Body weight change during a smoking cessation intervention for individuals with overweight or obesity.

INTRODUCTION: A more comprehensive understanding of the factors regarding weight control in individuals with overweight or obesity after quitting smoking is needed. The study aimed to analyze the changes of in-treatment variables during a smoking cessation intervention and examine their impact on weight. METHODS: A total of 120 individuals who smoke with overweight or obesity (MBMI = 31.75 ± 4.31; 54.16 % female) participated in a cognitive-behavioral therapy for smoking cessation and weight control or the same treatment plus contingency management. Weight, smoking variables (cotinine and continuous abstinence), eating behaviors (appetite, grazing), exercise, and sleep were assessed weekly throughout the treatment. RESULTS: More participants gained weight over time with reduced nicotine use or abstinence. There was a tendency during treatment to increase appetite and exercise time, while grazing episodes and sleeping hours remained stable. Higher baseline weight (p < .001), greater cotinine reduction (p = .021) and time (p = .009) were associated with greater weight gain, while more hours of exercise (p = .003), no appetite changes (p = .003) and diminished appetite (p < .001) were associated with less gain over the treatment. Both treatment conditions showed similar results in all in-treatment variables. DISCUSSION: Individuals with overweight and obesity with higher baseline weight and higher baseline cotinine levels during smoking cessation interventions may require special attention to improve weight outcomes. Exercise and appetite regulation may be useful for mitigating weight gain in smoking cessation interventions for individuals with overweight or obesity.

Contingency management for smoking cessation for individuals with overweight or obesity: A randomized controlled trial.

BACKGROUND: Interventions for quitting smoking and weight control among individuals with excess weight are scarce. Our study evaluated the effectiveness of cognitive behavioral therapy (CBT) plus contingency management (CM) in this population, and examined whether CM for smoking cessation improved CBT treatment outcomes at end of treatment (EOT) and at 1-, 3-, 6-, and 12-month follow-ups (FU). METHODS: In an 8-week randomized clinical trial, 120 adults who smoke with overweight or obesity (54.16% females; MBMI = 31.75 ± 4.31) were randomly assigned to CBT for both quitting smoking and weight control (n = 60) or the same treatment plus CM for smoking cessation (n = 60). Outcome variables were compared (i.e., treatment completion, smoking abstinence, weight change and secondary outcomes). RESULTS: At EOT, the CBT + CM group achieved 78.33% 7-day point-prevalence abstinence rates compared to 61.67% in the CBT group (p = .073), and rates declined over time (12-month FU: 18% vs 12%). Participants who attained abstinence weighed more compared to baseline at EOT (Mkg = 1.07; SD = 1.88) and over time (12-month FU: Mkg = 4.19; SD = 4.31). No differences were found between the two groups in outcome variables. CONCLUSIONS: Both interventions were effective in promoting abstinence and reducing tobacco use over time. Combining CBT with CM for smoking cessation did not improve treatment outcomes in individuals with overweight or obesity compared to CBT only. Future studies should evaluate whether implementing CM for weight maintenance helps control post-cessation weight gain in this population.

The Broad Autism Phenotype-International Test (BAP-IT): A two-domain-based test for the assessment of the broad autism phenotype.

LAY ABSTRACT: The broad autism phenotype refers to a group of behaviors related to autism spectrum disorder, but that appear to a lesser extent. Its assessment has been performed through outdated broad autism phenotype/autism spectrum disorder definitions and tests. To address this problem, this study presents the development of a new test, the Broad Autism Phenotype-International Test, a 20-item measure consisting of two dimensions, SOCIAL-BAP and RIRE-BAP, targeting the two-domain operationalization of autism spectrum disorder in Spain and the United Kingdom. Unlike the Broad Autism Phenotype Questionnaire, this test received empirical support as a quick and effective broad autism phenotype measure that can facilitate both broad autism phenotype/autism spectrum disorder research and interventions. This is the first step to studying the BAP in several Spanish and English-speaking countries.

The role of the differential outcomes procedure and schizotypy in the recognition of dynamic facial expressions of emotions.

Emotional facial expression recognition is a key ability for adequate social functioning. The current study aims to test if the differential outcomes procedure (DOP) may improve the recognition of dynamic facial expressions of emotions and to further explore whether schizotypal personality traits may have any effect on performance. 183 undergraduate students completed a task where a face morphed from a neutral expression to one of the six basic emotions at full intensity over 10 s. Participants had to press spacebar as soon as they identified the emotion and choose which had appeared. In the first block, participants received no outcomes. In the second block, a group received specific outcomes associated to each emotion (DOP group), while another group received non-differential outcomes after correctly responding (NOP group). Employing generalized linear models (GLMs) and Bayesian inference we estimated different parameters to answer our research goals. Schizotypal personality traits did not seem to affect dynamic emotional facial expression recognition. Participants of the DOP group were less likely to respond incorrectly to faces showing Fear and Surprise at fewer intensity levels. This may suggest that the DOP could lead to better identification of the main features that differentiate each facial expression of emotion.

Prevalence of energy drink consumption world-wide: A systematic review and meta-analysis.

BACKGROUND AND AIMS: The increasing market for energy drinks (EDs) in recent years, as well as the health risks caused by their consumption, prompt calls to estimate the prevalence of ED use among different countries. This systematic review and meta-analysis aimed to synthesize the prevalence of ED use in different continents and age groups. METHOD: We searched two databases (i.e. PubMed and PsycInfo) on 31 March 2023 to identify studies reporting the prevalence of ED use. A total of 192 studies (196 distinct samples; n = 1 120 613; 53.37% males) from the United States, Europe, Asia, Oceania and Africa were included in the analysis. A random-effects model was applied to estimate the overall pooled prevalence at several time-periods. Subgroup analyses were performed to provide prevalence based on continent and age group. The quality of articles was assessed using Joana Brigg's Institute (JBI) critical appraisal checklist. Measurements included prevalence of ED use (i.e. life-time, past 12 months, past 30 days, past 7 days and daily use), continent and age group (i.e. children, adolescents, young adults and adults). RESULTS: The life-time ED use world-wide-pooled prevalence was estimated to be 54.7% [95% confidence interval (CI) = 48.8-60.6; I2 = 99.80], 43.4% (95% CI = 36.1-50.6; I2 = 99.92) in the past 12 months, 32.3% (95% CI = 28.8-35.8; I2  = 99.82) in the past 30 days, 21.6% (95% CI = 18.7-24.5; I2 = 99.95) in the past 7 days and 8.82% (95% CI = 6.3-11.4; I2 = 99.95) daily ED use. Subgroups analyses showed significant differences in ED life-time use within age groups (P = 0.002) and continents (P = 0.035). CONCLUSIONS: The world-wide prevalence of energy drink use appears to be high, particularly among adolescents and young adults.

Testing the cannabis gateway hypothesis in a national sample of Spanish adolescents.

BACKGROUND: The gateway hypothesis holds that the use of legal substances (i.e., tobacco and alcohol) increases the risk of initiating in cannabis use which, in turn, increases the chances of using other illegal substances. The validity of this hypothesis has been the subject of intense debate in recent years, finding sequences with a different order. Moreover, this pattern has been scarcely studied in Spain, where characteristics related to cannabis use are meaningfully different to other countries. This study aims to examine the gateway effects of cannabis towards other legal and illegal substances in Spanish adolescents. MATERIAL AND METHODS: Data were obtained from the Ministry of Health in Spain, through a representative survey of addictive behaviors of 36,984 Spanish adolescents (Mage = 15.7, SD = 1.2, 51.4% females). RESULTS: Lifetime cannabis use increased the likelihood of later legal substance use, both tobacco (OR = 2.0; 95%CI 1.81, 2.22) and alcohol (OR = 1.93; 95%CI 1.61, 2.31), as well as illegal substances (OR = 5.36; 95%CI 4.80, 5.98) and polysubstance (OR = 18.24; 95%CI 14.63, 22.73). Early age of cannabis use onset significantly increased the likelihood of subsequent legal and illegal substance use (ORs between 1.82 and 2.65). CONCLUSIONS: These findings confirm and expand the available evidence on cannabis as a gateway substance. These results can help to drive preventive strategies for substance use in Spanish adolescents.

Validation of the Food Purchase Task (FPT) in a clinical sample of smokers with overweight and obesity.

Obesity is a major health problem associated with disease burden and mortality. In this context, analyzing food as a powerful reinforcer from a behavioral economics framework could be relevant for the treatment and prevention of obesity. The purposes of this study were to validate a food purchase task (FPT) in a clinical sample of Spanish smokers with overweight and obesity and to assess the internal structure of the FPT. We also analyzed the clinical utility of single-item breakpoint (i.e., commodity price that suppresses demand). A total of 120 smokers [% females: 54.2; Mage = 52.54; SD = 10.34] with overweight and obesity completed the FPT and weight/eating-related variables. Principal component analysis was used to examine the FPT structure, and a set of correlations were used to examine the relationship between the FPT, eating and weight-related variables. The FPT demonstrated robust convergent validity with other measures of eating. Higher food demand was related to higher food craving (r = .33), more binge eating problems (r = .39), more weight gain concerns (r = .35), higher frequency of both controlled (r = .37) and uncontrolled (r = .30) grazing, as well as to an eating style in response to emotions (r = .34) and external eating (r = .34). Of the demand indices, Intensity and Omax showed the highest magnitudes of effects. The FPT factors, persistence and amplitude, do not improve individual FPT indices; and the single-item breakpoint was not related to any eating or weight variable. The FPT is a valid measure of food reinforcement with potential clinical utility in smokers with obesity/overweight.

Post-Cessation Weight Gain among Smokers with Depression Predicts Smoking Relapse.

Objective: Weight gain (WG) is one of the most widespread consequences of smoking cessation, although there is a great variability of post-cessation weight changes among smokers. Its approach is critical because it depicts an important barrier to trying to quit smoking and because it has been considered as a long-term predictor of relapse. Notwithstanding, little is known about post-cessation WG specifically among depressed smokers. The current study sought to: (1) describe the WG at posttreatment and follow-ups in smokers with depression, (2) examine the predictors of posttreatment WG, and (3) analyze whether post-cessation WG predicts smoking relapse at 6-month follow-up. Methods: The sample was comprised of 125 smokers with depression who achieved tobacco abstinence at posttreatment following a psychological smoking cessation intervention. Smoking abstinence was biochemically verified through carbon monoxide and urine cotinine. Multiple linear and hierarchical logistic regressions were conducted to examine predictors of WG at posttreatment and tobacco relapse at 6-month follow-up, respectively. Results: Abstinent participants gained an average of 3.55 kg at 6-month follow-up compared to 1.49 kg among participants who relapsed. Greater nicotine dependence (ß = .372, p = .001) and diastolic pressure at baseline (ß = .252, p = .021) predicted higher WG at end of treatment. WG at posttreatment increased the likelihood of relapse 6 months later (B = .303, OR = 1.354; 95% CI [1.006, 1.822]). Limitations: Weight concerns, disordered eating, and BMI were not recorded, and they could be related to the present findings. Conclusions: These results suggest that individuals with depression during treatment for smoking cessation should be regularly screened and offered treatment to prevent WG.

Association between e-cigarette and conventional cigarette use among Spanish adolescents. / Asociación entre el uso de cigarrillos electrónicos y cigarrillos convencionales en adolescentes españoles.

In recent years, studies have highlighted the upward trend in electronic cigarette use among adolescents, as well as the potential of e-cigarette use to lead to subsequent conventional cigarette use. The study's aims were two-fold: 1) to examine the progression from e-cigarette use to conventional cigarette use; and 2) to analyze the differences in the severity of smoking pattern among dual users (i.e., e-cigarette and conventional cigarette use), cigarette-only smokers, and e-cigarette-only users in a Spanish adolescent population. Data were obtained from the ESTUDES, a representative survey of addictive behaviors of Spanish adolescents aged 14-18, which was comprised of 38,010 adolescents (Mage = 15.69; SD = 1.19; 51.35% females). Results indicate that lifetime e-cigarette use increased the prevalence of subsequent conventional cigarette use by 1.86 times (95% CI 1.74, 1.99), and the prevalence of conventional cigarette use in the last month by 2.38 times (95% CI 2.19, 2.58), independently of whether the e-cigarette contains nicotine or not. Dual users showed a higher percentage of daily smokers, and a greater number of cigarettes per day, a higher use of e-cigarettes with nicotine, and an earlier age of smoking onset. Regarding risk perception, e-cigarette-only users perceived both conventional tobacco and e-cigarettes as less harmful (all p-values < .001). These findings document the strength of association between e-cigarette and conventional cigarettes, and underscore the importance of developing legal restrictions and prevention strategies aimed at reducing e-cigarette use, which in turn would reduce tobacco use.

En los últimos años, algunos estudios han destacado la tendencia ascendente en el uso del cigarrillo electrónico entre adolescentes, así como el potencial para el posterior consumo de cigarrillos convencionales. Este estudio tuvo dos objetivos: 1) examinar la progresión del cigarrillo electrónico al cigarrillo convencional; y 2) analizar las diferencias en el patrón de gravedad del tabaquismo entre consumidores duales (i.e., cigarrillos electrónicos y convencionales), fumadores de cigarrillos y consumidores de cigarrillos electrónicos. Los datos se obtuvieron de la encuesta ESTUDES, una encuesta nacional que recoge información de conductas adictivas en adolescentes entre 14 y 18 años, la cual consta de 38 010 personas (Medad = 15,69; DT = 1,19; 51,35% mujeres). Los resultados indicaron que haber usado alguna vez un cigarrillo electrónico incrementó la probabilidad de un consumo posterior de cigarrillos 1,86 veces (IC 95% 1,74-1,99), y la probabilidad de consumir tabaco en el último mes 2,38 veces (IC 95% 2,19-2,58), independientemente de si los cigarrillos electrónicos contienen o no nicotina. Los consumidores duales mostraron un mayor porcentaje de fumadores diarios, un mayor número de cigarrillos al día, un mayor uso de cigarrillos electrónicos con nicotina y una edad de inicio más temprana. Con respecto a la percepción de riesgo, los adolescentes que han usado solo cigarrillos electrónicos percibían tanto el tabaco como los cigarrillos electrónicos como menos dañinos (todos los valores p < ,001). Estos hallazgos indican la fuerte asociación entre los cigarrillos electrónicos y los convencionales, y subrayan la importancia de desarrollar restricciones legales y estrategias preventivas dirigidas al cigarrillo electrónico, lo que reduciría a su vez el consumo de tabaco.

Effectiveness of including weight management in smoking cessation treatments: A meta-analysis of behavioral interventions.

INTRODUCTION: The potential of weight gain after smoking cessation reduces the incentive to quit. This meta-analysis examines the efficacy of behavioral interventions for smoking cessation that also address post-cessation weight gain. METHODS: Medline, Web of Science, PsycINFO, and the Cochrane Central Register of Controlled Trials were searched for randomized controlled trials on behavioral treatments targeting both health outcomes. Six separate meta-analyses were undertaken to assess treatment efficacy on smoking abstinence and weight outcomes at end of treatment (EOT), short-term, and long-term follow-up. Individual and treatment moderators were examined as well as methodological quality and publication bias of studies. RESULTS: A total of 28 studies were included in the meta-analysis. There was a statistically significant positive impact of treatments addressing both targets on smoking outcomes at EOT (RR = 1.279, 95% CI: 1.096, 1.492, p = .002), but not at follow-ups. Age impacted on EOT abstinence rates Q (1) = 4.960, p = .026) while increasing the number of sessions significantly improved EOT abstinence rates (p = .020). There was no statistically significant impact of these treatments on weight at EOT (Hedges' g = -0.015, 95% CI: -.164, 0.135, p = .849) or follow-ups (short term: Hedges' g = 0.055, 95% CI: -0.060, 0.170, p = .347; long term: Hedges' g = -0.320, 95% CI: -.965, 0.325, p = .331). There were minimal impacts of publication bias, mostly related to sample size, meaning studies including small sample sizes revealed larger effect sizes on abstinence at EOT. DISCUSSION: Addressing post-cessation weight management in treatments for smoking cessation significantly enhances tobacco abstinence at EOT though it was not found to have a lasting impact after treatment.