Characteristics associated with smoking in a Hispanic college student sample

This study examined the smoking related behaviors of Hispanic young adult college students as part of a larger study that assessed characteristics of Hispanic smokers in a metropolitan area on the U.S./México border. One hundred seventy-four English-speaking Hispanic college students completed questionnaires that assessed tobacco use, drug/alcohol use, body mass index, weight concerns, acculturation, depressive symptoms, and expired carbon monoxide level. Of the 74 smoking participants (42.5% of the sample), 77% reported light or intermittent smoking. Univariate analyses and a backward elimination logistic regression model were used to compare smokers' and nonsmokers' characteristics. Significant univariate differences between smokers and nonsmokers were higher reported weekly alcohol use and ever use of marijuana. Logistic regression findings indicated smokers reported heightened odds of being younger, lower acculturation, ever use of drugs, and weekly drinking. These results suggest a drug and alcohol use component is important to cessation interventions targeted toward Hispanic college student smokers.     

A comparison of daily and occasional smokers' implicit affective responses to smoking cues

Previous research has not compared implicit affective responses to smoking-related stimuli in occasional (i.e., those who smoke less than one cigarette per day) and daily smokers (i.e., those who smoke at least once per day). In addition to assessing their motivations for smoking, implicit affective responses were measured using the Affect Misattribution Procedure (AMP) in occasional (n = 19) and daily smokers (n = 34) to smoking-related and neutral cues. Half of the cues depicted a human interacting with an object (i.e., active), whereas the remaining cues depicted objects alone (i.e., inactive). Results indicated that for the active cues, daily smokers responded more positively to smoking-related than to neutral cues, whereas occasional smokers showed no difference in their implicit responses. In addition to smoking frequency, relative differences in implicit responses to active cues were related to cognitive enhancement motivation. For inactive cues, implicit responses were related to cognitive enhancement as well as reinforcement. Because daily smokers have more positive implicit responses to active smoking-related cues than occasional smokers, these cues may play an important role in maintaining smoking behavior in daily smokers.     

Heterogeneity of intermittent smokers in a Hispanic college student sample

Hispanics are more likely to be daily light smokers (DLS) and intermittent smokers (ITS) than non-Hispanic whites. Although daily light (≤10 cigarettes per day [CPD]) and intermittent (nondaily) smoking have increased in recent years, few studies have compared DLS and ITS, especially within a Hispanic sample. The primary aims of this study were to investigate differences between DLS and ITS, and within ITS, differences between converted ITS (CITS; previously smoked daily for ≥6 months) and native ITS (NITS; never smoked daily) in a Hispanic college student sample (M_age = 23.74, SD = 5.17; 58.1% male). Analyses were conducted using baseline data from a larger study that evaluated attitudes toward tobacco free campus policies in a U.S. university on the border with México. This study included data from 45 DLS and 216 ITS (CITS: n = 77, NITS: n = 139; N = 261). Compared to DLS, ITS were younger (on average), less likely to identify as smokers, smoked on fewer days in the past month, smoked fewer cigarettes on smoking days, and reported less nicotine dependence. Compared to CITS, NITS were younger, less likely to self-identify as smokers, smoked on fewer days in the past month, smoked fewer CPD on smoking days, and were less dependent on nicotine. Given the similarities between current and past findings (suggesting that CITS are in between DLS and NITS—regarding smoking behavior), these data suggest a similar pattern likely exists also among Hispanic smokers. Additionally, the absence of some previously observed differences is relevant in characterizing this particular Hispanic college sample. These findings provide further insight for the tailoring of interventions that target Hispanic DLS, CITS and NITS).     

The effectiveness of an integrated multicomponent program for adolescent smoking cessation in Taiwan

If adolescents do not receive appropriate assistance in quitting smoking, they are highly likely to become regular smokers when they enter adulthood. Thus, an effective smoking-cessation program is required. A program was designed based on both the smoking-cessation barriers reported by students and effective strategies derived from the literature. We assigned 143 student smokers from 6 vocational high schools to intervention (n = 78) and comparison groups (n = 65). Data were collected at the baseline, the end of the program, and 1- and 4-month follow-up time points. For the intervention group, the smoking-abstinence rates confirmed using the urine cotinine test were 22.73% at the end of the program and 20.75% at the 4-month follow-up point. Days smoked in the past month, number of cigarettes smoked per day, and the Fagerström Test for Nicotine Dependence score of the intervention group decreased at all of the time points. The group differences in these variables were statistically significant; the magnitude of effect sizes ranged from 0.44 to 0.95. Multicomponent programs addressing smoking-cessation barriers that students encounter can help adolescents quit smoking.     

Differences in quit attempts between non-Hispanic Black and White daily smokers: The role of smoking motives

Introduction

The prevalence of smoking across racial/ethnic groups has declined over the years, yet racial health disparities for smoking persist. Studies indicate that non-Hispanic Black smokers attempt to quit smoking more often compared to non-Hispanic White smokers but are less successful at doing so. Research suggests that motives to quit smoking differ by race, however, less is known about the role of motives to smoke in explaining racial differences in attempts to quit smoking.

Methods

This study examined whether smoking motives accounted for the differential rates in quit attempts between non-Hispanic Black (n = 155) and non-Hispanic White (n = 159) smokers. Data were culled from a larger study of heavy-drinking smokers. The Wisconsin Index of Smoking Dependence Motives (WISDM) assessed motives to smoke.

Results

As expected, Black and White smokers reported similar smoking patterns, yet Black smokers reported higher rates of failed attempts to quit smoking than White smokers. Findings indicated that Black, compared to White, smokers endorsed lower scores in the negative reinforcement, positive reinforcement, and taste WISDM subscales and scores in these subscales mediated the relationship between race and quit attempts.

Conclusions

In this study, Blacks, compared to Whites, endorsed lower motives to smoke, which are generally associated with successful quit attempts, yet they experienced more failed attempts to quit smoking. This study demonstrates racial health disparities at the level of smoking motives and suggests that Black smokers remain vulnerable to failed quit attempts despite reporting lower motives to smoke.     

Variation in BAS–BIS profiles across categories of cigarette use

Cigarette smoking is a major health concern, especially among college students. Research suggests a number of individual difference variables may be useful for identifying people at risk of becoming smokers and their likelihood of successfully quitting. The current study focuses on individual differences relating to Behavioral Inhibition System sensitivity (BIS) and the fun seeking, reward responsiveness, and drive aspects of Behavioral Approach System sensitivity (BAS). The former relates to mitigation of potential threat, whereas the latter three relate to different motivations for approach. Noting that existing literature suggests the considerations influencing whether a person experiments with cigarettes differ from those influencing who becomes a habitual smoker which in turn differ from those influencing whether a person quits smoking, we hypothesized that never smokers, experimenters, smokers, and former smokers would differ from each other on BIS, fun seeking, reward responsiveness, and drive in predictable ways. Moreover, we predicted these groups would differ from each other in terms of member profiles across these four variables. We assessed these predictions in a sample of college students from geographically diverse institutions within the United States (N = 1840). The profile for never smokers was characterized by high BIS and low fun seeking, that of experimenters by moderately high BIS, high fun seeking, and moderate reward responsiveness, and that of former smokers by moderate BIS, high fun seeking, high reward responsiveness, and high drive. Contrary to expectations, current smokers were low on all four of these characteristics.     

Characteristics of American Indian light smokers

Introduction

American Indians (AI) have the highest smoking rates of any racial/ethnic group in the U.S. and have more difficulty quitting smoking. Little is known about the smoking characteristics of AI smokers. The present study compared the demographic and smoking characteristics of light (≤ 10 cigarettes per day; N = 206) and moderate/heavy (11 + cigarettes per day; N = 86) AI smokers participating in a cross-sectional survey about smoking and health.

Methods

Multiple methods were used to recruit participants in attendance at powwows, health and career fairs, and conferences. A total of 998 AI (76% cooperation rate) completed a survey assessing general health, sociodemographics, traditional and commercial tobacco use, knowledge and attitudes related to cancer, source of health information and care and other health-related behaviors.

Results

AI light smokers were younger and less likely to be married or living with a partner compared to moderate/heavy smokers. AI light smokers were less dependent on smoking and more likely to have home smoking restrictions. There were no differences with respect to number of quit attempts in the past year or the average length of their most recent quit attempt by light vs. moderate/heavy smoking. In addition, a similar proportion of light and heavy smokers reported using tobacco for traditional purposes such as ceremonial, spiritual and prayer.

Conclusions

These findings highlight important differences between AI light and heavier smokers. Differences related to smoking characteristics such as level of dependence and home smoking restrictions have important implications for the treatment of AI smokers.     

Cigarette Smoking Status Among Latino/Hispanic Middle and High School Students in the United States

Although Latino/Hispanic adolescent substance use is a growing research area in the United States, there is little research examining the prevalence and factors associated with adolescent cigarette smoking status in this population. A nationally representative sample of 5,929 middle and high Latino/Hispanic students in the 2009 US National Youth Tobacco Survey was selected to assess the prevalence and various risk and protective factors associated with cigarette smoking status. Results revealed one in five (20%) were experimental smokers, nearly one in eleven (8.5%) were occasional smokers, and 4% were regular smokers. Multinomial logistic regression analyses showed that, controlling for demographics, family members' smoking, refusal to smoke, school absence, and exposure to tobacco marketing were associated with experimental smoking; awareness of harmful effects of secondhand smoking, refusal to smoke, exposure to tobacco advertising, and receptivity to tobacco marketing were associated with occasional smoking; and refusal to smoke, school absence, and receptivity to tobacco marketing were associated with regular smoking. This study highlights the need to integrate various risk and proactive factors associated with different smoking status into practices and policies for Latino/Hispanic adolescent smokers.     

First cigarette on waking and time of day as predictors of puffing behaviour in UK adult smokers

Background

There is known inter- and intra-individual variation in how cigarettes are smoked. The aim of this study was to explore the influence of diurnal factors, particularly the first cigarette of the day, on puffing behaviour in a sample of adult smokers.

Methods

We recruited 130 adults aged 18–60 years who were smoking one of seven cigarette brands popular in the UK. Puffing behaviour was measured using a portable smoking device (CReSSmicro) through which participants smoked their cigarettes over a 24 h study period. The primary outcome was total smoke volume per cigarette (obtained by summing the puff volumes for each cigarette). Secondary outcome measures were puffing frequency, average puff volume, average puff flow, average puff duration and inter-puff interval.

Results

Total smoke volume was found to be significantly associated with the time the cigarette was smoked (P < 0.001), with cigarettes smoked between 2 and 10 a.m. being smoked less intensively than other cigarettes. After adjusting for time of cigarette, the first cigarette on waking was smoked slightly less intensively than other cigarettes and significantly so if smoked within 5 min of waking (P = 0.004).

Conclusions

This study suggests that cigarettes smoked during the night and early morning, including the first cigarette of the day, are puffed less intensively. This is a potentially important finding that merits more research given the importance of the first cigarette of the day and diurnal smoking patterns for determining dependence, cessation and relapse.     

Do cognitive attributions for smoking predict subsequent smoking development?

To develop more effective anti-smoking programs, it is important to understand the factors that influence people to smoke. Guided by attribution theory, a longitudinal study was conducted to investigate how individuals' cognitive attributions for smoking were associated with subsequent smoking development and through which pathways.Middle and high school students in seven large cities in China (N = 12,382; 48.5% boys and 51.5% girls) completed two annual surveys. Associations between cognitive attributions for smoking and subsequent smoking initiation and progression were tested with multilevel analysis, taking into account plausible moderation effects of gender and baseline smoking status. Mediation effects of susceptibility to smoking were investigated using statistical mediation analysis (MacKinnon, 2008).Six out of eight tested themes of cognitive attributions were associated with subsequent smoking development. Curiosity (β = 0.11, p < 0.001) and autonomy (β = 0.08, p = 0.019) were associated with smoking initiation among baseline non-smokers. Coping (β = 0.07, p < 0.001) and social image (β = 0.10, p = <.0001) were associated with smoking progression among baseline lifetime smokers. Social image (β = 0.05, p = 0.043), engagement (β = 0.07, p = 0.003), and mental enhancement (β = 0.15, p < 0.001) were associated with smoking progression among baseline past 30-day smokers. More attributions were associated with smoking development among males than among females. Susceptibility to smoking partially mediated most of the associations, with the proportion of mediated effects ranging from 4.3% to 30.8%.This study identifies the roles that cognitive attributions for smoking play in subsequent smoking development. These attributions could be addressed in smoking prevention programs.     

Reward dependence moderates smoking-cue- and stress-induced cigarette cravings

Background

Cigarette cravings following exposure to smoking cues in a smoker's environment are thought to play an important role in cessation failure. The possibility that dispositional factors may impact cue-induced cravings, though intriguing, has received little attention. According to Cloninger's Tridimensional Personality Theory, factors such as reward dependence (RD), harm avoidance (HA), and novelty seeking (NS) may figure prominently in risk for addiction, as well as relapse, in individuals attempting to abstain from drug and alcohol use. Particularly interesting in this regard is the possibility that smokers with higher levels of RD, who are especially sensitive to reward signals, will have heightened craving reactions to smoking cues.

Methods

To that end, non-treatment-seeking nicotine dependent smokers (n = 96, mean age = 41.1, 47% African American, 17% Caucasian, 22% Hispanic, 19.3 cigs/day, FTND = 7.5) underwent a classic experimental cue-induction, during which they were exposed to imagery of: (1) smoking, (2) neutral, and (3) stress cues, and reported their cigarette cravings (0–100) before and after each exposure. Participants also completed the Tridimensional Personality Questionnaire.

Results

Not surprisingly, smoking and stress cues (but not neutral cues) elicited significant elevations in craving (p's < 0.0001). Consistent with study hypothesis, smokers who scored higher on RD had stronger craving reactions to both smoking cues (p < .02) and stress cues (p < .03).

Conclusions

Findings raise the possibility that dispositional characteristics, in particular, reward dependence, influence smoking by potentiating reactions to environmental smoking cues. Furthermore, the similar effects of RD on stress-induced craving suggest that both cue-and stress-induced cravings may be influenced by a common underlying disposition.     

The effect of menthol containing cigarettes on adult smokers’ exposure to nicotine and carbon monoxide

There is limited information comparing biomarkers of exposure (BOE) to cigarette smoke in menthol (MS) and non-menthol cigarette smokers (NMS). Objective: To compare BOE to nicotine and carbon monoxide in MS and NMS. Methods: Cross-sectional, observational, ambulatory, multi-centre study in 3341 adult cigarette smokers. Nicotine equivalents (NE) in 24 h urine, NE/cigarette, COHb and serum cotinine were measured. Statistical analyses included analysis of variance and Wilcoxon test. Results: Analyses of variance revealed no statistically significant effects of mentholated cigarettes on NE/24 h, COHb, serum cotinine and NE/cigarette. On average MS smoked 15.0 and NMS 16.8 cigarettes/day. The unadjusted mean differences were as follows: MS had lower NE/24 h (5.4%) and COHb (3.2%), higher serum cotinine (3.0%) and NE/cigarette (5.7%) than NMS. African-Americans MS smoked 40% fewer cigarettes, showed lower NE/24 h (24%) and COHb (10%) and higher NE/cig (29%) and serum cotinine (8%) levels than their White counterparts. Conclusions: Smoking mentholated cigarettes does not increase daily exposure to smoke constituents as measured by NE and COHb. These findings are consistent with the majority of epidemiological studies indicating no difference in smoking related risks between MS and NMS.     

Pre-quit depression level and smoking expectancies for mood management predict the nature of smoking withdrawal symptoms in college women smokers

We assessed smoking withdrawal symptoms over a six-day period of abstinence among 21 female college students who were daily cigarette smokers [M = 20.3 (4.4); cigarettes per day] and were in the preparation stage of change for quitting smoking. We predicted that reported withdrawal symptoms would covary with baseline depression scores and baseline outcome expectancies for cigarette smoking as a mood management tool. Depression scores at baseline significantly predicted mood-related smoking withdrawal symptoms of Depression–Dejection and Vigor from the Profile of Mood States (POMS). Smoking outcome expectancies for relief of negative affect measured at baseline significantly predicted symptoms of Confusion–Bewilderment and Anger–Hostility. Neither baseline depression nor baseline smoking expectancies for mood management predicted smoking withdrawal symptoms measured by the Smoking Withdrawal Questionnaire (SWQ; [Shiffman, S. M., & Jarvik, M. E. (1976). Smoking withdrawal symptoms in two weeks of abstinence. Psychopharmacology, 50, 35–39]). Results imply that women smokers with baseline depressive symptomatology and expectancies for smoking to relieve negative mood endure greater abstinence-induced mood disturbance, but similar levels of other smoking withdrawal symptoms during initial abstinence. These results may inform smoking cessation efforts.     

Mood,mood regulation expectancies and frontal systems functioning in current smokers versus never-smokers in China and Australia

Indices of mood, mood regulation expectancies and everyday executive functioning were examined in adult current smokers and never-smokers of both genders in Australia (N = 97), where anti-smoking campaigns have dramatically reduced smoking prevalence and acceptability, and in China (N = 222), where smoking prevalence and public acceptance of smoking remain high. Dependent measures included the Depression Anxiety Stress Scales (DASS-21), the Negative Mood Regulation (NMR) expectancies scale, the Frontal Systems Behavior Scale (FrSBe), the Fagerström Test for Nicotine Dependence (FTND) and the Alcohol Use Disorders Identification Test (AUDIT). Multivariate analyses of covariance (MANCOVAs) controlling for demographic and recruitment related variables revealed highly significant differences between current smokers and never-smokers in both countries such that smokers indicated worse moods and poorer functioning than never-smokers on all dependent measures. Chinese smokers scored significantly worse on all dependent measures than Australian smokers whereas Chinese and Australian never-smokers did not differ on any of the same measures. Although nicotine dependence level as measured by FTND was significantly higher in Chinese than Australian smokers and was significantly correlated with all other dependent measures, inclusion of FTND scores as another covariate in MANCOVA did not eliminate the highly significant differences between Chinese and Australian smokers. Results are interpreted in light of the relative ease of taking up and continuing smoking in China compared to Australia today.     

We do not smoke but some of us are more susceptible than others: A multilevel analysis of a sample of Canadian youth in grades 9 to 12

Background

Smoking susceptibility has been found to be a strong predictor of experimental smoking. This paper examined which student- and school-level factors differentiated susceptible never smokers from non-susceptible never smokers among a nationally representative sample of Canadian students in grades 9 to 12.

Methods

Student-level data from the 2008–2009 Canadian Youth Smoking Survey were linked with school-level data from the 2006 Census, and one built environment characteristic (the density of tobacco retailers surrounding schools). These data were examined using multilevel logistic regression analyses.

Results

The likelihood of a never smoker being susceptible to smoking significantly varied across schools (p = 0.0002). Students in this study were more likely to be susceptible never smokers if they reported low self-esteem, held positive attitudes towards smoking, used alcohol or marijuana, had close friends who smoked, and came from homes without a total ban on smoking. The school location (rural versus urban), the socioeconomic status of the neighbourhood surrounding a school, and the density of tobacco retailers that were located within 1-km radius of each school were not associated with students' smoking susceptibility.

Conclusion

These findings underscore the continued need to develop school-based tobacco use prevention policies and/or programs that enhance students' self-esteem, address tobacco use misinformation and substance use, and include strategies targeting friends who smoke, and students who come from homes without a total ban on smoking.     

Do smokers of specialty and conventional cigarettes differ in their dependence on nicotine?

Specialty cigarettes, bidis and kreteks, have commonly been viewed by adolescent users as being less harmful than conventional cigarettes. Biochemical studies, however, have shown that the concentration and delivery of nicotine from these tobacco products are not insignificant. The current study tested whether the diagnosis and symptoms for nicotine dependence differed among conventional-only smokers (n = 16 959), specialty-only smokers (n = 313), and poly-tobacco smokers (n = 1288) from the 2002 and 2003 National Surveys on Drug Use and Health. Compared with the specialty-only smokers, the conventional-only and poly-tobacco smokers were more dependent on nicotine, assessed by the Nicotine Dependence Syndrome Scale and a single item from the Fagerstrom Test for Nicotine Dependence. However, after accounting for differences in smoking frequency, the specialty-only smokers had significantly greater odds of being nicotine dependent than the conventional-only smokers. The reversed effect was primarily attributed to the specialty-only smokers who smoked less frequently, but reported a shorter time to their first cigarette. These findings suggest that the nicotine acquired from specialty cigarettes may be sufficient in yielding a sense of urgency to smoke.     

Risk perception and intention to quit among a tri-ethnic sample of nondaily,light daily,and moderate/heavy daily smokers

Introduction

Although the relationship between risk perceptions and quit intentions has been established, few studies explore the potential impact of smoking level on these associations, and none have done so among diversely-aged samples of multiple ethnicities.

Methods

Participants, ranging in age from 25 to 81, were 1133 nondaily smokers (smoked ≥ 1 cigarette on 4 to 24 days in the past 30 days), 556 light daily smokers (≤ 10 cigarettes per day), and 585 moderate to heavy daily smokers (> 10 cigarettes per day). Each smoking level comprised approximately equal numbers of African Americans, Latinos, and Whites. A logistic regression analysis, adjusted for sociodemographics, self-rated health, time to the first cigarette of the day and smoking level, was used to examine the association between risk perception (perceived risk of acquiring lung cancer, lung disease, and heart disease) and intention to quit (≤ 6 months versus > 6 months/never). A second adjusted model tested moderation by smoking level with an interaction term.

Results

Greater risk perception was associated with a higher odds of planning to quit within 6 months (AOR = 1.34, CI_.95 = 1.24, 1.45). Smoking level did not moderate this association (p = .85).

Conclusions

Results suggest that educating all smokers, irrespective of their smoking level, about increased risk of developing smoking-related diseases might be a helpful strategy to enhance their intention to make a smoking quit attempt.     

Sleep deprivation increases cigarette smoking

Loss of sleep may impair the ability to abstain from drug use, through any of a number of mechanisms. Sleep loss may increase drug use by impairing attention and inhibitory control, increasing the value of drug rewards over other rewards, or by inducing mood states that facilitate use of a drug. In the present study, we examined whether sleep deprivation (SD) would increase smoking in cigarette smokers, and whether it would do so by impairing attention or inhibitory control. Healthy cigarette smokers (N = 14) were tested in a two-session within subject study, after overnight SD or after a normal night's sleep. Subjects were tested in both conditions in randomized order, after abstaining from cigarettes for 48 hours. The procedure was designed to model the human relapse situation. On each 6-h laboratory session after sleep or no sleep, subjects completed mood and craving questionnaires, tasks measuring behavioral inhibition and attention, and a choice procedure in which they chose between money and smoking cigarettes. SD increased self-reported fatigue and decreased arousal, it increased the number of cigarettes subjects chose to smoke, impaired behavioral inhibition and attention. However, the impairments in inhibition or attention were not related to the increase in smoking. It is possible that SD increases smoking because smokers expect that it will reduce sleepiness. Thus, the findings suggest that sleep loss may increase the likelihood of smoking during abstinence not through inhibitory or attentional mechanisms but because of the potential of nicotine to reduce subjective sleepiness.     

A longitudinal study of electronic cigarette users

Objective

To assess behavior change over 12 months in users of e-cigarettes (“vapers”).

Methods

Longitudinal Internet survey, 2011 to 2013. Participants were enrolled on websites dedicated to e-cigarettes and smoking cessation. We assessed use of e-cigarettes and tobacco among the same cohort at baseline, after one month (n = 477) and one year (n = 367).

Results

Most participants (72%) were former smokers, and 76% were using e-cigarettes daily. At baseline, current users had been using e-cigarettes for 3 months, took 150 puffs/day on their e-cigarette and used refill liquids containing 16 mg/ml of nicotine, on average. Almost all the daily vapers at baseline were still vaping daily after one month (98%) and one year (89%). Of those who had been vaping daily for less than one month at baseline, 93% were still vaping daily after one month, and 81% after one year. In daily vapers, the number of puffs/day on e-cigarettes remained unchanged between baseline and one year. Among former smokers who were vaping daily at baseline, 6% had relapsed to smoking after one month and also 6% after one year. Among dual users (smokers who were vaping daily at baseline), 22% had stopped smoking after one month and 46% after one year. In dual users who were still smoking at follow-up, cigarette consumption decreased by 5.3 cig/day after one month (from 11.3 to 6.0 cig./day, p = 0.006), but remained unchanged between baseline and 1-year follow-up.

Conclusions

E-cigarettes may contribute to relapse prevention in former smokers and smoking cessation in current smokers.