To examine cognitive and affective mechanisms underlying mindfulness-based addiction treatment (MBAT) versus cognitive-behavioral therapy (CBT) and usual care (UC) for smoking cessation. Participants in the parent study from which data were drawn (N = 412; 54.9% female; 48.2% African American, 41.5% non-Latino White, 5.4% Latino, 4.9% other; 57.6% annual income <$30,000) were randomized to MBAT (n = 154), CBT (n = 155), or UC (n = 103). From quit date through 26 weeks postquit, participants completed measures of emotions, craving, dependence, withdrawal, self-efficacy, and attentional bias. Biochemically confirmed 7-day smoking abstinence was assessed at 4 and 26 weeks postquit. Although the parent study did not find a significant treatment effect on abstinence, mixed-effects regression models were conducted to examine treatment effects on hypothesized mechanisms, and indirect effects of treatments on abstinence were tested. Participants receiving MBAT perceived greater volitional control over smoking and evidenced lower volatility of anger than participants in both other treatments. However, there were no other significant differences between MBAT and CBT. Compared with those receiving UC, MBAT participants reported lower anxiety, concentration difficulties, craving, and dependence, as well as higher self-efficacy for managing negative affect without smoking. Indirect effects of MBAT versus UC on abstinence occurred through each of these mechanisms. Whereas several differences emerged between MBAT and UC, MBAT and CBT had similar effects on several of the psychosocial mechanisms implicated in tobacco dependence. Results help to shed light on similarities and differences between mindfulness-based and other active smoking cessation treatments. (PsycINFO Database Record
Adults with mental health conditions (MHC) are especially likely to smoke and experience tobacco-related health disparities. Individuals with MHC may also use electronic nicotine delivery devices (ENDS) at disproportionately high rates. However, there is a relative dearth of knowledge regarding ENDS use among individuals with MHC. In a large representative sample of U.S. adults (n = 6051), associations between self-reported MHC diagnoses and ENDS use and susceptibility were examined, stratified by smoking status. Participants with MHC were approximately 1.5 times more likely to have used ENDS in their lifetime and almost twice as likely to currently use ENDS as those without MHC. MHC status was most strongly linked to higher ENDS use among former smokers, and former smokers with MHC were more likely to report using ENDS during past smoking quit attempts than those without MHC. Among participants who had not tried ENDS, former smokers with MHC were especially susceptible to future ENDS use. The potential advantage of ENDS for cessation purposes should be balanced with the risk of attracting former smokers with MHC to ENDS.
Following the Food and Drug Administration’s (FDA) April 2019 authorisation on their premarket tobacco product application,1 Philip Morris (PM) has officially launched its heated tobacco product, IQOS, in the USA in October 2019 in Atlanta, Georgia. IQOS consists of a charger and a holder, into which tobacco sticks, called ‘HeatSticks’ in the USA, are inserted (figure 1). The blade in the holder heats tobacco in a HeatStick, producing an aerosol. Prior to the US launch, IQOS was available in 43 countries. PM has also submitted to the FDA a modified risk tobacco product application for IQOS (decision pending).
1 September 2019 in American Journal of Public Health
Objectives. To investigate use of electronic nicotine delivery systems (ENDS) among priority populations. Methods. Using 2016 through 2017 US nationally representative surveys (n = 11 688), we examined ENDS use by sociodemographic variables (age, education, poverty status, insurance, employment, race/ethnicity, sexual orientation) and combustible tobacco use. Results. Among individuals who currently use noncigarette combustible tobacco, those from certain backgrounds (young adults, those living below the poverty level, those less educated, sexual minorities, Blacks, Hispanics, and those without health insurance) were more likely to use ENDS. Among current cigarette smokers, those who were younger, living at or above poverty (ever use), with higher education (current use), sexual minority, and non-Black were more likely to use ENDS. Conclusions. Associations between sociodemographic variables and ENDS use varied depending on combustible tobacco use status, highlighting the need to consider multiple types of tobacco products to understand ENDS use among priority populations. The impact on tobacco disparities will ultimately depend on whether ENDS are used to transition completely away from combustible tobacco products and how this may differ across priority populations who use diverse tobacco products.