A national survey of older smokers: treatment needs of a growing population

Examined smoking and quitting patterns among 289 smokers ages 50 to 74 years who took part in a nationwide survey of American Association of Retired Persons members. Respondents were predominantly chronic, heavy smokers. They had smoked for an average of 45 years, more than one third smoked 25 or more cigarettes per day, and more than two thirds showed evidence of high nicotine addiction. Nonetheless, most were interested in quitting smoking and reported plans to quit in the next year. Concerns about missing or craving cigarettes; losing a pleasure; and being nervous, tense, or irritable after quitting were the most common barriers to quitting reported. These problems were rated as more serious by heavier, longer term smokers and by smokers with lower quitting self-efficacy. The variables most strongly associated with "contemplating" quitting were beliefs in quitting health benefits, recent attempts to quit or cut down, prior attempts to quit, and high self-efficacy. Limitations of these findings are discussed along with implications for the design of treatments geared to the special needs of older smokers.     

Electroencephalographic responses to photic stimulation in habitual smokers and nonsmokers.

Two studies are reported in which electroencephalograms (EEGs) of habitual cigarette smokers and of nonsmokers were taken before and after they were required to smoke a cigarette. The EEGs were scored for incidence of EEG "driving" responses to photic stimulation, an index that appears to reflect the balance between central adrenergic and cholinergic nervous systems. The findings suggest that smokers tend to have a central autonomic balance less in favor of adrenergic functioning than do nonsmokers. Cigarette smoking may alleviate a possible central adrenergic insufficiency of smokers. These findings suggest a solution to "Nesbitt's paradox," which has reference to the fact that while nicotine is a central adrenergic stimulant, smokers describe the effect of smoking in sedational terms (i.e., as relaxing or calming).     

The acute effects of nicotine on positive and negative affect in adolescent smokers

Although adolescent cigarette smoking remains a critical public health concern, little is known about the reinforcing mechanisms governing smoking in this vulnerable population. To assess predictions derived from both positive and negative reinforcement models of drug use, the authors measured the acute effects of nicotine, as administered via tobacco cigarettes, on both positive and negative affect in a group of 15- to 18-year-old smokers. A matched group of nonsmokers served as a comparison group. Findings revealed that whereas adolescents who smoked a cigarette experienced reductions in both positive and negative affect, the observed reductions in negative affect were moderated by nicotine content of the cigarette (high yield vs. denicotinized), level of nicotine dependence, level of baseline craving, and smoking expectancies pertinent to negative affect regulation. Nonsmokers experienced no change in affect over the 10-min assessment period, and no interaction effects were observed for positive affect. Overall, the findings conform to a negative reinforcement model of nicotine effects and strongly suggest that, even among young light smokers, nicotine dependence and resultant withdrawal symptomatology may serve as motivating factors governing smoking behavior.     

Adolescent smoking behavior and outcome expectancies

Adolescent smoking behavior is assumed to be associated with smoking outcome expectancies. Results in this paper are based on data from the control group of two data collections among Norwegian secondary school students taken approximately 30 months apart (T1 and T2). The dimensionality of smoking outcome expectancies was the same at both time points, revealing three components ("Addicted", "Not harmful" and "Social"). After correction for attenuation, the Pearson's correlation between T1 and T2 was 0.41 for the total sumscore, indicating low to moderate relative stability. When examining smoking expectancy sumscore means by smoking habits at T1 and T2, never smokers were different from smokers on both occasions. Never smokers scored low on "Social" and "Not harmful", and high on "Addictive". All associations were statistically significant (p < 0.001). The "Social" dimension was the strongest predictor of smoking behavior at T1 and T2. One of the outcome expectancy sumscores ("Addictive") at T1 predicted smoking habits at T2 after controlling for smoking habits at T1 (p < 0.01). This predictor was significant also after entering outcome expectancy sumscores at T2 into the model (p < 0.05). These results indicate that outcome expectations other than the health-related ones should be paid attention to when planning new prevention programs.     

Perceived health: a test of incremental validity in relation to smoking outcome expectancies, motivation to smoke and desire to quit smoking

This study examined the role of perceived health in predicting theoretically-relevant aspects of smoking behavior among 161 young adult regular smokers (67 females; mean age = 21.9 years (SD = 7.2), cigarettes per day (M) = 12.2 (SD = 5.7)) recruited from the general community. Consistent with prediction, results indicated that relative to anxiety sensitivity, gender, number of cigarettes smoked per day and nicotine dependence, perceived physical health uniquely and significantly predicted expectancies for negative affect reduction and expectancies that smoking would lead to negative personal consequences. Additionally, perceived health incrementally predicted motivation to smoke to reduce negative affect. In contrast to expectation, perceived health was unrelated to motivation to quit smoking. Results are discussed in relation to the role of perceived health as a cognitive vulnerability factor for specific types of smoking patterns.     

A measure of perceived pain and tobacco smoking interrelations: pilot validation of the pain and smoking inventory

Mounting evidence indicates that pain can motivate cigarette smoking behavior, smokers have reliably endorsed the use of tobacco to cope with pain, and there is reason to suspect that pain may impede smoking cessation. Smoking-related outcome expectancies are among the best predictors of cigarette consumption and relapse, and the goal of this pilot study was to develop a standardized measure of how tobacco smokers perceive their pain and smoking behavior to be interrelated (i.e. pain as a motivator of smoking, expectancies for smoking as a means of coping with pain, and pain as a barrier to quitting). Participants (N = 75) completed an online survey that was designed to assess interrelations between pain and tobacco smoking. The nine-item Pain and Smoking Inventory (PSI) demonstrated excellent internal consistency (α = .95). As expected, PSI scores were higher among smokers with chronic pain (vs. no pain), and were positively associated with established indices of both pain and tobacco smoking dependence. These results corroborate the notion that smokers can effectively communicate perceptions of interrelations between their pain and smoking behavior. Future research is needed to establish reliability and validity of the PSI among larger, more diverse samples of smokers with varying levels of pain. Future work should also examine PSI scores as predictors of smoking cessation outcomes, and whether PSI data may usefully inform the development of tailored interventions for smokers in pain.     

尼古丁依赖对男性吸烟者感知戒烟行为控制的预测：社会支持与抱怨批评的作用

考察尼古丁依赖对男性吸烟者感知戒烟行为控制的预测及他人戒烟社会支持和抱怨批评的调节作用。对326名男性吸烟者进行问卷调查,结果显示：（1）尼古丁依赖显著负向预测感知行为控制;（2）社会支持和抱怨批评共同调节两者关系;在高社会支持且低抱怨批评、高抱怨批评且低社会支持的条件下,尼古丁依赖的预测作用不显著。结果说明,高社会支持在尼古丁依赖削弱感知行为控制过程中起缓冲作用,而高抱怨批评削弱社会支持的缓冲作用。     

Effects of nicotine deprivation on craving response covariation in smokers

Most models of craving propose that when cravings are strong, diverse responses--thought to index an underlying craving state--covary. Previous studies provided weak support for this hypothesis. The authors tested whether nicotine deprivation affects degree of covariation across multiple measures related to craving. Heavy and light smokers (N = 127) were exposed to smoking cues while either nicotine deprived or nondeprived. Measures included urge ratings, affective valence, a behavioral choice task assessing perceived reinforcement value of smoking, and smoking-related judgment tasks. Results indicated higher correlations in the nicotine-deprived than in nondeprived group. The measures principally responsible for this effect loaded onto a single common Craving factor for nicotine-deprived but not nondeprived smokers. These findings suggest that, under certain conditions, measures of craving-related processes covary.     

Effects of tobacco smoking on electroencephalographic, auditory evoked and event related potentials

After overnight abstinence, tobacco smokers smoked an average nicotine yield cigarette and nonsmokers sham smoked an unlit placebo cigarette. EEG alpha(1), delta, and theta frequency amplitudes decreased, whereas alpha(2) and beta frequency amplitude increased. Short, middle (EP) and long latency ERP were also studied in nonsmokers and smokers just after smoking, and after overnight abstinence from tobacco. Short latency potentials were unaffected by tobacco smoking or abstinence. Middle and long-latency potentials were reduced during abstinence and enhanced immediately after tobacco smoking. These findings indicate that compared to nonsmokers smokers have a higher arousal level after smoking than when partially abstinent. Evidence for both normalization from tobacco abstinence as well as stimulation was obtained.     

Perceived Health: A Test of Incremental Validity in Relation to Smoking Outcome Expectancies,Motivation to Smoke and Desire to Quit Smoking

This study examined the role of perceived health in predicting theoretically‐relevant aspects of smoking behavior among 161 young adult regular smokers (67 females; mean age = 21.9 years (SD = 7.2), cigarettes per day (M) = 12.2 (SD = 5.7)) recruited from the general community. Consistent with prediction, results indicated that relative to anxiety sensitivity, gender, number of cigarettes smoked per day and nicotine dependence, perceived physical health uniquely and significantly predicted expectancies for negative affect reduction and expectancies that smoking would lead to negative personal consequences. Additionally, perceived health incrementally predicted motivation to smoke to reduce negative affect. In contrast to expectation, perceived health was unrelated to motivation to quit smoking. Results are discussed in relation to the role of perceived health as a cognitive vulnerability factor for specific types of smoking patterns.     

Smoking cessation among Norwegian adolescents and young adults: preferred cessation methods

Despite generally declining smoking rates, particularly among young people, a large number of people remain smokers and many young people still pick up smoking. Helping smokers quit therefore remains a high priority for the public health sector. In the present study we examined adolescents and young adults' preferences regarding cessation methods and if these differed between genders and depended on smoking frequency. The data came from a nationally representative survey in Norway among 16-20 year olds. Only regular (weekly and daily) smokers were included in the statistical analyses (n = 509, 51% females). The findings suggest that the majority of both male (83.6%) and female (78.4%) smokers would prefer to quit smoking without help. More males than females reported that they would consider using snus as a cessation aid, while females more often reported willingness to attend cessation classes or use brochures and diaries as cessation aids. Both males and females had similar preferences albeit low, regarding the use of health services, nicotine gum or patches and internet and sms-services to quit smoking. Daily smokers would more often than weekly smokers prefer to attend cessation classes, seek help from health services, use nicotine gum or patches or use brochures and diaries. In contrast, weekly smokers preferred to use snus as a cessation aid more often than daily smokers. Identifying and making appropriate cessation methods attractive may lead to successful quitting and consequently public health gains.     

Effects of cigarette smoking on lexical decision-making

10 habitual smokers, aged 19-25 yr., were randomly assigned to smoke either a very low nicotine "Placebo" cigarette (.05-mg nicotine delivery as estimated by the FTC method) or a Nicotine cigarette (.7-mg estimated nicotine delivery). Each participant was asked to abstain from smoking for 4 to 7 hr. prior to testing. After completing a presmoking test of lexical decision-making, participants smoked either a Nicotine or Placebo cigarette and were then retested for reaction times and accuracy on the lexical decision test. When presented the most difficult lexical decisions, participants responded significantly faster after smoking a Nicotine cigarette than they did before smoking; smoking a Placebo cigarette did not affect reaction times. Response accuracy was unaffected by smoking either kind of cigarette. These results suggest that smoking a nicotine cigarette may improve attention or memory retrieval after several hours of smoking abstinence.     

Effects of smoking and nicotine on EEG lateralization as a function of personality

The effects of nicotine/smoking on lateralization of the EEG were evaluated in 40 smokers while they responded to a low-stress, visual vigilance task. Smoking a high-nicotine cigarette was associated with a relatively larger increase in right hemisphere EEG arousal in extraverts and Type-A individuals, but with a relatively larger increase in left hemisphere EEG arousal in introverts and Type Bs. These findings suggest that nicotine/smoking may differentially influence the left and right hemispheres and that this interaction may be a function of personality.     

Transdermal nicotine during cue reactivity in adult smokers with and without anxiety disorders

Transdermal nicotine almost doubles tobacco cessation rates; however, little is known about what happens to smokers during the quit process when they are wearing the nicotine patch and are confronted with high-risk smoking triggers. This is particularly important for smokers with psychological disorders who disproportionately represent today's smokers and have more trouble quitting. Using a mixed between- and within-subjects design, smokers with anxiety disorders (n = 61) and smokers without any current Axis I disorders (n = 38) received transdermal nicotine (21 mg) or a placebo patch over two assessment days separated by 48 hr. Urge to smoke was evaluated during a 5-hr patch absorption period (reflecting general smoking deprivation) and during imaginal exposure to theoretically high-risk triggers containing smoking cues, anxiety cues, both, or neutral cues. No differences were observed between smokers with and without anxiety disorders. Significant Patch × Time and Patch × Cue Content interactions were found. Both patch conditions experienced an increase in urge during the deprivation period, but postabsorption urge was significantly higher in the placebo condition, suggesting that transdermal nicotine attenuated the degree to which urge to smoke increased over time. During the cue reactivity trials, when participants received the nicotine patch, they experienced significantly lower urge in response to both smoking-only and neutral cues, but not when anxiety cues were present (alone or in combination with smoking cues). These data suggest that transdermal nicotine alleviates urge only under certain circumstances and that adjunctive interventions are likely necessary to address smoking urges in response to spikes in distress among smokers trying to quit. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Does cigarette smoking cause stress?

Smokers often report that cigarettes help relieve feelings of stress. However, the stress levels of adult smokers are slightly higher than those of nonsmokers, adolescent smokers report increasing levels of stress as they develop regular patterns of smoking, and smoking cessation leads to reduced stress. Far from acting as an aid for mood control, nicotine dependency seems to exacerbate stress. This is confirmed in the daily mood patterns described by smokers, with normal moods during smoking and worsening moods between cigarettes. Thus, the apparent relaxant effect of smoking only reflects the reversal of the tension and irritability that develop during nicotine depletion. Dependent smokers need nicotine to remain feeling normal. The message that tobacco use does not alleviate stress but actually increases it needs to be far more widely known. It could help those adult smokers who wish to quit and might prevent some schoolchildren from starting.     

Alcohol expectancies and context-specific drinking behaviors among female college athletes

Alcohol expectancies have been associated with drinking behaviors among college students. Few studies, however, have focused on researcher-labeled "positive" and "negative" expectancies as well as the valuations (i.e., desirability) of these expectancies. Moreover, research on the correlates of heavy drinking among female college athletes remain relatively sparse, despite the prevalence of elevated alcohol use in this population. We examined the associations of expectancies and valuations with frequency of heavy drinking and context-specific drinking behaviors. The sample consisted of 145 female college athletes (mean age=19.6; range=17 to 22) who completed self-report surveys and indicated alcohol use in the past 30 days. Regression analyses indicated that favorable valuations of negative expectancies were related to heavy drinking, and that valuations accounted for significant proportions of variance in the model. Elevated endorsement of negative expectancies was also associated with the perceived likelihood of heavy use in convivial and personal-social drinking contexts, and favorable valuations of these expectancies accounted for significant variance in these models. These findings highlight the relevance of negative expectancies and valuations with respect to heavy drinking and context-specific drinking behaviors among female college athletes. The perception of "negative" effects of alcohol as "positive" could help explain the high rates of problematic drinking among female athletes. Future research considerations and potential implications for assessment and prevention efforts are discussed.     

Expectancy Accessibility, Alcohol Expectancies, and Intentions to Consume Alcohol

Drug use tends to correlate more strongly with positive expectancies than with negative expectancies. The expectancy-accessibility model provides one explanation for this disparity. This model suggests that the association between positive expectancies of a drug's effects and intentions to use the drug are larger because positive expectancies are often more accessible in memory. Previous work supports the model for positive expectancies and intentions to use smokeless tobacco. Positive expectancies correlated significantly with intentions to use smokeless tobacco only when they were primed in memory. The current study attempted to extend these findings to alcohol consumption. Positive expectancies correlated significantly with intentions to drink when they were primed in memory, as the model predicts. Nevertheless, positive expectancies also correlated significantly with intentions when negative expectancies were primed. In addition, negative expectancies were not associated with intentions to drink, regardless of priming condition. These latter results are not consistent with the model. These findings suggest that the expectancy-accessibility model may be limited.     

Effects of smoking abstinence on movement regulation

The effect of smoking abstinence on performance of a reciprocal tapping task was investigated. 6 habitual smokers performed a single-plate and two versions of a two-plate tapping task. Fitts' Law was used to compute an index of difficulty (ID) in bits for the tasks which was 0 bits for the single-plate and 3.32 and 4.17 bits for the two-plate versions of the task. While smoking abstinence had no effect on performance of the single-plate tapping task, it increased movement time on performance of both two-plate task versions. These findings may provide a coherent explanation for the prior findings of nicotine deprivation on psychomotor performance in the literature. This explanation suggests that the effects of nicotine deprivation as incurred through smoking abstinence may be on the central mechanisms regulating information-processing rate for successful movement regulation. Thus nicotine deprivation may not affect performance of simple psychomotor tasks which require minimal information processing but will affect the performance of more complex tasks requiring significantly more information processing for successful movement regulation.     

Relationship of Acculturation and Family Functioning to Smoking Attitudes and Behaviors Among Asian-American Adolescents

The primary objective of this study was to examine the combination of acculturation, family functioning, and parental smoking as predictors of smoking attitudes and behaviors among Asian-American adolescents. The participants were 106 Asian-American high school students whose ages ranged from 15 to 19 (51 male and 55 female, mean age = 16.30 years). Of the sample, 49% reported having tried smoking, and 27% identified themselves as regular smokers. The results indicated that smoking attitudes were significantly associated with smoking behaviors. Compared to nonsmokers, adolescent regular smokers had more positive smoking attitudes, lower acculturation, poorer family functioning and were more likely to have a father who smoked.     

NICOTINE FADING AND SELF-MONITORING FOR CIGARETTE ABSTINENCE OR CONTROLLED SMOKING

This study compared four treatment approaches to cigarette smoking: (1) a nicotine fading procedure, in which subjects changed their cigarette brands each week to ones containing progressively less nicotine and tar; (2) a self-monitoring procedure in which subjects plotted their daily intake of nicotine and tar; (3) a combined nicotine fading/self-monitoring procedure; and (4) a slightly modified American Cancer Society Stop Smoking Program. Thirty-eight habitual smokers were assigned to one of the treatment groups. The study had two goals: (1) to achieve a clinically significant percentage of abstinence, and (2) to reduce the nonabstainers' smoking to a “safer” level by having them smoke low tar and nicotine cigarettes. The 18-month followup results showed that the nicotine fading/self-monitoring group was the most successful: 40 per cent were abstinent and all who had not quit were smoking cigarettes lower in tar and nicotine than their baseline brands. Half the nonabstainers had decreased their rate of smoking relative to baseline while the other half had increased. Furthermore, the fading/self-monitoring group achieved the largest reductions from baseline in daily nicotine and tar intake (61% and 70% respectively). The results suggest that the study's goals were achieved and that the nonaversive combined procedure could be used to treat not only habitual smokers but also smokers with severe cardiovascular and respiratory problems, because it does not have some of the inherent limitations of the successful aversive smoking cessation procedures.