The Impact of the Covid-19 Pandemic on Smoking Among Vulnerable Populations.

AIM: While accumulating evidence suggests that people modified their smoking during the ongoing COVID-19 pandemic, it remains unclear whether those most at risk for tobacco-related health disparities did so. The current study examined changes in smoking among several vulnerable smoker populations during the COVID-19 pandemic. METHODS: A web-based survey was distributed in 2020 to 709 adults with socioeconomic disadvantage, affective disorders, or opioid use disorder who participated in a previous study investigating the effects of very low nicotine content (VLNC) cigarettes on smoking. Current smoking status and rate, and adoption of protective health behaviors in response to the pandemic (eg social distancing, mask wearing) were examined. RESULTS: Among 332 survey respondents (46.8% response rate), 84.6% were current smokers. Repeated measures ANOVA showed that current cigarettes/day (CPD) was higher during COVID than pre-COVID (12.9 ± 1.0 versus 11.6 ± 1.0; p < .001). Most respondents had adopted protective health behaviors to prevent infection (>79% for all behaviors). More than half indicated that they were still leaving their homes specifically to buy cigarettes (64.6%) and were buying more packs per visit to the store (54.5%) than pre-COVID. Individuals unemployed at the time of the survey experienced greater increases in CPD (from 11.4 ± 1.4 to 13.3 ± 1.4, p = .024) as did those with higher levels of anxiety (from 11.5 ± 1.1 to 13.6 ± 1.1, p < .001). CONCLUSIONS: Smoking increased during the COVID-19 pandemic in this sample of adults from vulnerable populations, even while most adopted protective health measures to prevent infection. Unemployment and anxiety might identify those at greatest risk for increases in tobacco use. IMPLICATIONS: Individuals from populations especially vulnerable to smoking might be at risk for greater harm from cigarette smoking during times of pandemic-related stress. Public health interventions are warranted to ameliorate increases in smoking among these populations. Special attention should be paid to those experiencing unemployment and high anxiety.

Identifying the determinants of emotion regulation choice: a systematic review with meta-analysis.

Day-to-day life is inundated with attempts to control emotions and a wealth of research has examined what strategies people use and how effective these strategies are. However, until more recently, research has often neglected more basic questions such as whether and how people choose to regulate their emotions (i.e. emotion regulation choice). In an effort to identify what we know and what we need to know, we systematically reviewed studies that examined potential determinants of whether and how people choose to regulate their emotions. Eighteen determinants were identified across 219 studies and were categorised as being affective, cognitive, motivational, individual or social-cultural in nature. Where there were sufficient primary studies, meta-analysis was used to quantify the size of the associations between potential determinants and measures of whether and how people choose to regulate their emotions. Based on the findings, we propose that people's decisions about whether and how to regulate their emotions are determined by factors relating to the individual doing the regulating, the emotion that is being regulated, and both the immediate situation and the broader social context in which the regulation is taking place.

Re-examining borderline personality disorder and substance use disorder: The role of emotion dysregulation

BACKGROUND: Borderline personality disorder (BPD) and substance use disorder (SUD) frequently co-occur. Although some research has investigated the factors related to this comorbidity, few have isolated the effects of SUD on a BPD diagnosis. METHODS: Patients presenting for treatment were assessed with the Structured Clinical Interview for DSM-IV, the BPD module of the Structured Interview for DSM-IV Personality, the Difficulties in Emotion Regulation Scale (DERS), and the Five Facet Mindfulness Questionnaire (FFMQ). Analyses were conducted to determine how individuals diagnosed with BPD differ from individuals diagnosed with BPD and SUD. RESULTS: Among the BPD diagnostic criteria, patients with comorbid BPD and SUD endorsed impulsivity at higher rates, and patients with only BPD more frequently endorsed frantic efforts to avoid real or imagined abandonment. The 2 groups were not distinguished by scores on the DERS, although the comorbid group reported higher FFMQ scores, specifically on the acting with awareness subscale. CONCLUSIONS: Borderline personality disorder is fundamentally based on emotion dysregulation. Substance use and efforts to avoid abandonment are both forms of maladaptive coping that stem from this dysregulation, and individuals with BPD may tend to rely on one or the other. Future studies should continue to evaluate these clinical features across diverse groups.