Efficacy of a novel online integrated treatment for problem gambling and tobacco smoking: Results of a randomized controlled trial.

Background and aims: Problem gambling and tobacco use are highly comorbid among adults. However, there are few treatment frameworks that target both gambling and tobacco use simultaneously (i.e., an integrated approach), while also being accessible and evidence-based. The aim of this two-arm open label RCT was to examine the efficacy of an integrated online treatment for problem gambling and tobacco use. Methods: A sample of 209 participants (Mage = 37.66, SD = 13.81; 62.2% female) from North America were randomized into one of two treatment conditions (integrated [n = 91] or gambling only [n = 118]) that lasted for eight weeks and consisted of seven online modules. Participants completed assessments at baseline, after treatment completion, and at 24-week follow-up. Results: While a priori planned generalized linear mixed models showed no condition differences on primary (gambling days, money spent, time spent) and secondary outcomes, both conditions did appear to significantly reduce problem gambling and smoking behaviours over time. Post hoc analyses showed that reductions in smoking and gambling craving were correlated with reductions in days spent gambling, as well as with gambling disorder symptoms. Relatively high (versus low) nicotine replacement therapy use was associated with greater reductions in gambling behaviours in the integrated treatment condition. Discussion and conclusions: While our open label RCT does not support a clear benefit of integrated treatment, findings suggest that changes in smoking and gambling were correlated over time, regardless of treatment condition, suggesting that more research on mechanisms of smoking outcomes in the context of gambling treatment may be relevant.

Health psychology and behavioral medicine researchers in Canada: An environmental scan.

The purpose of this study is to characterize contemporary Canadian health psychology through an environmental scan by identifying faculty, research productivity and strengths, and collaborator interconnectivity. Profiles at Canadian universities were reviewed for faculty with psychology doctorates and health psychology research programs. Publications were obtained through Google Scholar and PubMed (Jan/18-Mar/21). A total of 284 faculty were identified. Cancer, pain, and sleep were key research topics. The collaborator network analysis revealed that most were linked through a common network, with clusters organized around geography, topic, and trainee relationships. Canada is a unique and productive contributor to health psychology.

Social norms of college students engaging in non-medical prescription drug use to get high: What's sex got to do with it?

Background: Relationships exist between perceived peer and own use of alcohol, cannabis, and tobacco, particularly when peers and participants are sex-matched. We investigated sex influences on social norms effects for college students' non-medical prescription drug use (NMPDU). Methods: N = 1986 college students reported on their perceptions of male and female peers' NMPDU frequency and their own past-month NMPDU. Results: Approximately 3% of students self-reported past month NMPDU, with no sex differences. In a linear mixed model, participants who engaged in NMPDU perceived significantly more frequent peer use. Female participants perceived more frequent peer NMPDU than did male participants, particularly when perceiving male peers' NMPDU. Significant positive correlations were found between perceived peer NMPDU frequency and participants' own NMPDU for all peer-participant sex combinations, with no evidence for stronger correlations with sex-matched pairs. Conclusions: While social norm interventions may be effective for college student NMPDU, sex-matching of these interventions is likely unnecessary.

A multiple baseline trial of adapted prolonged exposure psychotherapy for individuals with early phase psychosis, comorbid substance misuse, and a history of adversity: A study protocol.

Background: Adversity is prevalent among people with psychotic disorders, especially those within the first 5 years of a psychotic disorder, called early phase psychosis. Although adversity can lead to many negative outcomes (e.g., posttraumatic stress symptoms), very few treatments for adversity-related sequelae have been tested with individuals with psychotic disorders, and even fewer studies have specifically tested interventions for people in early phase psychosis. Furthermore, people who misuse substances are commonly excluded from adversity treatment trials, which is problematic given that individuals with early phase psychosis have high rates of substance misuse. For the first time, this trial will examine the outcomes of an adapted 15-session prolonged exposure protocol (i.e., PE+) to observe whether reductions in adversity-related psychopathology occurs among people with early phase psychosis and comorbid substance misuse. Methods: This study will use a multiple-baseline design with randomization of participants to treatment start time. Participants will complete baseline appointments prior to therapy, engage in assessments between each of the five therapy modules, and complete a series of follow-up appointments 2 months after the completion of therapy. Primary hypothesized outcomes include clinically significant reductions in (1) negative psychotic symptoms measured using the Positive and Negative Syndrome Scale, (2) adversity-related sequelae measured using the Trauma Symptom Checklist-40, and (3) substance use frequency and overall risk score measured with the Alcohol, Smoking, and Substance Involvement Screening Test. We also anticipate that clinically significant reductions in hopelessness and experiential avoidance, measured with the Beck Hopelessness Scale and Brief Experiential Avoidance Questionnaire, the theorized mechanisms of change of PE+, will also be observed. A secondary outcome is a hypothesized improvement in functioning, measured using the Clinical Global Impression and Social and Occupational Functioning Assessment scales. Discussion: The results of this treatment trial will contribute to the advancement of treatment research for individuals in early phase psychosis who have current substance misuse and a history of adversity, and the findings may provide evidence supporting the use of hopelessness and experiential avoidance as mechanisms of change for this treatment. Clinical trial registration: Clinicaltrials.gov, NCT04546178; registered August 28, 2020, https://clinicaltrials.gov/ct2/show/NCT04546178?term=NCT04546178&draw=2&rank=1.

Pain and Fear of Cancer Recurrence in Survivors of Childhood Cancer.

OBJECTIVES: Theoretical models suggest that anxiety, pain intensity, and pain catastrophizing are implicated in a cycle that leads to heightened fear of cancer recurrence (FCR). However, these relationships have not been empirically examined. The objective of this study was to examine the relationships between anxiety symptoms, pain intensity, pain catastrophizing, and FCR in childhood cancer survivors and their parents and to examine whether pain catastrophizing predicts increased FCR beyond anxiety symptoms and pain intensity. METHODS: The participants were 54 survivors of various childhood cancers (Mage=13.1 y, range=8.4 to 17.9 y, 50% female) and their parents (94% mothers). Children reported on their pain intensity in the past 7 days. Children and parents separately completed measures of anxiety symptoms, pain catastrophizing, and FCR. RESULTS: Higher anxiety symptoms were associated with increased pain intensity, pain catastrophizing, and FCR in childhood cancer survivors. Higher anxiety symptoms and pain catastrophizing, but not child pain intensity, were associated with FCR in parents. Hierarchical linear regression models revealed that pain catastrophizing explained unique variance in both parent (ΔR2=0.11, P<0.01) and child (ΔR2=0.07, P<0.05) FCR over and above the effects of their own anxiety symptoms and child pain. DISCUSSION: The results of this study provides novel data on the association between pain and FCR and suggests that a catastrophic style of thinking about pain is more closely related to heightened FCR than one's anxiety symptoms or the sensory pain experience in both childhood cancer survivors and their parents. Pain catastrophizing may be a novel intervention target for survivors and parents struggling with fears of recurrence.

Long-term alterations in somatosensory functioning in survivors of childhood cancer.

ABSTRACT: Cancer and its treatment can have lasting consequences on somatosensation, including pain, which is often underrecognized and undertreated. Research characterizing the impact of cancer on pain and sensory processing in survivors of childhood cancer is scarce. This study aimed to quantify generalized differences in pain and sensory processing in survivors of childhood cancer compared with reference data using a standardized thermal and mechanical quantitative sensory testing (QST) protocol. The association between demographic, clinical (eg, leukemia vs other cancers and treatment exposures), and psychosocial (eg, anxiety and pain catastrophizing) variables and sensitivity to pain and sensory stimuli were also evaluated. Participants were 56 survivors of various types of childhood cancer (52% male, Mage = 13.5 years, SD = 3.2, range = 8-17 years). On average, children were 7 years (SD = 4.1, range = 1.2-16.5) post treatment. Almost all participants (86%) had at least 1 abnormal QST parameter compared with age- and sex-matched reference data; however, few participants self-reported the presence of sensory abnormalities. Generally, participants exhibited reduced sensitivity across the QST parameters examined (Ps < 0.05, ds = 0.40-3.45). A significant minority (45%) also exhibited pain sensitization (P <0.001, d = 0.42). Several risk factors for changes in sensory processing were identified, including current age, history of leukemia, certain treatment exposures (eg, vincristine cumulative dose, major surgery, and bone marrow or stem cell transplant), time off treatment, and higher anxiety and pain catastrophizing scores. Overall, this study demonstrated that somatosensory changes are prevalent in survivors of childhood cancer years after the completion of treatment. Future research is needed to understand long-term implications of altered somatosensation in this complex population.

Different drugs come with different motives: Examining motives for substance use among people who engage in polysubstance use undergoing methadone maintenance therapy (MMT).

BACKGROUND: Substance use motives (i.e., reasons for using a substance) are thought to be the most proximal variable leading to substance use. These motives have been described by various typologies, the most well known being the four-factor drinking motives model which separates motives into enhancement, social, coping, and conformity (Cooper, 1994). Although extensively studied in adult community samples, motives for use have less commonly been investigated among populations at a later stage of addiction, where polysubstance use is more common. Moreover, because the motives literature has largely focused on drinking motives, it is not clear whether existing findings can also be applied to other substances (Cooper et al., 2016). METHODS: Using Zero-inflated beta Bayesian linear mixed modeling, we investigated the stability of seven distinct substance use motives (enhancement, social, expansion, coping with anxiety, coping with depression, coping with withdrawal, and conformity) across six different drug categories (tobacco, alcohol, cannabis, opioids, stimulants, and tranquilisers) to determine the extent to which drug class can influence motive endorsement. One-hundred-and-thirty-eight methadone maintenance therapy (MMT) clients (F = 34.1%; M = 65.9%; age = 40.18 years) completed a novel short-form polysubstance motives questionnaire. RESULTS: External motives (i.e., conformity and social motives) were the most stable across drug categories, while all internal motives (i.e., enhancement, expansion, and all three coping motives) demonstrated varying levels of inter-drug variability. CONCLUSIONS: These findings have important implications for prevention and intervention strategies among people who engage in polysubstance use, highlighting the importance of both universal and substance-specific programming.

Reactivity to Daily Self-Monitoring of Cannabis Use in Biological Females.

Assessment reactivity involves changes to behaviours from self-monitoring those behaviours (Nelson & Hayes, 1981). In the substance use field, reactivity has been identified both as a potential confound in daily diary research (Cohn et al., 2015) and as a possible intervention tool in clinical practice (Cohn et al., 2018). Reactivity to daily self-monitoring of alcohol and tobacco use has been inconsistent in prior research. Reactivity to daily self-monitoring of cannabis use quantity has received far less study. This study involved secondary analyses of data from N = 88 females who self-monitored their cannabis use for 32 days. We examined objective reactivity of cannabis use to daily self-monitoring by assessing changes in daily cannabis use over 32 days. We also explored participants' perceptions of the impact daily self-monitoring had on their cannabis use at study completion (i.e., subjective reactivity). In hurdle models testing objective reactivity, neither probability of cannabis use, nor quantity of cannabis use, changed significantly over the study period. Many respondents (45%) reported no subjective reactivity, though a slight majority (55%) reported some subjective reactivity. Subjective reactivity did not moderate objective reactivity over time; however, higher subjective reactivity was significantly associated with increased variability (interquartile range [IQR]) in cannabis use across the self-monitoring period. Overall, reactivity appears unlikely to confound research utilizing daily diary cannabis measures, and daily self-monitoring of cannabis use may be unlikely to serve as a useful stand-alone intervention for reducing cannabis use in non-treatment-seeking individuals. Potential clinical implications of the novel finding of a link between subjective reactivity and objective cannabis use variability are discussed.

Developing and testing the effectiveness of a novel online integrated treatment for problem gambling and tobacco smoking: a protocol for an open-label randomized controlled trial.

BACKGROUND: Gambling and tobacco smoking are highly comorbid among North American adults. However, there is a paucity of treatment options that are integrated (i.e. targeting both gambling and tobacco smoking simultaneously), accessible, and evidence based. METHODS: The aim of this two-arm open-label randomized controlled trial is to examine the effectiveness of an online, self-guided integrated treatment for problem gambling and tobacco smoking. A target sample of 214 participants will be recruited and be randomized into either an 8-week integrated or gambling only control condition. Both conditions will consist of seven online modules following cognitive behavioural therapy and motivational interviewing principles. Our three primary outcomes are (1) the number of days gambled, (2) money spent on gambling activities, and (3) time spent in gambling activities. Secondary outcomes include gambling disorder symptoms, cigarette use, and nicotine dependence symptoms. Assessments will be completed at baseline, at completion (i.e. 8 weeks from baseline), and at follow-up (i.e. 24 weeks from baseline). Generalized linear mixed modelling will be used to evaluate our primary and secondary outcomes. We expect that participants receiving online integrated treatment will show larger reductions in gambling relative to those receiving a control gambling only intervention. We further hypothesize that reductions in smoking will mediate these group differences. DISCUSSION: The rates of problem gambling and tobacco smoking are high in North America; yet, the treatment options for both are limited, with no integrated treatments available. If supported, our pilot study will be a cost-effective and accessible way to improve treatments for co-occurring problem gambling and tobacco use. TRIAL REGISTRATION: ClinicalTrials.gov NCT03614884 . Registered on August 3, 2019.

A Retrospective Study of the Clinical Characteristics Associated with Alcohol and Cannabis use in Early Phase Psychosis.

OBJECTIVE: Alcohol and cannabis misuse are common in patients with early phase psychosis (EPP); however, research has tended to focus primarily on cannabis misuse and EPP outcomes, with a relative lack of data on alcohol misuse. This retrospective cross-sectional EPP study investigated the relationship between cannabis, alcohol, and cannabis combined with alcohol misuse, on age, gender, psychotic, depressive and anxiety symptom severity, and social/occupational functioning, at entry to service. METHODS: Two-hundred and sixty-four EPP patients were divided into 4 groups based on substance use measured by the Alcohol, Smoking and Substance Involvement Screening Test: (1) no to low-level cannabis and alcohol misuse (LU), (2) moderate to high alcohol misuse only (AU), (3) moderate to high cannabis misuse only (CU), and (4) moderate to high alcohol and cannabis misuse (AU + CU). RESULTS: We found significant between group differences in age (with the AU group being the oldest and AU + CU group the youngest) as well as gender (with the CU group having the highest percentage of men). There were also group differences in positive psychotic symptoms (lowest in AU group), trait anxiety (highest in AU + CU group), and social/occupational functioning (highest in AU group). Further regression analyses revealed a particularly strong relationship between AU + CU group and trait anxiety (3-fold increased odds of clinical trait anxiety for combined misuse of alcohol and cannabis compared to non/low users). CONCLUSIONS: This study demonstrates the unique demographic and clinical characteristics found in the EPP population at entry to care associated with alcohol and cannabis misuse both separately and in combination. This work highlights the importance of including the assessment of alcohol misuse in addition to cannabis misuse in future treatment guidelines and research.

The Effect of Cigarette Packaging and Illness Sensitivity on Attention to Graphic Health Warnings: A Controlled Study.

INTRODUCTION: The social and health care costs of smoking are immense. To reduce these costs, several tobacco control policies have been introduced (eg, graphic health warnings [GHWs] on cigarette packs). Previous research has found plain packaging (a homogenized form of packaging), in comparison to branded packaging, effectively increases attention to GHWs using UK packaging prototypes. Past studies have also found that illness sensitivity (IS) protects against health-impairing behaviors. Building on this evidence, the goal of the current study was to assess the effect of packaging type (plain vs. branded), IS level, and their interaction on attention to GHWs on cigarette packages using proposed Canadian prototypes. AIMS AND METHODS: We assessed the dwell time and fixations on the GHW component of 40 cigarette pack stimuli (20 branded; 20 plain). Stimuli were presented in random order to 50 smokers (60.8% male; mean age = 33.1; 92.2% daily smokers) using the EyeLink 1000 system. Participants were divided into low IS (n = 25) and high IS (n = 25) groups based on scores on the Illness Sensitivity Index. RESULTS: Overall, plain packaging relative to branded packaging increased fixations (but not dwell time) on GHWs. Moreover, low IS (but not high IS) smokers showed more fixations to GHWs on plain versus branded packages. CONCLUSIONS: These findings demonstrate that plain packaging is a promising intervention for daily smokers, particularly those low in IS, and contribute evidence in support of impending implementation of plain packaging in Canada. IMPLICATIONS: Our findings have three important implications. First, our study provides controlled experimental evidence that plain packaging is a promising intervention for daily smokers. Second, the findings of this study contribute supportive evidence for the impending plain packaging policy in Canada, and can therefore aid in defense against anticipated challenges from the tobacco industry upon its implementation. Third, given its effects in increasing attention to GHWs, plain packaging is an intervention likely to provide smokers enhanced incentive for smoking cessation, particularly among those low in IS who may otherwise be less interested in seeking treatment for tobacco dependence.

The acute effects of tobacco smoking and alcohol consumption on video-lottery terminal gambling.

RATIONALE: Gamblers often use alcohol and/or tobacco when they gamble but little is known about the extent to which drinking or smoking affects gambling behavior. OBJECTIVES: This study examined the acute effects of alcohol and nicotine-containing tobacco administration on the subjective and behavioral responses to video-lottery terminal (VLT) gambling in 16 regular video-lottery terminal players (11 male) who were also regular consumers of alcohol and tobacco. METHODS: During four double-blind, counterbalanced sessions, participants assessed the subjective effects of nicotine-containing tobacco or denicotinized tobacco following the administration of a moderately intoxicating dose of alcohol or a placebo beverage. They were then given $40 and provided with an opportunity to gamble using an authentic VLT. RESULTS: Alcohol administration was associated with increased ratings of several subjective descriptors including "intoxicated", "high", "want alcohol", "crave cigarette", and "want to gamble" but did not affect subsequent gambling behavior. In contrast, relative to denicotinized tobacco, the administration of nicotine containing tobacco was associated with increased average wagers, but did not significantly alter subjective state. CONCLUSIONS: Findings suggest that both alcohol and nicotine-containing tobacco may acutely increase the propensity to gamble using VLTs, but they may do so through separate processes.

A sequential examination of parent-child interactions at anesthetic induction.

Parental presence is often employed to alleviate distress in children within the context of surgery under general anesthesia. The critical component of this intervention may not be the presence of the parent per se, but more importantly the behaviors in which the parent and child engage when the parent is present. The purpose of the current study was to examine the sequential and reciprocal relationships between parental behaviors and child distress during induction of general anesthesia. Participants were 32 children (3-6 years) receiving dental surgery as a day surgery procedure, and their parents. A modified Child Adult Medical Procedures Interaction Scale-Revised was used to code parent and child behaviors. Initial child distress led to increased parental provision of reassurance and decreased provision of physical comfort. Our findings may inform the development of preoperative preparation programs whereby parents can be appropriately educated about what behaviors will be helpful/unhelpful for their child during induction of general anesthesia.

Cannabis use motives and personality risk factors.

According to the model of substance abuse of Conrod, Pihl, Stewart, and Dongier (2000), four personality factors (i.e., anxiety sensitivity [AS], introversion/hopelessness [I/H], sensation seeking [SS], and impulsivity [IMP]) are associated with elevated risk for substance use/misuse, with each personality factor being related to preference for particular drugs of abuse (e.g., AS with anxiolytics). However, cannabis use has not been consistently linked to any one of these personality factors. This may be due to the heterogeneity in cannabis use motives. The present study explored the association between these four personality risk factors and different cannabis use motives. Cannabis users completed an interview about their motives for cannabis use as well as the self-report Substance Use Risk Profile Scale (SURPS; Woicik, Conrod, Stewart, & Pihl, 2009), which measures the four personality risk factors. Results showed that AS was associated with conformity motives and I/H was associated with coping motives for cannabis use. SS was positively associated with expansion motives and IMP was associated with drug availability motives. Thus, personality risk factors in the model of Conrod et al. (2000) are associated with distinct cannabis use motives in a pattern consistent with theory.

Multimodal neuroimaging of frontal white matter microstructure in early phase schizophrenia: the impact of early adolescent cannabis use.

BACKGROUND: A disturbance in connectivity between different brain regions, rather than abnormalities within the separate regions themselves, could be responsible for the clinical symptoms and cognitive dysfunctions observed in schizophrenia. White matter, which comprises axons and their myelin sheaths, provides the physical foundation for functional connectivity in the brain. Myelin sheaths are located around the axons and provide insulation through the lipid membranes of oligodendrocytes. Empirical data suggests oligodendroglial dysfunction in schizophrenia, based on findings of abnormal myelin maintenance and repair in regions of deep white matter. The aim of this in vivo neuroimaging project is to assess the impact of early adolescent onset of regular cannabis use on brain white matter tissue integrity, and to differentiate this impact from the white matter abnormalities associated with schizophrenia. The ultimate goal is to determine the liability of early adolescent use of cannabis on brain white matter, in a vulnerable brain. METHODS/DESIGN: Young adults with schizophrenia at the early stage of the illness (less than 5 years since diagnosis) will be the focus of this project. Four magnetic resonance imaging measurements will be used to assess different cellular aspects of white matter: a) diffusion tensor imaging, b) localized proton magnetic resonance spectroscopy with a focus on the neurochemical N-acetylaspartate, c) the transverse relaxation time constants of regional tissue water, d) and of N-acetylaspartate. These four neuroimaging indices will be assessed within the same brain region of interest, that is, a large white matter fibre bundle located in the frontal region, the left superior longitudinal fasciculus. DISCUSSION: We will expand our knowledge regarding current theoretical models of schizophrenia with a more comprehensive multimodal neuroimaging approach to studying the underlying cellular abnormalities of white matter, while taking into consideration the important confounding variable of early adolescent onset of regular cannabis use.

The effect of snus on alcohol-related cigarette administration in dependent and non-dependent smokers.

INTRODUCTION: Alcohol has been found to increase tobacco smoking in both dependent daily smokers (DDS) and nondependent nondaily smokers (NNS), yet little attention has been directed toward examining how different treatments/products modify drinking-related smoking behavior. METHODS: This study examined the acute effects of snus (4mg of nicotine) on alcohol-related smoking responses in 18 DDS and 17 NNS. During each double-blind session, participants were randomly assigned to receive one of the following combinations: alcohol and snus, alcohol and placebo snus, placebo alcohol and snus, or placebo alcohol and placebo snus. Participants consumed their assigned beverage before absorbing their session's product, and after 30min participants could self-administer puffs of their preferred brand of cigarette over a 60-minute period using a progressive ratio task. RESULTS: Alcohol significantly increased tobacco craving (p<.001) and tended to decrease latency to start smoking (p=.021) but only among NNS. In contrast, snus tended to decrease the number of puffs earned and how hard DDS worked for puffs in both beverage conditions (ps≤.019) but it did not alter the smoking behavior of NNS. Craving was not significantly impacted by snus in either type of smoker. DISCUSSION: These findings raise the possibility that different processes mediate alcohol and cigarette co-use in NNS and DDS and suggest that snus may be effective in reducing alcohol-related cigarette use in DDS specifically.

The effects of nicotine content information on subjective and behavioural responses to nicotine-containing and denicotinized cigarettes.

The effects of nicotine content information on subjective and behavioural responses to nicotine-containing and denicotinized cigarettes were examined in 30 dependent and 30 nondependent 12-h abstinent smokers. Using the four conditions of a balanced placebo design, participants were given either nicotine-containing cigarettes or denicotinized cigarettes during two laboratory sessions but were told that they received nicotine-containing cigarettes in one session and nicotine-free cigarettes in the other. During each session, participants completed subjective assessments before and after sampling three puffs from the assigned cigarette and were then invited to earn additional cigarette puffs using a computerized progressive ratio task. Regardless of the actual nicotine content, participants self-administered more cigarette puffs when they were told the cigarettes contained nicotine than when told the cigarettes were nicotine-free and tended to show a decrease in craving associated with the intention to smoke after cigarette sampling when told the cigarettes were nicotine-free relative to when they were told the cigarettes contained nicotine. However, regardless of nicotine instructions, participants given nicotine-containing cigarettes showed greater postsampling increases in subjective ratings of 'satisfied' and 'stimulated' than did those given denicotinized cigarettes. The findings suggest that nicotine dose expectancy can affect both subjective and behavioural indices of smoking reinforcement but that the satisfying and stimulating aspects of smoking are related to actual nicotine administration.

The effects of alcohol on responses to nicotine-containing and denicotinized cigarettes in dependent and nondaily smokers.

BACKGROUND: Alcohol consumption has been linked to increased tobacco use and craving in both dependent and nondaily smokers, yet the extent to which these relationships depend on interactions involving nicotine remains unclear. This study examined the acute effects of alcohol on the subjective and behavioral responses to nicotine-containing tobacco and denicotinized tobacco in 17 (10 male) dependent daily smokers (DDS) and 23 (11 male) nondependent nondaily smokers (NNS). METHODS: During 4 randomized double-blind sessions, participants assessed the effects of nicotine-containing tobacco or denicotinized tobacco following the administration of a moderately intoxicating dose of alcohol (mean blood alcohol concentration = 0.076 g/dl) or a placebo beverage. They could then self-administer additional puffs of the same type of cigarette sampled over a 60-minute period using a progressive ratio task. RESULTS: In NNS, alcohol significantly increased the self-administration of both nicotine-containing and denicotinized cigarettes, and no differences in self-administration were observed between the 2 types of tobacco within either beverage condition. In contrast, in DDS, alcohol was associated with decreased denicotinized tobacco self-administration relative to the placebo beverage condition as well as with increased self-administration of nicotine-containing tobacco relative to denicotinized tobacco. DDS also exhibited relatively elevated craving following the administration of a nicotine-containing cigarette in the alcohol beverage condition. CONCLUSIONS: Findings suggest that nicotine may be critical to the drinking-smoking relationship in DDS, but that nonnicotine smoking factors may be more important in NNS.

Outcome expectancy liking: a self-generated, self-coded measure predicts adolescent substance use trajectories.

This study tested the predictive validity of a novel, brief, and easy-to-use self-report measure of expectancies and their subjective values for alcohol and marijuana use. Canadian students in Grades 7 to 11 were administered paper-and-pencil questionnaires once per year for 3 consecutive years (Krank et al., 2011). As part of the questionnaire, participants completed an outcome expectancy measure where they were asked to list 3 or 4 things they expected would happen if they used a particular substance (i.e., alcohol, marijuana) and to indicate for each whether they would or would not like this outcome. "Liking" outcomes were coded as +1, "not like" as -1, and summed to obtain an outcome expectancy liking (OEL) sum for each participant and each substance. Participants also completed substance use behavior questions for alcohol and marijuana. Multilevel modeling demonstrated that OEL sum significantly predicted the intercept and slope of substance use trajectories by participants, even when demographic variables were controlled. For both alcohol and marijuana, multilevel modeling analyses indicated that a more positive OEL sum for a substance in the first year of the study were more likely to have tried that substance earlier (intercept) and were more likely to escalate their use at a greater rate over time (slope). The results complement the predictive validity found with other direct and indirect measures of substance use associations. The outcome expectancy liking task is a simple and unobtrusive method for identifying adolescents who are at risk for early substance abuse.

A comparison of gambling behavior, problem gambling indices, and reasons for gambling among smokers and nonsmokers who gamble: evidence from a provincial gambling prevalence study.

INTRODUCTION: Numerous epidemiological and clinical studies have found that tobacco use and gambling frequently cooccur. Despite high rates of smoking among regular gamblers, the extent to which tobacco potentially influences gambling behavior and vice versa is poorly understood. The current study aimed to provide more insight into this relationship by directly comparing nonsmoking and smoking gamblers on gambling behavior, problem gambling indices, and reasons for gambling. METHODS: The data for this study came from the 2005 Newfoundland and Labrador Gambling Prevalence Study. Gamblers identified as nonsmokers (N = 997) were compared with gamblers who smoke (N = 622) on numerous gambling-related variables. Chi-square analyses were used to compare groups on demographic variables. Associations between smoking status and gambling criteria were assessed with a series of binary logistic regressions. RESULTS: The regression analyses revealed several significant associations between smoking status and past 12-month gambling. Higher problem gambling severity scores, use of alcohol/drugs while gambling, amount of money spent gambling, use of video lottery terminals, and reasons for gambling which focused on positive reinforcement/reward and negative reinforcement/relief were all associated with smoking. CONCLUSIONS: The findings suggest an association between smoking and potentially problematic gambling in a population-based sample. More research focused on the potential reinforcing properties of tobacco on the development and treatment of problematic gambling is needed.