Longitudinal and Reciprocal Relationships Between Psychological Well-Being and Smoking.

INTRODUCTION: Smoking cessation treatments currently succeed at a rate of approximately 20%-30%, underscoring the importance of exploring factors that might increase intervention effectiveness. Although negative affect has been studied extensively in relation to smoking cessation, psychological well-being (PWB; eg, life satisfaction, optimism, positive affect, purpose in life) has received little attention. This study tested longitudinal and reciprocal relationships between PWB and smoking status in older adults. METHODS: Panel data were obtained from the biennial, longitudinal Health and Retirement Study. Using structural equation modeling, we developed cross-lagged models to examine the relationships of PWB in 2006 with smoking status in 2010 and of smoking status in 2006 with PWB in 2010 while controlling for covariates (Ns = 2939-4230, 55% women, 89% white, mean age = 64 years, mean years of education = 13, 25% smokers in 2006 and 21% smokers in 2010). Separate cross-lagged models were developed for each of the PWB variables: life satisfaction, optimism, positive affect, and purpose in life. RESULTS: Greater life satisfaction (standardized path coefficient = -0.04), optimism (standardized path coefficient = -0.07), and positive affect (standardized path coefficient = -0.08) in 2006 predicted a reduced likelihood of smoking in 2010. Being a smoker in 2006 predicted lower life satisfaction (standardized path coefficient = -0.25), optimism (standardized path coefficient = -0.10), positive affect (standardized path coefficient = -0.10), and purpose in life (standardized path coefficient = -0.13) in 2010. CONCLUSIONS: Findings warrant further exploration of the relationships between PWB and smoking, and support the incorporation of PWB-boosting components into existing treatments. IMPLICATIONS: Given the relatively low success rate of current smoking cessation treatments, the present results suggest that increasing PWB might promote abstinence and therefore warrant consideration as a focus of future cessation treatment research. Moreover, these results suggest that smoking might inhibit PWB, illuminating a negative consequence of smoking not previously identified. Helping smokers increase their PWB may benefit them beyond promoting cessation and contribute to a flourishing society. These results warrant further investigation of PWB and smoking, and support the continued evaluation of PWB-boosting components in smoking cessation treatments.

The Relationships of Expectancies With E-cigarette Use Among Hospitalized Smokers: A Prospective Longitudinal Study.

Background: Expectancies demonstrate cross-sectional associations with e-cigarette use, but the prospective relationships between expectancies and e-cigarette use are unknown. This study examined the longitudinal associations of expectancies with e-cigarette use among hospitalized tobacco cigarette smokers. Methods: E-cigarette expectancies (e-cigarette-specific Brief Smoking Consequences Questionnaire-Adult [BSCQ-A]), tobacco cigarette expectancies (tobacco-specific BSCQ-A), and number of days used e-cigarettes in the past 30 days were assessed at baseline hospitalization, 6-months post-hospitalization, and 12-months post-hospitalization among 978 hospitalized tobacco cigarette smokers. Expectancy difference scores (e-cigarette-specific expectancies minus tobacco-specific expectancies) were computed for each of the 10 BSCQ-A scales. Cross-lagged panel models tested the relationships between expectancy difference scores and number of days used e-cigarettes in the past 30 days for each of the 10 BSCQ-A scales. Results: Though some models revealed partial associations between expectancies and e-cigarette use, only one yielded results consistent with hypotheses. Greater e-cigarette use at baseline predicted greater expectancies that e-cigarettes taste pleasant as compared to tobacco cigarettes at 6 months, which then predicted greater e-cigarette use at 12 months. To a lesser degree greater expectancies that e-cigarettes taste pleasant as compared to tobacco cigarettes at baseline predicted greater e-cigarette use at 6 months, which then predicted greater expectancies that e-cigarettes taste pleasant as compared to tobacco cigarettes at 12 months. Conclusions: Expectancies that e-cigarettes provide similar or more pleasant taste sensations as compared to tobacco cigarettes may be both a cause and consequence of e-cigarette use. Focusing on the taste experience may prove most effective in modifying e-cigarette use behavior. Implications: The current study offers the first longitudinal examination of expectancies and e-cigarette use. Results suggest expectancies that e-cigarettes provide similar or more pleasant taste sensations relative to tobacco cigarettes are both a cause and consequence of e-cigarette use. Efforts that focus on the e-cigarette taste experience may prove most effective in modifying e-cigarette use behavior.

Withdrawal exposure with withdrawal regulation training for smoking cessation: a randomized controlled pilot trial.

INTRODUCTION: Although withdrawal processes form a key motivational basis for cigarette use, smoking cessation treatments appear to exert only modest effects on withdrawal. One treatment option for further reducing withdrawal severity would be to provide smokers with withdrawal regulation training. The objective of this study was to pilot a smoking cessation intervention comprising withdrawal exposure with withdrawal regulation training. METHODS: Adult smokers (N=80) were randomized to one of two conditions: 1) Withdrawal Exposure with Withdrawal Regulation Training (WT), which included the development and application of individualized withdrawal regulation strategies over four separate sessions that spanned the first four hours of abstinence; 2) or Relaxation Control (RC) training, which controlled for the therapeutic contact of WT. All sessions occurred before the quit date, after which differential treatment was discontinued and all participants received brief counseling, nicotine replacement therapy, and self-help literature. Biochemically-confirmed (CO≤3) seven-day point-prevalence abstinence was assessed at Months 2 and 3 after end-of-treatment. RESULTS: Treatment completion and ratings of credibility and efficacy were high and equivalent across conditions. 22.2% of participants in the WT condition were abstinent at both time points, whereas 0% and 4.2% of participants in the RC condition were abstinent at Months 2 and 3 (Month 3 OR=6.5 [0.73, 59.19]). In-session withdrawal ratings suggested WT improved regulation of withdrawal symptoms, which were in turn associated with abstinence. CONCLUSIONS: This small pilot study suggests that WT promotes abstinence by enhancing withdrawal regulation. Results warrant further investigation of this innovative treatment approach.

Classic psychedelic use is associated with reduced psychological distress and suicidality in the United States adult population.

Mental health problems are endemic across the globe, and suicide, a strong corollary of poor mental health, is a leading cause of death. Classic psychedelic use may occasion lasting improvements in mental health, but the effects of classic psychedelic use on suicidality are unknown. We evaluated the relationships of classic psychedelic use with psychological distress and suicidality among over 190,000 USA adult respondents pooled from the last five available years of the National Survey on Drug Use and Health (2008-2012) while controlling for a range of covariates. Lifetime classic psychedelic use was associated with a significantly reduced odds of past month psychological distress (weighted odds ratio (OR)=0.81 (0.72-0.91)), past year suicidal thinking (weighted OR=0.86 (0.78-0.94)), past year suicidal planning (weighted OR=0.71 (0.54-0.94)), and past year suicide attempt (weighted OR=0.64 (0.46-0.89)), whereas lifetime illicit use of other drugs was largely associated with an increased likelihood of these outcomes. These findings indicate that classic psychedelics may hold promise in the prevention of suicide, supporting the view that classic psychedelics' most highly restricted legal status should be reconsidered to facilitate scientific study, and suggesting that more extensive clinical research with classic psychedelics is warranted.

Hospitalized smokers' expectancies for electronic cigarettes versus tobacco cigarettes.

INTRODUCTION: The objectives of the current study were to compare hospitalized smokers' expectancies for electronic cigarettes (e-cigarettes) against their expectancies for tobacco cigarettes and evaluate relationships between e-cigarette expectancies and intention to use e-cigarettes. METHODS: Analysis of baseline data from a one-year longitudinal observational study. The setting was a tertiary care academic center hospital in the Southeastern U.S. Participants were 958 hospitalized tobacco cigarette smokers. A questionnaire of e-cigarette expectancies based on the Brief Smoking Consequences Questionnaire-Adult (BSCQ-A) was developed and administered along with the original, tobacco-specific, BSCQ-A. Intention to use e-cigarettes was assessed with a single 10-point Likert scale item. RESULTS: Participants reported significantly weaker expectancies for e-cigarettes relative to tobacco cigarettes on all 10 BSCQ-A scales. Participants held sizably weaker expectancies that e-cigarettes pose health risks (p<.001, Cohen's d=-2.07), relieve negative affect (p<.001, Cohen's d=-1.01), satisfy the desire for nicotine (p<.001, Cohen's d=-.83), and taste pleasant (p<.001, Cohen's d=-.73). Among the strongest predictors of intention to use e-cigarettes were greater expectancies that e-cigarettes taste pleasant (p<.001, adjusted ß=.34), relieve negative affect (p<.001, adjusted ß=.32), and satisfy the desire for nicotine (p<.001, adjusted ß=.31). CONCLUSIONS: Hospitalized tobacco smokers expect fewer negative and positive outcomes from e-cigarettes versus tobacco cigarettes. This suggests that e-cigarettes might be viable though imperfect substitutes for tobacco cigarettes.

Individuals in the criminal justice system show differences in cooperative behaviour: Implications from cooperative games.

BACKGROUND: The high rate of incarceration in the USA warrants continued exploration into understanding and ameliorating criminal behaviour. The growing use of cooperative games to measure developing prosocial behaviours has never been explored in a US criminal justice population. AIMS: The aim of this study is to examine cooperative game play among offenders under supervision in the community. We hypothesised that the offenders would use more guarded and self-preserving strategies and be more likely to excel in short-lived interactions than law-abiding community citizens. METHODS: Community supervised offenders (83) and general population comparison participants (41) were recruited by town centre adverts placed in popular shops. Using the supervision centres as venues, all participants were asked to complete four cooperative games (prisoner's dilemma, public goods game, ultimatum game and trust game), not knowing the identity of the other player who was always, in fact, the experimenter. RESULTS: The offender and general population groups were similar in age (early 30s), sex (2/3 men), race (45% white) and IQ distribution (low average range). Offenders made lower offers in the ultimatum game, had lower scores in the prisoner's dilemma, made lower investments and offered lower returns in the trust game and contributed less in the public goods game. CONCLUSIONS: Even community-based offenders thus seem to have deficits in the kinds of gameplay, which are informed by theories of social cooperation, but the direction of relationship with offending remains unclear. The apparent deficits may reflect adaptation to a hostile environment where trust and reciprocity are not rewarded. It is also important to recognise that these community-based offenders did develop play indicative of trust and reciprocity, they just did so more slowly than the comparison group. This may have implications for allowing time for rapport to develop in supervisory relationships. Finally, offenders may benefit from learning that although more guarded behaviours may be adaptive in a rough neighbourhood or in jail, they may be maladaptive and limit their success in other settings such as the work place.

Expectancies for smoking cessation among drug-involved smokers: implications for clinical practice.

Drug-involved smokers may be less motivated to quit smoking because they expect smoking cessation to occasion adverse outcomes (e.g., exacerbation of drug use). Non-treatment-seeking adult smokers from the community (N=507) reported drug involvement, expectancies for smoking abstinence via the Smoking Abstinence Questionnaire (SAQ), and motivation to quit smoking (desire to quit and abstinence goal). Mediation analyses evaluated the indirect effects of binge drinking, marijuana, cocaine, other stimulant, opiate, and barbiturate/other sedative involvement on motivation to quit smoking through the SAQ Adverse Outcomes scale. Adverse outcomes expectancies accounted for a reduced desire to quit smoking and a lower likelihood of endorsing a goal of complete smoking abstinence among those involved with binge drinking, marijuana, cocaine, other stimulants, opiates, and barbiturates/other sedatives. Drug-involved smokers' greater expectancies for adverse outcomes upon quitting smoking may deter smoking quit attempts. Interventions are encouraged to counteract the notion that smoking cessation jeopardizes sobriety.

Smoking abstinence-related expectancies among American Indians, African Americans, and women: potential mechanisms of tobacco-related disparities.

Research has documented tobacco-related health disparities by race and gender. Prior research, however, has not examined expectancies about the smoking cessation process (i.e., abstinence-related expectancies) as potential contributors to tobacco-related disparities in special populations. This cross-sectional study compared abstinence-related expectancies between American Indian (n = 87), African American (n = 151), and White (n = 185) smokers, and between women (n = 231) and men (n = 270) smokers. Abstinence-related expectancies also were examined as mediators of race and gender relationships with motivation to quit and abstinence self efficacy. Results indicated that American Indians and African Americans were less likely than Whites to expect withdrawal effects, and more likely to expect that quitting would be unproblematic. African Americans also were less likely than Whites to expect smoking cessation interventions to be effective. Compared with men, women were more likely to expect withdrawal effects and weight gain. These expectancy differences mediated race and gender relationships with motivation to quit and abstinence self-efficacy. Findings emphasize potential mechanisms underlying tobacco-related health disparities among American Indians, African Americans, and women and suggest a number of specific approaches for targeting tobacco dependence interventions to these populations.

Cooperation and depressive symptoms.

BACKGROUND: Deficits in pro-social cooperation are common in many individuals with mental illnesses such as depression. For decades, researchers have used economic game paradigms to compare cross-cultural cooperative behavior. However, research using economic games to assess cooperative behavior in clinical populations is in the early stages. We hypothesized that individuals with greater depressive symptoms would struggle to maintain reciprocity in iterative games, but not in single-iteration games measuring personal values. METHODS: Participants (n=41) played four computer-based economic games (prisoner's dilemma, the public goods game, the ultimatum game, and the trust game) measuring different aspects of cooperation. Participants completed the Depression Anxiety and Stress Scale (DASS) and other measures of personality and demographics. Analyses assessed the relationships between game performance and psychological distress as measured by the DASS. RESULTS: Significant correlations were found between game performance and depressive symptoms, but not symptoms of anxiety or stress. Performance in the prisoner's dilemma and public goods game was significantly related to depression in a linear regression even when known associations with depressive affect such as age, gender, race, education, marital status, and neuroticism were controlled for. CONCLUSIONS: Depressive symptoms were associated with an inability to sustain reciprocal cooperation. Participants showed the predicted deficits in cooperation in these economic games. Economic games show the potential for assessing the social deficits associated with depressive symptoms.