An exploration of self-reported negative affect by adolescents as a reason for smoking: implications for tobacco prevention and intervention programs

The Intergenerational Impact of Adverse Childhood Experiences on Hispanic Families: The Mediational Roles of Parental Depression and Parent-Adolescent Communication

Parental exposure to adverse childhood experiences (ACEs) has been documented as a strong risk factor for subsequent externalizing behaviors in their youth. Although studies have investigated ACEs and their intergenerational association with youth externalizing behaviors, this association has not been investigated in Hispanic families. Additionally, substantial gaps in the literature exist explaining the mechanisms by which this association occurs. The purpose of this study was to examine whether parent-adolescent communication and parental depressive symptomatology explain the relationship between parent's ACE score and adolescent externalizing behaviors. This secondary data analysis utilized baseline data from an ongoing randomized controlled trial evaluating the relative effectiveness of an online parenting intervention for Hispanic adolescents. The sample consisted of 456 parents and their adolescents between the ages of 12-16. Using path modeling, parental depressive symptomatology and parent-adolescent communication were simultaneously examined as mechanisms that may explain the intergenerational relationship between parental exposure to ACEs and externalizing behaviors in Hispanic youth. Parental depressive symptomatology and parent-adolescent communication both significantly mediated the association between parental exposure to ACEs and adolescent externalizing behaviors. Understanding the mechanisms explaining the intergenerational association between parental exposure to ACEs and adolescent externalizing behaviors may aid future research examining problematic behaviors in Hispanic youth.

Understanding susceptibility to e-cigarettes: A comprehensive model of risk factors that influence the transition from non-susceptible to susceptible among e-cigarette naïve adolescents

The primary objective of this study was to identify risk factors associated with becoming susceptible to e-cigarette use over the course of a year among e-cigarette-naive adolescents considering a comprehensive model of risk factors (risk perceptions, social influences and norms, affective risk factors, and other behavioral risk factors). Data came from the Texas Adolescent Tobacco and Marketing Surveillance system (TATAMS), a longitudinal cohort study of students who were in the 6th, 8th, and 10th grades (n = 3907) during the 2014-2015 academic year. Weighted generalized linear mixed models assessed multiple predictors' associated with the transition to susceptibility to e-cigarettes at 12 months. Among 6th graders, family influence, use of other substances, and positive affect were important. Adolescents transitioning from 8th grade to high school presented the greatest number of risk factors (e.g., social and normative influences). Only sensation seeking increased the risk of susceptibility to e-cigarettes among 10th graders. Overall, by grade level, incidence of susceptibility to e-cigarettes at 12 months did not vary, but risk factor profiles varied substantially.

The roles of sex, anxious reactivity to bodily arousal, and anxiety sensitivity in coping motives for cigarette smoking among adolescents

Evidence suggests that smoking to cope among adolescents is associated with a number of problematic outcomes (e.g., greater smoking frequency, higher rates of dependence). It is thus imperative to better understand factors that may increase the likelihood of smoking to cope among adolescents. Research suggests anxiety sensitivity (AS) is associated with smoking to cope among adults, although the link between AS and coping motives for cigarette use among youth is less clear. Gender differences have also been noted in AS. The current study investigates this association using a biological challenge paradigm. Specifically, the indirect effects of anxious reactivity to bodily arousal on the relation between the physical and mental AS factors and coping motives for cigarette smoking were examined within a sample of 108 adolescent cigarette smokers. Gender was examined as a moderator. Results suggested significant indirect effects of self-reported anxiety in response to bodily arousal on the relation between physical AS and coping motives for cigarette smoking. This indirect effect was moderated by gender, such that it was significant for females but not males. Models examining AS mental concerns and psychophysiological responding to the challenge were not significant. These results suggest that, relative to their low AS counterparts, female adolescents high in physical concerns respond with elevated anxiety in response to interoceptive arousal and, in turn, endorse elevated coping-related smoking motives. Findings are discussed in terms of implications for understanding the nature and origins of coping-related smoking motives and how such information can be used to inform intervention efforts. (PsycINFO Database Record

Daily Smoking and Subjective Health Complaints in Adolescence

INTRODUCTION

Using data from the Health Behaviour in School-aged Children survey, this study used a repeated cross-sectional design to examine associations between daily smoking, gender, and self-reported health complaints in five cohorts of adolescents over a 16-year period.

METHODS

Data were from nationally representative cohorts of 15-year-old youth in Norway in 1993/1994, 1997/1998, 2001/2002, 2005/2006, and 2009/2010 (n _total = 7761). Dependent variables were psychological, somatic, and total health complaints. A mixed GLM model examined main and interaction effects of smoking (daily, intermittent, nonsmoking), year, and gender in predicting complaints. Time periods were segmented to compare trends across smoking groups in specific periods.

RESULTS

Prevalence of daily smoking declined from 15.5% (1993/1994) to 6.0% (2009/2010). All health complaint scores were significantly higher for smokers and for girls (vs. boys). Smoking status by year interactions were significant for all complaint variables during the period of sharpest decline of daily smoking prevalence (2001/2002-2005/2006), with daily smokers experiencing increases in health complaints while intermittent and nonsmokers did not. Smoking status by gender interactions were significant for all health complaint variables, indicating that the main effect for gender (females higher) was even stronger among smokers compared with nonsmokers. Using year as unit of analysis, the size of mean differences between daily smokers and intermittent/nonsmokers in total complaints was significantly negatively correlated with daily smoking prevalence (-.963, n = 5, p < .01).

CONCLUSIONS

As prevalence of daily smoking declined, daily smokers reported higher levels of complaints, suggesting increasing health problems within this group. Girls who smoke daily had particularly elevated levels of complaints.

IMPLICATIONS

This study indicates that the relationship between daily smoking and concurrent health symptomatology in adolescents is changing over time, with higher levels of health complaints reported as overall smoking prevalence declines. To our knowledge, this finding has not previously been reported. If youth are smoking to cope with distress, pain, or other health concerns, tobacco control objectives will be increasingly difficult to achieve with adolescents. Levels of health complaints are particularly high among girls who are daily smokers. The findings suggest that restrictive measures and persuasive communications may not be sufficient tobacco prevention strategies for adolescent populations. Young smokers may need counseling and support.

Adverse childhood experiences and substance use among Hispanic emerging adults in Southern California

INTRODUCTION

Emerging adults who experienced stressful childhoods may engage in substance use as a maladaptive coping strategy. Given the collectivistic values Hispanics encounter growing up, adverse childhood experiences may play a prominent role in substance use decisions as these events violate the assumptions of group oriented cultural paradigms. Alternatively, adverse childhood events might not increase the risk of substance use because strong family ties could mitigate the potential maladaptive behaviors associated with these adverse experiences. This study examined whether adverse childhood experiences were associated with substance use among Hispanic emerging adults.

METHOD

Participants (n = 1420, mean age = 22, 41% male) completed surveys indicating whether they experienced any of 8 specific adverse experiences within their first 18 years of life, and past-month cigarette use, marijuana use, hard drug use, and binge drinking. Logistic regression models examined the associations between adverse childhood experiences and each category of substance use, controlling for age, gender, and depressive symptoms.

RESULTS

The number of adverse childhood experiences was significantly associated with each category of substance use. A difference in the number of adverse childhood experiences, from 0 to 8, was associated with a 22% higher probability of cigarette smoking, a 24% higher probability of binge drinking, a 31% higher probability of marijuana use, and a 12% higher probability of hard drug use respectively.

CONCLUSIONS

These findings should be integrated into prevention/intervention programs in hopes of quelling the duration and severity of substance use behaviors among Hispanic emerging adults.

Relationships Between Craving Beliefs and Abstinence Self-Efficacy are Mediated by Smoking Motives and Moderated by Nicotine Dependence

INTRODUCTION

Decreased abstinence self-efficacy is linked to increased craving and negative affect, as well as poorer smoking outcomes, such as lapse, relapse, and withdrawal symptom severity. Research suggests that beliefs and cognitions concerning ourselves and the world orient us toward specific goals and thus impact our judgments and behavior. This study serves to investigate whether motives for smoking mediate the relationship between beliefs about craving and abstinence self-efficacy judgments and whether this may differ by nicotine dependence.

METHODS

In a sample of 198 smokers (M age = 34.96, 51.8% female, 81.8% Caucasian), self-report measures of craving beliefs, situational abstinence self-efficacy, and smoking motives were measured. We examined the effect of beliefs on abstinence self-efficacy in both craving and negative affect situations, with craving and negative reinforcement smoking motives as mediators, and nicotine dependence as a moderator.

RESULTS

Results indicate that craving beliefs predict lower abstinence self-efficacy judgments in craving situations indirectly through increased craving motives. However, this relationship was only significant for less dependent smokers. Additionally, regardless of nicotine dependence, craving beliefs predicted lower abstinence self-efficacy in negative affect situations via increased negative reinforcement smoking motives.

CONCLUSIONS

These findings suggest that beliefs concerning the specific nature of craving correlate with smoking motives (ie, smoking goals) and thus abstinence self-efficacy judgments. Furthermore, these associations are stronger for less dependent smokers. Such findings suggest the importance of addressing craving beliefs during smoking cessation treatment, especially for less dependent smokers whose craving beliefs are associated with abstinence self-efficacy across multiple situations.

Indirect effects of smoking motives on adolescent anger dysregulation and smoking

Cigarette smoking is one of the leading causes of disease and death in the United States, and smoking typically begins in adolescence. It is therefore important to understand factors that relate to increased risk for cigarette smoking during this stage of development. Adolescence is a period when emotion regulatory capacities are still emerging and a common affective state to be regulated is anger, which adult research has linked to nicotine use. Drawing from work suggesting that negative affect reduction motives are one of the most common reasons for cigarette smoking, the current study was designed to evaluate the indirect effects of negative affect reduction motives on the relation between anger dysregulation and nicotine use within a sample of 119 treatment-seeking adolescents enrolled in group-based residential therapy. Results were generally consistent with hypotheses, suggesting significant indirect effects of negative affect reduction smoking motives on the relation between anger dysregulation and smoking outcomes. Findings are discussed in terms of negative affect reduction motives for cigarette use in the context of anger regulation among youths.

Affective motives for smoking among early stage smokers

BACKGROUND

As most smokers initiate smoking during adolescence, assessment of smoking motives that underlie trajectories of dependence is critical for both prevention and cessation efforts. In the current study, we expected participants with higher nicotine dependence would smoke (a) less for positive reinforcement (PR) and (b) more for negative reinforcement (NR) motives. We secondarily assessed the relative contribution of PR to NR motives across levels of dependence.

METHODS

Data were drawn from a study on cue-elicited craving among occasional versus daily adolescent smokers aged 16-20 years (N = 111). Smoking motives were assessed in relation to 3 commonly used measures of nicotine dependence: (a) Fagerström Test for Nicotine Dependence (FTND), (b) Autonomy over Smoking Scale (AUTOS), and (c) Nicotine Dependence Syndrome Scale (NDSS).

RESULTS

Compared to occasional smokers, daily smokers had significantly higher scores on each dependence measure and endorsed more prominent NR smoking motives. Each measure of nicotine dependence was strongly associated with NR motives for smoking, although measures differed in their association with PR motives. As expected, the FTND, AUTOS, and NDSS each significantly predicted smoking motive difference score (PR - NR), such that higher dependence was associated with more prominent NR motives for smoking.

CONCLUSIONS

Results are consistent with our understanding of dependence and provide further support for 3 common measures of nicotine dependence among early stage smokers.

Relationships between drinking motives and smoking expectancies among daily smokers who are also problem drinkers

OBJECTIVE

There is a high co-occurrence of problem drinking and regular cigarette smoking, and cognitive processes (e.g., motivation to use, expectations about the consequences of use) related to each are positively associated with one another. We explored drinking motives in relation to cognitive-based smoking processes among smokers with problematic drinking. We expected that drinking coping motives would be associated with smoking consequences related to negative reinforcement and negative personal outcomes and inflexibility of smoking behavior; observed effects for coping motives would be unique from shared variance with other motives and incrementally evident beyond the variance accounted for by tobacco-related health problems, smoking rate, negative affectivity, cannabis use, and gender.

METHODS

The sample included 195 individuals recruited into a larger study of smoking cessation treatments (i.e., they were interested in quitting), who were heavy drinkers and smoked daily. Participants were primarily male (n = 122, 63%), fairly young (Mage = 30.3 years; SD = 12.46), and predominantly White/Caucasian (n = 175, 80%). Roughly 57% (n = 111) had at least one comorbid Axis I disorder, the most common being social anxiety (n = 21, 11%) and generalized anxiety disorder (n = 12, 6%).

RESULTS

Coping drinking motives predicted negative smoking consequences, negative reinforcement, and smoking inflexibility. Enhancement drinking motives marginally predicted positive reinforcement. Conformity drinking motives predicted smoking consequences related to appetite/weight control. Social drinking motives predicted negative reinforcement and barriers to cessation and marginally predicted positive reinforcement.

CONCLUSIONS

Theoretical models and clinical activities focused on smoking cessation among problem drinkers may benefit from considering the role of drinking motives, particularly coping-oriented motives, to better understanding cognitive-based smoking processes.

Modeling mood variation and covariation among adolescent smokers: application of a bivariate location-scale mixed-effects model

INTRODUCTION

Ecological momentary assessments (EMAs) are useful for understanding both between- and within-subject dynamic changes in smoking and mood. Modeling 2 moods (positive affect [PA] and negative affect [NA], PA and NA) simultaneously will better enable researchers to explore the association between mood variables and what influences them at both the momentary and subject level.

METHODS

The EMA component of a natural history study of adolescent smoking was analyzed with a bivariate location-scale mixed-effects model. The proposed model separately estimates the between- and within-subject variances and jointly models the 2 mood constructs. A total of 461 adolescents completed the baseline EMA wave, which resulted in 14,105 random prompts. Smoking level, represented by the number of smoking events on EMA, entered the model as 2 predictors: one that compared nonsmokers during the EMA week to 1-cigarette smokers, and the second one that estimated the effect of smoking level on mood among smokers.

RESULTS

Results suggest that nonsmokers had more consistent positive and negative moods compared to 1-cigarette smokers. Among those who smoked, both moods were more consistent at higher smoking levels. The effects of smoking level were greater for NA than for PA. The within-subject association between mood constructs was negative and strongest among 1-cigarette smokers; the within-subject association between positive and negative moods was negatively associated with smoking.

CONCLUSIONS

Mood variation and association between mood constructs varied across smoking levels. The most infrequent smokers were characterized with more inconsistent moods, whereas mood was more consistent for subjects with higher smoking levels.

The mediating sex-specific effect of psychological distress on the relationship between adverse childhood experiences and current smoking among adults

Background

Research suggests that ACEs have a long-term impact on the behavioral, emotional, and cognitive development of children. These disruptions can lead to adoption of unhealthy coping behaviors throughout the lifespan. The present study sought to examine psychological distress as a potential mediator of sex-specific associations between adverse childhood experiences (ACEs) and adult smoking.

Method

Data from 7,210 Kaiser-Permanente members in San Diego California collected between April and October 1997 were used.

Results

Among women, psychological distress mediated a significant portion of the association between ACEs and smoking (21% for emotional abuse, 16% for physical abuse, 15% for physical neglect, 10% for parental separation or divorce). Among men, the associations between ACEs and smoking were not significant.

Conclusions

These findings suggest that for women, current smoking cessation strategies may benefit from understanding the potential role of childhood trauma.

A Unified Latent Curve, Latent State-Trait Analysis of the Developmental Trajectories and Correlates of Positive Orientation

Literature documents that the judgments people hold about themselves, their life, and their future are important ingredients of their psychological functioning and well-being and are commonly related to each other. In this article, results from a longitudinal study (N = 298, 45% males) are presented. Using an integrative Latent Curve, Latent State-Trait Model ( Tisak & Tisak, 2000 ), results corroborated (a) the impressive mean level and rank-order stability of positive orientation across a 4-year period, (b) the traitlike nature of positive orientation, and (c) the strong association of positive orientation with intrapersonal (i.e., quality of daily emotional experiences) and interpersonal (i.e., quality of friendships) adolescents' areas of functioning and on psychological resilience. These results attest to the utility of the new construct as a critical component of individuals' optimal well-functioning.

Cross-cultural analysis of cognitive attributions of smoking in thai and South Korean adolescents

BACKGROUND

Understanding the cognitive attributions of smoking has the potential to advance youth smoking prevention efforts; however, research on this subject is limited in Asian countries. We attempted to determine the degree to which cognitive attributions of smoking differ among adolescents in 2 Asian countries, Thailand and South Korea.

METHODS

We surveyed 10th- to 12th-grade students in Chiang Mai, Thailand (N = 2516) and Seoul, South Korea (N = 1166). Logistic regression determined association of attributions and current smoking and differences in attributions between Thai and South Korean students.

RESULTS

Items with the highest agreement among South Koreans were "helps me to deal with stress" and "helps relax" and among Thai were "feel like I am making my own decisions" and "keeps from being bored." Significant predictors of current smoking were different between samples. Only 1 cognitive attribution predicted current smoking in both samples ("helps me to deal with stress").

CONCLUSION

The pattern of relevant cognitive attributions of smoking for the 2 samples was distinct, suggesting that cross-cultural differences merit consideration when designing prevention and cessation programs. Health education should strive to dispel the use of smoking as a coping strategy for dealing with stressful situations and distressful feelings and teach adolescents alternative healthy strategies for dealing with stress.

Meanings of Smoking among Adolescents in Chiang Mai, Thailand

The Meanings of Smoking Index-2 (MSI-2) was administered to 2516 Thai adolescents in an urban, suburban, rural, and vocational high school. Factor analysis identified six meanings of smoking factor domains: coping, social image, stimulation, weight, independence, and difficulty refusing smoking. Logistic regression analyses determined that the strongest positive association with smoking behavior and ever smoking was the coping domain, and coping was also positively associated with susceptibility to smoking. The individual meaning item which most differentiated current smokers from nonsmokers was “keeps from being bored” and the dimension of stimulation (gives more energy, helps to concentrate, helps to study, gives something to do) was positively associated with current smoking. Findings suggest that meanings of smoking is important because it can provide guidance to health educators and other health professionals in tailoring smoking prevention and cessation interventions by identifying and targeting meanings that are salient within specific adolescent populations.

Cigarette smoking status and recurrent subjective health complaints among US school-aged adolescents

BACKGROUND

Subjective health complaints are common among adolescents. There is evidence that girls are more likely to register complaints than boys. This study examines gender differences in the relationship between daily smoking and recurrent subjective health complaints in school-aged adolescents in the USA.

METHODS

A cross-sectional design with a multistage probability sample was used to survey 13,339 middle and high school students (grades 6 through 10) with the US 2001-2002 Health Behavior in School-Aged Children Survey.

RESULTS

Recurrent subjective health complaints were higher for adolescents who smoke daily and experiment with cigarettes than for those who never smoke. In logistic regression analyses, the odds of daily smoking increased twofold for both boys and girls who report recurrent irritability/bad temper. For girls, the odds of daily smoking were higher among those who reported recurrent headache, stomachache and backache compared with never smokers. For boys only recurrent backache and feeling dizzy were associated with increased odds of daily smoking.

CONCLUSIONS

The relationship between recurrent subjective health complaints and daily smoking provides new insights into both conditions for school-aged adolescents. Findings from this study suggest different patterns of association between daily smoking and recurrent subjective health complaints occur for girls and boys. Further studies are needed to explore causes and treatment of daily smoking and recurrent health complaints among school-aged children.

Self-efficacy mediates the effect of depression on smoking susceptibility in adolescents

INTRODUCTION

Research indicates that negative affect and/or depression is associated with increased prevalence for smoking and higher levels of nicotine dependence in adults and adolescents. A previous study with adult smokers attempting to quit indicated that low levels of self-efficacy partially mediated depression's adverse effect on posttreatment cessation.

METHOD

The current study attempted to test self-efficacy as a potential mediator between depressive symptoms and smoking susceptibility in adolescents. One thousand and ninety-three nonsmoking high-school students who were part of a large clinical trial evaluating an interactive CD-ROM-based smoking prevention/cessation curriculum (project ASPIRE) were included in this analysis. These students completed an extensive battery before treatment and 18 months after treatment, which included measures of depression, self-efficacy, smoking status, and smoking susceptibility.

RESULTS

Results indicated that self-efficacy partially mediated the positive relationship between baseline depressive symptoms and susceptibility to smoke at 18 months, accounting for approximately 27% of the variance.

CONCLUSIONS

Perhaps future interventions to prevent smoking in adolescents can target self-efficacy potentially resulting in more effective outcomes, particularly in adolescents with current depressive symptoms or who may be at risk for future depression.

Adolescents' expectancies for smoking to regulate affect predict smoking behavior and nicotine dependence over time

AIMS

Mounting evidence suggests that individuals smoke, in part, to regulate affective experience (e.g., tension reduction, mood enhancement). Implicit in such motives is the expectancy or belief that smoking will decrease negative affect and increase positive affect. The contribution of cognitively-driven expectancies to the initiation and continuation of smoking during adolescence remains largely uninvestigated. The current study examined the influence of negative affect relief expectancies (NAREs) for smoking on smoking behavior and nicotine dependence using longitudinal data from a study on the emotional and social contexts of youth smoking.

METHODS

Participants were 568 adolescents with smoking experience (mean age 15.67, 56.7% female). Three separate mixed regression models were estimated to determine the relative contribution of NAREs to smoking behavior and nicotine dependence measured at 4 time points over 2 years.

RESULTS

NAREs for smoking influenced all smoking outcomes at baseline and predicted increases in smoking behavior and nicotine dependence over time, even after controlling for anxious and depressive symptoms and baseline nicotine dependence.

CONCLUSIONS

Outcome expectancies for affect management emerged as an important risk factor for smoking escalation and the development of nicotine dependence during adolescence. The present findings highlight the potential importance of cognitively-driven expectancies as a risk factor for smoking escalation during this critical developmental period.

A randomized controlled open comparative trial of varenicline vs nicotine patch in adult smokers: efficacy, safety and withdrawal symptoms (the VN-SEESAW study)

BACKGROUND

It has been suggested that anti-smoking therapy gives encouraging results, but this has not been verified by well-randomized study protocols. The present study was a randomized controlled trial of varenicline vs nicotine patch in adult smokers for comparison of efficacy, safety and withdrawal symptoms.

METHODS AND RESULTS

The 32 adult smokers were randomly divided into a varenicline group (VG, n=16) and a nicotine patch group (NG, n=16). The primary endpoints were the 12- and 24-week smoking-abstinence rates, safety and withdrawal symptoms including stress. No significant difference in abstinence rates was observed between the 2 groups over weeks 9-12 (71.4% vs 78.6% in the VG and NG, respectively), and weeks 9-24 (64.3% vs 71.4%, respectively). The frequencies of inability to concentrate at 2, 4, and 8 weeks, and wakeful nights at 2 weeks were higher in the VG than in the NG. Adverse side-effects associated with a gastrointestinal disorder occurred in 14 cases and 1 case in the VG and NG, respectively, and skin allergy was seen in 0 and 9 cases, respectively.

CONCLUSIONS

The selection of treatment depends on the balance of desired acuteness of cessation of smoking and side-effects, such as psychiatric and gastrointestinal problems or skin allergy.

Predictors of intention to quit smoking in Hong Kong secondary school children

BACKGROUND

Behavioral theories suggest that a past quit attempt influences psycho-social determinants to predict smokers' intention to quit, although no study has tested the hypothesis among youth smokers.

METHODS

A sample of 1561 Chinese secondary students, who were current smokers, were collected in a cross-sectional school-based survey in Hong Kong.

RESULTS

For the 943 students with past quit attempts, those with lower daily cigarette consumption; who perceived smoking would not elicit positive social responses from others; who had one parent/teacher who prohibited them to smoke; who were aware of the health hazards of smoking and being male smokers, were more likely to have an intention to quit smoking. For the 618 students without a past quit attempt, those who did not perceive any benefit from smoking; who had parents and teachers to prohibit them to smoke and who received social support to quit, were more likely to have an intention to quit smoking.

CONCLUSION

Strengthening the prohibition of smoking and providing social support may help initiate the intention to quit among youth smokers without a past quit attempt, while de-normalizing social images of smoking, providing information about the health hazards of smoking and relieving nicotine addiction may sustain quitting intentions among youth smokers with past quit attempts.

Smoking determinants in Turkish university students

The aim was to explore the prevalence and the correlates of smoking in a group of Turkish university students. A sample of 1,870 students (21.2 ± 2.0 years old) completed the Beck Depression Inventory, Beck Hopelessness Scale, Anxiety Sensitivity Index, 20-item Toronto Alexithymia Scale. Smoking was highly prevalent (35.9%) in this sample. Male gender (OR = 2.72, CI 2.15–3.44), and parental smoking (OR = 1.41, CI 1.13–1.78) were factors associated with increased likelihood of smoking. Higher depressive symptoms and hopelessness levels were significantly related to smoking behavior. Smoking behavior might initiate as a mild and transient habit and unfortunately could become more serious and lead to an actual dependence. The results of this study show that it is necessary to pay attention to levels of depression and hopelessness, as well as parental influence.

Examining anger as a predictor of drug use among multiethnic middle school students

BACKGROUND

Anger, a component of negative affect, has previously been associated with increased drug use primarily among white high school-aged students. However, few studies have examined these associations over time, and fewer have examined them among younger adolescents and students of color. Affective factors may play a greater role in drug use for girls relative to boys; yet, little is known regarding differences in associations between affect and drug use by gender.

METHODS

The current study used data from the control condition (N = 2025) of a drug and violence preventive intervention trial to examine the association between self-reported anger levels among multiethnic urban adolescents in the sixth grade and their use of cigarettes, alcohol, and marijuana use 1 year later. Potential gender differences were examined as well.

RESULTS

Multivariate generalized estimating equations models found anger to be significantly associated with increases in smoking, drinking, and marijuana use. There were no significant gender differences found for any of the drug use outcomes.

CONCLUSIONS

Results are consistent with studies conducted on primarily white high school youth, where anger had a small but significant effect on drug use over time. The findings also suggest that drug prevention programs should include emotion regulation skills, such as anger management, in addition to drug resistance skills.

Impulsivity and the role of smoking-related outcome expectancies among dependent college-aged cigarette smokers

The relationship between trait-impulsivity and smoking expectancies on smoking progression in undergraduate college students was examined over a 48-hour period of smoking abstinence. Participants were forty-nine college-aged dependent cigarette smokers who completed measures designed to assess impulsivity, nicotine dependence, and smoking expectancies. Using a series of multilevel models, impulsivity by time analyses indicated significant differences in positive reinforcement expectancies, [F (2, 94)=3.19, p<.05], but not in negative reinforcement expectancies, [F (2, 94)=0.49, p=.61]. Simple slopes analyses indicated that heightened trait-impulsivity predicted greater increases in positive reinforcement outcome expectancies at 48 h of abstinence. Level of impulsivity, however, was not related to changes in negative reinforcement expectancies. Results indicate that during an abstinence period, college students higher in trait-impulsivity may be more prone to relapse due to stronger beliefs about the positive effects from smoking a cigarette. These findings highlight the importance of understanding the interaction of personality and cognitive factors when working with young adult smokers wishing to quit this health-compromising behavior.

Adolescents' perceptions of smoking and stress reduction

The present study examined how adolescents perceive the relationship between smoking and stress and where they learn that smoking cigarettes may be an effective stress-reduction mechanism. Eight focus groups were conducted with low-income African American and European American 14- to 16-year-olds in urban and rural locations, in which they suggested that the primary reasons why they smoked-namely, as a coping mechanism (to calm nerves), for social acceptance, and because of environmental influences. Family issues, boyfriend/girlfriend problems, and school were common stressors. Although participants overwhelmingly believed that people smoke to reduce their stress, a few believed that cigarettes do not actually reduce stress. When asked for examples of smoking in popular media, teens predominantly generated examples of individuals smoking to reduce stress. Ethnic and gender differences were found among the types of media in which they had seen smoking, their opinions of anti-smoking messages, and the media's perceived influence.

Measuring nicotine intake among highly-dependent adolescent smokers: comparability of saliva and plasma cotinine concentrations

Cotinine is the most common biomarker used to assess nicotine exposure and abstinence. It can be measured in various matrices including saliva, plasma, and urine. Previous research with adults has shown high correlations between saliva and plasma cotinine concentrations. However, the research has not examined this relationship in adolescents. Additionally, variability in saliva flow and metabolism across gender, ethnicity, and age may impact the relationship between saliva and plasma cotinine concentration. Our aim was to examine the relationship between saliva and plasma cotinine concentration in a group of nicotine-dependent adolescent smokers. Additionally, we examined these correlations across gender, ethnicity and age. The sample consisted of 66 adolescent smokers (age 15.1+/-1.3, 63.6% girls, 66.7% European American, CPD 18.3+/-8.5, FTND 7.1+/-1.3). Saliva and plasma specimens were collected before the treatment phase of a nicotine replacement therapy trial and analyzed. The relationship between saliva and plasma cotinine concentration was analyzed using Pearson's correlation coefficients. We performed a secondary analysis using multiple regressions to compare correlations across race, gender and age. Results indicated a positive correlation between saliva cotinine and plasma cotinine concentration (r=0.84, p<0.001). Differences in correlations across age were significant (t=3.03, p<0.01). Differences across ethnicity approached significance (t=-1.93, p=0.058). Future research should seek to further validate saliva-to-plasma cotinine concentration ratios in adolescents as well as characterize saliva-to-plasma concentration differences and their underlying mechanisms.

Confirming the structure of the Why Do You Smoke? Questionnaire: a community resource for adolescent tobacco cessation

In response to the problem of adolescent smoking and limited appropriate cessation resources, this study examined the pattern and structure of the American Lung Association, Why Do You Smoke? (WDS) to determine its appropriateness for use in youth smoking cessation programs. The WDS is used to help smokers identify primary motivations for using tobacco and is comprised of eight subscales, each with three items representing primary smoking motivations ("Stimulation," "Handling," "Pleasure," "Crutch," "Psychological," "Habit," "Peer," and "Independence"). Study participants were all minors enrolled in a tobacco cessation program (n = 251). The pattern and structure of this self-assessment was examined using a correlated multiple group component factor analysis as a confirmatory approach. Findings show that the level of endorsement (as evidenced by subscale means and standard deviations) was relatively large across the eight subscales. Alpha coefficients ranged from .54 to .85. Results also underlined that the pattern coefficient matrix provided support for the hypothesized subscales through an examination of simultaneously extracted confidence intervals. These subscales should be further examined as to their usefulness in cessation interventions, such as the validity of using this instrument by gender, ethnicity, and age. However, from a measurement perspective, the confirmatory analysis provides excellent credence for the continued use of the WDS in cognitive/behavioral intervention programs targeting adolescents.