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Objective: Racial and ethnic disparities in smoking cessation persist. This randomized controlled trial compared the efficacy of group cognitive behavioral therapy (CBT) for cessation among African American/Black, Latino/Hispanic, and White adults. Method: African American/Black (39%), Latino/Hispanic (29%), and White (32%) adults (N = 347) were randomly assigned to eight group sessions of CBT or general health education (GHE), both including nicotine patch therapy. Biochemically confirmed 7-day point prevalence abstinence (7-day ppa) was measured at the end-of-therapy, and at 3-, 6-, and 12-month followups. Generalized linear mixed models and logistic regressions tested abstinence rates by condition, stratified by race and ethnicity, and interaction effects. Results: CBT led to greater abstinence than GHE across 12-months of follow-up (AOR = 1.84, 95% CI [1.59, 2.13]) overall [12-month follow-up: CBT = 54% vs. GHE = 38%] and within racial and ethnic groups [12-months: African American/Black (CBT = 52%, GHE = 29%), Latino/Hispanic (CBT = 57%, GHE = 47%), and White (CBT = 54%, GHE = 41%)]. African American participants were less likely than White participants to quit irrespective of condition, as were persons with lower education and income. Socioeconomic status indicators positively predicted abstinence among racial and ethnic minority participants, but not White participants. Conclusions: Group CBT was efficacious compared with GHE. However, cessation patterns suggested that intensive group interventions were less beneficial over the longer term among lower socioeconomic African American and Latino individuals, compared with White participants. Tobacco interventions should target racial and ethnic and socioeconomic differences, via culturally specific approaches and other means. Public Health Significance Statement When treating individuals who wish to quit smoking, this study demonstrated that cognitive behavioral therapy (CBT) delivered in a group format is efficacious across racial and ethnic groups. An intersectional look within racial and ethnic groups, revealed that CBT worked equally well among White persons irrespective of their socioeconomic status (SES), yet was more effective among higher SES racial and ethnic minority persons. Within group diversity is an important consideration when "gold-standard" interventions are recommended universally. To address cessation disparities particularly among racial and ethnic minority individuals with less privileged socioeconomic status, the implementation of culturally specific approaches may be beneficial. [ABSTRACT FROM AUTHOR]

There is strong evidence that cigarette smoking causes adverse outcomes in people with cancer. However, more research is needed regarding those effects and the effects of alternative tobacco products and of secondhand smoke, the effects of cessation (before diagnosis, during treatment, or during survivorship), the biologic mechanisms, and optimal strategies for tobacco dependence treatment in oncology. Fundamentally, tobacco is an important source of variation in clinical treatment trials. Nevertheless, tobacco use assessment has not been uniform in clinical trials. Progress has been impeded by a lack of consensus regarding tobacco use assessment suitable for cancer patients. The NCI-AACR Cancer Patient Tobacco Use Assessment Task Force identified priority research areas and developed recommendations for assessment items and timing of assessment in cancer research. A cognitive interview study was conducted with 30 cancer patients at the NIH Clinical Center to evaluate and improve the measurement items. The resulting Cancer Patient Tobacco Use Questionnaire (C-TUQ) includes "Core" items for minimal assessment of tobacco use at initial and follow-up time points, and an "Extension" set. Domains include the following: cigarette and other tobacco use status, intensity, and past use; use relative to cancer diagnosis and treatment; cessation approaches and history; and secondhand smoke exposure. The Task Force recommends that assessment occur at study entry and, at a minimum, at the end of protocol therapy in clinical trials. Broad adoption of the recommended measures and timing protocol, and pursuit of the recommended research priorities, will help us to achieve a clearer understanding of the significance of tobacco use and cessation for cancer patients.

Objectives: This study investigated a) racial/ethnic differences in past-year discrimination experiences and b) associations between discrimination and smoking abstinence.Design: Prospective, longitudinal analysis of smoking status. Perceived past-year discrimination was assessed at baseline. ANCOVAs and intent-to-treat hierarchical logistic regressions were conducted.Setting: Dual-site (Tampa, FL and Miami, FL) randomized controlled trial testing the effects of a group cessation intervention plus pharmacotherapy.Participants: Treatment-seeking adult smokers (N=347; non-Hispanic White, non-Hispanic African American/Black, or Hispanic).Main Outcome Measures: Biochemically verified 7-day point prevalence abstinence (7-day ppa) was assessed immediately post-intervention and at 6-month follow-up.Results: After controlling for covariates, African Americans/Blacks reported greater perceived discrimination compared with non-Hispanic Whites (P=.02), and Hispanics (P=.06). Non-Hispanic Whites and Hispanics did not differ in perceived racial/ethnic discrimination experiences over the past year. Irrespective of race/ethnicity, past-year perceived discrimination was inversely associated with 7-day ppa, both post-intervention (AOR=.97, CI: .95-.99) and at 6-months (AOR=.98, CI: .96-.99). Among African Americans/Blacks, past-year perceived discrimination was inversely associated with 7-day ppa, both post-intervention (AOR=.95, CI: .92-.97) and at 6-months (AOR=.97, CI: .94-.99). Perceived discrimination was unrelated to 7-day ppa among Hispanics. Among non-Hispanic Whites, past-year perceived discrimination was inversely associated with post-intervention 7-day ppa (AOR=.95, CI: .91-.99), but not 6-months.Conclusions: Perceived racial/ethnic discrimination was greater among African American/Black smokers compared with non-Hispanic Whites. Perceived discrimination was negatively associated with tobacco cessation in the full sample, and for African Americans at 6-months post-intervention. These data have implications for intervention delivery and health disparities. [ABSTRACT FROM AUTHOR]

Background: To the authors' knowledge, there are currently no standardized measures of tobacco use and secondhand smoke exposure in patients diagnosed with cancer, and this gap hinders the conduct of studies examining the impact of tobacco on cancer treatment outcomes. The objective of the current study was to evaluate and refine questionnaire items proposed by an expert task force to assess tobacco use.Methods: Trained interviewers conducted cognitive testing with cancer patients aged ≥21 years with a history of tobacco use and a cancer diagnosis of any stage and organ site who were recruited at the National Institutes of Health Clinical Center in Bethesda, Maryland. Iterative rounds of testing and item modification were conducted to identify and resolve cognitive issues (comprehension, memory retrieval, decision/judgment, and response mapping) and instrument navigation issues until no items warranted further significant modification.Results: Thirty participants (6 current cigarette smokers, 1 current cigar smoker, and 23 former cigarette smokers) were enrolled from September 2014 to February 2015. The majority of items functioned well. However, qualitative testing identified wording ambiguities related to cancer diagnosis and treatment trajectory, such as "treatment" and "surgery"; difficulties with lifetime recall; errors in estimating quantities; and difficulties with instrument navigation. Revisions to item wording, format, order, response options, and instructions resulted in a questionnaire that demonstrated navigational ease as well as good question comprehension and response accuracy.Conclusions: The Cancer Patient Tobacco Use Questionnaire (C-TUQ) can be used as a standardized item set to accelerate the investigation of tobacco use in the cancer setting. Cancer 2016;122:1728-34. © 2016 American Cancer Society. [ABSTRACT FROM AUTHOR]

Background and aims Many smokers who have tried electronic cigarettes ('e-cigarettes') continue to smoke, perhaps influenced by their beliefs about the outcomes of using e-cigarettes ('e-cigarette expectancies'). The primary aims of this study were to compare expectancies of dual users to former smokers, and to examine the association between expectancies and intentions to quit or reduce 'vaping' among former smokers. Design and Setting A large cross-sectional online survey of e-cigarette users conducted in the United States. Participants We surveyed current e-cigarette users ( n = 1815), including both current cigarette smokers ('dual users', n = 381) and former smokers ( n = 1434). We further subdivided former smokers into those with ( n = 686) and without ( n = 748) intentions to reduce or quit e-cigarette use. Measurements The primary outcomes were self-reported past-month smoking status and, among former smokers, current intentions to reduce or quit e-cigarette use, both adjusted for potential confounders. E-cigarette expectancy items were derived primarily from a previously validated measure of smoking expectancies. Findings Dual users reported less positive expectancies than former smokers about e-cigarettes, rating e-cigarettes as more physically irritating (β = 0.10, P < 0.001) and addictive (β = 0.06, P = 0.016), as well as less satisfying (β = -0.11, P < 0.001). Former smokers with intentions to quit e-cigarettes also rated e-cigarettes less positively than former smokers without intentions to quit e-cigarettes, rating them more likely to damage health (β = 0.16, P < 0.001) and cause addiction (β = 0.10, P < 0.001), but less likely to taste good (β = -0.08, P = 0.006). Conclusions Positive e-cigarette expectancies among e-cigarette users are associated with a greater likelihood of having quit smoking, but lower likelihood of intention to quit e-cigarette use. [ABSTRACT FROM AUTHOR]

Aims To quantify the effect of negative affect (NA), when manipulated experimentally, upon smoking as measured within laboratory paradigms. Quantitative meta-analyses tested the effects of NA versus neutral conditions on (1) latency to smoke and (2) number of puffs taken. Methods Twelve experimental studies tested the influence of NA induction, relative to a neutral control condition ( n = 1190; range = 24-235). Those providing relevant data contributed to separate random-effects meta-analyses to examine the effects of NA on two primary smoking measures: (1) latency to smoke (nine studies) and (2) number of puffs taken during ad libitum smoking (11 studies). Hedge's g was calculated for all studies through the use of post-NA cue responses relative to post-neutral cue responses. This effect size estimate is similar to Cohen's d, but corrects for small sample size bias. Results NA reliably decreased latency to smoke ( g = -0.14; CI = -0.23 to -0.04; P = 0.007) and increased number of puffs taken ( g = 0.14; CI = 0.02 to 0.25; P = 0.02). There was considerable variability across studies for both outcomes (I2 = 51 and 65% for latency and consumption, respectively). Potential publication bias was indicated for both outcomes, and adjusted effect sizes were smaller and no longer statistically significant. Conclusions In experimental laboratory studies of smokers, negative affect appears to reduce latency to smoking and increase number of puffs taken, but this could be due to publication bias. [ABSTRACT FROM AUTHOR]

Abstract: Smoking cessation is a primary method of reducing excess mortality and morbidity. Unfortunately, the vast majority of cessation attempts end in eventual relapse. Relapse-prevention interventions have shown some success at improving the long-term maintenance of tobacco abstinence among individuals motivated to abstain. However, involuntary tobacco abstinence (e.g., military training, hospitalization, incarceration) presents another opportunity for intervention to prevent relapse. During basic military training (BMT), tobacco use is strictly forbidden in all service branches, but tobacco relapse (and initiation) following BMT is extremely high. This paper reports on the design, intervention development, and baseline characteristics of a randomized controlled trial testing minimal interventions designed to prevent tobacco relapse among United States Air Force (USAF) personnel following BMT. Participants are randomized by squadron to receive either a standard smoking-cessation booklet, a new motivation-based booklet designed specifically for USAF personal, or the latter booklet combined with a brief, face-to-face motivational session. Primary outcomes will be self-reported tobacco use at 12 and 24month follow-up. Given that the Department of Defense is the world's largest employer, the potential of leveraging involuntary tobacco abstinence during BMT into extended abstinence has substantial public health significance. [Copyright &y& Elsevier]

Background and aims Retrospective self-report and observational studies have yielded inconsistent findings regarding the capacity of negative affect ( NA) to increase smoking motivation among dependent samples. Controlled laboratory studies offer an alternative paradigm for testing the role of affective state upon smoking motivation. The aim of the current study was to quantify cue-provoked cravings produced by affective manipulations in the published literature, and to identify theoretical and methodological moderators. Methods We conducted a systematic literature search to identify experimental studies that manipulated NA or positive affect ( PA), and assessed post-manipulation craving. Separate random-effects meta-analyses examined NA and PA cues as predictors of self-reported craving. Self-reported affect ( NA and PA), nicotine deprivation, gender, nicotine dependence, order of cue presentation, single versus multi-item craving assessment and affect induction method were tested as moderators of affective cue-induced craving. Results NA manipulations produced a medium effect [ g = 0.47; confidence interval ( CI) = 0.31-0.63] on craving, but no main effects were found for PA manipulations ( g = 0.05; CI = −0.09 to 0.20) on craving. Self-reported NA moderated the extent to which NA and PA manipulations elicited craving ( P < 0.02 for each). That is, more effective NA manipulations produced greater cravings, and PA manipulations reduced cravings when they reduced NA. Conclusions Laboratory studies indicate that negative, but not positive, affect is a situational determinant of cravings to smoke among dependent smokers. Adverse emotional states increase craving to smoke among dependent smokers, but positive emotional states do not consistently reduce craving to smoke. [ABSTRACT FROM AUTHOR]

Tobacco addiction and chronic pain represent 2 highly prevalent and comorhid conditions that engender substantial burdens upon individuals and systems. Interrelations between pain and smoking have been of clinical and empirical interest for decades, and research in this area has increased dramatically over the past 5 years. We conceptualize the interaction of pain and smoking as a prototypical example of the biopsychosocial model. Accordingly, we extrapolated from behavioral, cognitive, affective, biomedical, and social perspectives to propose causal mechanisms that may contribute to the observed comorbidity between these 2 conditions. The extant literature was 1st dichotomized into investigations of either effects of smoking on pain or effects of pain on smoking. We then integrated these findings to present a reciprocal model of pain and smoking that is hypothesized to interact in the manner of a positive feedback loop, resulting in greater pain and increased smoking. Finally, we proposed directions for future research and discussed clinical implications for smokers with comorbid pain disorders. We observed modest evidence that smoking may be a risk factor in the multifactorial etiology of some chronically painful conditions and that pain may come to serve as a potent motivator of smoking. We also found that whereas animal studies yielded consistent support for direct pain-inhibitory effects of nicotine and tobacco, results from human studies were much less consistent. Future research in the emerging area of pain and smoking has the potential to inform theoretical and clinical applications with respect to tobacco smoking, chronic pain, and their comorbid presentation. [ABSTRACT FROM AUTHOR]

The article presents a study on the task persistence among smokers with schizophrenia and schizoaffective disorder (SZ/SA) and non-psychiatric control smokers. It states that 203 smokers from a tobacco dependence treatment clinic in New Jersey were recruited to participate in the study wherein they undergo mirror tracing persistence task to predict smoking cessation. Results show that lower task persistence partially explains the decreased smoking cessation successes among smokers with SZ/SA.

The article presents an experimental study on the effect of negative body image in the motivation of college women to smoke. It states that the objective of the study is to assess the negative affect as mediator on the smoking urges and body dissatisfaction among women. The U.S. Department of Health and Human Services (USDHHS) explains that smoking is the major cause of death and disease in both genders, but women are at greater risk. It also notes that men and women have different kind of motivations in terms of smoking. Moreover, it concludes that body image manipulation increases the urge to smoke and female college students are in the transitory period of smoking behavior.

Tobacco smoking has been associated with the development and exacerbation of chronically painful conditions. Conversely, there is reason to believe that smokers may be motivated to use tobacco as a means of coping with their pain. To date, no controlled, experimental studies have tested for a causal relationship between pain and smoking motivation. The primary aim of the current study was to test the hypothesis that laboratory-induced cold pressor pain would enhance smoking motivation, as measured by self-reported urge to smoke and observation of immediate smoking behavior. Smokers (N = 132) were randomly assigned to either pain or no pain conditions. Results indicated that situational pain increased urge ratings and produced shorter latencies to smoke. The relationship between pain and increased urge to smoke was partially mediated by pain-induced negative affect. The relationship between pain and shorter latency to smoke was fully mediated by pain-induced urge to smoke. This study provides the 1st experimental evidence that situational pain can be a potent motivator of smoking. [ABSTRACT FROM AUTHOR]

Objective: To conduct pilot research examining smoking cessation counseling as a teachable moment for skin cancer prevention. Methods: Study I surveyed 199 beachgoers regarding skin cancer protection. Study II compared a standard smoking cessation treatment against one that incorporated skin cancer education (N = 35). Results: In Study I, smokers were less likely than nonsmokers to wear sunscreen or perform skin self-examinations. In Study II, participants were satisfied with the integrated program; smoking cessation treatment efficacy was not compromised; and skin cancer knowledge and self-efficacy increased. Conclusions: Further study of smoking cessation as a teachable moment for other health behavior change is warranted. [ABSTRACT FROM AUTHOR]

The article presents a study on comparison of smoking versus nicotine based from smokers' expectancies. Smokers' expectancies on smoking and nicotine were compared based on word association tests. Smokers were randomly picked to receive instructions to complete either "Smoking makes one" or "Nicotine makes one" with as many words as possible within 30 seconds. Results shows that smokers held similar expectancies for smoking and nicotine. Negative results, however, were more connected with nicotine than with smoking.

Objective: College may represent an untapped opportunity to reach the growing number of student smokers who are at risk of progressing toward regular smoking. The aim of this study was to test the efficacy of a theory-based experiential intervention for increasing motivation to quit smoking and reducing smoking behavior. Design: This study used a 3-arm, randomized design to examine the efficacy of an experiential secondary prevention intervention. The control groups included a traditional didactic smoking intervention and an experiential intervention on nutrition. Main Outcome Measures: The 2 primary dependent variables were change in self-reported intention to quit smoking, measured pre- and postintervention, and change in smoking behavior over the month following the intervention. Results: As hypothesized, the experiential smoking intervention was more effective than either control group in increasing immediate motivation to quit, but the effect was found only among female participants. At 1-month follow-up, both smoking interventions produced higher rates of smoking cessation and reduction than did the nutrition control condition. Conclusion: Findings support the potential efficacy of an intensive experiential intervention for female smokers. [ABSTRACT FROM AUTHOR]

The present study examined mechanisms underlying the effectiveness of tailored interventions for motivating smoking cessation. The study used a placebo-tailoring design to test whether the efficacy of tailoring was due, in part, to personalized features in addition to the theoretically based content. Two hundred forty adult smokers were randomized to 1 of 3 conditions: standard booklet, minimally personalized booklet, or extensively personalized booklet. The interventions varied in their degree of ostensible tailoring, yet the actual smoking-related content of the booklets was identical. A dose-response relationship was hypothesized, with the greatest apparent tailoring producing the most positive outcomes. This pattern was found for evaluation of the booklets, with trends for readiness to change and self-efficacy increases. Moreover, as hypothesized, the effect of the interventions on readiness was moderated by participants' expectancies about tailoring. [ABSTRACT FROM AUTHOR]

Although it has been suggested that implicit expectancies influence smoking and other addictive behaviors, there is little direct evidence to support this notion. This study offers the first step in exploring implicit expectancy operation in cigarette smoking. Ninety-nine college smokers completed the sentence, “Smoking makes one_____.” with as many words as possible within 30 s, developing a list of expectancy associates. The results of the sentence completion task were positively correlated with an explicit measure of smoking-related expectancies. Future studies will be able to use the expectancy associates developed by this study to employ implicit memory tasks and further the understanding of the role of smoking-related expectancies. [Copyright &y& Elsevier]

Individuals with schizophrenia have a much higher prevalence of tobacco smoking, a lower cessation rate, and a higher incidence of tobacco-related diseases than the general population. The initial challenge has been to motivate these individuals to quit smoking. This study tested whether motivational inter- viewing is effective in motivating smokers with schizophrenia or schizoaffective disorder to seek tobacco dependence treatment. Participants (N = 78) were randomly assigned to receive a 1-session motivational interviewing (MI) intervention, standard psychoeducational counseling, or advice only. As hypothesized, a greater proportion of participants receiving the MI intervention contacted a tobacco dependence treatment provider (32%, 11%, and 0%, respectively) and attended the 1st session of counseling (28%, 9%, and 0%) by the I-month follow-up as compared with those receiving comparison interventions. [ABSTRACT FROM AUTHOR]

Practicing psychologists are well positioned to provide at least minimal interventions for tobacco dependence among their clients. Because smoking covaries with psychopathology, a substantial proportion of psychologists' clients are likely to be smokers. Psychologists have expertise in motivating behavior change, and they have greater contact and stronger relationships with their patients than do most other health providers. Despite these advantages, the current study found that psychologists were less likely to intervene for tobacco use than for other client behaviors, such as alcohol or illicit drug abuse. Psychologists do not regularly ask their clients whether they smoke, advise them to quit, assess their willingness to quit, assist them with quitting, or arrange follow-up. Recommendations for additional training are provided. [ABSTRACT FROM AUTHOR]

This paper is part of a series that has the goal of identifying potential approaches toward developing new instruments for assessing tobacco dependence among adolescents. The fundamental assumption underlying the series is that contemporary theories of drug dependence offer a rich source of opportunities for the development of theoretically based assessment tools. The present paper focuses on cognitive and social-learning models of drug dependence and the implications of these models for novel assessment instruments. In particular, the paper focuses on Mark Goldman's model of drug expectancies, Albert Bandura's model of self-efficacy, Thomas Wills's model of stress and coping and Stephen Tiffany's cognitive-processing model of drug urges and cravings. In addition to traditional self-report measures, naturalistic and laboratory-based assessments are identified that may yield information relevant to multi-dimensional measurement of tobacco dependence. [ABSTRACT FROM AUTHOR]

Smokers (N=188) recruited from the local community completed a questionnaire that measured expected outcomes of using cigarettes, nicotine gum, nicotine patch, and nicotine nasal spray. Expectancy questions relating to negative affect, craving, weight, and health risks were derived from the Smoking Consequences Questionnaire-Adult. As predicted, smokers held much greater expectancies that cigarettes help control negative affect, craving, and weight relative to nicotine replacement therapy (NRT). All NRT products were expected to cause fewer health risks than cigarette smoking. As predicted, smokers held strong negative affect reduction expectancies for cigarette smoking. For NRT, although still relatively low, craving reduction was the strongest expectancy. Individuals who had experience using the nicotine patch had greater positive expectancies for NRT. Greater positive expectancies for NRT were correlated with more immediate plans to quit smoking. In summary, cigarette smokers' positive expectancies about cigarettes do not appear to generalize to NRT products, which may limit their use and effectiveness. [ABSTRACT FROM AUTHOR]

Provides information on the nature of cigarette smoking and its natural history and features. Epidemiology of cigarette smoking and tobacco dependence among U.S. youth; Age-related trends in smoking; Motivational basis of cigarette dependence.

We hypothesized that tobacco usage is an independent prognostic factor in patients with myelodysplastic syndromes (MDS). To evaluate the impact of tobacco usage in this population, we identified patients diagnosed with MDS in our Center's MDS database and reviewed individual charts retrospectively. Of the 767 MDS patients identified, 743 patients (97%) had a known tobacco usage history. Given that the majority of tobacco users were smokers, we stratified patients as having never smoked (never-smoker group) versus current or former smokers (ever-smoker group). Greater than 60% of ever-smokers were risk stratified as having low or intermediate-1 (int-1) risk at diagnosis based on the International Prognostic Scoring System for MDS. In patients with lower-risk MDS, we found that ever-smokers had an increased proportion of poor-risk karyotypes (8.8%) compared with never-smokers (2.4%) ( P = 0.003). The adverse effect of smoking was greatest in the low-risk and int-1-risk groups, where median overall survival was 69 months (95% CI 42–96) in never-smokers versus 48 months (95% CI 41–55) in ever-smokers ( P = 0.006). The median overall survival for never-smokers, former smokers, and current smokers was 69 months (95% CI 42–96), 50 months (95% CI 43–57), and 38 months (95% CI 23–53), respectively, in patients risk stratified as lower-risk MDS ( P = 0.01). Our findings suggest that tobacco usage negatively impacts overall survival in patients with lower-risk MDS. [ABSTRACT FROM AUTHOR]

Based on a model in which self-control (SC) is considered to be a limited resource, research suggests that diminished SC resources may increase the likelihood of tobacco smoking. Yet, the inverse—how smoking may influence SC resources—has not been tested. The authors of this study utilized a randomized, 2 × 2 crossed-factorial (SC Depletion Manipulation × Smoking Manipulation), between-subjects design to test the hypothesis that smoking restores depleted SC resources. To manipulate SC depletion, experimenters instructed half of 132 nicotine dependent smokers to suppress their emotional reaction to a brief video depicting environmental damage (i.e., depletion), whereas the other half were instructed to "act natural" (i.e., no depletion) during viewing. Half of the participants in each condition then smoked a cigarette, whereas the other half sat patiently without smoking (i.e., smoke vs. no smoke). All participants then completed behavioral measures of SC. As hypothesized, an interaction occurred between the depletion and smoking manipulations for duration of time spent on a frustrating mirror-tracing task. That is, depletion reduced persistence on the task, unless depletion was followed by smoking. This effect was mediated by positive affect (PA). Thus, smoking appeared to restore depleted SC resources via modulation of PA, but independent of negative affect or smoking urges. These findings suggest that restoration of SC resources may represent another means by which smoking is negatively reinforced. The application of the self-control strength model to the study of nicotine dependence may inform the development of novel treatment modalities. [ABSTRACT FROM AUTHOR]

The combined use of cigarettes and alcohol is associated with a synergistic increase in the risk of morbidity and mortality. Continued alcohol use during a smoking quit attempt is a considerable risk factor for smoking relapse. As such, there is a need for interventions that address both behaviors concurrently. Mindfulness-based interventions hold much promise for simultaneously addressing tobacco and alcohol use. This pilot study evaluated the feasibility and acceptability of a mindfulness-based intervention using a two-arm randomized controlled trial of Mindfulness-Based Relapse Prevention for Smoking and Alcohol (MBRP-SA) vs Cognitive Behavioral Therapy (CBT). Interventions were delivered via telehealth in a group setting; all participants received a 6-week supply of the nicotine patch. Participants (N = 69) were adults who smoked cigarettes who reported binge drinking and were motivated to both quit smoking and change their alcohol use. Primary outcomes were feasibility and acceptability of MBRP-SA compared to CBT. Changes in tobacco and alcohol use are also presented. Participants in MBRP-SA and CBT indicated that the treatments were highly acceptable, meeting a priori benchmarks. Feasibility was mixed with some outcomes meeting benchmarks (e.g., recruitment) and others falling below (e.g., retention). Participants in both conditions demonstrated significant reductions in tobacco and alcohol use at the end of treatment. In sum, MBRP-SA had comparable outcomes to CBT on all metrics measured. Future research should evaluate the efficacy of MBRP-SA on smoking abstinence and drinking reductions in a large-scale, fully powered trial. This study was registered on clinicaltrials.gov (NCT03734666). • Both MBRP-SA and CBT were highly acceptable, meeting a priori benchmarks. • Both MBRP-SA and CBT had significant reductions in tobacco and alcohol use. • Telehealth was acceptable as a group-treatment delivery modality. • MBRP-SA had comparable outcomes to CBT on all metrics measured. [ABSTRACT FROM AUTHOR]

Abstract: There is growing empirical and clinical interest in purported associations between smoking and the aggravation of cancer symptoms and treatment side effects, such as pain. Both pain and smoking are highly prevalent among persons with cancer, and there is recent evidence to suggest that cancer patients who continue to smoke despite their diagnosis experience greater pain than nonsmokers. Accordingly, the main goal of this cross-sectional study was to examine associations between multiple levels of smoking status and several pain-related outcomes among a sample of 224 cancer patients about to begin chemotherapy. Patients completed self-report measures of pain severity, pain-related distress, and pain-related interference, as well as a demographics questionnaire. Results indicated that persons who continued to smoke despite being diagnosed with cancer reported more severe pain than never smokers, F (2, 215)=3.47, p <.05. Current smokers also reported greater interference from pain than either former or never smokers, F (2, 215)=5.61, p <.01. Among former smokers, an inverse relation between pain severity and the number of years since quitting smoking was observed, r (104)=−.26, p <.01. These data suggest that continued smoking despite a cancer diagnosis is associated with greater pain severity and interference from pain; however, future research is warranted to determine the directionality of this relationship. [Copyright &y& Elsevier]

Abstract: The task persistence construct has previously been measured primarily behaviorally (e.g., with a mirror-tracing task, or breath holding), and only in adults. It has been shown to differentiate between adult smokers and non-smokers and to predict smoking cessation in adult smokers trying to quit. This theory-based analysis is the first to examine task persistence in adolescent smokers and to examine a two-item, internally consistent, self-report measure of task persistence. Results indicate that task persistence is greater among adolescent non-smokers as compared to adolescent current smokers, and those planning to quit smoking as compared to those with no plans to quit. Contrary to hypotheses, task persistence was not found to be related to prior successful attempts to quit smoking. Our results suggest that a brief, self-report measure of task persistence may be a methodologically sound, practical clinical tool for this population. [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]