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This study examined prevalence and correlates of using cigarettes, e-cigarettes, and other tobacco/nicotine delivery products in a U.S. national sample of women of reproductive age. Weighted data were obtained from women aged 15-44 years who were not currently pregnant in the first wave of the Population Assessment of Health and Tobacco (PATH, 2013–2014) study (N = 12,848). 20.1% of women were current cigarette smokers, 5.9% current e-cigarette users, 4.9% current cigar smokers, and 6.5% current hookah users. Prevalence of current use of other tobacco products was < 1.0%. Current cigarette smoking was the strongest correlate of current e-cigarette use (OR = 65.7, 95% CI = 44.8-96.5), cigar smoking (OR = 19.2, 95% CI = 14.1-26.1), and hookah use (OR = 6.6, 95% CI = 5.1-8.5). Among former cigarette smokers, 3.8%, 6.9%, and 3.2% were also currently using e-cigarettes, hookah, and cigars, respectively. Use of other tobacco and nicotine delivery products was low among those who never smoked tobacco cigarettes: 2.5% used hookah and < 1.0% used other products. Cigarette smoking prevalence remains relatively high among women of reproductive age and strongly correlated with use of other tobacco products. Monitoring tobacco and nicotine use in this population is important due to the additional risk of adverse health impacts should they become pregnant. Clinicians working with cigarette smokers should assess for use of other tobacco products. Among women of reproductive age, use of emerging tobacco and nicotine products appears to be largely, although not exclusively, restricted to current cigarette smokers.

This study examined quit rates longitudinally for cigarettes, e-cigarettes, hookah, cigars, and all tobacco products in a U.S. national sample of women aged 18–44 who completed both Wave 1 (W1) and Wave 2 (W2) of the Population Assessment of Tobacco and Health (PATH, 2013–2014, 2014–2015) study (N = 7814). Quit rates were examined among women who transitioned into pregnancy across survey waves, and among a comparable sample of non-pregnant women to provide contextual information about quitting among the broader population of reproductive-aged women. Multiple logistic regression modeling was used to estimate the associations of pregnancy and quitting adjusting for other demographic and psychosocial characteristics. Quit rates among women who were pregnant in W2 were highest for hookah (98.3%), followed by cigars (88.0%), e-cigarettes (81.3%), and lowest for tobacco cigarettes (53.4%). Slightly more than half (58.7%) of women reported quitting use all tobacco products while pregnant. Pregnancy was independently associated with increased odds of quitting hookah (AOR = 52.9, 95%CI = 3.4, 830.2), e-cigarettes (AOR = 21.0, 95%CI = 2.6, 170.3), all tobacco products (AOR = 9.6, 95%CI = 6.4, 14.5), and cigarettes (AOR = 6.5, 95%CI = 4.2, 10.1), although not cigars. Relative to other demographic and psychosocial characteristics, pregnancy was the strongest predictor of quitting use of each tobacco product. While these data indicate that pregnancy has strong, independent associations with quitting a variety of commercially available tobacco products, the comparatively lower quit rates for cigarettes versus other tobacco products underscores the long-standing need for more intensive, multipronged clinical and regulatory interventions to reduce cigarette use among reproductive-aged women.

Smoking status following cardiac events strongly predicts future morbidity and mortality. Using a nationally representative sample of United States adults, aims of this study were (1) to estimate use of, and attitudes towards, tobacco products as a function of level of cardiac risk, and (2) to explore changes in attitudes and tobacco use among adults experiencing a recent myocardial infarction (MI). Data were obtained from the first and second waves of the Population Assessment of Tobacco and Health (PATH) study. Use and attitudes towards tobacco products were examined at Wave 1 among adults with no chronic health condition (n = 18,026), those with risk factors for heart disease (n = 4593), and those who reported ever having had an MI (n = 643). Changes in perceived risk of tobacco and use between the two waves and having an MI in the last 12 months (n = 240) were also examined. Those who reported lifetime MI were more likely to believe that smoking/using tobacco was causing/worsening a health problem. Having had a recent MI event increased perceived tobacco-related risk and attempts at reduction/quitting, but did not significantly impact combusted tobacco cessation/reduction or uptake of non-combusted tobacco products. Sociodemographic characteristics and use of other tobacco products were associated with change in use of tobacco products. Those who have an MI are sensitized to the harm of continued smoking. Nonetheless, having an MI does not predict quitting combusted tobacco use or switching to potentially reduced harm products. Intense intervention is necessary to reduce combusted use in this high-risk population.

Monitoring use of tobacco products among pregnant women is a public health priority, yet few studies in U.S. national samples have been reported on this topic. We examined prevalence and correlates of using cigarettes, e-cigarettes, and other tobacco/nicotine delivery products in a U.S. national sample of pregnant women. Data were obtained from all pregnant women (≥ 18 years) in the first wave of the Population Assessment of Tobacco and Health (PATH, 2013–2014) Study (N = 388). Prevalence of current and prior use of tobacco/nicotine products was examined overall and among current cigarette smokers. Multiple logistic regression was used to examine correlates of use of cigarettes, e-cigarettes, hookah and cigars. Overall prevalence was highest for cigarettes (13.8%), followed by e-cigarettes (4.9%), hookah (2.5%) and cigars (2.3%), and below 1% for all other products. Prevalence of using other tobacco products is much higher among current smokers than the general population, with e-cigarettes (28.5%) most prevalent followed by cigars (14.0%), hookah (12.4%), smokeless (4.7%), snus (4.6%), and pipes (2.1%). Sociodemographic characteristics (poverty, low educational attainment, White race) and past-year externalizing psychiatric symptoms were correlated with current cigarette smoking. In turn, current cigarette smoking and past year illicit drug use were correlated with using e-cigarettes, hookah, and cigars. These results underscore that tobacco/nicotine use during pregnancy extends beyond cigarettes. The results also suggest that use of these other products should be included in routine clinical screening on tobacco use, and the need for more intensive tobacco control and regulatory strategies targeting pregnant women.

Disparities in tobacco use are worsening in the United States, disproportionately affecting those with chronic medical conditions. One possible contributor is that physicians may not screen and advise cessation uniformly across patients and/or tobacco products.This study examined provider communications regarding cigarette and non-cigarette tobacco products among adults with chronic conditions.Cross-sectional study drawn from two waves (2013-2014) of the National Survey on Drug Use and Health (NSDUH).Adults (≥ 18 years) who used tobacco in the past year.Prevalence of tobacco use included past-year use of cigarettes, cigars, or smokeless tobacco among those with and without chronic conditions. Chronic conditions included asthma, anxiety, coronary heart disease, depression, diabetes, hepatitis, HIV, hypertension, lung cancer, stroke, and substance abuse. Odds ratio of receipt of screening and advice to quit across chronic condition and tobacco product type were reported. Data were analyzed using logistic regression, controlling for basic sociodemographic factors and number of provider visits.Adults with anxiety, depression, and substance use disorders had the highest prevalence of past-year cigarette (37.2-58.2%), cigar (9.1-28.0%), and smokeless tobacco (3.1-11.7%) use. Patients with any chronic condition were more likely to receive advice to quit than those without a condition (OR 1.21-2.37, p 0.01), although the odds were lowest among adults with mental health and substance use disorders (OR 1.21-1.35, p 0.01). Cigarette smokers were more likely to report being screened and advised to quit than non-cigarette tobacco users (OR 1.54-5.71, p 0.01).Results support the need for provider training to expand screening and cessation interventions to include the growing spectrum of tobacco products. Screening and referral to interventions are especially needed for those with mental health and substance use disorders to reduce the disparate burden of tobacco-related disease and death.

BACKGROUND: Researchers in several studies have examined correlations between tobacco harm perceptions and tobacco use in youth, but none have prospectively addressed the association between harm perceptions and subsequent new use across multiple noncigarette products. METHODS: Product-specific absolute and relative harm perceptions for cigarettes, electronic cigarettes (e-cigarettes), cigars, pipes, hookah, and smokeless tobacco were collected at wave 1 (W1) (2013–2014) among youth in the nationally representative US Population Assessment of Tobacco and Health Study (12–17 years of age; n = 10 081). At wave 2 (W2) (2014–2015), product-specific new use was calculated. Adjusted relative risks were used to estimate if harm perceptions at W1 predicted W2 new tobacco use. RESULTS: The proportion of youth who endorsed “a lot of harm” was highest for cigarettes (84.8%) and lowest for e-cigarettes (26.6%); the proportion of youth who thought products were “more harmful” than cigarettes was highest for cigars (30.6%) and lowest for e-cigarettes (5.1%). Among youth who had not used those products at W1, product-specific new use at W2 ranged from 9.1% (e-cigarettes) to 0.6% (pipes). Youth who believed that noncombustible tobacco products posed “no or little harm” at W1 were more likely to have tried those products at W2 (P < .05). Youth who viewed e-cigarettes, hookah, and smokeless tobacco as “less harmful” than cigarettes at W1 were more likely to try those tobacco products at W2 (P < .05). CONCLUSIONS: Low harm perceptions of noncigarette tobacco products predict new use of these products by youth within the next year. Targeting product-specific harm perceptions may prevent new tobacco use among youth.

Colorectal surgery outcomes must be accurately assessed and aligned with patient priorities. No study to date has investigated the patient's subjective assessment of outcomes most important to them during and following their surgical recovery. Although surgeons greatly value the benefits of laparoscopy, patient priorities remain understudied.This study aimed to assess what aspects of patients' perioperative care and recovery they value most when queried in the postoperative period.This study is an exploratory cross-sectional investigation of a defined retrospective patient population. Enrollees were stratified into subcategories and analyzed, with statistical analysis performed via χ test and unpaired t test.This study was conducted at a single academic medical center in New England.Patients who underwent a colorectal surgical resection between 2009 and 2015 were selected.Patients within a preidentified population were asked to voluntarily complete a 32-item questionnaire regarding their surgical care.The primary outcomes measured were patient perioperative and postoperative quality of life and satisfaction on selected areas of functioning.Of 167 queried respondents, 92.2% were satisfied with their recovery. Factors considered most important included being cured of colorectal cancer (76%), not having a permanent stoma (78%), and avoiding complications (74%). Least important included length of stay (13%), utilization of laparoscopy (14%), and incision appearance and length (2%, 4%).The study had a relatively low response rate, the study is susceptible to responder's bias, and there is temporal variability from surgery to questionnaire within the patient population.Overall, patients reported high satisfaction with their care. Most important priorities included being free of cancer, stoma, and surgical complications. In contrast, outcomes traditionally important to surgeons such as laparoscopy, incision appearance, and length of stay were deemed less important. This research helps elucidate the outcomes patients truly consider valuable, and surgeons should focus on these outcomes when making surgical decisions. See Video Abstract at http://links.lww.com/DCR/A596. See Visual Abstract at https://tinyurl.com/yb25xl66.

U.S. smoking prevalence is declining at a slower rate in rural than urban settings and contributing to regional health disparities. Cigarette smoking among women of reproductive age is particularly concerning due to the potential for serious maternal and infant adverse health effects should a smoker become pregnant. The aim of the present study was to examine whether this rural-urban disparity impacts women of reproductive age (ages 15–44) including pregnant women. Data came from the ten most recent years of the U.S. National Survey on Drug Use and Health (2007–2016). We estimated prevalence of current smoking and nicotine dependence among women categorized by rural-urban residence, pregnancy status, and trends using chi-square testing and multivariable modeling while adjusting for common risk factors for smoking. Despite overall decreasing trends in smoking prevalence, prevalence was higher among rural than urban women of reproductive age overall (χ2(1) = 579.33, p < .0001) and among non-pregnant (χ2(1) = 578.0, p < .0001) and pregnant (χ2(1) = 79.69, p < .0001) women examined separately. An interaction between residence and pregnancy status showed adjusted odds of smoking among urban pregnant compared to non-pregnant women (AOR = .58, [.53 –.63]) were lower than those among rural pregnant compared to non-pregnant women (AOR = 0.75, [.62 –.92]), consistent with greater pregnancy-related smoking cessation among urban pregnant women. Prevalence of nicotine dependence was also higher in rural than urban smokers overall (χ2(2) = 790.42, p < .0001) and among non-pregnant (χ2(2) = 790.58, p < .0001) and pregnant women examined separately (χ2(2) = 63.69, p < .0001), with no significant changes over time. Associations involving residence and pregnancy status remained significant in models adjusting for covariates (ps < 0.05). Results document greater prevalence of smoking and nicotine dependence and suggest less pregnancy-related quitting among rural compared to urban women, disparities that have potential for direct, multi-generational adverse health impacts.

Objectives. To examine urban–rural differences in US prevalences of traditional and emerging tobacco product use as well as dual or polytobacco use of these products. Methods. Our data were derived from wave 1 (2013–2014) of the Population Assessment of Tobacco and Health (PATH) Study. We estimated weighted prevalences of adult tobacco use across urban–rural geographies and examined prevalences classified by gender, poverty level, and region of the country. Results. Nationally, cigarette use and smokeless tobacco use, as well as dual or polytobacco use of traditional products, were more prevalent in rural than in urban areas. Conversely, cigarillo and hookah use and dual or polytobacco use of emerging products were higher in urban areas. There was no significant urban–rural difference in use of e-cigarettes. Gender, poverty, and region of the country did not seem to be driving most urban–rural differences, although differences related to cigarillo use and dual or polytobacco use of emerging products became nonsignificant after control for covariates. Conclusions. Our findings highlight important urban–rural differences in tobacco use. Whether the changing tobacco product landscape will contribute to a continuation of rural health disparities remains to be seen.

Introduction Understanding patterns of single and multiple tobacco product use among reproductive-aged women is critical given the potential for adverse health effects on mother and infant should a woman become pregnant. Methods Patterns of tobacco use over a 2-year period were examined among all women (18–44 years) who completed wave 1 (W1) and wave 2 (W2) of the US Population Assessment of Tobacco and Health (PATH, 2013–2014, 2014–2015) Study. We examined the most common patterns of single and multiple tobacco product use in W1, and longitudinal trajectories of women engaged in each of these patterns of use from W1 to W2, among women not pregnant in either wave (n = 7480), not pregnant in W1 and pregnant in W2 (n = 332), and pregnant in W1 and not pregnant in W2 (n = 325). Results The most prevalent patterns of tobacco use in W1 among all three subgroups were using cigarettes alone followed by using cigarettes plus e-cigarettes. In all three subgroups, women using multiple products in W1 were more likely to adopt new use patterns in W2 relative to single-product users, with the new patterns generally involving dropping rather than adding products. The majority of multiple product use included cigarettes, and transitions to single product use typically involved dropping the noncigarette product. The most common trajectory among tobacco users transitioning to or from pregnancy was to use cigarettes alone in W2. Discussion This study contributes new knowledge characterizing tobacco use patterns across time and reproductive events among reproductive-aged women.

Rural areas of the United States have a higher smoking prevalence than urban areas. However, no recent studies have rigorously examined potential changes in this disparity over time or whether the disparity can be explained by demographic or psychosocial characteristics associated with smoking. The present study used yearly cross sectional data from the National Survey on Drug Use and Health from 2007 through 2014 to examine cigarette smoking trends in rural versus urban areas of the United States. The analytic sample included 303,311 respondents. Two regression models were built to examine (a) unadjusted rural and urban trends in prevalence of current smoking and (b) whether differences remained after adjusting for demographic and psychosocial characteristics. Results of the unadjusted model showed disparate and diverging cigarette use trends during the 8-year time period. The adjusted model also showed diverging trends, initially with no or small differences that became more pronounced across the 8-year period. We conclude that differences reported in earlier studies may be explained by differences in rural versus urban demographic and psychosocial risk factors, while more recent and growing disparities appear to be related to other factors. These emergent differences may be attributable to policy-level tobacco control and regulatory factors that disproportionately benefit urban areas such as enforcement of regulations around the sale and marketing of tobacco products and treatment availability. Strong federal policies and targeted or tailored interventions may be important to expanding tobacco control and regulatory benefits to vulnerable populations including rural Americans.

[Objective]: The present study seeks to extend previous bibliometric studies on eating disorders (EDs) by including a time-dependent analysis of the growth and evolution of multi-author collaborations and their correlation with ED publication trends from 1980 to 2014 (35 years). [Methods]: Using standardized practices, we searched Web of Science (WoS) Core Collection (WoSCC) (indexes: Science Citation Index-Expanded [SCIE], & Social Science Citation Index [SSCI]) and Scopus (areas: Health Sciences, Life Sciences, & Social Sciences and Humanities) to identify a large sample of articles related to EDs. We then submitted our sample of articles to bibliometric and graph theory analyses to identify co-authorship and social network patterns. [Results]: We present a large number of detailed findings, including a clear pattern of scientific growth measured as number of publications per five-year period or quinquennium (Q), a tremendous increase in the number of authors attracted by the ED subject, and a very high and steady growth in collaborative work. [Conclusions]: We inferred that the noted publication growth was likely driven by the noted increase in the number of new authors per Q. Social network analyses suggested that collaborations within ED follow patters of interaction that are similar to well established and recognized disciplines, as indicated by the presence of a “giant cluster”, high cluster density, and the replication of the “small world” phenomenon—the principle that we are all linked by short chains of acquaintances., This work was performed with a subsidy from Universidad Católica de Valencia “San Vicente Mártir” to resarch group INDOTEI: Evaluación de la Ciencia, for the years 2016-2017. This work is benefited from Spanish Government assistance through Government Delegation for the National Drugs Plan of the Ministry of Health, Social Services and Equality (project 2016/028); and National R+D+I (projects: CSO2012-39632-C02-01 and CSO2015-65594-C2-2-R) and 2015-Networks of Excellence Call (project CSO2015-71867-REDT) of the Ministry of Economy and Competitiveness.

This study examined the effect of emotion on opiate withdrawal induced hyperalgesia to determine whether emotional states modulate the magnitude of hyperalgesia. One hundred Hispanic men were recruited into one of three groups: heroin withdrawal, long-term heroin abstinence, and control. Participants were presented with pictures to induce neutral, positive, and negative emotional states. Affective valence, arousal, pain threshold, and tolerance to ischemic pain were measured. When pain threshold and tolerance were compared, the withdrawal group displayed significant heightened pain sensitivity when negative affect was induced. The authors also found that former heroin addicts showed heightened pain sensitivity following months of abstinence.

This is the first study to evaluate the psychometric properties of the Food Craving Questionnaire-Trait (FCQ-T), and Food Craving Questionnaire—State (FCQ-S) measures using a clinically heterogeneous sample of eating disorder patients (N = 177) recruited from seven different outpatient eating disorder treatment centers in Spain. Confirmatory factor analyses (CFAs) corroborated the factor structures of the FCQ-T and FCQ-S. The measures' scores and their factor-derived scale—scores yielded internal consistency reliability indexes that ranged from adequate to excellent. The measures were predictive of eating disorder symptoms. As expected, the FCQ-T was more strongly associated with eating disorder psychopathology than the FCQ-S. The results replicated the psychometric properties of the FCQ-T and FCQ-S in eating disorder populations and could become useful tools in clinical and research settings.

English and Spanish versions of the FCQ-T [Cepeda-Benito, A., Gleaves, D. H., Williams, T. L., & Erath, S. A. (2000). The development and validation of the state and trait food-cravings questionnaires. Behavior Therapy, 31, 151-173] were adapted to create the food chocolate-craving questionnaire trait (FCCQ-T). Female college students from England (N=293), and Spain (N=373) completed the FCCQ-T. Good and similar measurement fits for the English and Spanish versions were found. In concordance with the higher consumption of chocolate in Britain, British women reported greater chocolate cravings than Spanish women. Overall, the FCCQ-T appears a well-suited instrument to investigate chocolate cravings in English- and Spanish-speaking populations.

Cue-reactivity to chocolate images was assessed using self-report and physiological measures. From a pre-screening sample of 454, young women were selected and assigned to high and low chocolate craving groups (N = 36/group). The experimental procedure consisted in the elicitation and measurement of the cardiac defense and startle reflexes while viewing chocolate and standard affective images selected from the International Affective Picture System. In response to chocolate images, high cravers reported more pleasure and arousal but less control than low cravers. In high cravers, viewing chocolate images inhibited the cardiac defense but potentiated the startle reflex, as compared to low cravers. The results confirmed at the physiological level that the motivational state that underlies the experience of chocolate craving include both appetitive (inhibition of the defense reflex) and aversive (potentiation of the startle response) components. The findings supported a motivational conflict theory of chocolate craving.

We examined the potential for ethnicity to moderate the relationships between awareness and internalization of sociocultural ideals of appearance and between internalization and body dissatisfaction.Spanish (n = 100), Mexican American (n = 100), and European American (n = 100) female participants completed measures of sociocultural attitudes and body dissatisfaction. Path analysis using maximum likelihood with robust standard errors tested the relationships across and within ethnic groups.There was evidence for the mediational effect of internalization on the relationship between awareness and body dissatisfaction. Furthermore, both relationships were significantly stronger for European American women than for Mexican American or Spanish women (the predicted moderator effect).Results demonstrate how ethnicity may protect against the development of eating disorder symptoms and suggest that eating disorder prevention should involve denouncing the thin ideal, minimizing appearance as an indicator of value, and emphasizing traits other than appearance as determinants of worth.

Using 2 different samples of smokers, the authors developed and cross-validated a Spanish, brief version of the Questionnaire of Smoking Urges (QSU; S. T. TiffanyD. J. Drobes, 1991). The smokers in Study 1 (N = 245) and Study 2 (N = 225) were from the province of Alicante, Spain. In both samples, a 2-factor model provided an excellent fit for a 10-item, all positively worded version of the QSU. Moreover, in both studies each factor uniquely contributed to predict nicotine dependence. Overall, there was clear evidence of construct validity for the multidimensionality of smoking cravings among Spanish smokers.

This study evaluated the factor structure of the Questionnaire of Smoking Urges (QSU) across American and Spanish smokers. Using confirmatory factor analyses, the fits of one-, two-, and four-factor models of smoking craving in American and Spanish data sets were compared. The two-factor model provided the best fit in both samples. However, negatively worded items confounded the interpretation of the two-factor structure in both the American and Spanish data. The first factor had positively and negatively worded items, whereas the second had only positively worded items. The two-factor structure was reexamined, removing either the positively or the negatively worded items. Using only positively worded items resulted in a loss of fit, whereas using only negatively worded items improved model fit substantially. Thus, the results supported the generalization of smoking craving across Spanish and American smokers and suggested that negatively worded items play a larger role in the two-factor structure of the QSU than originally thought.

The Body Image Assessment (BIA) is a simple measure of body image disturbance. However, it has currently only been used with an individual administration format and only to assess ratings of current body size, ideal body size, and body dissatisfaction. It has also only been validated for use with women. In the current two studies, the reliability and validity of a group-administered version of the BIA procedure for both men and women that also assessed ratings of the ideal opposite sex and predictions about what the opposite sex would prefer as most attractive was examined. In the first study, results indicated good test-retest reliability for the group version for current and ideal body size and good concurrent validity with the individual administration format of the BIA. The results of the second study supported the construct and predictive validity of the group administered BIA, suggesting that it is a time-efficient alternative to the original, individually administered assessment.

Objective: We developed and tested the psychometric properties of Spanish versions of the Trait and State Food Cravings Questionnaires (FCQ–T and FCQ–S respectively). Method: The instruments were translated and adapted to Spanish and administered to undergraduate students from a Southern university in Spain (N=271). The data were analyzed using confirmatory factor analysis to compare the factor structure of the English and Spanish versions of both questionnaires. Results: The factors structure of both questionnaires obtained excellent fit indices across their Spanish versions with the one exception that some factors of the FCQ–S were more highly intercorrelated among the Spanish sample than the American. Discussion: This study supports the conceptualization of food cravings as universal multidimensional motivational states that can be reliably measured and supports the use of the Spanish versions of the FCQ.

To determine if the Hopkins Symptom Checklist-21 demonstrates equivalent validity across different ethnic groups, the authors tested the factor structure of the instrument with a sample of European American (n = 514), African American (n = 154), and Latino (n = 229) college students using confirmatory factor analysis with tests of invariance across groups. For the most part, a 3-factor model with Performance, General, and Somatic factors fit equally well for all 3 racial/ethnic groups. Differences involved only a few items in terms of either the strength of a factor loading or an error term. The results generally support the validity of the use of the instrument for measurement of distress in these different racial/ethnic groups.

Researchers have found that dietary restraint increases food cravings and may contribute to loss of control over eating. Negative mood states often precede food cravings and binge eating. In the present study, we tested the influence of a prolonged food deprivation period over emotional states and food cravings. Twenty-one bulimia nervosa participants and 20 healthy women participants were asked to refrain from any eating for 20 hours and reported, at baseline, after 6 hours and at the end of the fasting period, their mood and craving states. Food consumption was also measured. Fasting increased food cravings in both groups but increased negative mood in healthy women only. Bulimia nervosa participants reported improved mood following food deprivation. Whereas Bulimia nervosa and healthy women participants ate moderate and similar amounts of food following the 20-hour fasting period, food cravings were significantly associated with the number of calories ingested. These findings are congruent with self-regulation theories that predict that prolonged fasting may reduce negative emotions in women with bulimia nervosa.

The cocaine craving questionnaire-brief (CCQ-Brief English) asks cocaine users to report their level of craving now. We constructed two brief scales of cocaine craving in a sample of 107 Spanish-speaking natives in treatment for cocaine abuse or dependence: the CCQ-Brief(Spanish) and the pictographic assessment of desire (PAD), which relies less on language. Principal component analyses yielded a one-component solution for the CCQ-Brief, explaining between 62% and 68% of the sample variability. Cronbach's alpha ranged from .92 to .94. The CCQ-Brief and the PAD were strongly correlated; effect sizes ranged from .42 to .68 in separate trials. Laboratory cue-exposure results showed that in both scales craving was higher upon presentation of cocaine-related rather than neutral pictorial stimuli. The CCQ-Brief and PAD are potentially valuable scales for evaluating cocaine craving.

Combining two different samples of cocaine users (N = 183), we tested the factor structure of a brief (12-item), Spanish version of the Cocaine Craving Questionnaire-General using confirmatory factor analysis. The four-factor model provided excellent fit to the measure. Moreover, the measure significantly differentiated between recent cocaine users and abstainers, as well as between participants with different levels of severity of drug-use history. Factor 1 expresses highly intense and overwhelming desires, Factor 2 expresses lack of self-control over cocaine use, Factor 3 items express lack of positive reinforcement expectancies, and Factor 4 expresses stimulating expectancies for cocaine use. The results revealed the validity of the CCQ-General brief as an instrument to assess cocaine craving in Spanish and supported the conceptualization of cocaine craving as a multifaceted construct.

Food cravings are subjective, motivational states thought to induce binge eating among eating disorder patients. This study compared food cravings across eating disorders. Women (N = 135) diagnosed with anorexia nervosa, restrictive (ANR) or binge–purging (ANBP) types, or bulimia nervosa, non-purging (BNNP) or purging (BNP) types completed measures of food cravings. Discriminant analysis yielded two statistically significant functions. The first function differentiated between all the four group pairs except ANBP and BNNP, with levels of various food-craving dimensions successively increasing for ANR, ANBP, BNNP, and BNP participants. The second function differentiated between ANBP and BNNP participants. Overall, the functions improved classification accuracy above chance level (44% fewer errors). The findings suggest that cravings are more strongly associated with loss of control over eating than with dietary restraint tendencies.

The purpose of this study was to examine the psychometric properties of a Spanish version of the Bulimia Test-Revised (BULIT-R). The goal was to test the factor-structure equivalence of the BULIT-R across two samples of college students from two different cultures, Spain and the US. Researchers using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) have reported different model solutions for the factor-structure of the BULIT-R: a one-factor model, a four-factor model, a five-factor model and a six-factor model. For the two samples, CFA did not support any of the models previously reported in the literature. EFA supported a six- and a four-factor models for the US and Spanish samples, respectively.

The factor structure of smoking expectancies was examined in daily smokers and never smokers. Participants completed the Smoking Consequences Questionnaire—Spanish (SCQ—Spanish; [Cepeda-Benito, A., & Reig-Ferrer, A. (2000). Smoking consequences questionnaire—Spanish. Psychology of Addictive Behaviors, 14, 219-230.]). Using confirmatory factor analysis (CFA), the eight-factor structure of the SCQ—Spanish was replicated in smokers only. Except for beliefs about negative-health outcome expectancies, daily smoking rate was strongly associated with all types of smoking outcome expectancies. In comparison to men, women smokers reported greater weight control and negative-affect reduction consequences from smoking. An exploratory factor analysis (EFA) suggested a four-factor structure for the scores of never smokers. The findings represent not only the first cross-validation of the SCQ—Spanish but they were also congruent with the notion that first-hand smoking experience is not necessary for the development of multifaceted smoking expectancies. Nonetheless, the finding of a more complex factors structure in smokers than in never smokers is in line with the hypothesis that drug-use expectancies become more complex with drug-use experience. This research was supported by two grants awarded to the authors, one from l'Oficina de Ciència i Tecnologia del Govern Valencià, (Ajuda per a estades d'investigadors convidats en Universitats i altres Centres d'investigació situats a la Comunitat Valenciana [ref: INV 01–35]) and one from the Ministerio de Educación, Cultura y Deporte de España (Ayudas para Estancias de Profesores, Investigadores, Doctores y Tecnólogos Extranjeros en España [ref: SB2000–0020]).

Gender differences in the efficacy of nicotine replacement therapies (NRTs) were examined in a meta-analytical review of 90 effect sizes obtained from a sample of 21 double-blind, placebo-controlled randomized studies. Although NRT was more effective for men than placebo at 3-month, 6-month, and 12-month follow-ups, the benefits of NRT for women were clearly evident only at the 3- and 6-month follow-ups. Giving NRT in conjunction with high-intensity nonpharmacological support was more important for women than men. That is, NRT and low support were efficacious for women at only short-term follow-up, and men benefited from NRT at all the follow-ups regardless of the intensity of the adjunct support. The results suggest that long-term maintenance of NRT treatment gains decrease more rapidly for women than men.

This study examined psychometric characteristics of the Spanish translation of the Marital Satisfaction Inventory–Revised (MSI-R) in a community sample of 205 couples from Spain. Overall, analyses of the scales’ internal consistency compared favorably with findings for both the English and Spanish versions of this instrument with U.S. samples. Confirmatory factor analyses revealed similar scale factor structures across the original measure and Spanish translation, lending further support to using the MSI-R with couples from diverse cultural backgrounds whose sole or preferred language is Spanish. Mean profile comparisons between the current Spanish sample and the original standardization sample revealed significant differences on several scales. Implications of findings for clinical applications and further research are discussed.

A total of 212 Spanish smokers completed a Spanish version of a smoking questionnaire based on the Smoking Consequences Questionnaire--Adult (A. L. Copeland, T. H. Brandon,E. P. Quinn, 1995) and a nicotine dependence (ND) measure. Confirmatory factor analysis results supported an a priori defined 8-factor structure. The results also indicated good internal consistency for the instrument and the scales derived from each factor. Positive outcome smoking expectancies scales were significantly and substantially associated with ND scores. Also, after controlling for the influence of ND, the authors found higher smoking expectancies in women than in men in (a) weight control, (b) craving reduction and addictiveness, and (c) negative-affect reduction. The results support the instrument's construct validity.

Reference Citation: Cororve Fingeret M, Warren CS, Cepeda-Benito A, Gleaves DH. Eating disorder prevention research: a meta-analysis. Eat Disord. 2006;14(3):191–213. Clinical Questions: (1) Does presenting educational material on eating disorders produce iatrogenic (harmful because of the intervention) effects on eating attitudes and behaviors? (2) Is targeting specific populations with eating disorder prevention more beneficial than targeting general populations? (3) Which outcome variables are most affected by intervention efforts? (4) To what degree can interventions effectively influence behavioral outcome variables? Data Sources: Studies included in the meta-analysis were found using PsycInfo, Web of Science, Dissertation Abstracts International, and ERIC. Studies were also located using the reference lists from searched articles and by contacting researchers in the field for unpublished studies. The search terms used were eating disorders, prevention, intervention, eating, attitudes, and behaviors. These terms were used in various combinations in the search to find appropriate articles. Study Selection: Only empirical studies that tested interventions focused on reducing the risk of eating disorders or improving protective factors were included. These studies also had to include a nonclinical sample and a comparison group. Any studies that did not report data for a control group, did not report SDs, or only presented adjusted means were excluded because data were insufficient to determine an effect size. As a result of the small number of studies with male participants and the difference in eating disorder risk between males and females, only studies with female participants were analyzed. Data Extraction: Because of the different clinical questions addressed, each study had specific features that were coded to ease data comparison among studies. Three categories of features were coded: population targeted, length of intervention and follow-up, and intervention strategies. To code for the targeted population, the Gordon (1983) classification system was used, including universal (normal), selective (at-risk), and indicated (symptomatic) populations. The intervention strategies used in each study were also categorized in the meta-analysis. One category of intervention strategies looked at the amount of information related to eating disorders included in the prevention program. In addition, the authors categorized the intervention strategies as being (1) purely educational, (2) enhanced educational with elements of cognitive-behavioral therapy, or (3) purely interactive cognitive-behavioral therapy with no educational component. The first 2 authors rated and coded the studies independently. Standardized mean difference effect size (d) was calculated from reported means and SDs or was estimated from reported t and F values. Statistics were analyzed using DSTAT 1.10 and Comprehensive Meta-Analysis software programs. Data were analyzed based on the outcome variables of knowledge, general eating abnormalities, dieting, body dissatisfaction, and thin-ideal internalization. These outcome variables were used to evaluate the efficacy of the intervention programs. Each outcome set had weighted mean effect sizes determined, and the variability of the effect sizes was assessed using the homogeneity statistic Q. These were calculated for both the posttest and follow-up results. Homogeneity among effect sizes was the desired outcome, and a positive value indicated a more desirable outcome. The effect sizes were described as small (d ≤ .20), medium (d = .50), or large (d ≥ .80). Main Results: A total of 57 studies were identified by the search criteria. Eleven studies were excluded because they provided insufficient data to calculate effect sizes. The final pool included 46 studies (32 published and 14 unpublished). All eating disorder prevention programs produced the largest positive change in participant knowledge (d = .75) without regard to the targeted population. The biggest gains in knowledge occurred right after completion of the prevention program (d = 1.2). During follow-up, the gains in knowledge decreased but still remained higher than knowledge before the program. General eating abnormalities, dieting, and thin-ideal internalization showed small positive changes. Even though the changes were relatively small at posttest for all the outcomes (d = .17 to .21), they seemed to last, because the follow-up studies showed results very similar to those obtained at posttest (d = .13 to .18). Body dissatisfaction was the most frequently measured outcome but had the smallest change. Effect sizes for body dissatisfaction at posttest (d = .13) and at follow-up (d = .07) were not different from zero (95% confidence interval = −0.02, 0.15). Thus, even though small positive trends were noted in participants' body dissatisfaction after the interventions, the measured changes may have been due to measurement error. All outcome variables measured appeared to show improvements; however, most of the effect sizes were small and may not be clinically significant. All outcome variables were also analyzed while comparing the targeted populations. During posttest measurements, targeted at-risk participant groups had more positive scores related to dieting (d = .28) than did the symptomatic (d = .07) and normal (d = −.01) groups. Targeted, symptomatic participant groups showed greater improvement regarding thin-ideal internalization during the posttest (d = .48) than did the at-risk (d = .13) or normal (d = .18) subgroups. At follow-up, the same positive trend was apparent, but the changes were no longer significant. Comparably, the targeted, symptomatic group also showed greater improvement with regard to body dissatisfaction (d = .30) than did the at-risk (d = .11) and normal (d = .08) subgroups during posttest measurements, yet the results were not significant at follow-up. General positive trends were found regarding participant knowledge for symptomatic, at-risk, and normal subgroups, but because of the wide range of results among studies, no decisive interpretations could be made. The third measured variable was intervention strategy used. No differences were noted between educational and enhanced educational interventions concerning dieting behavior at posttest, thin-ideal internalization at posttest, or body dissatisfaction at posttest or follow-up. No differences were found among groups for the outcome sets related to potential harmful effects resulting from the prevention programs. From these findings, the authors determined that no harmful effects occurred as a result of including educational information about eating disorders in an eating disorder prevention program. Conclusions: Currently, evidence supports the potential benefits of eating disorder prevention programs for targeted populations, specifically those already demonstrating signs of an eating disorder. Eating disorder prevention programs seem to increase participants' knowledge of eating disorders. Limited evidence indicates small improvements on the behavioral outcome variables, dieting behaviors, and general eating abnormalities for a range of population groups. Knowledge is the outcome variable most affected by eating disorder prevention programs. No evidence indicating that providing educational information about eating disorders causes potentially harmful effects on attitudes or behaviors was found. Specific symptoms that signal an eating disorder were excluded from research assessments, so accurate conclusions regarding the actual prevention of eating disorders resulting directly from eating disorder prevention programs cannot be made.

The research on the effectiveness of nicotine gum as a treatment for smoking was reviewed through a meta-analysis of 33 studies. The differential effectiveness of experimental (nicotine gum) versus control (placebo and no gum) groups at both short- and long-term follow-up was indexed as d, the mean effect size. These effect sizes were contrasted within each brief and intensive treatments. Nicotine gum was superior to placebo and no-gum controls at both intervals with the intensive strategies, but the gum was effective only at short term for the brief treatments. Results show that the positive effects of nicotine gum in smoking treatment are a function of an interaction between the gum's pharmacological properties and the effectiveness of intensive treatment strategies. The theoretical and clinical implications of the results are discussed.