A randomized controlled trial of intermittent theta burst stimulation to the medial prefrontal cortex for tobacco use disorder: Clinical efficacy and safety.

OBJECTIVE: This study aimed to evaluate the clinical efficacy and safety of administering intermittent theta burst stimulation (iTBS) to the medial prefrontal cortex for tobacco use disorder. METHODS: A randomized sham-controlled trial was conducted, with 38 participants receiving 28 sessions of active (n=25) or sham (n=13) iTBS (2 sessions/day, 600 pulses/session, 110% resting motor threshold, AFz target) along with smoking cessation education (Forever Free © booklets) over 14 visits. Primary outcomes included self-reported cigarette consumption and abstinence, verified by urinary cotinine tests. Secondary outcomes included symptoms of tobacco use disorder, negative mood, and safety/tolerability. RESULTS: Both active and sham groups reported reduced cigarette consumption (ß = -0.12, p = 0.015), cigarette craving (ß = -0.16, p = 0.002), and tobacco withdrawal symptoms (ß = -0.05, p < 0.001). However, there were no significant time x group interaction effects for any measure. Similarly, the two groups had no significant differences in urinary cotinine-verified abstinence. Adverse events occurred with similar frequency in both groups. CONCLUSION: There were no differences in cigarette consumption between the active and sham iTBS groups, both groups decreased cigarette consumption similarly. Further research is needed to compare iTBS to standard high-frequency rTMS and explore the potential differences in efficacy. Despite limitations, this study contributes to experimental design considerations for TMS as a novel intervention for tobacco and other substance use disorders, emphasizing the need for a more comprehensive understanding of the stimulation parameters and target sites.

Expanding on cross-price elasticity: Understanding tobacco product demand and substitution from the cross-price purchase task.

We examine whether cigarettes serve as substitutes for electronic nicotine delivery systems (ENDS) among ENDS users and demonstrate methodological extensions of data from a cross-price purchase task to inform policies and interventions. During a clinical laboratory study, n = 19 exclusive ENDS users and n = 17 dual cigarette/ENDS users completed a cross-price purchase task with cigarettes available at a fixed price while prices of own-brand ENDS increased. We estimated cross-price elasticity using linear models to examine substitutability. We defined five additional outcomes: nonzero cross-price intensity (purchasing cigarettes if ENDS were free), constant null demand (not purchasing cigarettes at any ENDS price), cross-product crossover point (first price where participants purchased more cigarettes than ENDS), dual-demand score (percentage of prices where both products were purchased), and dual-use break point (minimum relative price to force complete substitution). The cross-price elasticity results indicated that cigarettes could serve as substitutes for ENDS among ENDS users on average, but this average effect masked substantial heterogeneity in profiles of demand (here, a measure of the drug's reinforcement potential). Policies and regulations that increase ENDS prices appear unlikely to steer most exclusive ENDS users toward cigarette use, as most would not purchase cigarettes at any ENDS price, but they could prompt some dual users to substitute cigarettes completely while others remain dual users. This heterogeneity in consumer responses suggests additional indices of cross-product demand are useful to characterize the anticipated and unanticipated effects of tobacco price policies more fully.

Illegal product purchasing in the experimental tobacco marketplace: Effects of menthol cigarette and cigarette ventilation ban.

BACKGROUND: Tobacco regulations may increase demand for illegal cigarettes. We use the Experimental Tobacco Marketplace to estimate the impact of banning menthol cigarettes (Experiment 1) and decreasing allowable cigarette filter ventilation levels (Experiment 2). METHODS: Crowdsourced participants were randomized into one of four groups (2×2 factorial design). Experiment 1 included menthol availability (yes/no) by purchasing option (legal only vs illegal available). Experiment 2 included filter-vented cigarettes availability (yes/no) by purchasing option (legal only vs illegal available). Participants were given an individualized budget to purchase tobacco. Percent budget spent was the outcome measure. RESULTS: Experiment 1, with a legal marketplace only, non-menthol cigarette purchasing was lower (p=0.010) and electronic-cigarette purchasing was higher (p=0.016), when cigarettes were banned compared to when they were available. With an illegal marketplace, switching to legal non-menthol cigarettes was less likely (p<0.001) and purchasing illegal menthol cigarettes was higher (p<0.001), when cigarettes were banned compared to when they were available. Experiment 2, with a legal marketplace only, cigarette purchasing was lower (p=0.010), when the participant's filtered vented cigarettes were banned compared to when they were available. With an illegal marketplace, purchasing the legal low-ventilated cigarette option was lower (p<0.001) and significant differences in illegal filter-vented cigarette purchasing were not observed, when their filter-vented cigarettes were banned compared to when they were available legally. CONCLUSIONS: Without an illegal option, both restrictions decreased cigarette purchasing, but the menthol ban increased e-cigarette purchasing. With an illegal option, a menthol ban increased illegal cigarette purchasing, but decreasing filter ventilation did not.

Semaglutide and Tirzepatide reduce alcohol consumption in individuals with obesity.

Alcohol Use Disorder (AUD) contributes significantly to global mortality. GLP-1 (Glucagon-like peptide-1) and GLP-1/GIP (Glucose-dependent Insulinotropic Polypeptide) agonists, FDA-approved for managing type 2 diabetes and obesity, where the former has shown to effectively reduce the consumption of alcohol in animal models but no reports exist on the latter. In this report, we conducted two studies. In the first study, we conducted an analysis of abundant social media texts. Specifically, a machine-learning based attribution mapping of ~ 68,250 posts related to GLP-1 or GLP-1/GIP agonists on the Reddit platform. Secondly, we recruited participants (n = 153; current alcohol drinkers; BMI ≥ 30) who self-reported either taking Semaglutide (GLP-1 agonist), Tirzepatide (the GLP-1/GIP combination) for ≥ 30 days or, as a control group; no medication to manage diabetes or weight loss for a within and between subject remote study. In the social media study, we report 8 major themes including effects of medications (30%); diabetes (21%); and Weight loss and obesity (19%). Among the alcohol-related posts (n = 1580), 71% were identified as craving reduction, decreased desire to drink, and other negative effects. In the remote study, we observe a significantly lower self-reported intake of alcohol, drinks per drinking episode, binge drinking odds, Alcohol Use Disorders Identification Test (AUDIT) scores, and stimulating, and sedative effects in the Semaglutide or Tirzepatide group when compared to prior to starting medication timepoint (within-subjects) and the control group (between-subjects). In summary, we provide initial real-world evidence of reduced alcohol consumption in people with obesity taking Semaglutide or Tirzepatide medications, suggesting potential efficacy for treatment in AUD comorbid with obesity.

The Phenotype of Recovery X: Associations between delay discounting, regulatory flexibility, and remission from substance use disorder.

INTRODUCTION: Delay discounting (DD) and self-regulation are important predictors of substance use disorder (SUD) outcomes. Further, regulatory flexibility (RF; i.e., selecting, monitoring, and adapting coping techniques based on contextual demands) is related to psychological resilience. However, studies have yet to examine associations among DD, RF, and remission from SUDs among individuals in recovery. METHODS: Individuals (N = 148) in SUD recovery completed the Context Sensitivity Index (CSI), the Flexible Regulation of Emotional Expression (FREE) Scale, and the Perceived Ability to Cope with Trauma (PACT) Scale to assess RF and, an $1000 hypothetical reward Adjusting Amount Delay Discounting Task. The study considered individuals to be in remission from SUD if they did not endorse any SUD DSM-5 symptom other than craving (except tobacco use disorder) in the past three months. The study team used t-tests to examine differences in RF and DD by remission status. Univariate linear regressions were used to examine the relationship between RF and DD. Finally, mediation models examined the dynamic relationship among DD, RF, and remission status. RESULTS: Remitted individuals (n = 82) had significantly lower DD (i.e., greater preference for larger, later rewards) rates (p < .001) and higher context sensitivity (p < .001) and coping flexibility (p < .001). The study found significant negative associations between DD and context sensitivity (p = .008), coping flexibility (p = .002), and emotion regulation flexibility (p < .001). Finally, context sensitivity (p = .023) and coping flexibility (p = .009) mediated the relationship between DD and SUD remission. CONCLUSIONS: Results suggest that individuals in recovery with broader temporal windows can better identify contextual demands and flexibly cope, contributing to improved SUD recovery outcomes.

Predictors of smoking cessation outcomes identified by machine learning: A systematic review.

This systematic review aims to characterize the utility of machine learning to identify the predictors of smoking cessation outcomes and identify the machine learning methods applied in this area. In the current study, multiple searches occurred through December 9, 2022 in MEDLINE, Science Citation Index, Social Science Citation Index, EMBASE, CINAHL Plus, APA PsycINFO, PubMed, Cochrane Central Register of Controlled Trials, and the IEEE Xplore were performed. Inclusion criteria included various machine learning techniques, studies reporting cigarette smoking cessation outcomes (smoking status and the number of cigarettes), and various experimental designs (e.g., cross-sectional and longitudinal). Predictors of smoking cessation outcomes were assessed, including behavioral markers, biomarkers, and other predictors. Our systematic review identified 12 papers fitting our inclusion criteria. In this review, we identified gaps in knowledge and innovation opportunities for machine learning research in the field of smoking cessation.

Presentation matters: Effects of cigarette purchase task design on systematic data and purchasing behavior.

Hypothetical purchase tasks (HPTs) are effective tools for evaluating participants' demand for substances. The present study evaluated the effect of task presentation on producing unsystematic data and purchasing behavior in a sample of individuals who smoke cigarettes. Participants (n = 365) were recruited from Amazon Mechanical Turk and randomly assigned to complete two of three HPT presentations: List (prices on one page in an increasing order), Ascending (one price per page in an increasing order), or Random (one price per page in a random order). We evaluated outcomes using a mixed model regression with a random effect for participants. We observed a significant effect of task presentation on passing the criterion assessing consistency in effects of contiguous prices (i.e., Bounce; X²(2) = 13.31, p = .001). A significant effect of task presentation on Trend or Reversals from Zero was not observed. For purchasing behavior, we observed a significant effect of task presentation on R², X²(2) = 17.89, p < .001; BP1, X²(2) = 13.64, p = .001; ln(α), X²(2) = 332.94, p < .001; and ln(Omax), X²(2) = 20.26, p < .001; we did not observe a significant effect of task presentation on ln(Q0) or ln(Pmax). We recommend against using the Random HPT presentation to avoid unsystematic data. While the List and Ascending presentations do not differ across unsystematic criteria or purchasing behavior, the List presentation may be preferred due to participant experience. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Perceived research burden of a novel therapeutic intervention: A study of transcranial magnetic stimulation for smoking cessation.

Background: Translating repetitive transcranial magnetic stimulation (rTMS) into evidence-based clinical applications relies on research volunteers with different perspectives on the burden of study participation. Additionally, clinical applications of rTMS require multiple visits over weeks or months, the impact of research burden is an important component for these studies and translation of these findings to clinical practice. High frequency rTMS has significant potential to be developed as an evidence-based treatment for smoking cessation, however, the optimal rTMS dosing strategies have yet to be determined. Participant burden is an important component of determining optimal dosing strategy for rTMS as a treatment for long-term smoking cessation. Methods: In this double-blinded, sham-controlled, randomized design, the effects of treatment duration, intensity, and active/sham assignment of rTMS on research burden were examined. Results: Overall level of perceived research burden was low. Experienced burden (M = 26.50) was significantly lower than anticipated burden (M = 34.12). Research burden did not vary by race or income. Conclusions: Overall research burden was relatively low. Contrary to our hypotheses, we found little evidence of added significant burden for increasing the duration or intensity of rTMS, and we found little evidence for differences in research burden by race or income. Clinical Trial Registration: identifier NCT03865472.

Is perception reality? Associations among "light" cigarettes and number of cigarettes smoked per day.

INTRODUCTION: Cigarette filter ventilation and light descriptors are associated with lowered perceptions of risk and smoking more cigarettes per day (CPD). This study examined the relationship between usual cigarette ventilation, perception, and CPD. METHODS: A crowdsourced sample (N = 995) of individuals who smoke higher-ventilated (=>20% ventilation) or lower-ventilated (=<10% ventilation) cigarettes identified their usual cigarette as "light" or "full flavor", and reported their average CPD. RESULTS: We found: 1) no association between ventilation status and perception of light versus full flavor (AUC=0.58), with the inaccurate perception being more prevalent in younger individuals (p = 0.041) and those who smoke L&M (73%, p < 0.001) and Camel (61%, p = 0.006) brands; and 2) perception, but not ventilation of usual cigarette, was significantly associated with CPD (p = 0.006), with individuals who perceived their cigarettes as light reporting an average of 13% more cigarettes per day (2.6 CPD), compared to those who perceived their cigarette as full flavor. CONCLUSIONS: Perceptions of light versus full-flavor, but not ventilation status, predicted CPD. These findings may inform anti-smoking health communication strategies and smoking cessation interventions. IMPLICATIONS: Tobacco control policies should eradicate the perception of cigarettes as light or full-flavored. Future research investigating the associations between cigarette filter ventilation and smoking behavior should consider the confounding effects that may lie in an individual's perceptions of their cigarettes.

Acute effects of flavored Black and mild cigars among young adult cigarette smokers.

The U.S. Food and Drug Administration proposed new product standards that would ban characterizing flavors (other than tobacco) in cigars. To inform this regulatory action, we compared physiological effects, use behavior, and subjective effects of four popular cigar flavors in cigar-naïve young adult cigarette smokers. Across five laboratory visits, participants (n = 25) used and evaluated own brand (OB) cigarettes or Black & Mild cigars (original, wine, apple, and cream flavors). Linear mixed models tested differences in saliva nicotine, exhaled carbon monoxide (CO), heart rate (HR), blood pressure (BP), puff topography, and subjective effects (p < .05). Compared to all cigars, OB resulted in higher nicotine boost (953 vs. < 300 ng/ml) and lower CO boost (4 vs. 8-9 ppm). Nicotine boost for original cigars (283 ng/ml) was significantly higher than wine (190 ng/ml). All products significantly increased HR/BP relative to baseline, but across time wine and apple cigars were associated with significantly lower HR than OB and BP effects varied. Relative to OB, participants took approximately 0.5 s longer puffs for all cigars and took significantly larger puffs (+ 21%-24%) of original, wine, and apple cigars. OB was rated more positively than all cigars, which had similar subjective effects. Wine cigars were disliked most and were less effective in reducing tobacco abstinence symptoms than OB; cream cigars were harsher and had stronger flavor intensity than original. The consistency in toxicant exposure, use behavior, and subjective effects across cigar flavors, including original, highlights the need for product standards to interpret characterizing flavors subject to prohibition broadly. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Utility of the 5-trial adjusting delay task in screening for high delay discounting rates: A cohort study of individuals reporting harmful alcohol and tobacco use.

High delay discounting (DD) rates are associated with several health conditions, including addiction. Investigators interested in the modulation of DD rates may be interested in screening for individuals with high DD rates within substance-using samples. The adjusting delay discounting task (ADT) is a brief DD rate measure suitable for screening purposes, but how performance on this task is related to more granular DD measures (e.g., adjusting amount task; AAT) in individuals who use substances is unknown. This study investigated the relationship between DD rates measured by the ADT and AAT to assess the utility of the ADT in screening for high discounting rates in individuals who use tobacco and alcohol. Participants (N = 488) were screened for high discounting rates, ln(k) ≥ -4.3118, using the ADT. Subsequently, participants completed the AAT. Linear regressions were conducted to understand the relationship between the ADT and AAT DD rates. Separate analyses between the total, high-quality and low-quality samples were conducted. Significant relationships between the ADT and AAT were found for the total (p < .001), high-quality (p < .001), and low-quality samples (p < .001). Although the ADT overestimated DD rates on the AAT by 2.49, 2.29, and 2.97 units in the total, high-quality, and low-quality samples, the ADT accurately identified individuals with high discounting rates. Specifically, 71% of the total sample, 80% of the high-quality sample, and 66% of the low-quality sample maintained a high DD rate on the AAT. These results demonstrate that ADT can be used as a quick, accurate screening tool to identify high discounting rates in individuals who use substances. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The electronic nicotine delivery system (ENDS) purchase task: Are results sensitive to price framing?

Extension of the cigarette purchase task (CPT) to electronic nicotine delivery systems (ENDS) is complicated by the heterogeneous nature of this product class, as ambiguity exists regarding the appropriate price-frame (i.e., unit of the product being purchased). We explored correlations between ENDS purchase task (E-CPTs) outcomes featuring two common price-frames: 10 puffs and 1 mL of liquid. Adult exclusive ENDS users (N = 19) and dual users of ENDS and cigarettes (N = 16) completed two own-brand E-CPTs. One E-CPT used "10 puffs" as its price-frame; the other used "1 mL of liquid." Five outcomes were generated for each E-CPT: breakpoint, intensity, Omax, Pmax, and α. Exploratory Factor Analyses (EFA) considered how these outcomes captured latent structures of demand for ENDS. Spearman correlations in E-CPT outcomes assessed within-person variation between price-frames. Analyses also considered whether correlations differed by user group. E-CPT outcomes were highly correlated across price-frames (ρs > 0.57, ps < .001), and EFA revealed little difference in how outcomes from the tasks loaded onto two latent structures of demand ("Persistence" and "Amplitude") reported in the previous literature. The magnitude of correlations for E-CPT outcomes tended to be higher for exclusive ENDS users than for dual users. Participant responses to purchase task outcomes were similar across two E-CPT price-frames. Using "10 puffs" as a price-frame may be a generalizable approach among heterogenous groups of ENDS users, but researchers should consider their target population and structure the E-CPT to reflect participants' knowledge and purchasing behaviors. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Narrative theory v: Narratives about penalties resulting from illegal tobacco purchases increase psychological distress.

Previous research with individuals with substance use disorder indicated that different narratives have different effects on one's behaviors and decision-making. One question that remains unanswered is whether simulating real-world consequences of illegal purchases using narratives would induce psychological distress levels as expected in real-world situations. The present experiment used a between-group design to study how different narratives regarding penalties impact smokers' affective state and more specifically, psychological distress. Participants (N = 93) were randomized into one of the three groups: (a) legal tobacco purchases (LTP), (b) illegal tobacco purchases with fines (ITP_F), and (c) illegal tobacco purchases with fines, criminal record, and negative public exposure (ITP_F + CR + NPE) to complete an online survey. The survey contained one narrative randomly assigned to each participant, demographic questions, the heaviness of smoking index, the Positive and Negative Affect Schedule (PANAS), and a single-item psychological distress question. The results showed that (a) narratives about making illegal tobacco purchases significantly increased psychological distress when compared to narratives about making LTP, (b) no differences were observed on psychological distress and negative affective state between a narrative describing a fine and a narrative describing a fine, a criminal record, and negative public exposure, and (c) a narrative about a criminal record had the greatest effect on psychological distress among the different narratives about penalty types. Narratives involving illegal purchases increase psychological distress, which varies according to the hypothetical penalties described. More research regarding the use of narratives on decision-making and purchasing of hypothetical substances is warranted. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The relationship between nonsystematic delay discounting and low-quality survey responses in a sample of smokers: ROC curve analysis.

Delay discounting (DD), the decrease of the subjective value of a reward as the delay to its receipt increases, is a crucial aspect of decision-making processes. As evidence continues to mount, additional attention needs to be given to nonsystematic DD, a response pattern that has been reported in the literature but rarely investigated. We noticed in our recent online research an increase in the proportion of nonsystematic DD responses across samples, consistent with the so-called Amazon Mechanical Turk (MTurk) data quality crisis. The significant proportion of nonsystematic responses created an opportunity to investigate its association with data quality in the present study. In a sample of smokers recruited from MTurk (n = 210), three independent quality check indexes evaluated participants' response quality. The degree of nonsystematic DD was quantified by the algorithms developed by Johnson and Bickel (2008). The area under the receiver operating characteristic curve (AUC) predicting response quality by nonsystematic DD was obtained. The observed AUC values were at the extreme of the null distributions (ps < .001) in a permutation test. Furthermore, the nonsystematic DD cutoffs provided in Johnson and Bickel (2008) showed good sensitivity (0.77-0.93), albeit low-moderate specificity (0.42-0.74), in detecting low-quality responses. The findings showed that nonsystematic DD was associated with low-quality responses, although other factors contributing to the nonsystematic responses remain to be identified. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Illegal Experimental Tobacco Marketplace II: effects of vaping product bans - findings from the 2020 International Tobacco Control Project.

SIGNIFICANCE: Restrictive e-cigarette policies may increase purchases from illegal sources. The Illegal Experimental Tobacco Marketplace (IETM) allows examination of how restrictions impact illegal purchases. We investigated (1) the effect of a vaping ban, total flavour vaping ban and partial flavour vaping ban on the probability of purchasing illegal vaping products among different regulatory environments (USA, Canada and England) and tobacco user types (cigarette smokers, dual users and e-cigarette users); and (2) the relation between ban endorsement and illegal purchases. METHODS: Participants (N=459) from the International Tobacco Control Survey rated their support of bans and chose to purchase from a hypothetical legal experimental tobacco marketplace or IETM under control and the three ban conditions. RESULTS: In total, 25% of cigarette smokers, 67% of dual users and 79% of e-cigarette users made IETM purchases. Cross-country comparisons depicted dual users from Canada (OR: 19.8), and e-cigarette users from the USA (OR: 12.9) exhibited higher illegal purchases odds than the same user type in England. Within-country comparisons showed e-cigarette and dual users are more likely to purchase from the IETM than cigarette smokers in the most restrictive condition, with the largest effects in e-cigarette users (England-OR: 1722.6, USA-OR: 22725.3, Canada-OR: 6125.0). Increased opposition towards partial or total flavour ban was associated with increased IETM purchasing in the corresponding condition. CONCLUSIONS: Vaping restrictions may shift users' preference to the illegal marketplace in a regulatory environment. Evidence of the IETM generalisability in a geographically dispersed sample enhances its utility in tobacco regulatory science.

Transcranial Magnetic Stimulation for Long-Term Smoking Cessation: Preliminary Examination of Delay Discounting as a Therapeutic Target and the Effects of Intensity and Duration.

Background: Repetitive transcranial magnetic stimulation (rTMS) is a novel treatment for smoking cessation and delay discounting rate is novel therapeutic target. Research to determine optimal therapeutic targets and dosing parameters for long-term smoking cessation is needed. Due to potential biases and confounds introduced by the COVID-19 pandemic, we report preliminary results from an ongoing study among participants who reached study end prior to the pandemic. Methods: In a 3 × 2 randomized factorial design, participants (n = 23) received 900 pulses of 20 Hz rTMS to the left dorsolateral prefrontal cortex (PFC) in one of three Durations (8, 12, or 16 days of stimulation) and two Intensities (1 or 2 sessions per day). We examined direction and magnitude of the effect sizes on latency to relapse, 6-month point-prevalence abstinence rates, research burden, and delay discounting rates. Results: A large effect size was found for Duration and a medium for Intensity for latency to relapse. Increasing Duration increased the odds of abstinence 7-8-fold while increasing Intensity doubled the odds of abstinence. A large effect size was found for Duration, a small for Intensity for delay discounting rate. Increasing Duration and Intensity had a small effect on participant burden. Conclusion: Findings provide preliminary support for delay discounting as a therapeutic target and for increasing Duration and Intensity to achieve larger effect sizes for long-term smoking cessation and will provide a pre-pandemic comparison for data collected during the pandemic. Clinical Trial Registration: [www.ClinicalTrials.gov], identifier [NCT03865472].

Using an experimental tobacco marketplace to pilot test the substitutability of JUUL e-cigarettes and other alternative nicotine and tobacco products for conventional cigarettes among vulnerable populations.

The Experimental Tobacco Marketplace (ETM) is an online research marketplace where increasing the cost of cigarettes is used to investigate the substitutability of other fixed-price tobacco products such as electronic nicotine delivery systems (ENDS). The ETM is useful for modeling effects of potential policy changes on use of various concurrently available products. To our knowledge, the ETM has not been used to investigate substitutability of newer generation e-cigarettes or populations at increased risk for smoking, heavy smoking, nicotine dependence, and smoking-attributable adverse effects. In the current pilot study, participants were 30 adult daily smokers with socioeconomic disadvantage or comorbid psychiatric conditions (substance-use disorder or mental illness). In each session, cigarette prices increased ($0.12, $0.25, $0.50, $1.00. and $2.00 per cigarette) while prices for alternative products remained fixed. Across three ETM sessions, either all products, all products except little cigars and cigarillos (LCCs), or all products except ENDS (JUUL e-cigarettes) were available. Linear regression was performed on individual participant data using log-transformed cigarette price to determine demand and substitution. Cigarette demand decreased as price increased across sessions (significantly non-zero slopes, ps ≤ 0.0001). When all products were available, ENDS substitution increased as cigarette price increased (significantly non-zero slope, p = .016). When LCCs were unavailable, ENDS again were a significant substitute (p = .008). When ENDS were unavailable, LCCs did not substitute (ps ≥ 0.48). In all sessions, participants rarely purchased other products (e.g., snus). Overall, ENDS were the most robust substitute for cigarettes, further underscoring the potential importance of ENDS availability on the impact of tobacco regulatory policies.

Understanding data quality: Instructional comprehension as a practical metric in crowdsourced investigations of behavioral economic cigarette demand.

Crowdsourcing platforms allow researchers to quickly recruit and collect behavioral economic measures in substance-using populations, such as cigarette smokers. Despite the broad utility and flexibility, data quality issues have been an object of concern. In two separate studies recruiting cigarette smokers, we sought to investigate the association between a practical quality control measure (accuracy on an instruction quiz), on internal consistency of number of cigarettes smoked per day and purchasing patterns of tobacco products in an experimental tobacco marketplace (ETM; Study 1), and in a cigarette purchase task (CPT; Study 2). Participants (N = 312 in Study 1; N = 119 in Study 2) were recruited from Amazon mechanical turk. Both studies included task instructions, a quiz, a purchase task, cigarette usage and dependence questions, and demographics. The results show that participants who answered all instruction items correctly: (a) reported the number of cigarettes per day more consistently (partial η² = 0.11, p < .001, Study 1; partial η² = 0.09, p = .016, Study 2), (b) demonstrated increased model fit among the cigarette demand curves (partial η² = 0.23, p < .001, Study 1; partial η² = 0.08, p = .002, Study 2), and purchased tobacco products in the ETM more consistently with their current usage. We conclude that instruction quizzes before purchase tasks may be useful for researchers evaluating demand data. Instruction quizzes with multiple items may allow researchers to choose the level of data quality appropriate for their studies. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Episodic Future Thinking about Smoking-Related Illness: A Preliminary Investigation of Effects on Delay Discounting, Cigarette Craving, and Cigarette Demand.

Cigarette smokers show excessive delay discounting (devaluation of delayed rewards), which may contribute to tobacco use disorder. Episodic future thinking (EFT), or mental simulation of future events, has been shown to reduce both delay discounting and laboratory smoking behavior. Traditionally, EFT involves vividly imagining positive future events. In this preliminary investigation, we examined the effects of EFT specifically about smoking-related illness (SRI) on delay discounting, cigarette craving, and behavioral economic demand for cigarettes. In a 2 (episodic thinking) × 2 (smoking-related illness) factorial design, we randomly assigned smokers from Amazon Mechanical Turk to one of two EFT groups: EFT alone or EFT + SRI; or one of two episodic "recent" thinking (ERT) control groups: ERT alone or ERT + SRI. Both EFT groups generated and imagined positive future events, while both ERT groups imagined real events from the recent past. Both EFT + SRI and ERT + SRI groups imagined these events while also experiencing SRI symptoms. Participants then completed assessments of delay discounting, cigarette craving, and measures of cigarette demand. We observed significant main effects on delay discounting of both EFT (reduced discounting) and SRI (increased discounting), as well as significant main effects of both EFT and SRI on cigarette craving (in both cases, reduced craving). No significant main effect of EFT was observed on cigarette demand measures, although we observed a main effect of SRI on quantity of demand when cigarettes were free (Q0) (reduced demand). In all analyses, we observed no significant EFT × SRT interactions, indicating that these variables operate independently of one another. These methods may be adapted for use in clinical treatment to aid in smoking cessation interventions.

A Bayesian hierarchical model for individual participant data meta-analysis of demand curves.

Individual participant data meta-analysis is a frequently used method to combine and contrast data from multiple independent studies. Bayesian hierarchical models are increasingly used to appropriately take into account potential heterogeneity between studies. In this paper, we propose a Bayesian hierarchical model for individual participant data generated from the Cigarette Purchase Task (CPT). Data from the CPT details how demand for cigarettes varies as a function of price, which is usually described as an exponential demand curve. As opposed to the conventional random-effects meta-analysis methods, Bayesian hierarchical models are able to estimate both the study-specific and population-level parameters simultaneously without relying on the normality assumptions. We applied the proposed model to a meta-analysis with baseline CPT data from six studies and compared the results from the proposed model and a two-step conventional random-effects meta-analysis approach. We conducted extensive simulation studies to investigate the performance of the proposed approach and discussed the benefits of using the Bayesian hierarchical model for individual participant data meta-analysis of demand curves.