Factors associated with intentions to quit vaping and quit attempts among Adolescents: A structural equation modeling approach.

OBJECTIVES: Previous youth tobacco research has identified multiple factors relating to intentions to quit vaping and quit attempts among current e-cigarette users in adolescents. The pathways in the complex associations with vaping cessation behaviors remain unclear. METHODS: Using data from the 2022 National Youth Tobacco Survey (NYTS) (grades 6-12), structural equation models (SEMs) are developed to examine the associations of social environment, vaping risk perceptions, e-cigarette marketing, vaping characteristics, and demographics with two outcome measures - intentions to quit vaping and past year quit attempts among current e-cigarette users. RESULTS: The national sample of current e-cigarette users (n = 2,701) consisted of 52.7 % females, 47.0 % non-Hispanic Whites, 80.1 % high school students, and 56.2 % heterosexual individuals. Among them, 70.2 % reported intentions to quit vaping and 66.3 % reported past year quit attempts. The protective factor for quit intentions was vaping risk perceptions (p < 0.001). Risk factors included e-cigarette marketing (p = 0.04), dual use of e-cigarettes and other tobacco products (p = 0.003), vaping due to feeling anxious or stressed (p = 0.01), vaping for nicotine buzz (p = 0.002), nicotine dependence (p = 0.02), identifying as Gay or Lesbian (p < 0.001), bisexual (p = 0.03), or Hispanic (p = 0.04). Similar associations were observed with quit attempts except that e-cigarette marketing, vaping due to feeling anxious or stressed, vaping dependence, and identifying as Hispanic were not significant. Besides, high vaping frequency (p < 0.001), grade level (p < 0.001) and not sure about sexual orientation (p = 0.01) were also negatively associated with quit attempts. CONCLUSIONS: This study provided insights into factors influencing vaping cessation outcomes among adolescent current e-cigarette users. Developing tailored vaping cessation programs based on these findings could enhance quit success.

Impact of New York City Cigarette Floor Price Policy on Reducing Smoking Disparities.

INTRODUCTION: In 2017, New York City (NYC) passed a minimum floor price law (MFPL) to raise the minimum price of a pack of cigarettes to $13.00. Evaluation of the MFPL in NYC is limited and has yet to examine its potential as a pro-equity policy. METHODS: Data (n = 20,241; pre-policy n =15,037, post-policy n =5,204) were obtained from the New York State Adult Tobacco Survey, a quarterly repeated cross-sectional survey. Using the Difference-in-Differences approach, we compared changes in reported cigarette prices, cigarette consumption, and smoking status among NYC residents before and after policy implementation to changes in the same outcomes among residents in the rest of the state (ROS) over the same period. RESULTS: For some smokers, cigarette price increased in NYC for post-policy period; moreover, prices increased more in NYC than in ROS. NYC smokers who reported higher income, more education, or White or "Other" race, reported a bigger price increase than their ROS counterparts. Cigarette consumption decreased more in the post-policy period for people in the ROS, in general and among certain groups. Everyday smoking status decreased similarly in both NYC and ROS, whereas someday smoking status decreased primarily in the ROS during the analysis period. CONCLUSIONS: Cigarette prices in NYC increased after the 2017 MFPL; these increases were greater than those occurring elsewhere in the state, suggesting the policy might be a factor in the change. However, the increases were concentrated among relatively higher priced purchases, and groups with lower smoking prevalence. Changes in smoking status and cigarette consumption did not correspond to study hypotheses. IMPLICATIONS: This study provides an empirical analysis of a real-world policy in tobacco control. It examines the potential of the MFPL in New York City as a pro-equity policy. Findings extend the current MFPL literature and suggest that they may be able to raise cigarette prices for some purchases, but also may have a limited impact on smoking behaviors.

How Do Behavioral Framing, Linguistic Certainty, and Target Specification Impact Responses to Vaping Prevention Messages?

While research on youth vaping prevention has begun to grow, little work has examined language choice in vaping prevention messages. This study examined adolescents' responses to vaping prevention statements that varied on three features: behavioral framing, linguistic certainty, and target specification. We conducted a 2 (behavioral framing) by 2 (linguistic certainty) by 2 (target specification) by 3 (risk type) plus control condition between-subjects experiment using a national probability sample. Adolescents (N = 1,603) were randomly assigned to one of 25 conditions in which they viewed a vaping prevention statement (or a control statement about vape litter) followed by measures of perceived message effectiveness (PME), perceived severity and susceptibility of vaping risks, message trustworthiness, message relevance, and intentions to seek more information about vaping risks. Results showed main effects of behavioral framing, such that a declarative frame ("Vaping can … ") led to higher PME, higher perceived severity, and greater information seeking intentions than a contingent frame ("If you vape, it can…"), while an interaction revealed that most declarative frame effects were driven by adolescents who were susceptible to vaping. There were also main effects of linguistic certainty, such that the word "can" ("Vaping can … ") led to higher PME, higher perceived susceptibility and severity, and greater information seeking intentions than the word "could" ("Vaping could … "). No main effect of target specification ("you" vs. "teens") was observed. Overall, findings suggest that vaping prevention messages that communicate greater certainty have greater behavior change potential.

Identifying promising themes and messages for youth vaping prevention: A national study.

Use of e-cigarettes and vapes among adolescents continues to be a major public health concern. Health communication efforts can discourage e-cigarette use among adolescents by influencing beliefs and behavior. However, to do so, studies need to identify the most promising themes and messages based on the latest evidence about the harms of e-cigarettes and vaping. Participants were a nationally representative sample of 1,603 US adolescents aged 13-17 years, recruited in the summer of 2022. Adolescents were randomly assigned to view 7 vaping prevention statements (one from each theme: nicotine addiction, chemical harms, health symptoms, mental health, organ effects, cosmetic effects, and monetary cost) and 1 control statement (vape litter theme) from a pool of 46 statements that were developed through a systematic process. Participants rated each statement on perceived message effectiveness (PME), awareness, and believability. Results of linear mixed models indicated that all vaping prevention themes out-performed control messages on PME, with chemical harms and organ effects having the largest effects, followed by nicotine addiction and then other themes. For most message themes, PME effects were stronger for youth susceptible to vaping compared to non-susceptible youth and users. Both awareness and believability predicted higher levels of PME. In secondary analyses, we found that statements specifying the target ("you") and longer statements were also rated higher on PME. Results suggests that the most potent vaping prevention messages for adolescents are those that focus on vape chemicals and the potential of vaping to damage organs and increase disease risk.

Pan-Cancer Profiling of Intron Retention and Its Clinical Significance in Diagnosis and Prognosis.

Alternative splicing can produce transcripts that affect cancer development and thus shows potential for cancer diagnosis and treatment. However, intron retention (IR), a type of alternative splicing, has been studied less in cancer biology research. Here, we generated a pan-cancer IR landscape for more than 10,000 samples across 33 cancer types from The Cancer Genome Atlas (TCGA). We characterized differentially retained introns between tumor and normal samples and identified retained introns associated with survival. We discovered 988 differentially retained introns in 14 cancers, some of which demonstrated diagnostic potential in multiple cancer types. We also inferred a large number of prognosis-related introns in 33 cancer types, and the associated genes included well-known cancer hallmarks such as angiogenesis, metastasis, and DNA mutations. Notably, we discovered a novel intron retention inside the 5'UTR of STN1 that is associated with the survival of lung cancer patients. The retained intron reduces translation efficiency by producing upstream open reading frames (uORFs) and thereby inhibits colony formation and cell migration of lung cancer cells. Besides, the IR-based prognostic model achieved good stratification in certain cancers, as illustrated in acute myeloid leukemia. Taken together, we performed a comprehensive IR survey at a pan-cancer level, and the results implied that IR has the potential to be diagnostic and prognostic cancer biomarkers, as well as new drug targets.

Reactance, Mortality Salience, and Skin-Cancer Prevention Among Young Adults.

In an experiment (N = 206) using skin cancer prevention messages and a 2 (mortality: salient, control) × 2 (freedom-limiting language: freedom-limiting, autonomy-supportive) independent-group design, we tested the terror management health model and integrated its predictions with the theory of psychological reactance. We used a sample of young adults because they are most at risk for excessive tanning. Consistent with the study predictions about proximal defenses, mortality salience significantly increased intentions to wear sunscreen all year around, relative to the control condition. A significant interaction between freedom-limiting language and mortality salience on behavioral intention to purchase high-SPF lotion revealed that, when a freedom-limiting message was paired with mortality salience, intentions to purchase high-SPF lotion were significantly greater as compared to autonomy-supportive language, indicating that mortality salience mitigated the maladaptive effects of reactance. These results add to a growing body of research identifying boundary conditions for reactance effects and, further, point to the utility of directive (albeit freedom-limiting language) in health-prevention messages attempting to communicate deadly health risks.

Does the Pro-Environmental Behavior of Household PV Installation Contribute to the Shaping of Users' Green Purchasing Behavior?-Evidence from China.

In order to achieve the "dual carbon goal", the Chinese government is actively encouraging the adoption of household photovoltaic (PV) systems. While there has been considerable research on residents' inclination to install PV, limited attention has been given to understanding how the installation and utilization of PV systems influence pro-environmental behaviors. Therefore, this paper aims to investigate the potential impact of pro-environmental behavior resulting from household PV installation on users' green purchasing behavior. Based on the "learning by doing" theory, a survey was conducted with 1249 participants, and the generalized structural equation model was employed as our analytical approach. The findings of this research indicate that the adoption and utilization of household photovoltaic (PV) systems have a positive impact on green consumption. The test results demonstrate that the overall effect coefficient is 0.03, indicating that current PV promotion policies have an indirect impact on green consumption. Moreover, economic incentive policies have a more substantial influence than environmental publicity policies, with total indirect effect coefficients of 0.005 and 0.002, respectively. Based on the findings above, the following recommendations are proposed: (1) It is recommended to maintain stable economic incentives to promote the adoption of household PV systems. (2) Emphasizing the dissemination of knowledge and skills for promoting environmental protection should be prioritized. (3) Efforts should be made to align personal interests and societal interests with low-carbon policies.

Examining the Longitudinal Relationship Between Perceived and Actual Message Effectiveness: A Randomized Trial.

We sought to examine the relationship between perceived message effectiveness (PME) and actual message effectiveness (AME) in a 3-week randomized trial of vaping prevention advertisements. Participants were US adolescents (n = 1,514) recruited in 2021. We randomly assigned them to view The Real Cost vaping prevention ads or control videos online. Participants viewed three videos at Visit 1, again at Visits 2 and 3, and completed a survey at each visit that assessed AME (susceptibility to vaping) and two types of PME - effects perceptions (potential for behavioral impact) and message perceptions (potential for message processing). At Visit 4, AME was measured. Compared to control, The Real Cost ads led to improved AME (lower susceptibility to vaping at Visit 4, p < .001). This was anticipated by The Real Cost ads eliciting higher PME ratings (higher effects and message perceptions at Visit 1, both p < .001). Furthermore, PME (both effects and message perceptions) at Visit 1 predicted susceptibility to vaping at Visits 1, 2, 3, and 4 (all p < .001). Finally, effects perceptions fully mediated the impact of The Real Cost ads on susceptibility to vaping (ß = -.30; p < .001), while message perceptions only partially mediated the effect (ß = -.04; p = .001). Our findings indicate a relationship between PME and AME, especially effects perceptions, and suggest that PME may be useful in message pre-testing to select messages with greater behavior change potential.

Can Extant Vaping Prevention Message Experiments Tell Us Something About What Works? A Response to O'Keefe.

In his commentary, O'Keefe raises some interesting questions about the meaning of effect sizes in meta-analyses of experiments, focusing on our recent meta-analysis on vaping prevention messages. In this commentary, we respond to O'Keefe's comments and make several points. First, it is not uncommon to include experiments with different control conditions in a meta-analysis. Second, the set of studies in our meta-analysis were relatively homogenous, all being experiments testing messages to discourage vaping among adolescents and young adults. Third, the control conditions in each of the studies in the meta-analysis were appropriate for each given study, and our results show homogenous effects on most outcomes. Fourth, our meta-analysis finds meaningful effects that are timely and will be useful to researchers and practitioners alike. As this literature continues to grow, so too will knowledge about the effects of vaping prevention messages and moderators of those effects.

National Youth tobacco surveys (2014-2019) show increasing beliefs in the harm and relative addiction of e-cigarettes but decreasing associations between those beliefs and e-cigarette use.

BACKGROUND: To evaluate the potential efficacy of increasing harm and relative addiction beliefs in discouraging e-cigarette use, we examined how adolescents' beliefs about e-cigarettes have changed over 6 years and how the predictive validity of these beliefs has changed over time. METHODS: Using data from the 2014-2019 National Youth Tobacco Survey (NYTS) (grades 6-12; N = 117,472), we evaluated the association between adolescents' beliefs about the harm and relative addiction of e-cigarettes and current e-cigarette use, as well as susceptibility to use. Logistic regressions and pairwise contrasts were used to analyze changes in these beliefs and determine how well these beliefs predict ever use, current use, and susceptibility to use over time. RESULTS: E-cigarette harm and relative addiction beliefs tended to increase over time. In most years, these beliefs were negatively associated with e-cigarette use, including ever use, current use, and susceptibility to use. Interactions between these beliefs were also observed in some years such that harm belief better predicted use when e-cigarettes were also perceived as more addictive. Survey year also interacted with health harm and relative addiction beliefs such that the predictive validity of these beliefs for e-cigarette use decreased over time. CONCLUSIONS: Beliefs about e-cigarette harm and relative addiction have increased over time and predict use of, and susceptibility to, e-cigarettes among US adolescents. However, the predictive validity of these beliefs has decreased over time. Future research should explore the reasons for the decreased predictive validity of health beliefs in e-cigarette use and identify constructs that predict adolescent e-cigarette use over and above general harm and relative addiction beliefs.

Do Vaping Prevention Messages Impact Adolescents and Young Adults? A Meta-Analysis of Experimental Studies.

Vaping prevention messages are widely used to communicate the health harms and addiction risks of vaping and discourage vaping among adolescents and young adults. We conducted a meta-analysis of experimental studies to examine the effects of these messages and to understand their theoretical mechanisms. Systematic, comprehensive searches generated 4,451 references, among which 12 studies (cumulative N = 6,622) met inclusion criteria for the meta-analysis. Across these studies, a total of 35 different vaping-related outcomes were measured, and 14 outcomes assessed in two or more independent samples were meta-analyzed. Results showed that compared to control, exposure to vaping prevention messages led to higher vaping risk perceptions, including harm perceptions (d = 0.30, p < .001), perceived likelihood of harm (d = 0.23, p < .001), perceived relative harm (d = 0.14, p = .036), addiction perceptions (d = 0.39, p < .001), perceived likelihood of addiction (d = 0.22, p < .001), and perceived relative addiction (d = 0.33, p = .015). Also, compared to control, exposure to vaping prevention messages led to more vaping knowledge (d = 0.37, p < .001), lower intentions to vape (d = -0.09, p = .022), and higher perceived message effectiveness (message perceptions; d = 0.57, p < .001; effects perceptions; d = 0.55, p < .001). Findings suggest vaping prevention messages have an impact, yet may operate through different theoretical mechanisms than cigarette pack warnings.

Threat Type Moderates Agency Assignment: A Partial Matching Effect.

This study examined the effects of agency assignment on response to messages advocating threat preparedness, highlighting interactions between agency assignment and threat type. Participants were randomly assigned to one of four conditions crossing human agency vs. threat agency with human ascribed threats vs. threats not ascribed to humans. Two messages were shown in random order in each condition with responses measured after each message. In line with extant research, results showed a significant main effect for agency assignment on behavioral intentions such that, relative to human agency, threat agency increased intentions to follow message recommendations for threat preparedness. The main effect of agency assignment was qualified by an agency assignment by threat type interaction, indicating a partial matching effect on behavioral intentions wherein threat agency led to greater behavioral intentions than human agency for threats not ascribed to humans - but not for threats ascribed to humans. Results, limitations, and implications of the study are discussed.

Impact of Vaping Prevention Advertisements on US Adolescents: A Randomized Clinical Trial.

Importance: Understanding whether prevention advertisements reduce susceptibility to vaping is important owing to concerning levels of adolescent vaping. Objective: To examine whether vaping prevention advertisements from the US Food and Drug Administration (FDA) national Real Cost campaign lead to lower susceptibility to vaping among adolescents. Design, Setting, and Participants: For this 3-group randomized clinical trial with parallel assignment, participants were US adolescents aged 13 to 17 years who were susceptible to vaping or current e-cigarette users, recruited from online panels. Adolescents were randomized to 1 of 2 Real Cost vaping prevention trial groups (health harms- or addiction-themed advertisements) or to a control group (investigator-created neutral videos about vaping). Adolescents completed 4 weekly online surveys at visits 1 to 4 over a 3-week period. Data were analyzed from December 1, 2021, to August 25, 2022. Interventions: Adolescents saw 3 randomly ordered 30-second video advertisements online at each of 3 weekly study visits (visits 1, 2, and 3). Main Outcomes and Measures: The primary trial outcome was susceptibility to vaping. Surveys also assessed susceptibility to smoking cigarettes to examine any spillover effects of vaping prevention advertisements on smoking outcomes. Both susceptibility measures had 3 items and ranged from 1 (indicating not susceptible) to 4 (indicating highly susceptible). The primary analyses compared Real Cost groups (combined) with the control group, while exploratory analyses compared the Real Cost groups with each other. Results: Participants were 1514 adolescents (1140 [75.3%] boys; mean [SD] age, 15.22 [1.18] years), including 504 randomized to the Real Cost health harms group, 506 randomized to the Real Cost addiction group, and 504 randomized to the control group. Adolescents in the Real Cost groups (combined) had lower susceptibility to vaping at visit 4 than those in the control group (b = -0.21; 95% CI, -0.32 to -0.10). The Real Cost groups did not differ from one another on susceptibility to vaping (visit 4: b = -0.05; 95% CI, -0.17 to 0.07). Adolescents in the Real Cost groups (combined) also had lower susceptibility to smoking cigarettes than those in the control group (b = -0.21; 95% CI, -0.32 to -0.10). For both vaping and smoking, Real Cost groups had less positive attitudes (vaping: b = -0.27; 95% CI, -0.40 to -0.14; smoking: b = -0.23; 95% CI, -0.39 to -0.08) compared with the control group. Conclusions and Relevance: These findings suggest that vaping prevention advertisements from the FDA Real Cost campaign led to lower adolescent susceptibility to vaping and had beneficial spillover effects on cigarette smoking outcomes. Tobacco prevention campaigns can help reduce youth tobacco use. Trial Registration: ClinicalTrials.gov Identifier: NCT04836455.

"I Felt Completely Turned off by the Message": The Effects of Controlling Language, Fear, and Disgust Appeals on Responses to COVID-19 Vaccination Messages.

Psychological reactance theory (PRT) posits that when individuals' perceived freedoms are threatened or restricted, they become aversively aroused and are motivated to reestablish those freedoms, leading to a state of psychological reactance. Applying PRT, this study examined the effects of controlling language, fear, and disgust appeals on responses to COVID-19 vaccination promotion messages. Participants were randomly assigned to one of eight conditions across controlling language (high/low), fear appeals (high/low), and disgust appeals (high/low), wherein they viewed two messages, with responses measured after each message. Results showed persuasion was diminished when the levels of any of these three variables were elevated, as in conditions of either high controlling language, high fear appeals, or high disgust appeals. Relative to low levels of these variables, high levels resulted in greater freedom threat perceptions, reactance, source derogation, and less positive attitudes toward the message. A 2-way interaction between fear and disgust appeals on source derogation and message attitudes in the low controlling language condition was significant-participants reported the least source derogation and most positive attitudes toward the message in response to the low controlling language, low fear, and low disgust appeals.

Multicomponent Stress-Strength Model Based on Generalized Progressive Hybrid Censoring Scheme: A Statistical Analysis.

The statistical inference of the reliability and parameters of the stress-strength model has received great attention in the field of reliability analysis. When following the generalized progressive hybrid censoring (GPHC) scheme, it is important to discuss the point estimate and interval estimate of the reliability of the multicomponent stress-strength (MSS) model, in which the stress and the strength variables are derived from different distributions by assuming that stress follows the Chen distribution and that strength follows the Gompertz distribution. In the present study, the Newton-Raphson method was adopted to derive the maximum likelihood estimation (MLE) of the model parameters, and the corresponding asymptotic distribution was adopted to construct the asymptotic confidence interval (ACI). Subsequently, the exact confidence interval (ECI) of the parameters was calculated. A hybrid Markov chain Monte Carlo (MCMC) method was adopted to determine the approximate Bayesian estimation (BE) of the unknown parameters and the high posterior density credible interval (HPDCI). A simulation study with the actual dataset was conducted for the BEs with squared error loss function (SELF) and the MLEs of the model parameters and reliability, comparing the bias and mean squares errors (MSE). In addition, the three interval estimates were compared in terms of the average interval length (AIL) and coverage probability (CP).

The Impact of Cognitive Behavioral Therapy on Peripheral Interleukin-6 Levels in Depression: A Systematic Review and Meta-Analysis.

There is interest in the role of peripheral interleukin-6 (IL-6) in depression and the effect of treatment (e. g., pharmacologic, psychosocial, neurostimulation). However, the relationship between cognitive behavioral therapy (CBT), IL-6 and depression has not yet been established. We conducted a meta-analysis to explore the association between CBT and change of peripheral IL-6 levels in depressive symptoms or major depressive disorder (MDD). A systematic search of online databases (i.e., PubMed, Web of Science, Google Scholar, PsycINFO, and Cochrane Library) was completed from inception to May 2021. In total, 10 eligible papers with 940 participants reporting peripheral IL-6 levels before and after CBT were included in the analysis. The main result indicates that peripheral levels of IL-6 were significantly lower after CBT intervention in individuals with depression, with a small effect (SMD = 0.38, 95% CI: 0.07, 0.69, p = 0.02). The results of subgroup analyses demonstrate that (1) there was a significant decrease in IL-6 for studies that were equal to or <8 weeks in duration vs. more than 8 weeks in duration, and (2) IL-6 was significantly reduced in the Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnosis (i.e., DSM-IV, DSM-IV-TR, or DSM-V) of MDD, but not for the subgroup without DSM diagnosis. Publication year was identified as a potential contributor to heterogeneity of the results from our analysis. Taken together, our findings support the notion that CBT influences peripheral IL-6 in individuals with depression and represents a point of commonality with other antidepressant treatment modalities (e.g., antidepressants). Systematic Review Registration: https://doi.org/10.17605/osf.io/tr9yh, identifier: 10.17605/osf.io/tr9yh.

Trends in Cigarette Marketing Expenditures, 1975-2019: An Analysis of Federal Trade Commission Cigarette Reports.

INTRODUCTION: With tightened regulations on cigarette marketing and decreased smoking, the major tobacco companies quickly shifted their marketing expenditures in recent decades to maintain profits. We investigated cigarette marketing expenditures in the United States from 1975 through 2019 to examine the trends in cigarette marketing expenditures over the past 45 years. AIMS AND METHODS: Cigarette marketing expenditure data were obtained from the Federal Trade Commission (FTC) cigarette reports, 1975-2019. Based on individual expenditure categories included in the FTC reports, we created seven aggregate categories for marketing expenditures: Retail; Print; Out of home; Free tobacco products and gifts; Sports, public entertainment, and sponsorships; Telephone and digital; and Other. Dollar amounts and percentages by category were examined to assess trends in marketing expenditures. RESULTS: Cigarette marketing expenditures increased since 1975 and peaked in 2003 at $21.1 billion (adjusted dollars); afterward, they declined dramatically until 2010 and remained stable at around $9 billion through 2019. While all other expenditures decreased, retail expenditures increased, comprising more than 50% of expenditures in 1988 and reaching about 98% in 2019. In the retail category, tobacco companies spent the most on promotional allowances, coupons, and retail-value-added bonuses between 1988 and 2003, after which price discounts dominated retail spending. CONCLUSIONS: Overall, cigarette marketing expenditures peaked in 2003 and retail first became the leading category in 1988. Tobacco companies adapted their marketing strategies in retail and allocated most of their retail spending on price discounts since 2003 to lower cigarette prices. IMPLICATIONS: The major US tobacco companies directed the bulk of their vast spending on the retail environment since 1988. Moreover, they have dramatically shifted their marketing strategies within the retail category from cigarette advertising before 2003 to customer-directed price discounts since then. This shift may imply a change in focus from recruiting new smokers to retaining current smokers, in response to tax increases and government regulations. Accordingly, restrictions on price-related promotions in retail and nontax strategies should be implemented to counter tobacco companies' marketing efforts in retail.

Does cognitive behaviour therapy affect peripheral inflammation of depression? A protocol for the systematic review and meta-analysis.

INTRODUCTION: Cognitive-behavioural therapy (CBT) is becoming the most commonly implemented and standard treatment for depression. Up to date, only a few numbers of studies have investigated the potential relationship between CBT and the change of inflammatory biomarkers in individuals of depression. And the results are inconsistent among studies. The current study aims to provide a comprehensive, systematic review of the association between CBT and changes of peripheral inflammation of individuals with depression, and clarify the alterations of inflammatory cytokines pre-CBT and post-CBT treatment by meta-analysis, anti-inflammatory. METHODS AND ANALYSIS: This study will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic search of predetermined terms will be conducted with electronic databases of CENTRAL, MEDLINE, EMBASE and PsycINFO from inception to July 2021. Database searches will be supplemented by expert contact, reference and citation checking, and grey literature. Primary outcomes of interest will be validated measures for levels of inflammatory cytokines pre-CBT and post- CBT treatment in individuals with depression. Hedges' g will be used to represent the effect size. SYSTEMATIC REVIEW REGISTRATION: The protocol of current meta-analysis has been registered at the Open Science Framework (https://doi.org/10.17605/osf.io/tr9yh). ETHICS AND DISSEMINATION: Formal ethical approval is not required by the National Ethical Review Board in China as primary data will not be collected. The results alterations of peripheral inflammatory cytokines pre-CBT and post-CBT treatment in individuals with depression will be disseminated through a peer-reviewed publication and inform the most up-to-date evidence of the roles of CBT treatment for depression.

Psychophysiological responses to hookah tobacco public education messages among young adults.

OBJECTIVE: Hookah tobacco use among young adults may be driven by misperceptions of health harms and addictiveness, appealing flavors, and social use. This study examined the effects of hookah prevention messages on participants' cognitive and emotional processing in a lab setting. METHOD: One hundred twenty participants (61 susceptible never-users, 59 current users) were exposed to messages representing six categories: health risks only, health risks of social use, health risks of flavors, addiction risks only, addiction risks of social use, and addiction risks of flavors. Guided by the Limited Capacity Model of Motivated Mediated Message Processing, participants' psychophysiological responses (heart rate, skin conductance, facial action coding) were recorded while participants viewed the messages. Recognition memory and counterarguing were measured postexposure. RESULTS: The combination of heart rate, skin conductance, both positive and negative facial action coding, and recognition memory indicated that social themed messages were more defensively processed than the other message types. Addiction-social messages, in particular, were least likely to be encoded. Further, defensive processing indicated by the psychophysiological and recognition data did not vary according to user status. Counterarguing was higher for users than for never-users across all message themes and risks. DISCUSSION: Messages about health risks and addiction, whether or not they included information on flavors, evoked relatively similar responses. But social themed messages stand out as potentially problematic, especially addiction-social messages. Using psychophysiological and self-report measures extend opportunities to identify optimal hookah tobacco public education message features. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Trapped in a Double Bind: Chinese Overseas Student Anxiety during the COVID-19 Pandemic.

The severe acute respiratory syndrome coronavirus 2 (SARS CoV-2), the COVID-19 disease cases stemming from it, and the resulting pandemic have imposed severe, distressing, physical, and psychological challenges on communities worldwide. The stressful situation faced by Chinese overseas students (COSs) has been particularly acute. With this population as the focus, the current study evaluated the psychological state of COSs abroad during the initial phases of the pandemic. Participants (N = 182) were recruited to complete an online survey (during April 7-14, 2020) assessing their physical and social circumstances, and sense of wellbeing. Results showed COSs experienced high levels of anxiety primarily stemming from discrimination from the media, fear of COVID-19, and mixed messages from their social connections. Feeling entrapped in a double bind (DbB) situation with their close relations significantly increased anxiety. Perceived social support negatively correlated with anxiety, and those experiencing a DbB felt the greatest stress, particularly those unable to effectively differentiate the opposing messages. Findings of the study, limitations, and implications are discussed.