Questionnaire Of Smoking Urges Research Articles

E-Cigarette Nicotine Delivery Among Young Adults by Nicotine Form, Concentration, and Flavor

Concerns have been raised about the abuse liability of modern e-cigarettes that use acidic additives to form nicotine salts, making the inhalation of nicotine smoother than freebase nicotine. To examine the effects of nicotine form and concentration and e-liquid flavor on subjective effects ratings, vaping behavior, and nicotine uptake among young adults who use e-cigarettes. In this single-blind, within-participant, crossover randomized clinical trial, a convenience sample of young adults aged 21 to 25 years who currently used e-cigarettes was recruited from December 2021 to August 2023, for in-person research laboratory visits in Columbus, Ohio. Participants completed up to 9 vaping sessions, starting with their usual e-cigarette brand in the first session followed by 1 of 8 laboratory-prepared e-liquids in a randomly assigned order in each subsequent session. Prepared e-liquids varied by nicotine form (salt-based vs freebase), nicotine concentration (5% vs 1% weight per weight), and flavor (menthol vs tobacco). Each session included a 5-minute, 10-puff standardized vaping period followed by 30 minutes of ad libitum vaping. At 4 time points (0, 5, 10, and 35 minutes) during each vaping session, plasma samples were collected for assessing nicotine uptake, and self-reports of urges, craving, and withdrawal were collected via questionnaires. Positive subjective effects were self-reported after 35 minutes of vaping using a visual analog scale; urges and cravings were reported using the Questionnaire of Smoking Urges (QSU). Puff topography data were collected throughout each vaping session. Seventy-two participants (mean [SD] age, 22.4 [1.4] years; 42 [58.3%] female) who sampled at least 1 laboratory-prepared e-liquid composed the analytic sample. Salt-based (vs freebase) nicotine e-liquids increased nicotine intake, with 5% salt-based e-liquids delivering the highest mean plasma levels of nicotine (11.2 ng/mL [95% CI, 9.3-13.2 ng/mL] at 5 minutes; 17.2 ng/mL [95% CI, 14.3-20.1 ng/mL] at 35 minutes) irrespective of flavors. Higher positive subjective effect ratings (eg, for liking) were received by salt-based (42.8; 95% CI, 39.4-46.1) vs freebase (32.0; 95% CI, 28.6-35.3) nicotine, 1% (43.4; 95% CI, 40.2-46.6) vs 5% (31.2; 95% CI, 27.7-34.6) nicotine, and menthol-flavored (43.2; 95% CI, 39.7-46.7) vs tobacco-flavored (31.5; 95% CI, 28.4-34.7) e-liquids. Salt-based and 1% but not menthol-flavored nicotine elicited more intense puffing (eg, 25% [95% CI, 12%-40%] more total puffs for nicotine salts vs freebase). All study e-liquids reduced urges and cravings, with 5% vs 1% nicotine being more effective (mean [SE] QSU-Desire score at 35 minutes, 15.4 [0.5] vs 16.7 [0.5]). In this crossover randomized clinical trial among young adult e-cigarette users, salt-based (vs freebase) nicotine e-liquids increased nicotine intake and yielded more positive subjective effects ratings and intense puffing behaviors, suggesting higher abuse potential. Restricting the level of acidic additives and menthol flavoring may reduce the addictiveness of e-cigarettes. ClinicalTrials.gov Identifier: NCT05458895.

Acupuncture for treatment of tobacco withdrawal syndrome: systematic review and Meta-analysis

To systematically review the efficacy of acupuncture for the treatment of tobacco withdrawal syndrome. The randomized controlled trials (RCTs) regarding acupuncture for treatment of tobacco withdrawal syndrome were searched in CNKI, Wanfang, VIP, SinoMed, PubMed, Cochrane, Medline and EMbase databases. The search period was from January 1st of 2011 to December 31st of 2021. After data extraction and bias risk assessment of the included literature, the Meta-analysis was performed using RevMan5.4.1 software. Totally 23 RCTs were included, including 2 120 patients. The Meta-analysis results showed that compared with medication, acupuncture showed no significant difference at improving Fagerström test for nicotine dependence (FTND) score (MD=0.16, 95%CI: -0.08, 0.41), heaviness of smoking index (HSI) score (MD=0.11, 95%CI: -0.13, 0.36), Minnesota nicotine withdrawal scale (MNWS) score (MD=0.12, 95%CI: -0.11, 1.35), questionnaire of smoking urges (QSU) score (MD=-0.30, 95%CI: -2.78, 2.18), Hamilton depression scale (HAMD) score (MD=0.76, 95%CI: -1.54, 3.06), abstinence rate (RR=0.95, 95% CI: 0.82, 1.10) and effective rate (RR=1.01, 95%CI: 0.95, 1.07). Acupuncture was superior to sham acupuncture in reducing MNWS score (MD=-4.88, 95%CI: -5.21, -4.55, P<0.000 01). Acupuncture was superior to cognitive behavioral therapy in reducing FTND score (MD=-1.41, 95%CI: -1.74, -1.08), MNWS score (MD=-4.28, 95%CI: -5.31, -3.25) and increasing abstinence rate (RR=2.19, 95%CI: 1.39, 3.45, P<0.000 01, P<0.001). Acupuncture could effectively improve tobacco withdrawal syndrome, increase abstinence rate and effective rate. Limited by the quantity and quality of the included studies, this conclusion needs to be verified by more studies.

Perceived Stress and Smoking Cessation: The Role of Smoking Urges.

Despite the fact that perceived stress is related to abstinence smoking outcomes, no studies have investigated the mediational effect of specific tobacco-related variables on this relationship. This study aimed to explore the indirect effect of perceived stress on abstinence at the end of treatment through smoking urges. The sample comprised 260 treatment-seeking smokers (58.5% female; Mage = 46.00; SD = 11.1) who underwent psychological smoking cessation treatment. The brief version of the Questionnaire of Smoking Urges (QSU) and the Perceived Stress Scale (PSS14) were used. Mediation analyses were conducted in which smoking urges and their dimensions were potential mediators in the relationship between perceived stress and abstinence at the end of treatment. The results showed a non-significant direct effect of perceived stress on abstinence. However, a significant indirect effect was found through smoking urges (QSU-total) and, specifically, through smoking urges associated with the expectation of negative affect relief (QSU-Factor 2). A non-significant indirect effect through smoking urges related to the expectation of tobacco use as a pleasurable experience (QSU-Factor 1) was also found. Analyzing possible mediator variables could contribute to understanding previous conflicting data. These findings point to potential interest in including treatment components targeting perceived stress and smoking urges to improve the effectiveness of smoking cessation treatments.

Pilot randomized controlled trial evaluating the effect of random nicotine delivery on cigarettes per day and smoke exposure

BackgroundMany smokers report attempting to quit each year, yet most relapse, in part due to exposure to smoking-related cues. It is hypothesized that extinction of the cue-drug association could be facilitated through random nicotine delivery (RND), thus making it easier for smokers to quit. The current study aimed to evaluate the effects of RND on smoking cessation-related outcomes including cigarettes per day (CPD) and exhaled carbon monoxide (CO). MethodsParticipants were current smokers (>9 CPD) interested in quitting. Novel trans-mucosal, orally dissolving nicotine films, developed by Bionex Pharmaceuticals, were used in the study. The pharmacokinetic profile of these films was assessed in single (Experiment 1) and multiple-dose (Experiment 2) administrations prior to the smoking cessation study (Experiment 3). In Experiment 3, participants were randomized 1:1:1 to recieve 4 nicotine films per day of either: placebo delivery (0 mg), steady-state delivery (2 mg), or random nicotine delivery (RND) (0 mg or 4 mg). After two weeks, participants were advised to quit (target quit date, TQD) and were followed up 4 weeks later to collect CPD and CO and to measure dependence (Penn State Cigarette Dependence Index; PSCDI) and craving (Questionnaire of Smoking Urges; QSU-Brief). Means and frequencies were used to describe the data and repeated measures ANOVA was used to determine differences between groups. ResultsThe pharmacokinetic studies (Experiment 1 and 2) demonstrated that the films designed for this study delivered nicotine as expected, with the 4 mg film delivering a nicotine boost of approximately 12.4 ng/mL across both the single and the multiple dose administration studies. The films reduced craving for a cigarette and were well-tolerated, overall, and caused no changes in blood pressure or heart rate. Using these films in the cessation study (Experiment 3) (n = 45), there was a significant overall reduction in cigarettes smoked per day (CPD) and in exhaled CO, with no significant differences across groups (placebo, steady-state, RND). In addition, there were no group differences in dependence or craving. Adverse events included heartburn, hiccups, nausea, and to a lesser extent, vomiting and anxiety and there were no differences across groups. ConclusionOverall, this pilot study found that RND via orally dissolving films was feasible and well tolerated by participants. However, RND participants did not experience a greater reduction in self-reported CPD and exhaled CO, compared with participants in the steady-state and placebo delivery groups. Future studies to evaluate optimal RND parameters with larger sample sizes are needed to fully understand the effect of RND on smoking cessation-related outcomes.

Clinical Observation of Auricular Acupressure Combined with Transcranial Direct Current Stimulation for Nicotine Dependence

<sec><title>Objective</title> To observe the clinical effect of auricular acupressure combined with transcranial direct current stimulation (tDCS) for nicotine dependence. </sec><sec><title>Methods</title> A total of 90 patients with nicotine dependence were divided into three groups (combination group, tDCS group and auricular acupressure group), using the method of random number table, with 30 cases in each group. In the auricular acupressure group, vaccaria segetalis were applied at the point representing the lung,stomach, shenmen, mouth, pizhixia and heart. The patients were asked to self-administrate auricular acupressure for two minutes per session, five times a day. When the desire to smoke was strong, patients were adviced to press and pinch it for 3 minutes. In addition, the auricular acupressure pads were changed every 2 days, three times per week, for four weeks. In the tDCS group, tDCS was applied at the dorsolateral prefrontal cortex, 1.4 mA in intensity, 20 min each time, three times per week, for four weeks. In the combination group, we applied the auricular acupressure combined with tDCS and the methods were the same as the tDCS group and the auricular acupressure group. Before treatment and 2, 4 weeks after treatment, the smoking frequency a day, Fagerström test of nicotine dependence (FTND) score, the questionnaire of smoking urges (QSU) score, Minnesota nicotine withdrawal scale (MNWS) score and the concentration of cotinine in urine were observed in all three groups. </sec><sec><title>Results</title> There was no significant difference in daily smoking frequency, FTND score, QSU score, MNWS score and cotinine concentration in urine before treatment (<italic>P</italic><0.05). Compared with before treatment, the daily smoking frequency of each group decreased after 4 weeks of treatment (<italic>P</italic><0.05); the daily smoking frequency of the combination group was (8.50±3.60), which was better than that of the tDCS group (11.16±4.29) and the auricular acupressure group (12.83±3.39) (<italic>P</italic><0.05); at 4 weeks of follow-up period, the daily smoking frequency in the combination group was (10.38±4.56), which was better than that in the tDCS group (13.76±5.87) and the auricular acupressure group (15.65±6.25) (<italic>P</italic><0.05). Compared with before treatment, FTND score, MNWS score and QSU score in each group decreased after 4 weeks of treatment (<italic>P</italic><0.05); the FTND score of the combination group was (1.46±1.41), which was better than that of the tDCS group (2.70±2.03) and the auricular acupressure group (2.83±1.23) (<italic>P</italic><0.05); the MNWS score of the combination group was (4.73±3.16), which was better than that of the tDCS group (6.33±3.38) and the auricular acupressure group (6.96±2.09) (<italic>P</italic><0.05); the QSU score of the combination group was (12.70±3.15), which was better than the tDCS group (15.86±5.34) and the auricular acupressure group (16.60±6.71) (<italic>P</italic><0.05). Compared with before treatment, the concentration of cotinine in urine of each group decreased after 4 weeks of treatment (<italic>P</italic><0.05); the concentration of cotinine in urine in the combination group was (11.42±6.33), which was better than that in the tDCS group (18.23±8.54) and the auricular acupressure group (20.74±9.04) (<italic>P</italic><0.05). </sec><sec><title>Conclusion</title> Auricular acupressure combined with tDCS could reduce daily smoking frequency, decrease tobacco dependence and smoking craving, and alleviate withdrawal symptoms. Its efficacy is better than auricular acupressure alone or tDCS treatment alone, and this treatment is of great value to promotion. </sec>

Sigara İçenlerde Psikolojik Bağımlılığın ve Sigara İçme İsteğinin Bırakma Başarısı Üzerine Etkisinin Değerlendirilmesi

Aim: Psychological dependence and smoking desire are as important as physical dependence on smoking. The aim of this study is to evaluate the effects of the addiction levels and smoking urge of people who want to quit smoking on their success. Patients and Methods: This study, which is a cross-sectional analytical study, was conducted people who applied to a smoking cessation clinic between 10 January 2020 - 30 April 2020. Sociodemographic information form, the Fagerstrom Nicotine Dependence Test (FNDT) and the Test for the Assessment of the Psychological Addiction of Smoking (APAS) were applied and CO levels were measured. Motivational interviews were made and treatments were arranged if necessary. The Carbon monoxide (CO) levels of the patients who were called for control one month later were measured and the Questionnaire of Smoking Urges (QSU) was applied. Those with a CO level of 5 ppm and above were considered to be unable to quit smoking. Results: The average age of 176 patients participating in the study was 37.68±11.89 years and 81.3% were male. The mean of cigarette consumption per pack was 23.42±16.06, the average FNDT was 6.13±2.39 and the CO was 13.33±6.31 ppm. APAS scale mean score was 15.19±2.63 points. According to the FNDT score, 41.5% of the patients were highly dependent, and 6.8% according to the APAS score were severely dependent. Control CO level of the patients who came for control one month later was found to be 5.03±3.03 ppm. Accordingly, 67.6% of the patients could not quit smoking, and the mean QSU score was 33.56±15.71. FNDT, APAS and QSU scale mean scores of those who quit smoking were statistically significantly lower than those who did not quit smoking (p=0.015, p<0.001 and p=0.025, respectively). Conclusion: Those who are high psychological dependence to smoking have low success to quitting smoking. Psychological addiction such as nicotine addiction of those who apply to smoking cessation clinics should be evaluated and ways of coping with smoking desire should be expl ained during motivational interviews.

Effectiveness of Non-Nicotinic E-Cigarettes to Reduce Cue- and Abstinence-Induced Cigarette Craving in Non-Treatment Seeking Daily Dependent Smokers.

Electronic cigarettes (e-cigarettes) are potential tools for smoking cessation because they deliver nicotine and simulate smoking behaviors. The contribution of sensorimotor versus pharmacological substitution is unknown. To evaluate whether non-nicotinic e-cigarettes, used alone or with nicotine lozenges, can attenuate cigarette craving following visual cue presentation or acute (3 h post ad-lib use) abstinence in dependent daily smokers. Following overnight (12 hours) abstinence, 41 daily smokers were exposed to 4 experimental conditions on separate days: (i) tobacco cigarettes (CIG); (ii) non-nicotinic e-cigarettes with placebo lozenges (EPL); (iii) non-nicotinic e-cigarettes with 4 mg nicotine lozenge (ENL); and (iv) 4 mg nicotine lozenge (NL). Cigarette craving was assessed following presentation of neutral and smoking cues at various time points using the Brief Questionnaire of Smoking Urges (QSU-B) and visual analog scales (VAS). All experimental conditions significantly reduced participants' baseline overnight abstinence cigarette craving. ENLs and NLs attenuated smoking-cue-induced cravings to a greater extent than CIGs, where cravings were significantly higher with CIGs compared to ENLs [mean difference (MD) ± standard error (SE) in QSU-B = 3.2 ± 0.84, P = 0.002; VAS = 12.7 ± 2.7, P < 0.0005] and NLs [MD ± SE in QSU-B = 2.7 ± 0.92, P = 0.031; VAS = 8.1 ± 2.3, P = 0.005]. Craving responses to cues after 3 h were higher after smoking CIGs compared to ENLs [MD ± SE in QSU-B = 3.9 ± 1.4, P = 0.047; VAS = 14.1 ± 3.6, P = 0.002] and NLs [MD ± SE in QSU-B = 3.2 ± 1.1, P = 0.046; VAS = 9.7 ± 3.1, P = 0.017]. Behavioral simulation of smoking with or without nicotine reduces nicotine craving. Compared to cigarettes, ENL with NL or NL alone attenuates cigarette craving over time. Future clinical trials should evaluate the combination of ENL and NL as a method for smoking reduction or cessation. NCT02108626.

Association of Leptin and Dried Fruit Mix and Nuts With Craving During Smoking Cessation

Objective: The objective of this study was to assess dried fruit mix and nuts and their effect on craving associated with the serum leptin of tobacco smokers. Materials and Methods: This is a clinical intervention study with a nonprobabilistic sample (n=23). The intervention group (IG) received 30 g of dried fruit and mix, and the control group (CG) received standard interventions. Test craving was analyzed using the Questionnaire of Smoking Urges (QSU-Brief). Serum leptin was assessed at the beginning and after 3 weeks. The data was tested using the SPSS program through the Shapiro-Wilk, unpaired Student t, or Mann-Whitney tests and multivariate linear regression. Results: The study showed significant difference between initial and final weights and body mass indices. The IG showed a high degree of smoking dependence. The IG showed reduced craving. In the CG, median serum leptin levels showed increased craving in the second and third weeks. Conclusions: Our results establish that craving decreased among smokers only in the IG. In the CG, above-median serum leptin levels reported a greater sense of pleasure in the second week. And in the third week, they experienced difficulties maintaining abstinence.

Association of frequency of perceived exposure to discrimination with tobacco withdrawal symptoms and smoking lapse behavior in African Americans.

Frequent experiences of discrimination could increase vulnerability to tobacco withdrawal and smoking lapse in populations subject to tobacco-related health disparities. This laboratory study (2013-17) examined whether individual differences in perceived exposure to discrimination in one's daily life predicted tobacco withdrawal symptoms and smoking lapse behavior following acute tobacco deprivation in African American smokers. Mixed design with the between-subjects continuous variable of perceived discrimination crossed with the within-subject variable of tobacco deprivation status (deprived versus non-deprived). Academic medical center in Los Angeles, CA, USA. African American non-treatment seeking daily cigarette smokers (n=607, ≥10 cig/day). At a baseline visit, self-reported frequency of perceived exposure to discrimination in one's daily life was measured [everyday discrimination scale (EDDS)]. At two subsequent counterbalanced experimental visits (16-hour tobacco deprivation versus ad-libitum smoking), self-report assessments of various tobacco withdrawal symptom domains [Brief Questionnaire of Smoking Urges), Wisconsin Smoking Withdrawal Scale (WSWS), Profile of Mood States (POMS), Snaith-Hamilton Pleasure Scale (SHAPS) and Current Impulsivity Scale (CIS)) and a behavioral smoking lapse analogue task were measured. Adjusted models demonstrated that greater frequency of perceived exposure to discrimination was associated with larger deprivation-induced increases in acute urges to smoke to alleviate negative mood, several negative mood states and subjective cognitive functioning-effect sizes were small in magnitude (βs=0.09-0.13; Ps<0.02). Data were inconclusive for associations between perceived exposure to discrimination and deprivation-induced changes in cravings, urges to smoke for pleasure, positive mood reduction, other symptoms or smoking reinstatement behavior. Frequency of perceived exposure to discrimination appears to be modestly associated with increased severity of some deprivation-induced tobacco withdrawal symptoms in African American smokers.

Eye tracking of smoking-related stimuli in tobacco use disorder: A proof-of-concept study combining attention bias modification with alpha-transcranial alternating current stimulation

BackgroundTobacco use disorder (TUD) is characterized by the presence of an attentional bias (AB) towards smoking-related stimuli. We investigated whether combining an AB modification paradigm (ABM) with transcranial alternating current stimulation (tACS) applied over the dorsolateral prefrontal cortex (DLPFC) reduces the AB towards smoking-related stimuli, as well as craving level and impulsive choices. MethodsIn a sham-controlled, crossover preliminary study, 19 subjects with TUD received two stimulation arms: 1) active tACS (10 Hz, 2 mA, 30 min) combined with ABM and 2) sham tACS combined with ABM, in a randomized order, separated by one week. AB towards smoking cues during passive observation of smoking and neutral cues was assessed with an eye-tracking device and reactions times at a visual-probe task. Craving level was measured with the Questionnaire of Smoking Urges. Impulsive choices were assessed with the delay discounting task. ResultsActive tACS combined with ABM reduced the amount of time spent looking at smoking-related pictures (p = 0.03), prevented the increase of self-reported desire to smoke (p = 0.026), and reduced the proportion of impulsive choices (p = 0.049), compared to sham tACS combined with ABM. No significant effects were reported on other craving dimensions and on AB based on reaction times. ConclusionsThese preliminary findings suggest that combining tACS with ABM may help smokers who wish to quit by reducing the desire to smoke, attention to smoking-cues, and impulsive decision-making.

Differential effects of nicotine delivery rate on subjective drug effects, urges to smoke, heart rate and blood pressure in tobacco smokers.

The nicotine delivery rate is a key feature of tobacco product design, yet there have been limited human studies examining the effects of nicotine as a function of delivery rate. We developed an intravenous nicotine infusion protocol to evaluate differential effects of nicotine delivery rate on subjective drug effects, smoking urges, abstinence symptoms, heart rate, and blood pressure. Eighteen non-treatment seeking, overnight abstinent male and female smokers (18 to 30years old), who smoked ≥ 5 cigarettes per day for the past year completed four sessions, in which they were randomly assigned to a saline infusion, or a 1mg per 70-kg body weight dose of nicotine delivered over 1, 5, or 10min at rates of 0.24, 0.048, or 0.024μg/kg/s, respectively. Smoking urges, as assessed by the Brief Questionnaire of Smoking Urges, were reduced relative to placebo for the 1- and 5-min infusion, but not the 10-min infusion. Although the 1- and 5-min infusions reduced smoking urges to a similar extent, the 1-min infusion induced a greater heart rate and blood pressure increase. Changes to subjective drug effects, heart rate, and blood pressure delineate the differential effects of nicotine delivery rate for these outcomes. We have characterized the delivery rate-response curve for a nicotine dose that is roughly the amount of nicotine (~ 1mg) delivered by smoking a standard tobacco cigarette. Our findings reinforce the importance of nicotine delivery rate when evaluating the potential effects of nicotine from tobacco products.

Measurement properties of the translations of instruments evaluating the subjective effects of tobacco- and nicotine-containing products: a systematic review of the literature

Background: Several instruments are widely used for assessing dependence, craving, withdrawal symptoms, and reinforcing effects in users of tobacco- and nicotine-containing products (TNP), including the Fagerström Test for Nicotine Dependence (FTND), Questionnaire of Smoking Urges, original (QSU) and brief (QSU-b) versions; Minnesota Nicotine Withdrawal Scale, original (MNWS) and revised (MNWS-R) versions; and Cigarette Evaluation Questionnaire, original (CEQ) and modified (mCEQ) versions. Although these instruments have been translated extensively, their translations and corresponding measurement properties have not been systematically assessed. This study aimed to (1) identify the translations of these instruments for which psychometric properties have been published, (2) describe the methods used for translation, and (3) describe the measurement properties and the context in which these translations were evaluated (e.g., target population and TNP used). Methods: Embase and MEDLINE databases were systematically searched. Results: While no information could be found for the CEQ/mCEQ, several translations were available for the remaining instruments: FTND, 25; QSU and QSU-b, 4 each; QSU (12-item version), 1; MNWS, 4; and MNWS-R, 1. Cigarette smokers represented the main target population in which the validation studies were conducted. Information about the translation process was reported for 25 translations. In most cases, the properties of the translations mirrored those of the originals. Differential item functioning was explored in only one case. Conclusions: There are few publications describing the measurement properties of the translations of the FTND, QSU/QSU-b, and MNWS/MNWS-R. None of these translations have been validated for TNPs other than cigarettes, which suggests the need for greater development and validation of instruments in this area.

Film clips smoking behavior and nicotine craving: The interrelationship between stress, smoking cues and craving.

Αn abundance of research has demonstrated that substance addicted individuals, when they are exposed to a substance related stimulus, show a positive correlation between physiological measurements, such as an increase in heart rate and sweating, and behavioral reactions, that include craving and substance use or consumption. Films depicting smoking behavior are regarded as cues to induce smoking behavior. The current study aimed to investigate the effects of smoking behavior portrayed in movies on actual craving experienced by smokers who watch on screen actors consume tobacco products. In addition, the effects of receiving orally administered nicotine (chewing gum), a regular chewing gum or no additional intervention were examined. In particular, the study aimed to investigate how these factors impact nicotine craving as well as the heart rate and sweating. The majority of the participants were University of Bedfordshire students and staff. Thirty smokers (12 males and 18 females) having received a nicotine gum, a regular chewing gum or no gum, were exposed to a digital video clip showing actors smoking. The participants chose the type of chewing gum they wanted. Heart rate (HR) and galvanic skin response (GSR) were measured during the course of the experiment. Prior to and after watching the movie clip participants completed the Brief Questionnaire of Smoking Urges (QSU-Brief) and the Perceived Stress Scale (PSS). According to the results, the craving was increased when compared to the baseline score (t=-3.76, p<0.001). Additionally, a correlation was found between the baseline level of craving and perceived stress before and after the movie (r=0.39). Nicotine chewing gum was found to have a significant impact on participants' heart rate (p<0.05) but not on GSR. A significant difference was found in participants in the normal chewing gum condition reporting higher levels of craving than the other two groups (p<0.05). Age was found to positively related to post-measures of nicotine craving which was found to be higher for young respondents (r=-0.47, p<0.01). The data further show that the depiction of smoking behavior in the media is likely to have a significant impact on smoking craving, smoking behavior and nicotine consumption. The current study confirms and replicates some of the previous findings within the field of smoking behavior and nicotine craving such as high susceptibility of younger adults to media influence.

Cue salience of the use of an electronic nicotine delivery system (ENDS) device marketed to women

IntroductionPassive exposure to the use of electronic nicotine delivery systems (ENDS or e-cigarettes) has been shown to generalize as a smoking cue. As young adult women in particular are increasingly targeted by ENDS distributors, the present study examined whether passive exposure to the use of a female-marketed ENDS product selectively enhanced smoking urge, cigarette and e-cigarette desire, and smoking behavior among women (vs men) smokers. MethodsUsing a mixed design, young adult smokers (n = 64; mean age 28.2 yrs.; ≥5 cigarettes/day) observed a study confederate drink bottled water (control cue) and then vape a female-marketed tank-based ENDS (active cue). Main measures were the Brief Questionnaire of Smoking Urges (BQSU) and visual analog scales (VAS) for cigarette and e-cigarette desire pre- and post-cue exposure, followed by a smoking latency task. ResultsCompared to the control cue, the female-marketed ENDS cue increased smoking urge and desire for cigarettes and e-cigarettes to a similar extent in women and men. It also affected subsequent smoking behavior similarly between the sexes, with 68% of men and 58% of women opting to smoke (vs. obtaining monetary reinforcers). ConclusionsBoth women and men were sensitive to the use of the female-marketed ENDS as a smoking cue. Consistent with prior work by our group, findings demonstrate the cue salience of ENDS, which may be attributable to the aspects of vaping that resemble traditional smoking (e.g. hand-to-mouth and inhalation and exhalation behaviors).

Effects of acupuncture on craving after tobacco cessation: a resting-state fMRI study based on the fractional amplitude of low-frequency fluctuation.

To explore the immediate effects and mechanism of acupuncture on craving after tobacco cessation based on the fractional amplitude of low-frequency fluctuation (fALFF). This was a functional magnetic resonance imaging (fMRI) study. Forty participants were recruited and divided into a smoking group and a non-smoking group, 20 cases in each one. The smoking participants were requested to quit smoking 24 hours before the fMRI scan. The scan process was scan - acupuncture - scan. Between the two scans, acupuncture was applied at Lieque (LU 7), Hegu (LI 4), Baihui (GV 20), Zusanli (ST 36), Sanyinjiao (SP 6) and Taichong (LR 3) in two groups. After acupuncture, self-made craving for smoking, Minnesota Nicotine Withdrawal Scale (MNWS) and Questionnaire of Smoking Urges (QSU) were all reduced (P<0.05). The fMRI results indicated the immediate effects of acupuncture on smoking craving were significant, and identified salience network (SN) consisted of anterior cingulate cortex and insula, prefrontal cortex, visual cortex and cerebellum as key brains area. Correlation analysis indicated that NWNS scores were positively correlated with the mean fALFF in the ACC (P<0.05) and negatively correlated with the mean fALFF in the insula (P<0.05) in the smoking group. This was the first study in China to explore the neural mechanisms of acupuncture for smoking craving. The results indicated that the effects of acupuncture on smoking craving were significant, and the SN played a critical role in the process.

A Pilot Study of E-Cigarette Naïve Cigarette Smokers and the Effects on Craving After Acute Exposure to E-Cigarettes in the Laboratory.

Recent surveys confirm continued increases in the use of electronic-cigarettes (e-cigarettes) in adolescents and adults. Users often state that e-cigarettes reduce tobacco craving and withdrawal symptoms in addition to their smoking. Data from laboratory studies and clinical trials have confirmed these statements, though there are inconsistencies in the outcomes. In this pilot study, we set out to evaluate the effects of e-cigarettes, as compared to the participants' own cigarettes, on baseline craving and smoking severity. Using a within-subjects, placebo-controlled study design, 15 tobacco-dependent, e-cigarette naïve participants sustained abstinence overnight. They completed distinct phases of this protocol during four separate study sessions. Participants were randomized to an e-cigarette device containing one of three doses of nicotine (0, 18, or 36 mg/ml) or their own cigarette. Each study visit was ~3 hours long and separated by at least 7 days. Visits included assessments of craving and smoking severity. The data showed that after 10 puffs in both the Own cigarette and e-cigarette conditions, breath carbon monoxide levels increased significantly in the former but not the latter. Questionnaire of Smoking Urges and Choices to Smoke scores were not statistically different across groups after two distinct bouts of 10 puffs each. Additionally, E-cigarette Perceptions Questionnaire responses were not significantly different according to dose. This experiment provides data demonstrating that e-cigarettes did not reduce craving or smoking severity in e-cigarette naïve users. However, since this was a pilot study, the conclusions that can be drawn are limited. (Am J Addict 2019;28:361-366).

Validation of a brief behavioral economic assessment of demand among cigarette smokers.

Basic and clinical addiction research use demand measures and analysis extensively to characterize drug use motivations. Hence, obtaining an accurate and brief measurement of demand that can be easily utilized in different settings is highly valued. In the current study, 2 versions of a breakpoint measure, designed to capture cigarette demand, were investigated in 119 smokers who were recruited from an online crowdsourcing platform. The first version determines the maximum price a smoker is willing to pay for one cigarette received right now when paid out of pocket, and the second determines the maximum price when paid using a hypothetical $100 gift card received for free. The breakpoint measures were administered along with the Cigarette Purchase Task (CPT), Fagerström Test for Cigarette Dependence (FTCD), and The Questionnaire of Smoking Urges (QSU-brief). Both single-item breakpoint versions were significantly correlated with CPT-derived demand measures loaded on the persistence factor (i.e., elasticity of demand, breakpoint, Pmax, and Omax), but not with those loaded on the amplitude factor (i.e., intensity of demand). In addition, both single-item measures were associated with metrics of tobacco dependence (e.g., FTCD, QSU) with effect sizes that are similar to the ones found between CPT-derived breakpoint and those same metrics. These findings suggest that the single-item breakpoint measure is a viable method for measuring demand that may provide a useful and efficient tool to capture crucial and distinct aspects of smoking. In addition, the breakpoint measures may help increase the utility of behavioral demand measures in novel research and clinical settings. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The study of nicotine addiction abstinence in patients with insular infarction

Objective To investigate the effect of insular on the addiction of nicotine after insular infarction. Methods Totally 35 patients with lesions involving insular infarction were enrolled in insular damage group. The patients matched with the demographic data of the study subjects who did not involve insular infarction were the control group(n=114). All patients were given the internationally popular questionnaire of smoking urges (QSU) and fagerstrom test for nicotine dependence(FTND)during hospitalization, and they were followed up 3 months after stroke.The QSU and the minnesota nicotine withdrawal scale(MNWS) were assessment for patients who did not smoke again and did not relapse, and the QSU and FTND scale were used for the patients who still smoke. Results After 3 months follow-up, the rate of withdrawal from insular damage was 77.14%, and that in non-insular damage was 52.63%(χ2=6.62, P=0.01), and the MNWS in two groups(insular damage patients (0.59±0.97) and non-insular damage patients(1.15±1.29)), the difference was statistically significant (t=-2.00, P=0.04). All subjects were evaluated by questionnaire of smoking urges (QSU), among which QSU score was (19.40±9.63) in insular damage group and (24.47±10.39) in non-insular group, the difference was statistically significant (t=-2.57, P=0.01) . Conclusion Patients with insular lesion are more likely to cause withdrawal of nicotine addiction, suggesting that insular may be involved in cognitive processing of addiction. Key words: Insular infarction; Nicotine; Addiction; Abstinence

Sleep quality in cigarette smokers: Associations with smoking-related outcomes and exercise

IntroductionCompared to the general population, cigarette smokers report poorer sleep quality. Poor sleep quality in cigarette smokers is associated with greater nicotine dependence. While exercise is known to improve sleep quality in the general population, less is known about how exercise effects sleep in those who smoke. The goal of this study was to explore the relationships between exercise, sleep, and smoking in cigarette smokers. MethodsData on sleep quality (Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI)), smoking-related outcomes (e.g., cigarettes/day, Fagerstrom Test for Nicotine Dependence, Minnesota Nicotine and Withdrawal Scale, and Questionnaire of Smoking Urges) and exercise (Fitbit activity measures) were collected for 32 participants (63% female, mean age 30.3 ± 1.0 years) participating in a 12-week clinical research study. Analyses included simple linear regression models. ResultsOverall, participants reported poor sleep quality at baseline (PSQI > 5). Poorer sleep quality at baseline was associated with increased withdrawal (β = 1.63 ± 0.53, p = 0.0043), craving (β = 0.51 ± 0.43, p = 0.2471), and total smoking urges (β = 1.10 ± 0.41, p = 0.0118). During follow-up (i.e., from baseline to week 12), a daily increase in exercise was associated with improved sleep quality over the same time period (PSQI: β = −0.82 ± 0.35, p = 0.0379). ConclusionOur data suggest that better sleep quality may be associated with lower levels of withdrawal, craving, and smoking urges. Further, exercise may be associated with better sleep quality in cigarette smokers. Future work should explore how increasing exercise and improving sleep quality could inform future smoking cessation interventions.

Effects of nicotine versus placebo e-cigarette use on symptom relief during initial tobacco abstinence.

Because electronic cigarettes (e-cigs) containing nicotine may relieve smoking abstinence symptoms similar to nicotine replacement therapy medication, we used within-subjects designs to test these effects with a first-generation e-cig in nonquitting and quitting smokers. In Study 1, 28 nontreatment-seeking smokers abstained overnight prior to each of 3 sessions. Minnesota Nicotine Withdrawal Scale (MNWS) withdrawal (and craving item) relief was assessed following 4 exposures (each 10 puffs) over 2 hr to e-cigs that either did (36 mg/ml) or did not (i.e., placebo, 0 mg/ml) contain nicotine or after no e-cig. Relief was greater after nicotine versus placebo e-cig (p < .05) but not after placebo versus no e-cig, showing relief was due to nicotine per se and not simple e-cig use behavior. Using a crossover design in Study 2, smokers preparing to quit soon engaged in 2 experimental 4-day quit periods on separate weeks. In weeks 1 and 3, all received a nicotine or placebo e-cig on Monday to use ad libitum while trying to abstain from smoking on Tuesday through Friday. (Week 2 involved resumption of ad libitum smoking.) MNWS and Questionnaire of Smoking Urges (QSU) craving were assessed at daily visits following 24-hr abstinence. Of 17 enrolled, 12 quit for ≥24 hr at least once, allowing test of relief because of e-cig use on quit days. Withdrawal and craving were reduced because of nicotine versus placebo e-cig use (both p < .05). In sum, compared with placebo e-cigs, nicotine e-cigs can relieve smoking abstinence symptoms, perhaps in a manner similar to Food and Drug Administration-approved nicotine replacement therapy products, although much more research with larger samples is needed. (PsycINFO Database Record