Tobacco Craving Research Articles

Tobacco Craving Questionnaire Short Version: Translation and Validation in Urdu

Tobacco Craving Questionnaire is a very important measure and is widely used in many countries to measure tobacco craving among cigarette smokers. But unfortunately, most of the cigarette smokers in Pakistan do not know about English language and therefore it was a need to translate the Tobacco Craving Questionnaire into the Urdu language. Cross-Sectional survey design has been used. Forward and backward translation was conducted on a sample of 40 cigarette smokers. Both SPSS (Version-26) and AMOS (Version-10) have been used for data analysis. Descriptive statistics and alpha reliability analysis were conducted on the scale. To verify the validity of the scale, 500 smokers were included in a sample and subjected to Confirmatory Factor Analysis (CFA). The scale's Cronbach alpha reliability was 0.73 which indicated satisfactory reliability. 11 items from the translated Urdu version of the Tobacco Craving Questionnaire were validated by Confirmatory Factor Analysis. In CFA item number 9 was excluded from the model because it explained zero regression weight. Reliability and validity were confirmed in the findings of the study of the translated Urdu version of the questionnaire. Tobacco Craving Questionnaire Short Version (TCQ-SF) among Pakistani habitual smokers has been verified by translation and cross-lingual validation of the Pakistani version of the scale and confirmed its cross-cultural use. The findings have significant implications for Pakistan's indigenous population.

Approach Bias and Tobacco Craving as Mechanisms of the Effect of Approach Bias Retraining on Smoking Cessation.

Approach bias, the automatic tendency to advance toward, rather than move away from appetitive cues, has been associated with greater tobacco cravings, dependence, and likelihood of smoking relapse. Approach bias retraining (ABR) has emerged as one way to reduce approach bias and promote avoidance toward smoking cues. Yet, additional research is needed to identify the mechanisms that may help explain the effect of ABR on smoking cessation. The current study uses data collected as part of a randomized controlled trial to test two unique mechanisms of action ([1] approach bias and [2] tobacco craving) for the efficacy of standard smoking cessation treatment (ST) augmented by ABR on smoking abstinence. Participants were 96 adult daily smokers (Mage=43.1, SD=10.7) motivated to quit smoking. Results showed that lower approach bias and lower cravings at a treatment session were significantly related to next session smoking abstinence (p's<.018). Further, deviations in approach bias partially mediated the effect of ABR on smoking abstinence (ab=-12.17, 95%CI: [-29.67, -0.53]). However, deviations in tobacco craving did not mediate this relation (ab=.40, 95%CI: [-.27, 1.34]). The current findings add to extant literature by identifying approach bias as a mechanism of action of the effect of ABR on smoking abstinence during smoking cessation treatment. The current study adds to our knowledge on the effectiveness of approach bias retraining (ABR) as a part of smoking cessation treatment. Results indicate that reductions in approach bias partially mediate the effect of ABR on smoking abstinence. These findings are consistent with previous research on alcohol-dependent adults and underline the potential of ABR to reduce approach bias and promote smoking cessation among smokers. Such findings could inform the development of future research exploring more targeted and effective smoking cessation interventions, ultimately improving outcomes for individuals attempting to quit smoking.

A randomized controlled experiment testing the use of virtual reality to trigger cigarette craving in people who smoke

Automated delivery of therapy in virtual reality (VR) has the potential to be used for smoking cessation. Most obviously, it could be used to practise and establish alternative reactions to smoking cues. The first step in treatment development is to show that VR environments can trigger sufficient cravings in smokers. We evaluated a new VR public house outdoor scenario with 100 individuals who smoked daily. Participants were randomly assigned to the VR scenario with smoking cues or a neutral experience in VR. The VR experiences were presented in a standalone VR headset. Before and after VR, we collected self-reported craving scores for cigarettes and alcohol using the Tobacco Craving Questionnaire (TCQ) and visual analogue scales (VAS). Physiological data were also collected. Compared to the neutral condition, exposure to the smoking cues led to a large increase in craving for a cigarette (TCQ β = 11.44, p < 0.0001, Cohen’s d = 1.10) and also a moderate increase in craving for alcohol (β=0.7,p=0.017,d=0.50)\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$(\\upbeta =0.7,\ ext{ p}=0.017,\ ext{ d}=0.50)$$\\end{document}. There were no significant physiological differences between the two conditions. These results provide good evidence that VR experiences can elicit strong craving for cigarettes. The programming can be part of developing a new VR cognitive therapy to help people reduce smoking.

Attentional Bias, Pupillometry, and Spontaneous Blink Rate: Eye Characteristic Assessment Within a Translatable Nicotine Cue Virtual Reality Paradigm.

Incentive salience processes are important for the development and maintenance of addiction. Eye characteristics such as gaze fixation time, pupil diameter, and spontaneous eyeblink rate (EBR) are theorized to reflect incentive salience and may serve as useful biomarkers. However, conventional cue exposure paradigms have limitations that may impede accurate assessment of these markers. This study sought to evaluate the validity of these eye-tracking metrics as indicators of incentive salience within a virtual reality (VR) environment replicating real-world situations of nicotine and tobacco product (NTP) use. NTP users from the community were recruited and grouped by NTP use patterns: nondaily (n=33) and daily (n=75) use. Participants underwent the NTP cue VR paradigm and completed measures of nicotine craving, NTP use history, and VR-related assessments. Eye-gaze fixation time (attentional bias) and pupillometry in response to NTP versus control cues and EBR during the active and neutral VR scenes were recorded and analyzed using ANOVA and analysis of covariance models. Greater subjective craving, as measured by the Tobacco Craving Questionnaire-Short Form, following active versus neutral scenes was observed (F1,106=47.95; P<.001). Greater mean eye-gaze fixation time (F1,106=48.34; P<.001) and pupil diameter (F1,102=5.99; P=.02) in response to NTP versus control cues were also detected. Evidence of NTP use group effects was observed in fixation time and pupillometry analyses, as well as correlations between these metrics, NTP use history, and nicotine craving. No significant associations were observed with EBR. This study provides additional evidence for attentional bias, as measured via eye-gaze fixation time, and pupillometry as useful biomarkers of incentive salience, and partially supports theories suggesting that incentive salience diminishes as nicotine dependence severity increases.

Tobacco Images Choice and Its Association with Craving and Dependence in People who Smoke Cigarettes.

Increased salience of drug-related cues over non-drug reinforcers can drive drug use and contribute to tobacco use disorder (TUD). An important scientific and clinical goal is to effectively measure this elevated drug-seeking behavior in TUD. However, most TUD assessments rely on self-reported cravings and cigarette consumption, not providing an objective measure of the impact of drug-cues on biasing behavior towards drugs. The probabilistic image choice (PIC) task investigates the choice of viewing drug-related pictures as compared to other salient pictures (e.g., pleasant and unpleasant). This study aimed to develop and validate the PIC task for TUD and evaluate the associations between behavioral choice and tobacco craving, daily cigarette consumption, quit attempts and motivation to quit, and nicotine dependence (the Fagerström score). We recruited 468 smokers and 121 nonsmokers using the Prolific online platform. Participants performed the PIC task twice (at a one-month interval) and completed other measures relevant to TUD. compared to nonsmokers, tobacco smokers selected to view significantly more tobacco images and less pleasant (non-drug reinforcer) images, a profile that remained stable at retest. Individual differences in choice of tobacco as compared to pleasant images on the PIC task were associated with craving but not with the other tobacco dependence measures, suggesting that the task may serve as a behavioral proxy measure of drug "wanting" rather than of cumulative nicotine exposure or physical dependence. these results suggest that the PIC task can be a valuable tool for objectively assessing craving-associated tobacco seeking in TUD. which should provide a brief description about what the study addsMost of the current measures of tobacco use disorder (TUD) rely on self-reports of consumption, dependence and craving and do not take into consideration the role of drug-related cues in driving tobacco seeking. This study shows that the probabilistic image choice (PIC) task provides an objective, reliable proxy measure of tobacco image seeking behavior in people who smoke cigarettes that is linked to craving (desire) for smoking but not to other measures of TUD. Therefore, the PIC task may be a useful complementary tool for the classification, diagnosis, and prognosis of TUD.

Efficacy of simple and very brief handgrip and isometric exercises for reducing withdrawal symptoms in cigarette smokers: A pilot randomized controlled trial.

Withdrawal symptoms lead to smoking relapse and reduce the intention to quit. The present pilot RCT examined the effect of simple and very brief handgrip and isometric exercises on reducing withdrawal symptoms, measured by the strength of tobacco craving, Questionnaire of Smoking Urges-Brief (QSU-B), Mood and Physical Symptoms Scale (MPSS), and Positive and Negative Affect Schedule (PANAS). In this 2-arm, open-labeled pilot RCT, 30 current smokers who had abstained from tobacco for at least 9 hours were randomly assigned (allocation ratio 1:1) to either the intervention group that watched a 5-minute video and did 5-minute handgrip and isometric exercises (pulling and pushing) or control group that watched 10-minute healthy-diet videos. Measurements were taken before, immediately after, and 10 minutes post-intervention. Outcomes were self-reported strength of tobacco craving, QSU-B, MPSS, and PANAS scores. The effect size for group-by-time interaction was assessed using Cohen's f2 (small=0.02, medium=0.15, large=0.35). Group-by-time interactions showed that the intervention group showed larger reductions than the control group in the strength of tobacco craving (Cohen's f2=0.54, 95% CI: 0.52-0.57), QSU-B (Cohen's f2=0.77; 95% CI: 0.74-0.80), and MPSS (Cohen's f2=0.51; 95% CI: 0.46-0.56) over the three measurement points. This RCT showed that simple and brief handgrip and isometric exercises could immediately reduce withdrawal symptoms and up to 10 minutes. in https://clinicaltrials.gov/. NCT04059497.

Isradipine augmentation of virtual reality cue exposure therapy for tobacco craving: a triple-blind randomized controlled trial.

Preclinical research with rodents suggests that the L-type calcium channel blocker isradipine can enhance long-term extinction of conditioned place preference for addictive substances when it is administered in conjunction with extinction training. Although isradipine alone, which is FDA-approved for hypertension, has not shown a direct effect on craving in human drug users, its potential to augment behavioral treatments designed to reduce craving remains unknown. We conducted a triple-blind, randomized placebo-controlled pilot clinical trial of isradipine combined with a novel virtual reality cue exposure therapy (VR-CET) approach with multimodal cues that targeted craving. After 24 hours of abstinence, 78 adults with an ongoing history of daily cigarette use received isradipine (n = 40) or placebo (n = 38) and reported craving levels after each of 10 trials of VR-CET. Consistent with pre-registered hypotheses, the isradipine group had significantly lower mean craving across cue exposure trials at the medication-free 24-hour follow-up (d = -0.42, p = 0.046). There were no serious adverse events; however, side effects such as headache and dizziness occurred more frequently in the isradipine group. The findings of the current study support follow-up clinical trials that specifically test the efficacy of isradipine-augmented VR-CET for reducing smoking relapse rates after an initial quit attempt. clinicaltrials.gov: NCT03083353.

The Effects of Alpha Linolenic Acid (Omega-3 Fatty Acid) on Tobacco Craving Intensity, Withdrawal Symptoms and Biochemical Markers in Tobacco Users

The Effects of Alpha Linolenic Acid (Omega-3 Fatty Acid) on Tobacco Craving Intensity, Withdrawal Symptoms and Biochemical Markers in Tobacco Users

Impact of Flaxseed Oil Supplementation on Tobacco Dependence, Craving, and Haematological Parameters in Tobacco-Dependent Subjects.

Background Tobacco is prevalently used in smoking or smokeless forms and remains a major public health concern worldwide, with its adverse effects on overall health. Omega-3 fatty acid (FA) has shown its promising effects in various health conditions. Objective The purpose of this study was to evaluate the effect of flaxseed oil (omega-3 supplementation) on tobacco dependence, craving, withdrawal symptoms, and haematological parameters in tobacco users. Methods In this randomised, single-blind, placebo-controlled study, 104 tobacco users (54 in the omega-3 group and 50 in the placebo group) were supplemented with 10 ml of food-grade flaxseed oil and 10 ml of placebo for six months, respectively. Their demographics, frequency of daily tobacco use, tobacco dependence, tobacco craving, tobacco withdrawal symptoms, and complete blood count (CBC) were assessed at baseline (before intervention) and after a six-month intervention. Results The demographic characteristics of the two groups were similar except for gender at baseline. There were 50 males and four females in the omega-3 group, while there were 42 males and eight females in the placebo group. After a six-month flaxseed oil intervention, BMI values showed a significant reduction (p = 0.0081) in the omega-3 group when compared to baseline; however, CBC parameters did not show any significant changes when comparing baseline to follow-up values. On the contrary, haemoglobin and red blood cells (RBCs) showed significant changes when comparing the follow-ups of the omega-3 group with the placebo group, indicating p = 0.0016 and p = 0.0163, respectively. Also, omega-3 effectively decreased daily tobacco use frequency (p<0.0001), tobacco dependence (p<0.0001), and craving (p<0.0001). Conclusion Supplementation of 10 ml of flaxseed oil per day (omega-3 FA) for six months significantly reduced tobacco dependence and cravings. Additionally, the flaxseed oil supplementation effectively reduced the frequency of daily tobacco intake and modulated tobacco withdrawal symptoms. Thus, our results suggest that flaxseed oil supplementation is a useful adjunct for tobacco users who intend to quit tobacco use.

Moroccan version of the short Tobacco Craving Questionnaire (MTCQ-12)

IntroductionCraving is a key clinical dimension in the assessment and management of substance use disorders. It is also a recognized predictor of relapse in addictology. To date, no scale for measuring tobacco craving is available to Moroccan clinicians. This work proposes a cross-cultural validation of the Tobacco Craving Questionnaire (TCQ) in its short version. MethodsThis work consists of the creation of a translated version according to a rigorous methodology and the evaluation of its psychometric properties in a statistical study. ResultsThe validation study was done on a sample of 130 smokers with a majority of men (95%). It showed a high acceptability and homogeneity with a Cronbach's alpha coefficient of 0.82. The four scale factors showed a high discriminant validity. Finally, the scale showed high reproducibility with an inter-observer stability of 0.95 and 0.94 between tests and retests. ConclusionThe Moroccan version of the TCQ-12 scale shows good validity indices for measuring craving in Moroccan smokers and also shows that it measures independently the four clinical dimensions of the scale.

N-acetylcysteine for smoking cessation among dual users of tobacco and cannabis: Protocol and rationale for a randomized controlled trial

BackgroundTobacco and cannabis co-use is a growing public health problem. The synergistic effects of cannabis and nicotine on neurobiological systems that mediate reward and shared environmental cues reinforcing use may make tobacco smoking cessation more difficult. N-acetylcysteine (NAC), an FDA-approved medication and over-the-counter supplement, has shown promise in animal studies and randomized controlled trials (RCTs) in reducing tobacco and cannabis craving and use. NAC's potential efficacy in treating addiction may be attributable to its central nervous system effects in reducing excessive glutamatergic activity, oxidative stress, and inflammation. To date, no RCT has examined NAC for smoking cessation among dual users of tobacco and cannabis. MethodIn a double-blind, placebo-controlled RCT, we will examine NAC for smoking cessation among dual users of tobacco and cannabis. Sixty adult cigarette-cannabis co-users are randomized to receive NAC 3600 mg per day or placebo over 8 weeks. Participants in both groups receive 8 weekly cognitive behavioral therapy sessions addressing smoking cessation and cannabis reduction. Outcomes are assessed at Weeks 0, 4, 8, and 12. Primary aims are to determine NAC's efficacy in decreasing cigarette craving, nicotine dependence, and use; and cannabis craving and use. Exploratory aims include examination of changes in neurocognition with NAC and their potential mediational effects on cigarette and cannabis use outcomes. ConclusionResults will inform smoking cessation treatment among dual users of tobacco and cannabis.ClinicalTrials.gov Identifier: NCT04627922.

The role of sex hormones in targeting stress-induced tobacco craving, stress-reactivity, and smoking with guanfacine among women who smoke

Women who smoke are particularly vulnerable to tobacco craving, smoking behaviors, and relapse in the context of stress when compared to men who smoke. One factor in this sex difference may be sex hormones, including estradiol and progesterone; however, smoking cessation medication trials often do not explore the impact of sex hormones on drug effects. This secondary analysis of a double-blind, placebo-controlled study explored the impact of levels of actual estradiol and progesterone on guanfacine, a noradrenergic α2a agonist, which attenuates stress-induced smoking behaviors in women. Women who smoke (n = 43) completed a stress induction laboratory paradigm followed by an ad-libitum smoking period. Assessment of tobacco craving, and stress-reactivity (via cortisol response) occurred pre- and post-stress induction. Results indicated that guanfacine attenuated stress-induced tobacco craving (F = 10.94, p = 0.02) and cortisol response (F = 14.23, p < 0.001); however, high levels of estradiol overrode guanfacine's effect on craving (F = 4.00, p = 0.05), cortisol response (F = 14.23, p < 0.001), and smoking during the ad-libitum period (F = 12.23, p = 0.001). Additionally, progesterone proved to be protective against tobacco craving and enhanced guanfacine's medication effect on craving (F = 5.57, p = 0.02). The present study found that sex hormones had a significant impact on medication effects in a smoking cessation trial and thus underscore the importance of examining the role of sex hormones in future medication trials.

Effectiveness of personalized tobacco cessation intervention package among patients with schizophrenia and related psychotic disorders - A two-group experimental study.

Persons with schizophrenia and related psychotic disorders (PwS) smoke more, and have twice the rate of mortality, with 10-25 years lower life expectancy than the general population. Evidence-based tobacco cessation interventions would help in quitting. To evaluate the effectiveness of a personalized tobacco cessation intervention package for patients attending the outpatient psychiatry department. The study adopted a two-group experimental design in PwS, using a simple randomization method. Eligible participants were randomly allocated to either the intervention group (n=85) receiving the intervention package or the control group (n=85) receiving brief advice to stop tobacco. The study outcomes were measured at baseline, 1, 3, and 6 months. SPSS 23 was used for data analysis. Intention-to-treat analysis was used to manage missing data. The p-value of <0.05 is considered statistically significant. At 6 months, there was a significant difference (p<0.001) in 7 days point-prevalence abstinence (28 % vs 10.8 %), reduction of tobacco by at least 50 % (62.4 % vs 40.9 %) with an attrition rate of 15.3 % vs 30.5 % in intervention and control group respectively. Reduction in nicotine dependence and tobacco craving, an increase in motivation level, quit attempts and clinical improvement favored the intervention group. 16.5 % of participants expressed interest in pharmacotherapy for tobacco cessation, 3.5 % were referred to a specialized tobacco cessation center, two control group participants were hospitalized for drug default, and withdrawal symptoms reported were mild. Implementing a tobacco cessation intervention based on the stage of motivation aids in abstinence and reduction of tobacco use in PwS.

Effects of an Interactive Smoking Cessation Coaching Program on Smoking in Female College Students

Purpose: This study aimed to examine the effects of an interactive smoking cessation coaching program on smoking cessation motivation, smoking knowledge, smoking shame, urine cotinine levels, tobacco craving and smoking abstinence self-efficacy. The conceptual framework of the study applied Cox’s interaction model of client health behavior for female college students who smoked.Methods: This was a before-and-after experimental design study with a non-equivalent control group. The participants were smoking female college students, who were assigned either to an experimental group (n=22) or a control group (n=24). The interaction model of client health behavior was the theoretical basis. The core tactic of smart management and strategy for health was applied as a coaching technique. The experimental group attended 11 sessions of an interactive smoking cessation coaching program, (60 to 120 minutes per session) for 6 weeks, and the control group received education regarding smoking cessation after the program finished. The data collection period was from January 23, 2019 to March 7, 2019.Results: This study showed differences in smoking cessation motivation (F=71.09, &lt;i&gt;p&lt;/i&gt;&lt;.001), smoking knowledge (F=20.77, &lt;i&gt;p&lt;/i&gt;&lt;.001), smoking shame (t=5.11, &lt;i&gt;p&lt;/i&gt;&lt;.001), urine cotinine levels (t=-9.58, &lt;i&gt;p&lt;/i&gt;&lt;.001) and smoking abstinence self-efficacy (t=11.68, &lt;i&gt;p&lt;/i&gt;&lt;.001). However, no difference in tobacco cravings (t=-1.57, &lt;i&gt;p&lt;/i&gt;=.127) was found.Conclusion: As a result of the interactive smoking cessation coaching program, statistically significant differences were found in smoking cessation motivation, smoking knowledge, smoking shame, urine cotinine levels and smoking abstinence self-efficacy. However, further research is needed because there was no statistically significant difference in tobacco cravings.

Accelerated intermittent theta burst stimulation in smoking cessation: No differences between active and placebo stimulation when using advanced placebo coil technology. A double-blind follow-up study

ObjectiveThis study aims to investigate the longer-term effects of accelerated intermittent theta burst stimulation (aiTBS) in smoking cessation and to examine whether there is a difference in outcome between active and placebo stimulation. The present study constitutes an ancillary study from a main Randomized Controlled Trial (RCT) evaluating the acute effects of aiTBS in smoking reduction. MethodA double-blind randomized control trial was conducted where 89 participants were randomly allocated to three groups (transcranial magnetic stimulation (TMS)&N group: active aiTBS stimulation combined with neutral videos; TMS&S group: active aiTBS stimulation combined with smoking-related videos; Placebo group: placebo stimulation combined with smoking-related videos). Nicotine dependence, tobacco craving, perceived stress and motivation to quit smoking were measured after completion of 20 aiTBS sessions and during various follow ups (post one week, post one month and post six months). ResultsOur results show that the positive effect on nicotine dependence and tobacco craving that occurred at the end of treatment lasts at least one month post treatment. This effect seems to dissipate six months post treatment. No significant differences were found between the three groups. ConclusionBoth active and placebo stimulation were equally effective in reducing nicotine dependence and tobacco craving up to one month after the end of treatment.

Association between successful smoking cessation and preferred smoking time.

We examined the relationship between preferred daily smoking times and typical situations in which smoking occurs and aimed to determine the association between successful smoking cessation and preferred smoking time. We conducted an internet survey and categorized participants based on their selected smoking status: 'successful smoking cessation', 'failed smoking cessation', or 'currently smoking'. Ultimately, 3637 people (1854 men, 1789 women) aged 30-59 years were included in the study. Participants also described the time points at which smoking seemed to be the most appealing and those at which smoking seemed the most difficult to resist. Regarding times of tobacco cravings, the number of non-smokers for more than 1 year who chose 'after dinner' was significantly higher than the number who chose 'after breakfast' or 'after waking up'. Regarding the time when smoking was the most difficult to resist, the proportion of people who chose 'after dinner' that had quit smoking for less than 3 months was significantly low. Those who prefer smoking 'after dinner' are less likely to start smoking cessation, but when they do, the rate of continuation for more than 1 year is high. We suggest that smoking cessation support based on preferred smoking times may lead to a decrease in the smoking rate.

Attribution of Use Characteristics to Electronic Cigarette Brands in the National Youth Tobacco Survey

_Background _This manuscript responds to a study published in the journal Drug and Alcohol Dependence (DAD). This re-analysis was submitted to DAD and received peer-review comments that were critical because the paper referred to the original authors by name and reviewers were concerned about conflict due to the sponsorship by JUUL Labs; no fundamental concerns were raised about the paper’s methods or findings. Following an appeal letter to DAD (see Supplemental Materials), which did not reverse the refusal to publish, the manuscript was transferred to the companion journal DAD Reports, where it was rejected, again without methodological concerns being raised. _Introduction_ A previous publication, using NYTS data, reported higher electronic nicotine delivery system (ENDS) use frequency and tobacco cravings among adolescents using JUUL-brand ENDS vs other ENDS brands. Re-analysis explores the effect of methodological decisions the original study employed that confound brand attributions: (1) imputing non-JUUL use to those reporting they “don’t know” what brand they used (“DKs”); and (2) counting as JUUL users those with _any_ JUUL use, even if they _usually_ used another ENDS brand. _Methods_ Analyses of the same data examined the effects of assigning DKs to the ‘other brands’ group vs. coding DKs as missing, and re-examined the effects reported for JUUL when brand assignment was based on _usual_ and _exclusive_ brand use, respectively. _Results_ DKs used ENDS significantly less frequently and were significantly less likely to report craving than other ENDS users; assigning DKs to the “other-brand” group, as in the original analysis, resulted in every ENDS brand, when considered in turn, appearing to be used more frequently and eliciting greater craving, than all comparison brands. When DKs were coded as missing, there was no association between JUUL use and these outcomes. When assignment was based on _usual_ or _exclusive_ use, JUUL users were significantly _less_ likely to be frequent users, compared to non-JUUL users (Usual: Relative Risk Ratio (RRR): 0.45 (0.28–0.75); Exclusive: RRR: 0.31 (0.18–0.55)), and non-significantly less likely to report cravings. _Conclusions_ Previous findings are attributable to methodological confounds in brand usage definitions. Re-analysis illustrates the impact of such methodological decisions.

P28. Effects of Varenicline on Tobacco Craving and Withdrawal in Smokers With and Without Schizophrenia

People with schizophrenia (SCZ) have significantly higher tobacco smoking rates and lower quit rates than the general population. Varenicline, a partial agonist at α4β2 nicotinic acetylcholine receptors (nAChRs) is an effective pharmacotherapy for non-psychiatric smokers, however, investigation into its effects in SCZ are less well-studied and mechanisms may differ from non-psychiatric controls due to dysregulation in nAChR neurotransmission associated with SCZ. Here, we investigate whether varenicline attenuates acute abstinence-induced increases in craving and withdrawal in patients with SCZ versus controls.

Dose-dependent effects of Varenicline on tobacco craving and withdrawal in tobacco smokers with and without schizophrenia

BackgroundPeople with schizophrenia (SCZ) have significantly higher tobacco smoking rates and lower quit rates than the general population. Varenicline, a partial agonist at α4β2 nicotinic acetylcholine receptors (nAChRs) is an effective smoking cessation pharmacotherapy, however, investigation into its effects in SCZ are less well-studied and mechanisms may differ from non-psychiatric controls due to dysregulation in nAChR neurotransmission associated with SCZ. Here, we investigate whether Varenicline attenuates acute abstinence-induced increases in craving and withdrawal in participants with and without SCZ. MethodsFollowing biochemically-verified overnight abstinence and subsequent smoking reinstatement, individuals with nicotine-dependence (n = 13 SCZ or schizoaffective; n = 12 controls) were assessed on the Minnesota Nicotine Withdrawal Scale (MNWS) and Tiffany Questionnaire for Smoking Urges (TQSU). Participants were pretreated in a double-blind, counterbalanced manner with Varenicline (0, 1 or 2 mg/day x 3 days) over three separate weeks. Data were analyzed using linear mixed-effects modelling and estimated marginal means. ResultsRobust effects of smoking abstinence were observed on TQSU and MNWS scores in SCZ and control participants. Relative to 1 mg, 2 mg/day of Varenicline attenuated abstinence-induced increases in craving (TQSU Factor 1 d=−0.47, p = .006; TQSU Factor 2 d=−0.42, p = .008) and withdrawal (MNWS d=−0.35, p = .03) in both groups. ConclusionOur preliminary findings suggest that subacute Varenicline treatment reduces abstinence-induced craving and withdrawal in participants with and without SCZ. The efficacy of Varenicline on tobacco withdrawal and craving requires further study.

Comparison of withdrawal symptom intensity between hypnosis and nicotine-replacement-therapies: A pilot study

ABSTRACT Smoking cessation is a global public health issue. Nicotine dependence is a dynamic process that is not limited to physical dependence. Hypnosis can be helpful in the global management of smoking cessation. We explored this effect by comparing the effects of hypnosis and nicotine-replacement therapies (NRT) on tobacco withdrawal. Thirty participants were included in this comparative-randomized pilot study in parallel controlled groups after ethical validation. Participants were recruited by a general practitioner and had standardized consultations with addiction and hypnosis specialists and adapted treatment. The evolution of withdrawal symptoms was compared using the Cigarette Withdrawal Scale-21 for one month after smoking cessation in an adult tobacco-addict population wishing to stop smoking and receiving either NRT or hypnosis, both supported by motivational interviews. Craving intensity (French version of the Tobacco Craving Questionnaire), nicotine dependence (Fagerström), tobacco consumption, anxiety (Hamilton scale), and depression (Montgomery-Asberg scale) were also evaluated. Hypnosis appeared to have an influence on reducing the number of smoked cigarettes, whereas NRT appeared to influence markers of both physical and psychic dependence. A complementarity of hypnosis and NRT may be a viable therapeutic alternative to reduce the intensity of withdrawal symptoms after voluntary smoking cessation. A study on a larger population with a longer follow-up is needed to assess the advantages of each method to quit smoking.