Associations between affect, craving, and smoking in Korean smokers: An ecological momentary assessment study

Intrinsic connectivity demonstrates a shared role of the posterior cingulate for cue reactivity in both gambling and cocaine use disorders

Cue reactivity is relevant across addictive disorders as a process relevant to maintenance, relapse, and craving. Understanding the neurobiological foundations of cue reactivity across substance and behavioral addictions has important implications for intervention development. The present study used intrinsic connectivity distribution methods to examine functional connectivity during a cue-exposure fMRI task involving gambling, cocaine and sad videos in 22 subjects with gambling disorder, 24 with cocaine use disorder, and 40 healthy comparison subjects. Intrinsic connectivity distribution implicated the posterior cingulate cortex (PCC) at a stringent whole-brain threshold. Post-hoc analyses investigating the nature of the findings indicated that individuals with gambling disorder and cocaine use disorder exhibited decreased connectivity in the posterior cingulate during gambling and cocaine cues, respectively, as compared to other cues and compared to other groups. Brain-related cue reactivity in substance and behavioral addictions involve PCC connectivity in a content-to-disorder specific fashion. The findings suggesting that PCC-related circuitry underlies cue reactivity across substance and behavioral addictions suggests a potential biomarker for targeting in intervention development.

Cannabis advertising impacts on youth cannabis use intentions following recreational legalization in Canada: An Ecological Momentary Assessment (EMA) study

OBJECTIVE

In 2018, Canada's Cannabis Act legalized adult recreational cannabis use and limited cannabis product advertising to adults. Cannabis product advertising to youth remains illegal. The extent to which adult-targeted, or illicit youth-targeted cannabis advertisements is reaching and impacting Canadian youth is unknown. We used Ecological Momentary Assessment (EMA) to describe how often and how much exposures to cannabis advertising influence Canadian youths' real-world, real-time intentions to use cannabis.

METHODS

120 Ontario, Canada youths ages 14-18, took photos of cannabis advertising that they encountered in their natural environments over a period of nine consecutive days. Following each exposure and twice daily device-issued random prompts, they also rated their intentions to use cannabis.

RESULTS

Many participating youth (n = 85; 70.83 %) reported at least one cannabis advertising exposure during the study (range 1-30, M = 4.02). Exposures occurred through a range of advertising channels (e.g., internet ads, billboards). Multilevel modeling showed that youth advertising exposure increased cannabis use intentions in vivo (β = 0.06,SE = 0.03;t = 1.98;p =.04;n = 1,348).

CONCLUSION

Data from this study shows that cannabis advertisements are regularly reaching Canadian youth and increasing their intentions to use cannabis. This suggests that current Canadian prohibitions on cannabis advertising to youth are ineffective and/or ineffectively enforced, and that the Canadian government needs additional or enhanced prohibitions on cannabis promotion to protect youth from harms associated with increased advertisement exposure, such as increased cannabis use.

Modeling Idiographic Longitudinal Relationships between Affect and Cigarette Use: An Ecological Momentary Assessment Study

Background: Despite public knowledge of the adverse health effects of tobacco use, cigarettes remain widely used due to the addictive nature of nicotine. Physiologic adaptation to the presence of nicotine over time leads to unpleasant effects during withdrawal periods. Alongside these physiological effects, tobacco users often report changes in their consumption of tobacco in response to their emotional state. Objectives: We hypothesized that idiographic, or person-specific level, increases in participants' negative affect (NA) and positive affect (PA) ratings at a given time point would be associated with higher and lower craving and smoking over the following several hours, respectively. Fifty-two participants completed block randomized ecological momentary assessment surveys on their smartphones 4 times per day for 30 days, reporting from 0-100 their level of seven discrete emotions, stress, current craving, and smoking behavior. We analyzed the relationships between affect and smoking and craving using idiographic generalized linear models. Results: While some participants exhibited the hypothesized relationships, each participant varied in the strength and direction of the relationships between affect and craving/smoking. These outcomes were partially moderated at the group level by anxiety/depression at baseline, but not by level of nicotine dependence or sex. Conclusions: This suggests that the factors driving cigarette use vary significantly between individuals.

Affective mechanisms of stress-induced cigarette craving: Considerations of gender and race/ethnicity

OBJECTIVE

Among the major impediments to successful smoking cessation are strong cravings, especially during times of heightened stress. Affective responses to stress (e.g., acute anxious and depressed mood) may serve as important mediators of cigarette cravings that are amenable to intervention. Experimental models have been developed to reliably induce cravings during stress under laboratory conditions, permitting a closer examination of possible changes in affect that may be driving cigarette cravings. A key limitation of the extant research is its reliance on samples of predominantly White males who smoke. Although several recent studies suggest possible gender- and race/ethnicity-based differences in affective responses to acute stress, no studies have explored how such differences may contribute to cigarette cravings.

METHOD

To address this gap, we conducted an experimental study in which a diverse sample of healthy volunteer female (n = 163) and male (n = 139) nicotine-dependent individuals who smoked were exposed to a stressor (guided imagery of painful dental work). We assessed negative affect and cigarette craving immediately before and after the imaginal dental stressor.

RESULTS

Path analyses revealed that the acute stressor induced increases in negative affect, which, in turn, increased cigarette craving (significant direct and indirect effects, p's < 0.05; R²_indirect = 0.5). Interestingly, effects were more pronounced in women and in non-White individuals who smoked.

CONCLUSIONS

Results highlight the important roles of stress and affect in craving, and the need to consider gender and race/ethnicity when developing interventions to manage stress-induced cigarette cravings among individuals attempting to quit.

Desire thinking as an underlying mechanism in alcohol use disorder and nicotine dependence

Desire thinking is an emerging construct in the addictive behaviours literature. No research, to date, has investigated its contribution to problematic alcohol use and nicotine dependence in patient samples when accounting for established predictors of addictive behaviours. The present study sought to clarify, in patient samples, the relative contribution of desire thinking in the associations between negative affect, impulsivity and thought suppression on the one hand and craving, problematic alcohol use and nicotine dependence on the other. To achieve this goal, two groups of individuals with alcohol use disorder (AUD) (n = 370; age range = 15-67 years) and nicotine dependence (n = 365; age range = 17-75 years) were selected, and measures of negative affect, impulsivity, thought suppression, craving, desire thinking, problematic alcohol use and nicotine dependence were completed by both groups. Results showed that in both groups, negative affect and thought suppression indirectly affected alcohol and nicotine craving, problematic alcohol use and nicotine dependence through the mediating role of desire thinking. The present study shows the independent role of desire thinking in predicting problematic alcohol use and nicotine dependence in patient samples, indicating its potential relevance for treatment.