The synergetic effect of alcohol consumption and cigarettes per day on smoking outcomes expectancies among Latinx adult smokers

Evaluating Alcohol Use Severity in Terms of Cigarette Smoking-Related Processes and Anxiety/Depression Among Adult Latinx Smokers

OBJECTIVE

Although empirical work focused on smoking-drinking comorbidity among Latinx persons is growing, no work has explored the relation between alcohol use severity in terms of co-occurring smoking processes and mental health. Therefore, the present investigation aimed to explore the prevalence and role of alcohol use severity in relation to clinically significant tobacco and mental health problems among English-speaking Latinx adults who smoke cigarettes.

METHODS

Participants included 338 English-speaking Latinx adults who smoked cigarettes daily (Mage = 35.5 years; SD = 8.65; age range 18-61; 37.3% female).

RESULTS

Results indicated that approximately 68% of male and 61% of female smokers scored above established clinical cutoffs for hazardous and harmful alcohol use and possible alcohol dependence. Moreover, alcohol use severity was associated with increased risk for cigarette dependence, perceived barriers for quitting, and more problematic symptoms when trying to quit. Alcohol use severity was also related to more severe anxiety and depressive symptoms.

CONCLUSIONS

Overall, the current findings suggest that intervening to reduce alcohol use severity may be important to improving smoking cessation and mental health among Latinx persons who smoke.

Pain Severity in Relation to Smoking Cessation Problems and Self-Efficacy for Quitting among Latinx Individuals Who Smoke Cigarettes: The Moderating Role of Perceived Discrimination

Background: Latinx individuals experience significant tobacco cigarette smoking-related diseases and illnesses. Although most Latinx smokers report a desire to quit smoking, evidenced-based cessation treatments are underutilized in this group, which may partially be due to lower likelihood of receiving advice from a healthcare professional. Further, there are a lack of cessation treatments that account for comorbid symptoms/conditions (e.g., co-occurring pain) and social determinants of health (e.g., perceived discrimination). Extant work has established the reciprocal relation between pain and smoking trajectories. Additionally, although social determinants, such as perceived racial/ethnic discrimination, have demonstrated clinical relevance to a variety of health-related behaviors, limited work has examined the role of perceived discrimination in pain-smoking relations. The current study examined the effects of perceived discrimination and pain severity in relation to smoking cessation problems and self-efficacy for quitting among Latinx cigarette smokers. Method: Participants included 226 (Mage = 34.95 years, SD = 8.62; 38.5% female) adult Latinx daily cigarette smokers. Results: Results indicated that the interaction of pain and perceived discrimination was predictive of greater quit problems (p = 0.041) as well as greater confidence in the ability to refrain from smoking in response to internal (p < 0.001) and external stimuli (p < 0.001). Conclusions: Overall, this work provides a more nuanced understanding of the psychosocial contexts in which Latinx smokers may encounter problems related to quitting, and this data is important for future smoking cessation research and treatment.

Alcohol use severity in relation to pain severity and interference among latinx adults with current pain who smoke cigarettes

Limited research has focused expressly on dual tobacco-alcohol use among the Latinx population. Latinx individuals who smoke represent a tobacco health disparities group and evince elevated rates of pain problems and symptoms. Prior research has consistently linked pain problems and severity to smoking and alcohol prevalence, maintenance, and behavior. Accordingly, the current study sought to build from the limited work that exists among Latinx persons who smoke and evaluate the role of alcohol use severity in terms of pain severity and interference. The current sample consisted of 228 adult Latinx daily cigarette smokers (Mage = 34.95 years; SD = 8.58; 39.0% female) who endorsed current pain. Results indicated that elevated alcohol use problems were associated with greater levels of pain severity (R2 = 0.06) and interference (R2 = 0.06). The present findings suggest that there may be utility in clinical screening for alcohol use problems among Latinx persons who smoke to offset pain problems among this high-risk group.

Pain Severity and Smoking Abstinence Expectancies among Latinx Individuals Who Smoke Cigarettes: The Moderating Role of Perceived Discrimination

Latinx individuals experience significant health disparities related to smoking cessation in the United States (US). Although past works have consistently implicated pain in the maintenance of smoking behavior, limited research has examined the role of social determinants (e.g., perceived discrimination) in pain-smoking relations. The current study sought to examine the moderating role of perceived discrimination in the relation between pain severity and smoking abstinence expectancies (i.e., a cognitive factor related to poor smoking outcomes) among 226 Latinx individuals who currently smoke cigarettes (Mage = 34.95 years; SD = 8.62; 38.5% female). The results indicated a statistically significant interaction between pain severity and perceived discrimination with regard to smoking abstinence expectancies (i.e., negative mood, somatic symptoms, harmful consequences, and positive consequences). Post-hoc analyses revealed the association of pain severity and negative mood, harmful consequences, and positive consequences smoking abstinence expectancies evident for individuals with higher perceived discrimination. Moreover, the association between pain severity and somatic symptoms smoking abstinence expectancies was stronger for individuals with higher perceived discrimination. Overall, these results suggest that clinical and community-based public health strategies may benefit from addressing the role of perceived discrimination among Latinx individuals who smoke cigarettes in the context of pain.

Efficacy of smartphone applications for smoking cessation in heavy-drinking adults: Secondary analysis of the iCanQuit randomized trial

INTRODUCTION

Efficacious smoking cessation treatments are needed for heavy-drinking adults who often have difficulty quitting smoking. In a secondary analysis of a parent randomized controlled trial, we explored the efficacy of an Acceptance and Commitment Therapy (ACT)-based smartphone application (iCanQuit) versus a US Clinical Practice Guidelines (USCPG)-based smartphone application (QuitGuide) for smoking cessation among heavy-drinking participants (4 + drinks/day for women; 5 + drinks/day for men).

METHODS

Participants were randomized to receive iCanQuit (n = 188) or QuitGuide (n = 160) for 12-months. Smoking cessation outcomes were measured at 3, 6 and 12-months. The primary outcome was self-reported complete-case 30-day point prevalence abstinence (PPA) at 12-months. Secondary outcomes were 7-day PPA at all timepoints; prolonged abstinence; and cessation of all nicotine-containing products at 12-months. Multiple imputation and missing-as-smoking analyses were also conducted. Exploratory outcomes were cessation of both smoking and heavy drinking and change in alcohol use (drinks/day) at 12-months. Treatment engagement and satisfaction and change in ACT-based processes were compared between arms.

RESULTS

Retention rate was 85% at 12-months and did not differ by arm. At 12-months, iCanQuit participants had nearly double the odds of smoking cessation compared to QuitGuide (complete-case 30-day PPA = 24% vs. 15%; OR = 1.87 95% CI: 1.03, 3.42). Findings were similar for the multiple imputation and missing-as-smoking outcomes at 12-months. Combined cessation of smoking and heavy drinking, and alcohol use at 12-months did not differ by arm. iCanQuit was significantly more engaging and satisfying than QuitGuide. Increased acceptance of thoughts about smoking mediated the effect of treatment on cessation of heavy drinking at 12-months.

CONCLUSIONS

The iCanQuit smartphone application was more efficacious and engaging for smoking cessation among heavy-drinking adults than a USCPG-based smartphone application.

Exploring pain experience and anxiety sensitivity among Latinx adults in a federally qualified health center

The Latinx population is the largest minority group in the United States (U.S.) and is expected to continue to grow through at least 2050. Although there is growing recognition of the importance of pain among Latinx individuals, few studies have examined individualized psychological processes governing pain severity and disability in Latinx populations. One psychological factor that has shown promise in relation to pain experience specifically and clinical conditions more generally is anxiety sensitivity. The present investigation sought to (1) characterize the severity of pain among an unselected sample of adult Latinx individuals attending a Federally Qualified Health Center (FQHC); (2) evaluate the severity of anxiety sensitivity as a function of pain severity; and (3) test the potential explanatory relevance of anxiety sensitivity as an individual difference factor for pain intensity, pain disability, psychological inflexibility for emotional distress, and global life impairment. Participants included 406 adult Spanish-speaking Latinx persons (87.2% female; M_age = 40.26 years, SD = 11.20, and 98.3% used Spanish as their first language) who attended an FQHC in Houston, Texas. Analyses revealed that 62.6% of the sample had at least some pain, and 21.9% of the same had high intensity, moderate interference, or severe interference chronic pain. Further, results provided evidence for anxiety sensitivity as a function of pain grade, such that individuals with grade 2 (high-intensity pain), grade 3 (moderate pain interference), and grade 4 (severe pain interference) chronic pain reported significantly higher levels of anxiety sensitivity than those with grade 0 pain (no chronic pain). Additionally, after controlling for age, gender, marital status, years of education, years living in the U.S., and generalized anxiety, anxiety sensitivity significantly accounted for significant variance in pain intensity, inflexibility in relation to emotional distress, and life impairment. Overall, the current study builds upon what is currently understood about anxiety sensitivity among the Latinx population and uniquely extends past work by linking individual differences in this construct to clinically relevant aspects of pain experience and life impairment among adults attending FQHC's. Additional clinical attention should be focused on anxiety sensitivity to offset pain disparities among this established health disparities group.