Smokers' Affective Responses to COVID-19-Related Health Warnings on Cigarette Packets: The Influence of Delay Discounting.

INTRODUCTION: The addition of graphic health warnings to cigarette packets can facilitate smoking cessation, primarily through their ability to elicit a negative affective response. Smoking has been linked to COVID-19 mortality, thus making it likely to elicit a strong affective response in smokers. COVID-19-related health warnings (C19HW) may therefore enhance graphic health warnings, when compared to traditional health warnings (THW). Further, because impulsivity influences smoking behaviours, we also examined whether these affective responses were associated with delay discounting. METHODS: In a between-subjects design, 240 smokers rated the valence and arousal elicited by tobacco packaging that contained either a C19HW or THW (both referring to death). Participants also completed questionnaires to quantify delay discounting and attitudes towards COVID-19 and smoking (eg, health risks, motivation to quit). RESULTS: There were no differences between the two health warning types on either valence or arousal, nor any secondary outcome variables. There was, however, a significant interaction between health warning type and delay discounting on arousal ratings. Specifically, in smokers who exhibit low delay discounting, C19HWs elicited significantly greater subjective arousal rating than did THWs, whereas there was no significant effect of health warning type on arousal in smokers who exhibited high delay discounting. CONCLUSION: The results suggest that in smokers who exhibit low impulsivity (but not high impulsivity), C19HWs may be more arousing than THWs. Future work is required to explore the long-term utility of C19HWs, and to identify the specific mechanism by which delay discounting moderates the efficacy of tobacco health warnings. IMPLICATIONS: The study is the first to explore the impact of COVID-19-related health warnings on cigarette packaging. The results suggest that COVID-19-related warnings elicit a similar level of negative emotional arousal, relative to traditional warnings. However, COVID-19 warnings, specifically, elicit especially strong emotional responses in less impulsive smokers, who report low delay discounting. Therefore, there is preliminary evidence supporting COVID-19 related warnings for tobacco products to aid smoking cessation. Additionally, there is novel evidence that, for some warnings, high impulsiveness may be a factor in reduced warning efficacy, which may explain poorer cessation success in this population.

Specific Pandemic-Related Worries Predict Higher Attention-Related Errors and Negative Affect Independent of Trait Anxiety in UK-Based Students.

Background: The COVID-19 pandemic has resulted in many individuals experiencing increased symptoms of anxiety. We predict that this increase may be underpinned by pandemic-related worry (PRW), characterised by repetitive negative thinking about pandemic-specific outcomes; and that this relationship is mediated through reduced attentional capacity required to regulate negative affect. Methods: We developed a novel scale to measure the contents of PRW in an initial sample of 255 participants, and explored its relationship with cognitive functioning and negative affect in a sample of 382 UK-based university students, whilst controlling for recalled pre-pandemic trait anxiety. Results: A five-factor model of PRW was identified, with factors reflecting worry about decline in quality of life (QoL) and probability of infection correlating with attention and memory-related errors. Importantly, attention-related errors partially mediated the positive relationship between PRW and negative affect, even when controlling for pre-pandemic trait anxiety. Conclusion: PRW's relationship with negative affect was partially mediated through attentional function, consistent with models of anxiety and attentional control. In UK-based students PRW may be predominantly focused on the decline in QoL; therefore, interventions targeting worry about the decline in QoL caused by COVID-19 are especially important in this population in the wake of the pandemic. Supplementary Information: The online version contains supplementary material available at 10.1007/s10608-022-10336-7.

Lapses in the Person Radar: ADHD Symptoms Predict Difficulty in Interpersonal Distancing.

OBJECTIVE: Across contexts, from social cognition to the COVID-19 pandemic response, individual variation in the regulation of interpersonal distance has typically been viewed as a voluntary choice. Here we examine the frequency of unintentional lapses in interpersonal distancing, and their relationship with childhood ADHD symptoms. METHOD: We administered a novel measure of difficulty with interpersonal distancing across three undergraduate samples (total N = 1,225), in addition to measures of recalled childhood ADHD symptoms, mind wandering, and hyperfocus. RESULTS: Almost all (>97%) participants reported unintentional lapses in maintaining interpersonal distance, with 16% experiencing such lapses frequently. Thirty percent of the variance in these reports was accounted for by attentional traits: Inattentive and hyperactive/impulsive ADHD symptoms jointly predicted difficulties with interpersonal distancing, with the former relationship fully mediated by hyperfocus and spontaneous mind wandering. CONCLUSION: Both inattentive and hyperactive/impulsive ADHD symptoms confer vulnerability to frequent unintentional lapses in interpersonal distancing.

The relationship between COVID-19-specific health risk beliefs and the motivation to quit smoking: A UK-based survey.

BACKGROUND: In some individuals who smoke, the COVID-19 pandemic has triggered an increase in the motivation to quit smoking due to the potential higher risk of severe COVID-19 infection. However, this change is not universal, and the motivation to quit appears dependent upon factors such as fear of COVID-19 and perceived risk from COVID-19. In the current investigation both COVID-19 severity and infection probability beliefs were measured to isolate which beliefs correlated with the motivation to quit smoking. METHODS: UK-based smokers (N = 243) completed an online survey between September and October 2020, in which they reported their current motivation to quit smoking, fear of COVID-19, and their beliefs about how severe COVID-19 infection would be and how probable COVID-19 infection was. RESULTS: The only significant predictor of the motivation to quit smoking was the perceived probability of COVID-19 infection, ß = .22, p < .001, 95CI[.10, .34]. This relationship remained when controlling for the general perceived probability and severity of other smoking-related health risks, ß = .20, p = .002, 95CI[.08,.32], suggesting a COVID-19-specific effect. Further, perceived probability of COVID-19 infection mediated the positive impact of fear of COVID-19 on motivation, ß = .07, p = .006, 95CI[.03,.13]. CONCLUSIONS: The result places the perceived probability of COVID-19 infection as a central predictor of the motivation to quit during the pandemic. Based on this evidence, messaging aiming to facilitate smoking cessation during the pandemic should focus on the highly contagious nature of the virus to increase the motivation to quit.