Association Test (IAT) has been used to assess automatic affective responses to drug cues. Smokers (n =57) completed the IAT at four experimental sessions. They abstained from smoking before two of the sessions (AB) and smoked normally before the other two sessions (NON). At one AB (and NON) session, they smoked a cigarette about 40min before completing the IAT (S), and at the other they did not smoke (NS). Overall, participants exhibited a negative IAT effect, indicating that they found the classification task easier when smoking was paired with bad than when smoking was paired with good. Using repeated measures ANOVA, the IAT effect was made less negative by pre-session abstinence, and made more negative by smoking. It was most negative in the NON-S condition. Using Generalized Estimating Equations analyses, the IAT effect was positively associated with pre-task craving ratings assessed on the Questionnaire of Smoking Urges-Brief but was not associated with a physiological measure of automatic affective responses (startles while viewing smoking versus neutral pictures). The IAT effect was associated with scores on the Fagerstrom Test for Nicotine Dependence. In sum, automatic affective responses assessed with the smoking IAT are associated with measures of smoking motivation and dependence. [Copyright &y& Elsevier]

The combined use of cigarettes and alcohol is associated with an increased risk of morbidity and mortality. Yet, efficacious interventions that address both behaviors concurrently are lacking. Smoking cessation and alcohol modification not only garner health benefits, but there is also value in addressing alcohol use in the context of smoking cessation to reduce the risk for smoking relapse. In this paper we describe the development of mindfulness-based relapse prevention for smoking cessation and alcohol modification (MBRP-SA) and pilot study findings (Phase 1). Next, details regarding the methods and design of an ongoing, randomized controlled trial, Project RISE (Phase 2), are described. MBRP-SA is a group-based intervention that consists of eight weekly treatment sessions. Results from the Phase 1 pilot study (N = 21 enrolled) indicated that participants planned to use the skills learned in their everyday activities and to address their smoking and alcohol goals. Based on the progression of Phase 1 cohorts, modifications were made to the inclusion/exclusion criteria and recruitment methods that will be implemented in Phase 2. Phase 2 will assess the feasibility and acceptability of MBRP-SA, delivered via live online groups, as a primary treatment option for smoking cessation and alcohol use modification. [ABSTRACT FROM AUTHOR]