Sara Weidberg

A systematic assessment of delay discounting in relation to cocaine and nicotine dependence

Delay discounting is a measure of impulsivity describing how a reinforcer loses value as the delay to its receipt increases. Greater delay discounting is reliably observed among those with different substance use disorders (SUDs) compared to the general population. Nevertheless, the relation between delay discounting and the type and number of substances used remains unclear. The aim of this study was to compare delay discounting across four groups of participants: cocaine- and nicotine-dependent participants, cocaine-dependent only participants, nicotine-dependent only participants, and non-dependent controls. One hundred and seven participants completed a computerized delay discounting task for hypothetical monetary values. Data were fit to Mazurs hyperbolic equation to derive the discounting rate k. Results showed that delay discounting was significantly greater in the cocaine- and nicotine-dependent group, compared to the nicotine-dependent only group, compared to control group. Delay discounting was also greater in the cocaine-dependent only group relative to the nicotine-dependent only and control groups, but no differences were observed between the cocaine- and nicotine-dependent group and the cocaine-dependent only group. This study provides evidence that delay discounting differs depending on the type of SUD but not on the number of SUDs.

Decreased delay discounting in former cigarette smokers at one year after treatment

Current cigarette smokers exhibit greater delay discounting relative to ex-smokers. However, few studies have assessed longitudinal changes in delay discounting and cigarette smoking. The purpose of this study was to assess changes in delay discounting of hypothetical monetary rewards and smoking among treatment-seeking smokers (N=80) at baseline, after 6 weeks of behavioral treatment, and at 12-month follow-up. Results showed no changes in delay discounting in either smokers or abstainers at the end-of-treatment. In contrast, at 12-month follow-up, significant decreases in delay discounting were observed in abstainers while delay discounting remained the same for smokers. To our knowledge, this is the first study to observe significant decreases in delay discounting following prolonged smoking abstinence. Such findings provide evidence that delay discounting may have more state-like characteristics than previously believed.

Smoking a virtual cigarette increases craving among smokers.

Previous studies have shown the efficacy of virtual reality (VR) environments that reproduce smoking-related stimuli for increasing self-reported craving and psychophysiological reactivity in smokers. However, no study to date has attempted to simulate smoking behavior itself by means of VR technology. The aim of this study was to assess the effect of smoking a virtual cigarette on self-reported craving levels and heart rate (HR) in a sample of smokers. Participants were 45 smokers randomly assigned to three VR conditions built into a virtual pub: smoking a virtual cigarette, throwing virtual darts at a virtual dartboard or just being in the virtual pub. Results showed that smoking a virtual cigarette significantly increased self-reported craving and HR when compared to the other two conditions. These results reveal that simulation of smoking behavior in a VR environment functions as an efficacious proximal cue that can be used for triggering craving under the cue-exposure paradigm.

Voucher-based contingency management and in-treatment behaviors in smoking cessation treatment

A high percentage of patients relapse within months following an attempt to quit smoking. For this reason, greater understanding of the determinants of successful smoking cessation is needed. The present study assessed the effect of Contingency Management (CM) combined with Cognitive-Behavioral Treatment (CBT) on certain in-treatment behaviors (treatment retention, in-treatment smoking abstinence, and weekly decrease of cotinine levels) and examined the effects of these in-treatment behaviors on smoking status at a 6-month follow-up. A total of 154 treatment-seeking patients in a community setting were randomly assigned to a CBT, CBT plus CM for Abstinence (CMA) or to a CBT plus CM for Shaping cessation (CMS) group. Both CBT + CM procedures improved the in-treatment behaviors compared to CBT alone. These in-treatment behaviors (particularly in-treatment smoking abstinence) were associated with long-term abstinence. The effect of CM on in-treatment behaviors may partially explain the positive long-term outcomes of this procedure. Our findings extend previous knowledge about the effect of CM on smoking behavior.

Interaction effect of contingency management and sex on delay-discounting changes among treatment-seeking smokers.

Despite the potential influence of sex on delay-discounting rates, there is no previous evidence with regard to the effect of this variable on the clinical interventions aimed at modifying delay-discounting rates. This study assessed the effect of sex on the association between the type of treatment received (either cognitive-behavioral treatment [CBT] alone or combined with contingency management [CM + CBT]) and delay-discounting changes at end of treatment and 6-month follow-up. This aim was addressed after controlling for the influence of baseline delay discounting. Treatment-seeking smokers (N = 116) were randomly assigned to either CM + CBT (n = 69) or CBT alone (n = 47). Participants completed delay-discounting assessments at intake, at end of treatment, and at 6-month follow-up. Results showed that there was a significant interaction effect of treatment type and sex, such that women who received CM decreased their discounting more than women who did not. However, this effect was not found among men. Participants who discounted most at intake showed the greatest delay-discounting decreases. Lastly, smoking abstinence did not affect changes in delay discounting. The current results suggest that CM intervention may have a differential effect on delay-discounting changes as a function of sex. This finding supports the relevance of considering the effect of individual variables when assessing changes in delay discounting due to clinical interventions.

Delay discounting in e-cigarette users, current and former smokers

Background/Objective: Despite the fact that electronic cigarettes, or e-cigarettes, are being increasingly used as an alternative to smoking tobacco cigarettes, few studies have explored psychological factors associated with e-cigarette use. Prior studies aimed at exploring correlates of e-cigarette use have focused on sociodemographic and smoking-related characteristics. However, no previous work has examined psychological features such as impulsivity among e-cigarettes users. The main objective of this study was to compare impulsivity rates across four groups of participants: current e-cigarette users who were former smokers; current smokers; former smokers; and controls. Method: A sample of 136 participants completed a computerized delay discounting task for hypothetical monetary values. Results: Delay discounting was greater among e-cigarette users than former smokers. E-cigarette users also showed an intermediate discounting that did not differ from smokers and controls. Moreover, delay discounting was significantly greater among current smokers compared to former smokers and controls. Conclusions: Taken together, our results extend previous research on delay discounting by providing evidence on impulsivity levels among current e-cigarette users for the first time.

Contingency management for cigarette smokers with depressive symptoms.

Despite depressive symptoms being very common among smokers from the general population, few studies have examined the effects of depressive symptoms on smoking treatment outcomes, and even less research has been carried out in the context of contingency management (CM). The authors conducted a secondary analysis to assess the interrelation between treatment condition, depressive symptoms and treatment outcomes among treatment-seeking smokers. The sample was made up of 147 treatment-seeking smokers who were randomly allocated 2 treatment conditions: cognitive behavioral treatment (CBT; n = 74), or CBT + CM (n = 73). CBT was applied in 1-hr group-based sessions over 6 weeks. The CM protocol was voucher-based with maximum earnings of €300 (US

Evaluación de los niveles de dependencia de la nicotina en usuarios de cigarrillos electrónicos

339). Depressive symptoms were assessed using the Beck Depression Inventory-II. Smoking abstinence was verified though cotinine and carbon monoxide. Several analyses were conducted to explore the effect of treatment condition and baseline depressive symptoms on treatment outcomes, as well as the effect of treatment condition and smoking status on depressive symptoms. The CBT + CM condition was more effective than CBT, independent of depressive symptoms. The presence of depressive symptoms decreased the number of days of continuous smoking abstinence. Participants with a greater number of days of continuous smoking abstinence had fewer depressive symptoms than those with fewer days of continuous smoking abstinence. Findings suggest that health care providers should consider encouraging their patients with depressive symptoms to seek smoking cessation services that include both smoking cessation protocols and behavioral activation for mood management, thus maximizing both smoking and depressive outcomes.

Interaction of depressive symptoms and smoking abstinence on delay discounting rates.

Despite the fact that electronic cigarettes (e-cigarettes) are rapidly growing in popularity and use worldwide, there is scarce scientific data on abuse liability among e-cigarette users, and about whether e-cigarette use is related to nicotine dependence or not. The aim of this study is to explore nicotine dependence levels in a sample of experienced e-cigarette users (n= 39) and to compare them with current tobacco cigarette smokers (n=42). We conducted several face-to-face interviews in order to assess sociodemographic and dependence related characteristics in both e-cigarette users and in smokers. Adapted versions of both the Fagerström test for nicotine dependence (FTND) and the nicotine dependence syndrome scale (NDSS) were used to analyze nicotine dependence in each of the groups. Biochemical markers of carbon monoxide and urinary cotinine analysis were also collected. Results showed that e-cigarette users scored lower than cigarette smokers in both FTND and all NDSS subscales. Our findings extend previous research on e-cigarette use and nicotine addiction and suggest that e-cigarette users are less dependent on nicotine than current tobacco cigarette smokers. Further prospective studies are needed to better ascertain their addictiveness potential, comparing those smokers who switched to e-cigarettes from smoking cigarettes, and those who had never been tobacco cigarette smokers.

Latent structure of the CPT among treatment-seeking smokers with depression and its predictive validity on smoking abstinence

Delay discounting and depressive symptomatology have strong connections with smoking. However, few studies have examined interactions across delay discounting, depressive symptoms, and smoking status. The primary goal of this secondary analysis was to assess the interrelations across these 3 variables among treatment-seeking smokers. Delay discounting and depressive symptoms were assessed in 95 smokers enrolled in a clinical trial for smoking cessation at intake and 6-month follow-up. Participants with and without depressive symptoms did not differ in their discounting rates neither at intake nor at 6-month follow-up. However, delay discounting was significantly lower among abstainers at 6-month follow-up, and changes in discounting associated with smoking status were more pronounced among participants with depressive symptoms. These results clarify the relationship between delay discounting and depressive symptoms among current and former smokers and suggest that the association between smoking abstinence and lower delay discounting is significantly greater among individuals with depressive symptoms versus those who do not have depressive symptomatology.