Dual users of e-cigarettes and cigarettes have greater positive smoking expectancies than regular smokers: a study of smoking expectancies among college students.

Objective: In the present study, we sought to determine the differences among college students using e-cigarettes, cigarettes, or both products (dual users) on smoking outcome expectancies and the role of smoking expectancies and e-cigarette use in cessation attempts. Participants: We surveyed 1,370 undergraduate college students from November 2014 to November 2016. Methods: Participants completed questionnaires regarding demographics, smoking status/history, and expectancies. Results: Dual users reported significantly longer smoking histories and more past quit attempts than other smoking groups. Those reporting dual use reported higher expectancies on positive/negative reinforcement and appetite/weight control subscales of the SCQ. E-cigarette use was a negative predictor of cessation attempts. Conclusions: College students appear to be less motivated to use e-cigarettes for cessation and dual users endorsed higher levels of smoking expectancies previously shown to negatively impact treatment outcomes. Students, especially dual users, need targeted interventions to address the dangers of using tobacco products.

The association between problematic alcohol use, risk perceptions, and e-cigarette use.

Background: Use of e-cigarettes among college students has escalated, in part due to the perception that they are less harmful than traditional cigarettes and have other benefits such as circumventing smoking bans. College students also drink more heavily than other age groups, and e-cigarettes are associated with alcohol, especially among students who engage in problematic drinking.Objective: The present study sought to determine if an interaction between problematic alcohol use and increased perceptions of benefits and decreased perceptions of risks of e-cigarettes would predict whether participants had ever used an e-cigarette.Method: The present study included 1,133 undergraduate college students surveyed between November 2014 - November 2016. Participants were primarily Caucasian (82.3%) and female (78.1%). Participants completed questionnaires regarding demographics, smoking status/history, and expectancies.Results: Higher levels of problematic drinking and higher perceived benefits of e-cigarette use were both associated with having tried e-cigarettes. This relationship was significant even when controlling for several covariates such as cigarettes smoking status. However, there was not a significant interaction between problematic alcohol use and perceived benefits or risks of e-cigarettes. There was also no relationship between risk perceptions of e-cigarettes and e-cigarettes use.Conclusions: Both problematic alcohol use and perception of benefits of e-cigarettes were associated with having tried an e-cigarette. This finding is problematic as the use of e-cigarettes may influence further engagement in risky behaviors including problematic drinking or transitioning to regular cigarette use. Thus, it is important to develop interventions to help college students develop more accurate risk perceptions about e-cigarettes.

Motivation and readiness for tobacco cessation among nicotine dependent postmenopausal females: A pilot study.

Despite considerable health risks due to lower levels of estrogen production and the compounding antiestrogenic effects of nicotine, postmenopausal females continue to smoke. These females face significant barriers to cessation, including negative affect, weight concerns, and menopausal symptom severity. The current pilot study explored the effect of negative affect, weight concerns, and menopausal symptom severity on motivation and readiness to quit smoking. Eighteen postmenopausal smokers were randomized to receive brief motivational interviewing (B-MI; n = 8) or control treatment (i.e., a 1-hour video, n = 10). Participants completed measures of negative affect, weight concerns, and menopausal symptoms, as well as measures of motivation and readiness to quit. Motivation and readiness to quit were reassessed one week following treatment. At baseline, weight concerns, specifically surrounding smoking to prevent overeating, were identified as related to increased motivation to quit smoking. Menopausal symptom severity, specifically somatic symptoms, assessed at baseline, was associated with increased readiness for cessation. B-MI did not increase motivation or readiness to quit; however, results indicate that cigarettes per day decreased from baseline to follow-up by approximately 20-30%. These results provide valuable insight into enhancing engagement in a cessation treatment among this population. (PsycINFO Database Record

Perceived risk and benefits of e-cigarette use among college students.

Recent data demonstrates that the use of e-cigarettes is growing, especially among college students and young adults. This trend is increasingly problematic, as many of these individuals report never using traditional tobacco cigarettes, but nevertheless are using e-cigarettes. The present study sought to develop the Risks and Benefits of E-cigarettes (RABE) questionnaire to assess the perceptions about e-cigarette use among college students. College students (N=734) completed the RABE via online survey. Principal components analysis yielded two reliable scales representing perceptions about e-cigarette use. Based on the two-factor solution, subscales were named according to item content. The resulting 30 items demonstrated excellent internal consistency (Risks scale α=0.92; Benefits scale α=0.89). Subsequent confirmatory factor analysis generally supported the 2-factor structure. As an initial measure of construct validity, scale scores were compared across smoking status groups. Smoking status groups were defined by the following: "e-cigarette users" were current daily users of e-cigarettes, "conventional smokers" were daily traditional cigarette users, and "dual users" were individuals who used both e-cigarettes and traditional cigarettes daily. Scale scores for perceived Benefits of e-cigarette use differed significantly across groups (p<0.001), whereby students who reported using e-cigarettes or traditional cigarettes reported benefits associated with e-cigarette use. Scale scores for perceived Risks of e-cigarette use across smoking status groups did not significantly differ. The present results indicate that the RABE is a reliable instrument to measure college student's perceived risks and benefits of e-cigarettes.

Examination of trait impulsivity on the response to a brief mindfulness intervention among college student drinkers.

Mindfulness-based strategies show promise for targeting the construct of impulsivity and associated variables among problematic alcohol users. This study examined the moderating role of intervention (mindfulness vs relaxation vs control) on trait impulsivity and three outcomes examined post-intervention (negative affect, positive affect, and urge to drink) among 207 college students with levels of at-risk drinking. Moderation analyses revealed that the relationship between baseline impulsivity and the primary outcomes significantly differed for participants who underwent the mindfulness versus relaxation interventions. Notably, simple slope analyses revealed that negative urgency was positively associated with urge to drink following the mindfulness intervention. Among participants who underwent the relaxation intervention, analysis of simple slopes revealed that negative urgency was negatively associated with urge to drink, while positive urgency was positively associated with positive affect following the relaxation intervention. Findings suggest that level (low vs high) and subscale of impulsivity matter with regard to how a participant will respond to a mindfulness versus relaxation intervention.

Predictors for selection of insurance-funded weight loss approaches in individuals with severe obesity.

OBJECTIVE: To determine whether there are differences in baseline psychological and behavioral characteristics between individuals with severe obesity who chose a surgical or nonsurgical intervention for weight loss. METHODS: The current study utilized data from a larger study funded by a state insurance company and is unique in that the insurance company funded the weight loss interventions. Participants indicated their preferred method of weight loss, and completed several self-report psychological questionnaires, as well as demographic information. RESULTS: Participants (N = 605) were 58.8% Caucasian and mostly (86%) female. Logistic regression results indicated that an increased number of weight loss attempts, and select other measures of eating behavior and quality of life may influence individuals' selection for either surgical or nonsurgical treatments for weight loss. CONCLUSIONS: Practitioners should pay particular attention to these baseline characteristics that influence choice to examine potential characteristics that may influence the success of these weight loss treatments.

Why patients seek bariatric surgery: does insurance coverage matter?

Despite increasing prevalence of bariatric surgery, little is known about why patients seek out this treatment option. Heads Up is an observational study sponsored by a large benefits management group that examines surgical and nonsurgical approaches to weight management in obese adults. This study examined patients' reasons for choosing surgery. The sample included 360 adult obese patients seeking bariatric surgery who were invited to volunteer for a surgical or a medical weight loss program by their insurer. Participants rank ordered their top three reasons as a deciding factor for choosing to consider surgery. The top three reasons were concerns regarding health (52%), current obesity-related medical conditions (28%), and improved physical fitness (5%). Overall, 13% endorsed insurance coverage as one of their top three choices. When insurance coverage is assured, health and functionality issues were the major reasons reported for obese adults choosing to undergo bariatric surgery.