Exposure to workplace smoking bans and continuity of daily smoking patterns on workdays and weekends

IntroductionIndividuals may compensate for workplace smoking bans by smoking more before or after work, or escaping bans to smoke, but no studies have conducted a detailed, quantitative analysis of such compensatory behaviors using real-time data.Methods124 daily smokers documented smoking occasions over 3 weeks using ecological momentary assessment (EMA), and provided information on real-world exposure to smoking restrictions and type of workplace smoking policy (full, partial, or no bans). Mixed modeling and generalized estimating equations assessed effects of time of day, weekday (vs weekend), and workplace policy on mean cigarettes per hour (CPH) and reports of changing location to smoke.ResultsIndividuals were most likely to change locations to smoke during business hours, regardless of work policy, and frequency of EMA reports of restrictions at work was associated with increased likelihood of changing locations to smoke (OR = 1.11, 95% CI 1.05–1.16; p < 0.0001). Workplace smoking policy, time block, and weekday/weekend interacted to predict CPH (p < 0.01), such that individuals with partial work bans –but not those with full bans - smoked more at night (9 pm – bed) on weekdays compared to weekends.ConclusionsThere was little evidence that full bans interfered with subjects' smoking during business hours across weekdays and weekends. Smokers largely compensate for exposure to workplace smoking bans by escaping restrictions during business hours. Better understanding the effects of smoking bans on smoking behavior may help to improve their effectiveness and yield insights into determinants of smoking in more restrictive environments.     

Levels of dialkylphosphate metabolites in urine among general U.S. population

Data from National Health and Nutrition Examination Survey for years 2003–2008 were used to study the factors that affect urinary levels of dialkylphosphate (DAP) metabolites in urine. Separate regression models were fitted for children aged 6–11 years, adolescents aged 12–19 years, and adults aged ≥20 years. Specifically, DAP metabolites that were analyzed were: dimethylphosphate (DMP), diethylphosphate (DEP), dimethylthiophosphate (DMTP), and diethylthiophosphate (DETP). Males had statistically significantly lower adjusted levels than females for DMP for adolescents, for DEP for adults, for DMTP for both adolescents and adults, and for DETP for both children and adults. Nonsmokers had statistically significantly higher adjusted levels than smokers for DMTP for adolescents and for DMP and DMTP for adults. Exposure to second hand smoke at home was associated with relatively higher levels of DMP among children (p = 0.01) but the reverse was found to be true for DMTP (p < 0.01) among adolescents as well as adults (p = 0.02). Children had higher levels of DMTP than both adolescents and adults (p < 0.01) and higher levels of DETP than adolescents (p = 0.02). Age was found to be negatively associated with the levels of DMTP (p = 0.01) among children and positively associated (p < 0.01) with the levels of all four metabolites among adults.     

Other tobacco product and electronic cigarette use among homeless cigarette smokers

ObjectiveWe determined the prevalence and correlates of other tobacco product and electronic cigarette (e-cigarette) use in a clinic-based sample of homeless cigarette smokers.MethodsIn April–July 2014, we used time-location sampling to conduct a cross-sectional, in-person survey of 306 currently homeless adult cigarette smokers recruited from 5 clinical sites at Boston Health Care for the Homeless Program. We assessed past-month use of large cigars, little cigars, smokeless tobacco, and e-cigarettes. Among those who had used e-cigarettes, we assessed the reasons for doing so. We used logistic regression analysis to identify the participant characteristics associated with the use of each product.ResultsEighty-six percent of eligible individuals participated in the survey. In the past month, 37% of respondents used large cigars, 44% used little cigars, 8% used smokeless tobacco, 24% used an e-cigarette, and 68% used any of these products. Reasons for e-cigarette use included curiosity (85%) and to help quit conventional cigarettes (69%). In multivariable regression analyses, homeless smokers with greater subsistence difficulties were more likely to use little cigars (p = 0.01) and less likely to use e-cigarettes (p = 0.001). Non-Hispanic black (p = 0.01), Hispanic (p < 0.001), and rough-sleeping (p = 0.04) participants were more likely to use large cigars. Readiness to quit was not associated with other tobacco product use but was significantly associated with e-cigarette use to help quit smoking (p = 0.02).ConclusionsHealth care providers who serve homeless people should consider routine screening for the use of other tobacco products and e-cigarettes to help guide smoking cessation discussions and tobacco treatment planning.     

Reporting of cigar use among adolescent tobacco smokers

IntroductionWith the changing landscape of tobacco products, the divide between cigarettes and cigars is obscured, so understanding adolescent reporting of cigar use is needed to improve best practices for surveillance, screening, and prevention/intervention. This study examined adolescents' reported cigar use and correlates of use.MethodsParticipants (N = 186) were 13–17 year old tobacco users participating in a prospective study of adolescent smoking behaviors. Measurement occurred at baseline and 24-months, and included demographics, nicotine dependence, tobacco use, and quit attempts. Cigar use was assessed as, “have you smoked a cigar in the last 30 days” and by brand specific use in the past 30 days.FindingsCigar use was reported by 51 adolescents (27%), and increased to 76 (41%) when identifying by brand name. African Americans (32%) were more likely to smoke cigars than whites (10%, p < .01), Asian/Pacific Islanders (3%, p = .04), and multiracial participants (24%, p = .05). Cigarette-only users smoked more per day (p = .04) and had higher cotinine levels (p = .05) than cigar users. Number of prior quit attempts (p = .84) did not differ by group. Group differences in addiction were found between cigar users and cigarette only users (p < .01). At 24 months, more baseline cigar users were tobacco abstinent than cigarette only users (16% versus 7%, p < 0.01, respectively).ConclusionsAssessment of brand-specific cigars nearly doubled the reporting among adolescent users. Cigar users differed from cigarette-only users in consumption and likelihood of abstinence at 24-months. For more accurate surveillance and to inform treatment considerations, surveys of adolescent tobacco use should include cigars, including brand names, in the assessment strategy.     

Influence of point-of-sale tobacco displays and plain black and white cigarette packaging and advertisements on adults: Evidence from a virtual store experimental study

IntroductionWe examined the potential impact of banning tobacco displays and mandating plain packaging and cigarette advertisements at the point of sale (POS) on adult outcomes.MethodsA virtual convenience store was created with scenarios in which the tobacco product display was either fully visible (status quo) or enclosed behind a cabinet (display ban), and cigarette packs and advertisements were either in full color (status quo) or black and white, text only (plain). A national convenience sample of 1313 adult current smokers and recent quitters was randomized to 1 of 4 conditions and given a shopping task to complete in the virtual store. Main outcomes were participants' self-reported urge to smoke and tobacco purchase attempts in the virtual store.ResultsCompared with recent quitters in the status quo conditions, recent quitters in the display ban condition had lower urges to smoke (β = − 4.82, 95% CI = − 8.16–− 1.49, p < 0.01). Compared with current smokers in the status quo conditions, smokers in the display ban conditions were less likely to attempt to purchase cigarettes in the virtual store (OR = 0.05, 95% CI = 0.03–0.08, P < 0.01). Smokers exposed to plain packs and ads were significantly less likely to attempt to purchase cigarettes (OR = 0.31, 95% CI = 0.20–0.47, P < 0.01) than those exposed to color packs and ads.ConclusionsPolicies that ban the display of tobacco products or require plain packaging and advertising at the POS may help reduce adult smoking.     

Effectiveness of a selective alcohol prevention program targeting personality risk factors: Results of interaction analyses

AimTo explore whether specific groups of adolescents (i.e., scoring high on personality risk traits, having a lower education level, or being male) benefit more from the Preventure intervention with regard to curbing their drinking behaviour.DesignA clustered randomized controlled trial, with participants randomly assigned to a 2-session coping skills intervention or a control no-intervention condition.SettingFifteen secondary schools throughout The Netherlands; 7 schools in the intervention and 8 schools in the control condition.Participants699 adolescents aged 13–15; 343 allocated to the intervention and 356 to the control condition; with drinking experience and elevated scores in either negative thinking, anxiety sensitivity, impulsivity or sensation seeking.MeasurementsDifferential effectiveness of the Preventure program was examined for the personality traits group, education level and gender on past-month binge drinking (main outcome), binge frequency, alcohol use, alcohol frequency and problem drinking, at 12 months post-intervention.Intervention and comparatorPreventure is a selective school-based alcohol prevention programme targeting personality risk factors. The comparator was a no-intervention control.FindingsIntervention effects were moderated by the personality traits group and by education level. More specifically, significant intervention effects were found on reducing alcohol use within the anxiety sensitivity group (OR = 2.14, CI = 1.40, 3.29) and reducing binge drinking (OR = 1.76, CI = 1.38, 2.24) and binge drinking frequency (β = 0.24, p = 0.04) within the sensation seeking group at 12 months post-intervention. Also, lower educated young adolescents reduced binge drinking (OR = 1.47, CI = 1.14, 1.88), binge drinking frequency (β = 0.25, p = 0.04), alcohol use (OR = 1.32, CI = 1.06, 1.65) and alcohol use frequency (β = 0.47, p = 0.01), but not those in the higher education group. Post hoc latent-growth analyses revealed significant effects on the development of binge drinking (β = − 0.19, p = 0.02) and binge drinking frequency (β = − 0.10, p = 0.03) within the SS personality trait.ConclusionsThe alcohol selective prevention program Preventure appears to have effect on the prevalence of binge drinking and alcohol use among specific groups in young adolescents in the Netherlands, particularly the SS personality trait and lower educated adolescents.     

Impact of the Spanish smoking laws on tobacco consumption and secondhand smoke exposure: A longitudinal population study

BackgroundIn Spain, two smoke-free laws have been passed after the approval of the WHO-FCTC. This study assesses the impact of these Spanish smoking legislations on the active and passive smoking through a population cohort in Barcelona (Spain).MethodsThis is a longitudinal study before and after the implementation of two national smoking bans in Spain in a representative sample (n = 1245) of adults (≥ 16 years old) from Barcelona (Spain) surveyed in 2004–2005 and followed-up in 2013–2014. The final sample analyzed was 736 individuals. Both questionnaires (before and after the two laws) included the same variables about active and passive smoking. We calculated the prevalence and the prevalence ratio (PR, with their 95% confidence intervals, 95% CI) of smoking cigarettes and hand-rolled tobacco and also the prevalence of exposure to secondhand smoke (SHS) at home, work, public transport, leisure time and at any setting after vs. before Spanish legislations.ResultsAfter the implementation of the two Spanish smoke-free bans, a significant decrease was observed in the smoking prevalence (from 34.5% to 26.1%, PR = 0.76, p < 0.001), in the average cigarettes per day (median from 15.2 to 10.0, p < 0.001), and in the percentage of conventional tobacco consumption (from 92.6% to 74.4%, PR = 0.80, p < 0.001). Furthermore, a significant increase in the use of hand-rolled tobacco (from 6.1% to 30.9%, PR = 5.07, p < 0.001) and other tobacco products (from 17.1% to 32.8%, PR = 1.92, p < 0.001) was observed. In addition, a significant decrease in the self-reported SHS exposure was observed in all the assessed settings (home, work, transport, and leisure time).ConclusionsThe implementation of the two smoke-free legislations in Spain is related to a reduction in smoking prevalence and SHS exposure. However, the smoking of other tobacco products, particularly hand-rolled tobacco, has increased among young population.     

Breakdowns of eye movement control toward smoking cues in young adult light smokers

BackgroundMany studies suggest that dependent smokers have a preference or attentional bias toward smoking cues. The purpose of this study was to test the ability of infrequent non-dependent light smokers to control their eye movements by look away from smoking cues. Poor control in the lightest of smokers would suggest nicotine cue-elicited behavior occurring even prior to nicotine dependency as measured by daily smoking.Methods17 infrequent non-dependent light smokers and 17 lifetime non-smokers performed an antisaccade task (look away from suddenly appearing cue) on smoking, alcohol, neutral, and dot cues.ResultsThe light smokers, who were confirmed light smokers and non-dependent (M_{Faegerström Dependency Score} = 0.35), were significantly worse at controlling their eye movements to smoking cues relative to both neutral cues (p < .04) and alcohol cues (p < .02). Light smokers made significantly more errors to smoking cues than non-smokers (p < .004).ConclusionsThese data suggest that prior to developing clinical symptoms of severe dependence or progressing to heavier smoking (e.g., daily smoking), the lightest of smokers are showing a specific deficit in control of nicotine cue-elicited behavior.     

Prevalence and correlates of a lifetime cannabis use disorder among pregnant former tobacco smokers

BackgroundFollowing tobacco and alcohol, cannabis is the most commonly used substance during pregnancy. Given the high prevalence of concurrent cannabis and tobacco use as well as the health consequences associated with prenatal substance use, we sought to document the relative contributions of psychosocial and psychiatric factors commonly associated with cannabis use in predicting a lifetime cannabis use disorder (CUD) among women who had quit smoking tobacco as a result of pregnancy.MethodsPregnant former tobacco smokers (n = 273) enrolled in a larger randomized controlled trial for postpartum tobacco relapse prevention completed semi-structured psychiatric interviews and self-reported demographic, pregnancy, health, psychosocial, and tobacco use factors during their third trimester of pregnancy.ResultsIn total, 14% (n = 38) of women met criteria for a lifetime CUD. The strongest predictors of a lifetime CUD were a history of having multiple psychiatric disorders (OR = 36.44; 95% CI = 5.03–264.27; p < 0.001) followed by a lifetime alcohol use disorder (OR = 3.54; 95% CI = 1.27–9.87; p < 0.05). In addition, more frequent attempts to quit smoking tobacco (OR = 1.12; 95% CI = 1.01–1.25; p < 0.05) and lower self-efficacy about weight management after quitting smoking tobacco (OR = 0.78; 95% CI = 0.62–0.97; p < 0.05) also were significantly associated with a lifetime CUD.ConclusionsWomen with a history of both cannabis and tobacco dependence may represent a subset of women who need more specialized treatment during the perinatal period to improve substance use outcomes.     

Brief exposure to cigarette smoke impairs airway epithelial cell innate anti-viral defence

BackgroundHuman rhinovirus (hRV) infections commonly cause acute upper respiratory infections and asthma exacerbations. Environmental cigarette smoke exposure is associated with a significant increase in the risk for these infections in children.ObjectiveTo determine the impact of short-term exposure to cigarette smoke on innate immune responses of airway epithelial cells infected with hRV.MethodsA human bronchial epithelial cell line (HBEC-3KT) was exposed to cigarette smoke extract (CSE) for 30 min and subsequently infected with hRV serotype 1B. Viral-induced cytokine release was measured with AlphaLISA and viral replication quantified by shed viral titer and intracellular viral copy number 24 h post-infection.ResultsCSE induced a concentration-dependent decrease in CXCL10 (p < 0.001) and IFN-β (p < 0.001), with a 79% reduction at the highest dose with an associated 3-fold increase in shed virus. These effects were maintained when infection was delayed up to 24 h post CSE exposure. Exogenous IFN-β treatment at t = 0 after infection blunts the effects of CSE on viral replication (p < 0.05).ConclusionA single exposure of 30 min to cigarette smoke has a lasting impact on epithelial innate defence providing a plausible mechanism for the increase in respiratory infections seen in children exposed to second-hand tobacco smoke.     

Brief exposure to cigarette smoke impairs airway epithelial cell innate anti-viral defence

BackgroundHuman rhinovirus (hRV) infections commonly cause acute upper respiratory infections and asthma exacerbations. Environmental cigarette smoke exposure is associated with a significant increase in the risk for these infections in children.ObjectiveTo determine the impact of short-term exposure to cigarette smoke on innate immune responses of airway epithelial cells infected with hRV.MethodsA human bronchial epithelial cell line (HBEC-3KT) was exposed to cigarette smoke extract (CSE) for 30 min and subsequently infected with hRV serotype 1B. Viral-induced cytokine release was measured with AlphaLISA and viral replication quantified by shed viral titer and intracellular viral copy number 24 h post-infection.ResultsCSE induced a concentration-dependent decrease in CXCL10 (p < 0.001) and IFN-β (p < 0.001), with a 79% reduction at the highest dose with an associated 3-fold increase in shed virus. These effects were maintained when infection was delayed up to 24 h post CSE exposure. Exogenous IFN-β treatment at t = 0 after infection blunts the effects of CSE on viral replication (p < 0.05).ConclusionA single exposure of 30 min to cigarette smoke has a lasting impact on epithelial innate defence providing a plausible mechanism for the increase in respiratory infections seen in children exposed to second-hand tobacco smoke.     

Reducing alcohol consumption to minimize weight gain and facilitate smoking cessation among military beneficiaries

IntroductionSmoking cessation-related weight gain can have significant negative health and career consequences for military personnel. Alcohol reduction combined with smoking cessation may decrease weight gain and relapse.MethodA randomized clinical trial of military beneficiaries compared a standard smoking cessation (i.e., brief informational) intervention (N = 159), with a brief motivational smoking cessation intervention that emphasized reduced drinking to lessen caloric intake and minimize weight gain (N = 158).ResultsParticipants who received the motivational intervention were significantly more likely to quit smoking at the 3-month follow-up (p = 0.02), but the differences were not maintained at 6 (p = 0.18) or 12 months (p = 0.16). Neither weight change nor alcohol reduction distinguished the 2 groups. Smoking cessation rates at 12 months (motivational group = 32.91%, informational group = 25.79%) were comparable to previous studies, but successful cessation was not mediated by reduced drinking.ConclusionsAlcohol reduction combined with smoking cessation did not result in decreased weight gain or improved outcomes.     

Determinants associated with E-cigarette adoption and use intention among college students

ObjectiveThis study investigated characteristics of potential and current e-cigarette users based on four different levels of use acceptability along with the determinants that promote e-cigarette use acceptability among college students.MethodsCollege students (N = 1198) aged 18–25 years at a Midwestern university were surveyed in September–October 2015. Participants were categorized into four groups based on e-cigarette use acceptability adapted from the Diffusion of Innovation Theory (i.e., laggards, late majority, early majority, and adopters). Multinomial logistic regressions and Heckman two-step selection procedures were performed to examine the determinants that promote e-cigarette use acceptability.ResultsApproximately 40% of the participants reported ever using e-cigarettes. E-cigarette adopters agreed that e-cigarettes are more socially acceptable than traditional tobacco cigarettes (relative risk ratio [RRR] = 1.43, p < 0.01). Unique features such as flavor appeared to encourage college students' experimentation with e-cigarettes (ps < 0.05). Participants mentioned positive sensory experiences as a reason for e-cigarette use (ps < 0.01) and reported caring about their appearance more than their health (ps < 0.05) when asked about possible outcomes of e-cigarette use.ConclusionsStudy findings indicate a possible explosive increase in e-cigarette experimentation or use among college students. Unique features of e-cigarettes such as flavor and USB rechargeability appear to be strong factors making e-cigarettes more acceptable and appealing to young adults regardless of their smoking status. Concerted efforts should be initiated to effectively counter or eliminate attractive features that lure young adults to experiment with e-cigarettes.     

E-cigarette advertisements,and associations with the use of e-cigarettes and disapproval or quitting of smoking: Findings from the International Tobacco Control (ITC) Netherlands Survey

BackgroundMuch attention has been directed towards the possible effects of e-cigarette advertisements on adolescent never smokers. However, e-cigarette advertising may also influence perceptions and behaviours of adult smokers. The aim of our study was to examine whether noticing e-cigarette advertisements is associated with current use of e-cigarettes, disapproval of smoking, quit smoking attempts, and quit smoking success.MethodsWe used longitudinal data from two survey waves of the ITC Netherlands Survey among smokers aged 16 years and older (n = 1198). Respondents were asked whether they noticed e-cigarettes being advertised on television, on the radio, and in newspapers or magazines in the previous 6 months.ResultsThere was a significant increase in noticing e-cigarette advertisements between 2013 (13.3%) and 2014 (36.0%), across all media. The largest increase was for television advertisements. There was also a substantial increase in current use of e-cigarettes (from 3.1% to 13.3%), but this was not related to noticing advertisements in traditional media (OR = 0.99, p = 0.937). Noticing advertisements was bivariately associated with more disapproval of smoking (Beta = 0.05, p = 0.019) and with a higher likelihood of attempting to quit smoking (OR = 1.37, p = 0.038), but these associations did not reach significance in multivariate analyses. There was no significant association between noticing advertisements and quit smoking success in either the bivariate or multivariate regression analysis (OR = 0.92, p = 0.807).ConclusionNoticing e-cigarette advertisements increased sharply in the Netherlands between 2013 and 2014 along with increased e-cigarette use, but the two appear unrelated. The advertisements did not seem to have adverse effects on disapproval of smoking and smoking cessation.     

The effects of maternal smoking on pregnancy outcome and placental histopathology lesions

ObjectiveTo study the effects of maternal smoking on pregnancy outcome and placental histopathology findings.Materials & methodsMaternal and labor characteristics and pathological reports were compared between term placentas of complicated and uncomplicated pregnancies of: heavy smokers (>10 cigarettes per day, H-smokers), moderate smokers (<10 cigarettes per day, M-smokers) and non-smokers (controls, N-smokers).ResultsBirth-weights were lower in the H-smokers and M-smokers as compared to the N-smokers (p < 0.001), with a higher rate of small for gestational age (SGA): 18.2%, 19.2% and 11.4%, respectively (p = 0.01). Deliveries among smokers were characterized by higher rates of abnormal fetal heart rate tracings during labor as compared to non-smokers (p = 0.01). Rates of placental maternal and fetal stromal-vascular supply lesions was similar between the groups.ConclusionsMaternal smoking is associated with higher rates of SGA. Tobacco’s potential influence is probably through the disruption of normal placental epigenetic patterns, not expressed in placental histopathology lesions.     

Respiratory problems and anxiety sensitivity in smoking lapse among treatment seeking smokers

PurposeThe current study examined whether the interaction of lower respiratory symptoms and anxiety sensitivity is related to smoking lapse in the context of smoking cessation.MethodParticipants were adult daily smokers (N = 60) exposed to the World Trade Center (WTC) disaster who were in a smoking cessation treatment program (75.0% male, 50.6 years old [SD = 9.2], and current smoking rate was 17.6 cigarettes per day (SD = 10.6).ResultsResults indicated that the interaction between lower respiratory symptoms and anxiety sensitivity was a significant predictor of greater risk for lapse (i.e., lower survival time; B = 0.005, OR = 1.01, p = 0.039). Follow-up analysis showed that greater respiratory symptoms were a significant predictor of lapse risk among those with high (B = 0.116, OR = 1.12, p = 0.025), but not those with low (B = − 0.048, OR = 0.95, p = 0.322), levels of anxiety sensitivity.DiscussionThe findings from the current study suggest that smokers with greater respiratory symptoms and higher levels of anxiety sensitivity may be associated with early lapse to smoking following smoking cessation treatment. Future work has the potential to inform the development of tailored cessation interventions for smokers who experience varying levels of lower respiratory symptoms and anxiety sensitivity.     

Electronic cigarette awareness and use among adults in Hong Kong

IntroductionElectronic cigarettes (e-cigarettes) have gained popularity rapidly in the Western world but data in the East are scarce. We examined the awareness and ever use of e-cigarettes, and reasons for e-cigarette use in a probability sample of adults in Hong Kong.MethodsCross-sectional data were collected in 2014 from Chinese adults aged 15–65 in Hong Kong (819 never smokers, 800 former smokers, 800 current smokers) via computer-assisted telephone interviews (response rate: 73.8%). Analysis was limited to a subset of 809 respondents (i.e., 357 never smokers, 269 former smokers, 183 current smokers) who were randomly selected to answer questions on e-cigarettes. Chi-square analyses compared e-cigarette awareness and ever use by gender, age, education, and cigarette smoking status. Multivariable logistic regression examined if e-cigarette awareness was associated with demographic variables and cigarette smoking status.Results75.4% of adults had heard of e-cigarettes, and 2.3% reported having used e-cigarettes. Greater awareness was associated with male gender and higher education. Ever use of e-cigarettes was higher among males (3.6%, p = .03), younger adults (aged 15–29, 5.2%, p = .002), and current cigarette smokers (11.8%, p < .001). Common reasons for using e-cigarettes were curiosity (47.4%), the stylish product design (25.8%), and quitting smoking (13.6%).ConclusionsAwareness of e-cigarettes was widespread in Hong Kong. Although the use of e-cigarettes was low, its relation with younger age and current smoking is of concern. Health surveillance of e-cigarette use is needed. Interventions should target young adults and cigarette smokers, and address the marketing messages, especially the effect of e-cigarettes on smoking cessation.     

Examining the psychometric properties and predictive validity of a youth-specific version of the Nicotine Dependence Syndrome Scale (NDSS) among teens with varying levels of smoking

Current conceptualizations of nicotine dependence suggest assessing its multidimensional structure, especially for understanding how dependence develops in teen smokers. It is unknown if a multidimensional structure holds for teens with varying levels of smoking. The psychometric properties and predictive validity of the youth-specific, multidimensional Nicotine Dependence Syndrome Scale (NDSS) was assessed among 526 teens (55.5% female; 74.3% Caucasian) who reported smoking in the past 30 days. NDSS and smoking measures were obtained at baseline and six months. Confirmatory factor analysis supported the NDSS-Total (NDSS-T, α = 0.94) and five factors for the sample: Drive (α = 0.92), Tolerance (α = 0.85), Priority (α = 0.83), Stereotypy (α = 0.73), and Continuity (α = 0.64). NDSS-T, Drive, Tolerance, and Priority were predictors of subsequent amount smoked (p < 0.01). Drive, Tolerance, and Continuity predicted subsequent cessation (p < 0.05). Though the youth-specific NDSS has good psychometric properties, tests of predictive validity for subsequent smoking and cessation behavior suggest only certain dimensions of dependence, particularly Drive and Tolerance, appear to be salient in this sample. Further studies should assess the multidimensional nature of nicotine dependence among teens with varying levels of smoking.     

Affect and cortisol mechanisms through which acute exercise attenuates cigarette cravings during a temporary quit attempt

IntroductionA number of mechanisms have been proposed to explain how exercise attenuates cravings among temporarily abstinent smokers; however, research has presented mixed findings. The aim of this study was to further investigate the mechanistic role of positive and negative affect and cortisol in the exercise-craving reduction relationship.MethodsAdult smokers (N = 110, male = 56, M age = 33.1, M cigarettes/day = 15.4) provided baseline affective and cortisol data (T1). After an 18-h period of abstinence, participants were randomized to a passive sitting (PSG) or moderate exercise group (MEG; 40–68% of heart rate reserve) for 10 min. Affect and cortisol data were also collected immediately before (T2) and after (T3) the condition.ResultsThe smoking abstinence manipulation increased cravings (p < 0.001, eta = 0.40) and negative affect (p < 0.001, eta = 0.17), as well as decreased positive affect (p < 0.001, eta = 0.08) and cortisol (trending, p = 0.07, η2 = 0.04). As expected, a significant reduction in cravings from T2 to T3 was found for MEG but not PSG (p < 0.001, eta = 0.25). Mediation was tested using Sobel and bootstrapping tests with residual change scores of mediators and cravings. Findings showed that both positive and negative affect, but not cortisol, mediated the relationship between exercise and cravings.ConclusionsUnderstanding the mechanisms by which exercise induces craving reductions will better allow researchers and healthcare professionals to infer causality and implement interventions guided by the processes that yield such desirable outcomes.