The Acute Impact of Hatha Yoga on Craving Among Smokers Attempting to Reduce or Quit.

INTRODUCTION: Despite negative effects of smoking, smokers have difficulty quitting, suggesting a need for additional strategies to help them quit. A single-session hatha yoga intervention acutely reduced craving among nicotine-deprived smokers not attempting to reduce or quit, yet it is unknown if it reduces craving among those attempting to change their smoking. Thus, this study tested the efficacy of a single-session hatha yoga intervention for acutely reducing craving among smokers attempting to reduce or quit smoking. METHODS: Data presented are part of a larger dissertation project. Participants were 55 community-recruited smokers (62% male) motivated to reduce or quit smoking randomized to one session of hatha yoga (n = 25) or wellness control (ie, reading educational materials about healthy lifestyle; n = 30) on their intervention day (ie, the day on which they began to reduce or quit smoking). Participants rated, "I have a desire for a cigarette right now," on a 7-point Likert scale immediately before and after the intervention. RESULTS: After statistically controlling for CO in breath, participant type, age, gender, race, and ethnicity, a significant Time × Condition interaction was found, F(1, 47) = 4.72, p = .035, ηp2 = .09, suggesting craving decreased at a greater rate in the hatha yoga condition relative to the wellness condition. CONCLUSIONS: Results from this study add to a growing body of research demonstrating the potential clinical utility of hatha yoga as an adjunctive intervention tool for smoking cessation. IMPLICATIONS: This is the first known study to test the impact of a single-session hatha yoga intervention on craving among adult smokers attempting to reduce or quit smoking. We found that 30 minutes of hatha yoga produced a greater reduction in craving compared to a 30-minute wellness control condition. This relationship was evident even after statistically accounting for other important variables (eg, gender). Results of this study add to a growing body of literature demonstrating the potential clinical utility of hatha yoga as an adjunctive intervention strategy for smoking cessation.

The impact of PTSD clusters on cannabis use in a racially diverse trauma-exposed sample: An analysis from ecological momentary assessment.

BACKGROUND: Accumulating evidence indicates a link between post-traumatic stress disorder (PTSD) and cannabis use and suggests that this link may vary as a function of the PTSD symptom cluster type. Consistent with negative reinforcement models of substance use, individuals with elevated Cluster D (Hyperarousal) symptoms may be more likely to use cannabis in response to elevated state anxiety and experience decreases in state anxiety after using cannabis. OBJECTIVES: We aimed to test hypotheses that the interaction of Cluster D and state anxiety would be related to subsequent cannabis use and that those with elevated Cluster D symptoms who used cannabis would report the greatest decreases in state anxiety. To test the specificity, we tested whether Clusters B (re-experiencing) and C (avoidance) showed similar relationships. METHODS: The present study used ecological momentary assessment to examine cannabis use among 87 cannabis-using individuals with PTSD symptoms (64.4% male, 56.3% non-Hispanic Caucasian). State anxiety and cannabis use were assessed over the two-week period via signal contingent (six random prompts per day), interval contingent (each bedtime), and event contingent (cannabis use episodes) assessments. RESULTS: Consistent with negative reinforcement models, participants with clinically significant Cluster D symptoms with elevated state anxiety had a greater likelihood of subsequent cannabis use and cannabis use resulted in less subsequent anxiety. The negative reinforcement hypothesis was only partially supported for those with Cluster B and C symptoms. CONCLUSIONS: The results suggest that negative reinforcement models may be especially relevant to understanding cannabis use among those with clinically elevated Cluster D symptoms.

The Interactive Influence of Cannabis-Related Negative Expectancies and Coping Motives on Cannabis Use Behavior and Problems.

OBJECTIVES: The present study tested whether coping motives for cannabis use moderate the effect of negative expectancies on cannabis use. METHODS: Participants were 149 (36.2% female, 61.59% non-Hispanic Caucasian) current cannabis users aged 18-36 (M = 21.01, SD = 3.09) who completed measures of cannabis-related expectancies and motives for use. Hierarchical multiple regressions were employed to investigate the predictive value of the interaction between negative expectancies and coping motives on cannabis use outcomes. RESULTS: Results revealed interactions between negative expectancies and coping motives with respect to past 90 day cannabis use frequency and cannabis problems. Global negative effects expectancies were associated with less frequent cannabis use, particularly among those with fewer coping motives. However, negative expectancies were related to more cannabis problems, particularly among those with higher coping motives. CONCLUSIONS: These results suggest it may be advisable to take coping motives into account when addressing expectancies among cannabis users.

The role of mindfulness skills in terms of distress tolerance: a pilot test among adult daily smokers.

BACKGROUND AND OBJECTIVES: Low distress tolerance is associated with difficulties quitting smoking. Mindfulness is associated with improved cessation outcomes and may be one method by which to increase distress tolerance. The purpose of the current study was to examine the relationship between mindfulness skills and distress tolerance among regular smokers. METHODS: Daily smokers (n=125; Mage=37.5, 70% male) completed self-report measures assessing smoking and emotions. RESULTS: After controlling for age, gender, and nicotine dependence, and education the mindfulness skills of acting with awareness and accepting without judgment significantly predicted distress tolerance. DISCUSSION AND CONCLUSIONS: For smokers, being able to pay attention to present moment vents and accept negative events without judgment is associated with a greater ability to withstand such events. SCIENTIFIC SIGNIFICANCE: These findings suggest that mindfulness-based approaches to smoking cessation may be effective because of improvements in distress tolerance. However, future prospective and laboratory-based studies are needed to better understand the mindfulness-distress tolerance link among smokers.

Distress tolerance and perceived barriers to smoking cessation.

BACKGROUND: The present study examined the role of emotional distress tolerance (DT) in predicting barriers to smoking cessation and number of quit attempts. METHODS: The sample consisted of regular daily smokers (N = 126; 37 females; M age = 36.51, SD = 13.05) who completed self-report measures on affect and smoking. RESULTS: After controlling for daily smoking rate and anxiety sensitivity, emotional DT significantly predicted internal barriers to cessation (6.9% unique variance) but not external or addiction-related barriers to cessation. Inconsistent with prediction, emotional DT did not significantly predict number of quit attempts. CONCLUSIONS: These results suggest that individuals who are low in emotional DT believe that quitting smoking will be difficult because it takes away an important affect regulation strategy, and there may be utility in targeting emotional DT in smoking cessation interventions.

The Impact of University Sanctions on Cannabis Use: Individual Difference Factors that Predict Change in Cannabis Use.

Over one-third of college students use cannabis, yet the majority of students experiencing cannabis-use problems are not interested in seeking treatment. Therefore, the campus judicial process following a violation of university cannabis policies may be an important point of intervention. This study examined whether cannabis use decreased following being sanctioned by the university for violation of campus drug policy. We also identified individual difference factors related to changes in post-infraction use. University students (N = 98, 73.1% White, 88.2% Male) were referred to participate in a brief motivational intervention study as a component of their sanctions following violation of campus cannabis policies. Data were collected during the intake appointment. Approximately 91% of participants reported decreased post-infraction cannabis use and 58% of the sample reported abstinence in the month prior to intake. The following variables were significantly related to both abstinence or to reducing frequent use (from at least four times per month to less frequently): using less frequently prior to their infraction, descriptive friend norms, and enhancement motives. The following variables were significantly related only to reducing frequent use: injunctive norms regarding parents and expansion motives. Students sanctioned for cannabis violations appear to decrease cannabis use post-infraction. Thus, results support campus efforts to sanction students for violation of campus cannabis use policies. Identification of individual difference variables that predict post-infraction change in cannabis use can inform treatment and prevention efforts.

Social anxiety and suicidal ideation: Test of the utility of the interpersonal-psychological theory of suicide.

Social anxiety is related to greater suicidality, even after controlling for depression and other psychopathology. The Interpersonal-Psychological Theory of Suicide (IPTS; Joiner, 2005) proposes that people are vulnerable to wanting to die by suicide if they experience both perceived burdensomeness (sense that one is a burden to others) and thwarted belongingness (a greater sense of alienation from others). Socially anxious persons may be especially vulnerable to these interpersonal factors. The current study tested whether interpersonal IPTS components independently and additively mediate the social anxiety-suicidal ideation (SI) relation among 780 (80.5% female) undergraduates. Social anxiety was significantly, robustly related to SI and to thwarted belongingness and perceived burdensomeness. Social anxiety was indirectly related to SI via thwarted belongingness and perceived burdensomeness. The sum of these indirect effects was significant. Moderated mediation analyses indicated that perceived burdensomeness only mediated the relation between social anxiety and SI at higher levels of thwarted belongingness. Findings highlight that difficulties in interpersonal functioning may serve as potential pathways through which social anxiety may lead to greater suicidality. Findings highlight that difficulties in interpersonal functioning may serve as potential pathways through which social anxiety may lead to greater suicidality.

Anxiety and cannabis-related problem severity among dually diagnosed outpatients: The impact of false safety behaviors.

Cannabis use disorder (CUD) co-occurs with anxiety disorders at high rates. Little is known about the mechanisms linking CUD and anxiety disorders. One theoretically-driven perspective is that individuals with anxiety disorders may be more apt to use FSBs (i.e., behaviors that may be effective in decreasing anxiety in the short-term, but can maintain and even exacerbate anxiety in the long-term), which can perpetuate cannabis use despite cannabis-related problems. The present study tested whether FSB use explained the relation of anxiety symptom severity with cannabis quantity and related problems among 77 adults with CUD and comorbid anxiety disorders seeking outpatient CUD treatment. Results indicated that FSB frequency was significantly related to anxiety symptom severity and cannabis problem severity, but not cannabis quantity. Anxiety symptom severity was indirectly (via FSB frequency) related to cannabis problem severity, but not to cannabis quantity. These novel findings suggest that more frequent use of FSBs may play an important role in cannabis problem severity among individuals with CUD and anxiety disorders.

Distress Tolerance Among Students Referred for Treatment Following Violation of Campus Cannabis Use Policy: Relations to Use, Problems, and Motivation.

Students referred to treatment after violating campus drug policies represent a high-risk group. Identification of factors related to these students' cannabis use could inform prevention and treatment efforts. Distress tolerance (DT) is negatively related to substance-related behaviors and may be related to high-risk cannabis use vulnerability factors that can impact treatment outcome. Thus, the current study tested whether DT was related to cannabis use frequency, cannabis-related problems, and motivation to change cannabis use among 88 students referred for treatment after violating campus cannabis policies. DT was robustly, negatively related to cannabis use and related problems. DT was also significantly, negatively correlated with coping, conformity, and expansion motives. DT was directly and indirectly related to cannabis problems via coping (not conformity or expansion) motives. Motives did not mediate the relation of DT to cannabis use frequency. DT may be an important target in treatment with students who violate campus cannabis policies.

Cannabis craving in response to laboratory-induced social stress among racially diverse cannabis users: The impact of social anxiety disorder.

Social anxiety disorder appears to be a risk factor for cannabis-related problems. Although it is presumed that increases in cannabis craving during elevated social anxiety reflect an intent to cope with greater negative affectivity, it is unclear whether increases in physiological arousal during social stress are related to cannabis craving, especially among those with social anxiety disorder. Similarly, no studies have assessed motivational reasons for cannabis use during elevated social stress. Thus, the current study tested whether increases in state social anxiety (measured subjectively and via physiological arousal) were related to greater cannabis craving among 126 current cannabis users (88.9% with cannabis use disorder, 31.7% with social anxiety disorder, 54.0% non-Hispanic Caucasian) randomly assigned to either a social interaction or reading task. As predicted, cannabis users in the social interaction condition reported greater cannabis craving than those in the reading condition. This effect was particularly evident among those with social anxiety disorder. Although physiological arousal did not moderate the relationship between condition and craving, coping motives were the most common reasons cited for wanting to use cannabis and were reported more among those in the social interaction task. These experimental results uniquely add to a growing literature suggesting the importance of elevated state social anxiety (especially among those with social anxiety disorder) in cannabis use vulnerability processes.

Socially anxious smokers experience greater negative affect and withdrawal during self-quit attempts.

Despite evidence of a strong and consistent relation between smoking and elevated social anxiety, strikingly little empirical work has identified mechanisms underlying the smoking-social anxiety link. Persons with elevated social anxiety may rely on smoking to cope with more severe nicotine withdrawal and post-quit negative mood states; yet, no known studies have investigated the relation of social anxiety to withdrawal severity. The current study examined the relation of social anxiety to post-quit nicotine withdrawal severity among 51 (33.3% female, Mage = 34.6) community-recruited smokers during the first two weeks following an unaided (i.e., no treatment) cessation attempt. Ecological momentary assessment was used to collect multiple daily ratings of withdrawal and negative mood states. Baseline social anxiety was related to increases in negative affect during the monitoring period and remained significantly related to post-quit withdrawal after controlling for negative affect, gender, lapses, and substance use. Persons with elevated social anxiety experience more severe post-quit withdrawal symptoms and increases in negative affect during a cessation attempt and may therefore benefit from intervention and treatment strategies geared toward helping them learn to cope with withdrawal and negative affect to improve cessation rates among these vulnerable smokers.

The Role of Distress Tolerance in the Use of Specific Emotion Regulation Strategies.

The present study evaluated the role of distress tolerance (DT), defined as the ability to tolerate negative emotional states, in the use of four specific emotion regulation strategies (suppression, avoidance, rumination, and reappraisal). Undergraduate psychology students (N = 431, 71.7% female; Mage = 19.80 years, SD= 3.71) completed self-report measures online for course credit. It was hypothesized that, after controlling for the effects of anxiety sensitivity and negative affectivity, DT would be negatively associated with suppression, avoidance, and rumination, and positively associated with reappraisal. Consistent with prediction, low DT significantly predicted greater use of suppression, avoidance, and rumination. However, contrary to prediction, DT did not significantly predict reappraisal. These results suggest that individuals who are unable to withstand negative emotions are more likely to use maladaptive regulation strategies.

Addictive Behavior Interventions Among College Students.

PURPOSE OF REVIEW: Addictive behaviors among college students are a significant public health concern. This manuscript reviews the past two years of literature on prevention and treatment approaches for college students who engage in addictive behaviors. RECENT FINDINGS: In-person skills-based interventions and motivational interventions that incorporate personalized feedback are effective in the short-term but little support was found for long-term effects. Although web-based interventions reduced certain addictive behaviors (e.g., alcohol, problematic gambling), in-person interventions that include motivational interviewing components and personalized feedback appear to be more efficacious. SUMMARY: Research has largely focused on alcohol and little is known about the utility of interventions for students who use tobacco or illicit substances or who engage in problematic gambling. Research on interventions for these high-risk behaviors is recommended.

Event-specific cannabis use and use-related impairment: the relationship to campus traditions.

OBJECTIVE: Despite high rates of college cannabis use, little work has identified high-risk cannabis use events. For instance, Mardi Gras (MG) and St. Patrick's Day (SPD) are characterized by more college drinking, yet it is unknown whether they are also related to greater cannabis use. Further, some campuses may have traditions that emphasize substance use during these events, whereas other campuses may not. Such campus differences may affect whether students use cannabis during specific events. The present study tested whether MG and SPD were related to more cannabis use at two campuses with different traditions regarding MG and SPD. Further, given that Campus A has specific traditions regarding MG whereas Campus B has specific traditions regarding SPD, cross-campus differences in event-specific use were examined. METHOD: Current cannabis-using undergraduates (N = 154) at two campuses completed an online survey of event-specific cannabis use and event-specific cannabis-related problems. RESULTS: Participants used more cannabis during MG and SPD than during a typical weekday, typical day on which the holiday fell, and a holiday unrelated to cannabis use (Presidents' Day). Among those who engaged in event-specific use, MG and SPD cannabis use was greater than typical weekend use. Campus differences were observed. For example, Campus A reported more cannabis-related problems during MG than SPD, whereas Campus B reported more problems during SPD than MG. CONCLUSIONS: Specific holidays were associated with more cannabis use and use-related problems. Observed between-campus differences indicate that campus traditions may affect event-specific cannabis use and use-related problems.

Robust impact of social anxiety in relation to coping motives and expectancies, barriers to quitting, and cessation-related problems.

Although social anxiety is related to smoking and nicotine dependence, few researchers have sought to identify factors that contribute to these relations. The current study examined whether social anxiety was associated with cognitive vulnerability factors related to smoking: perceived barriers for quitting, cessation-related problems, negative-affect-reduction-outcome expectancies, and negative-affect-reduction motives. Further, we tested whether social anxiety was robustly related to these factors after controlling for cigarettes smoked per day, gender, alcohol-use frequency, lifetime cannabis-use status, panic attack frequency, anxiety sensitivity, and negative affectivity. The sample consisted of 580 (38.6% female) treatment-seeking smokers. Social anxiety was associated with perceived barriers for quitting, cessation-related problems, negative-affect-reduction-outcome expectancies, and negative-affect-reduction motives. After controlling for covariates, social anxiety was robustly related to perceived barriers for quitting, cessation-related problems, and negative-affect-reduction-outcome expectancies. Social anxiety was robustly related to negative-affect-reduction motives among men, but not women. Results indicate that social anxiety is robustly related to cognitive vulnerability factors associated with poorer cessation outcomes, suggesting that social anxiety may be an important therapeutic target during smoking cessation.

Asthma and its relation to smoking behavior and cessation motives among adult daily smokers.

Despite the negative effects of smoking on lung functioning and overall health, smoking is more prevalent among individuals with asthma compared to those without asthma. The purpose of this study was to examine the predictive ability of asthma diagnosis in terms of smoking behavior and reasons for quitting. Participants were 251 regular daily smokers: 125 smokers with self-reported, physician-diagnosed asthma and 126 smokers without asthma. Asthma diagnosis significantly predicted age of regular smoking onset, number of quit attempts, and reasons for quitting related to self-control suggesting that smokers with asthma may have more difficulty quitting and unique reasons for quitting.