Normatively irrelevant disgust interferes with decision under uncertainty: Insights from the Iowa gambling task.

This study investigates whether a not informative, irrelevant emotional reaction of disgust interferes with decision-making under uncertainty. We manipulate the Iowa Gambling Task (IGT) by associating a disgust-eliciting image with selections from Disadvantageous/Bad decks (Congruent condition) or Advantageous/Good decks (Incongruent condition). A Control condition without manipulations is also included. Results indicate an increased probability of selecting from a Good deck as the task unfolds in all conditions. However, this effect is modulated by the experimental manipulation. Specifically, we detect a detrimental effect (i.e., a significant decrease in the intercept) of the disgust-eliciting image in Incongruent condition (vs. Control), but this effect is limited to the early stages of the task (i.e., first twenty trials). No differences in performance trends are detected between Congruent and Control conditions. Anticipatory Skin Conductance Response, heart rate, and pupil dilation are also assessed as indexes of anticipatory autonomic activation following the Somatic Marker Hypothesis, but no effects are shown for the first two indexes in any of the conditions. Only a decreasing trend is detected for pupil dilation as the task unfolds in Control and Incongruent conditions. Results are discussed in line with the "risk as feelings" framework, the Somatic Marker Hypothesis, and IGT literature.

The Interest in Betting, Smoking, Alcohol, and Drugs in Malawi: Changing Trends between 2012-2022.

Background: In recent years, the online gambling market has rapidly developed, and betting has become one of the most popular forms of gambling. The aim of this study was to analyse the interest of the Malawian population in terms related to betting, sports betting, alcohol, cigarettes, and some psychoactive drugs through the relative search volumes of Google Trends. Methods: Internet search query data related to betting, sports betting, alcohol, cigarettes, and psychoactive drugs were obtained monthly from Google Trends for the period 2010-2022. Comparisons of interest levels in these topics were conducted in Malawi, and correlation coefficients were calculated. Results: In Malawi, relative search volumes for betting and sports betting terms were the highest (average RSVs: 66% and 30%). It was found that from 2019 onwards, the interest in betting and sports-related search topics and keywords increased significantly (p < 0.001). Strong positive correlations were found between betting-related keywords and alcohol and gross domestic product (r = 0.831 and r = 0.901, p < 0.001). A positive correlation was found between betting and psychoactive drug-related terms (minimum r = 0.417, p < 0.01). Conclusions: This study concludes that the interest of the Malawian population in betting has increased in recent years, while interest in psychoactive drugs and alcohol remains high. Gross domestic product is highly correlated with society's interest in betting. It was additionally found that Google Trends can be used as a tool to predict and monitor future risky behaviours, such as gambling disorder.

Mobile App Intervention to Reduce Substance Use, Gambling, and Digital Media Use in Vocational School Students: Exploratory Analysis of the Intervention Arm of a Randomized Controlled Trial.

BACKGROUND: During adolescence, substance use and digital media exposure usually peak and can become major health risks. Prevention activities are mainly implemented in the regular school setting, and youth outside this system are not reached. A mobile app ("Meine Zeit ohne") has been developed specifically for vocational students and encourages participants to voluntarily reduce or abstain from a self-chosen addictive behavior including the use of a substance, gambling, or a media-related habit such as gaming or social media use for 2 weeks. Results from a randomized study indicate a significant impact on health-promoting behavior change after using the app. This exploratory study focuses on the intervention arm of this study, focusing on acceptance and differential effectiveness. OBJECTIVE: The aims of this study were (1) to examine the characteristics of participants who used the app, (2) to explore the effectiveness of the mobile intervention depending on how the app was used and depending on participants' characteristics, and (3) to study how variations in app use were related to participants' baseline characteristics. METHODS: Log data from study participants in the intervention group were analyzed including the frequency of app use (in days), selection of a specific challenge, and personal relevance (ie, the user was above a predefined risk score for a certain addictive behavior) of challenge selection ("congruent use": eg, a smoker selected a challenge related to reducing or quitting smoking). Dichotomous outcomes (change vs no change) referred to past-month substance use, gambling, and media-related behaviors. The relationship between these variables was analyzed using binary, multilevel, mixed-effects logistic regression models. RESULTS: The intervention group consisted of 2367 vocational students, and 1458 (61.6%; mean age 19.0, SD 3.5 years; 830/1458, 56.9% male) of them provided full data. Of these 1458 students, 894 (61.3%) started a challenge and could be included in the analysis (mean 18.7, SD 3.5 years; 363/894, 40.6% female). Of these 894 students, 466 (52.1%) were considered frequent app users with more than 4 days of active use over the 2-week period. The challenge area most often chosen in the analyzed sample was related to social media use (332/894, 37.1%). A total of 407 (45.5%) of the 894 students selected a challenge in a behavioral domain of personal relevance. The effects of app use on outcomes were higher when the area of individual challenge choice was equal to the area of behavior change, challenge choice was related to a behavior of personal relevance, and the individual risk of engaging in different addictive behaviors was high. CONCLUSIONS: The domain-specific effectiveness of the program was confirmed with no spillover between behavioral domains. Effectiveness appeared to be dependent on app use and users' characteristics. TRIAL REGISTRATION: German Clinical Trials Register DRKS00023788; https://tinyurl.com/4pzpjkmj. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s13063-022-06231-x.

The relationship between the price and demand of alcohol, tobacco, unhealthy food, sugar-sweetened beverages, and gambling: an umbrella review of systematic reviews.

BACKGROUND: The WHO highlight alcohol, tobacco, unhealthy food, and sugar-sweetened beverage (SSB) taxes as one of the most effective policies for preventing and reducing the burden of non-communicable diseases. This umbrella review aimed to identify and summarise evidence from systematic reviews that report the relationship between price and demand or price and disease/death for alcohol, tobacco, unhealthy food, and SSBs. Given the recent recognition as gambling as a public health problem, we also included gambling. METHODS: The protocol for this umbrella review was pre-registered (PROSPERO CRD42023447429). Seven electronic databases were searched between 2000-2023. Eligible systematic reviews were those published in any country, including adults or children, and which quantitatively examined the relationship between alcohol, tobacco, gambling, unhealthy food, or SSB price/tax and demand (sales/consumption) or disease/death. Two researchers undertook screening, eligibility, data extraction, and risk of bias assessment using the ROBIS tool. RESULTS: We identified 50 reviews from 5,185 records, of which 31 reported on unhealthy food or SSBs, nine reported on tobacco, nine on alcohol, and one on multiple outcomes (alcohol, tobacco, unhealthy food, and SSBs). We did not identify any reviews on gambling. Higher prices were consistently associated with lower demand, notwithstanding variation in the size of effect across commodities or populations. Reductions in demand were large enough to be considered meaningful for policy. CONCLUSIONS: Increases in the price of alcohol, tobacco, unhealthy food, and SSBs are consistently associated with decreases in demand. Moreover, increasing taxes can be expected to increase tax revenue. There may be potential in joining up approaches to taxation across the harm-causing commodities.

Negative and positive mental health characteristics of affected family members: Findings from a cross-sectional Australian general population gambling study.

Despite the impact of problem gambling on affected family members (AFMs), there are limited large-scale population level studies identifying the negative mental health (NMH) and positive mental health (PMH) characteristics of AFMs. Furthermore, no study has explored whether PMH characteristics are protective in the relationships between AFM status and NMH characteristics. This study involved secondary data analysis from the Third Social and Economic Impact Study of Gambling in Tasmania. Using a subsample of 1,869 adults (48.30 % male; meanage = 48.48; 4.67 % AFMs), this study aimed to explore whether: (1) AFM status is associated with NMH (depression, anxiety, panic, post-traumatic stress disorder, social anxiety, binge drinking, tobacco use, and drug use symptoms) and PMH (quality of life [QOL], personal growth/autonomy, interpersonal/social skills, coping skills) characteristics after separately controlling for sociodemographic, problem gambling severity, and other NMH characteristics; (2) PMH characteristics moderate (buffer) the relationships between AFM status and NMH characteristics; and (3) gender influences these relationships. AFM status, defined as exposure to family member gambling problems, significantly positively predicted NMH characteristics (depression, anxiety, panic, PTSD, and tobacco use symptoms) and negatively predicted QOL (physical, social) and planning coping. The strength of these relationships generally attenuated after controlling for various covariates. Gender did not moderate these relationships. Religious coping exacerbated the relationship between AFM status and panic disorder symptoms. These findings can inform the development of intervention initiatives for family members exposed to gambling problems. Future population-representative research is required using a range of affected other types, longitudinal study designs, and more comprehensive measures.

Intersection of gambling with smoking and alcohol use in Great Britain: a cross-sectional survey in October 2022.

OBJECTIVES: Gambling is associated with cigarette smoking and alcohol consumption. We explored the intersection of gambling across all risk levels of harm with smoking and alcohol use among adults in Great Britain. DESIGN: A nationally representative cross-sectional survey in October 2022. SETTING: Great Britain. PARTICIPANTS: A weighted total of 2398 adults (18+ years). OUTCOME MEASURES: We examined the prevalence of past-year gambling and, among those reporting gambling, assessed the associations between the outcome of any risk of harm from gambling (scoring >0 on the Problem Gambling Severity Index) and the binary predictor variables of current cigarette smoking and higher risk alcohol consumption (AUDIT-C score≥4). We also explored data on weekly expenditure on gambling with smoking and alcohol use among those categorised at any-risk of harm from gambling. RESULTS: Overall, 43.6% (95% CI 41.2% to 45.9%) of adults gambled in the past year. Among these, 7.3% (95% CI 5.3% to 9.3%) were classified at any-risk of harm from gambling, 16.0% (95% CI 13.2% to 18.8%) were currently smoking and 40.8% (95% CI 37.2% to 44.4%) were drinking at increasing and higher risk levels. There were no associations between any risk of harm from gambling and current smoking (OR adjusted=0.80, 95% CI 0.35 to 1.66) or drinking at increasing and higher risk levels (OR adjusted=0.94, 95% CI 0.52 to 1.69), respectively. Analyses using Bayes factors indicated that these data were insensitive to distinguish no effect from a range of associations (OR=95% CI 0.5 to 1.9). The mean weekly spend on gambling was £7.69 (95% CI £5.17 to £10.21) overall, £4.80 (95% CI £4.18 to £5.43) among those classified as at no risk and £45.68 (95% CI £12.07 to £79.29) among those at any risk of harm from gambling. CONCLUSIONS: Pilot data in a population-level survey on smoking and alcohol use yielded similar estimates to other population-level surveys on gambling participation and at-risk gambling. Further data are needed to elucidate the intersections more reliably between gambling, smoking and alcohol use and inform population-level approaches to reduce harm.

[Substance use and the usage of social media, computer games, and gambling among apprentices at vocational schools]. / Substanzkonsum und Nutzung von sozialen Medien, Computerspielen und Glücksspielen unter Auszubildenden an beruflichen Schulen.

BACKGROUND: The aim of the current study was to assess the prevalence of the (problematic) consumption of alcohol, tobacco, and cannabis as well as the (problematic) use of social media, e­products, computer games, and gambling among apprentices. METHOD: Cross-sectional survey of 4591 apprentices at 17 vocational schools from Bavaria, Schleswig-Holstein, and Hamburg. Data was collected using questionnaires between March 2021 and April 2022. The primary endpoints were the 30-day prevalence and the problematic consumption and usage behavior of the mentioned substances/behaviors using screening instruments. RESULTS: Among the assessed substances/behaviors, social media were used most frequently by the apprentices with a 30-day prevalence of 97.7%, followed by alcohol (64.3%) and computer games (55.8%). Cigarettes were consumed by 35.1%, e­products by 17.9%, and cannabis by 15.4% of the apprentices. Of the apprentices, 12.2% reported having gambled in the past 30 days. Rates of problematic use were 47.4% for alcohol, 18.0% for tobacco, 6.2% for e­products, and 1.6% for cannabis. Problematic use of social media was indicated by 45.0% of the apprentices, of gambling by 2.2%, and of computer games by 0.7%. DISCUSSION: These results suggest that apprentices constitute a risk group for problematic substance use, indicating increased need for intervention. In particular, secondary prevention efforts in the areas of alcohol and social media should be taken into consideration due to their widespread prevalence in the vocational school setting.

Towards a conceptual framework for the prevention of gambling-related harms: Findings from a scoping review.

The global gambling sector has grown significantly over recent years due to liberal deregulation and digital transformation. Likewise, concerns around gambling-related harms-experienced by individuals, their families, their local communities or societies-have also developed, with growing calls that they should be addressed by a public health approach. A public health approach towards gambling-related harms requires a multifaceted strategy, comprising initiatives promoting health protection, harm minimization and health surveillance across different strata of society. However, there is little research exploring how a public health approach to gambling-related harms can learn from similar approaches to other potentially harmful but legal sectors such as the alcohol sector, the tobacco sector, and the high in fat, salt and sugar product sector. Therefore, this paper presents a conceptual framework that was developed following a scoping review of public health approaches towards the above sectors. Specifically, we synthesize strategies from each sector to develop an overarching set of public health goals and strategies which-when interlinked and incorporated with a socio-ecological model-can be deployed by a range of stakeholders, including academics and treatment providers, to minimise gambling-related harms. We demonstrate the significance of the conceptual framework by highlighting its use in mapping initiatives as well as unifying stakeholders towards the minimization of gambling-related harms, and the protection of communities and societies alike.

Brand and addiction: A network analysis of scientific literature.

OBJECTIVE: The paper conducts a network analysis of the fragmented literature on brand and addiction. METHOD: A thematic map, thematic evolution, word cloud, co-citation analysis, and cooperation networks were utilized to identify brand addiction study trends and topics. RESULTS: The data show that marketing and psychiatry have interdisciplinary groupings and multidisciplinary publications. These groups reflect societal changes, particularly the shift from traditional to digital challenges. Fast food addiction is different from alcohol and cigarette addictions due to its ease and extensive marketing. The decline in internet and gambling addiction suggests a shift in priorities. CONCLUSIONS: This research helps researchers, policymakers, and practitioners in addiction prevention and intervention. The study also understands brand addiction and its effects on psychology, psychiatry, and management by providing insights into emerging topics, thematic maps and evolution of studies, collaboration opportunities, geographical distribution of studies, and more.

Income Inequality and the Odds of Online Gambling Among a Large Sample of Adolescents in Canada.

Consistent evidence points to the detrimental effects of income inequality on population health. Income inequality may be associated with online gambling, which is of concern since gambling is a risk factor for adverse mental health conditions, such as depression and suicide ideation. Thus, the overall objective of this study is to study the role of income inequality on the odds of participating in online gambling. Data from 74,501 students attending 136 schools participating in the 2018/2019 Cannabis, Obesity, Mental health, Physical activity, Alcohol, Smoking, and Sedentary behaviour (COMPASS) survey were used. The Gini coefficient was calculated based on school census divisions (CD) using the Canada 2016 Census linked with student data. We used multilevel modeling to explore the association between income inequality and self-reported participation in online gambling in the last 30 days, while controlling for individual- and area-level characteristics. We examined whether mental health (depressive and anxiety symptoms, psychosocial wellbeing), school connectedness, and access to mental health programs mediate this relationship. Adjusted analysis indicated that a standardized deviation (SD) unit increase in Gini coefficient (OR = 1.17, 95% CI 1.05, 1.30) was associated with increased odds of participating in online gambling. When stratified by gender, the association was significant only among males (OR = 1.12, 95% CI 1.03, 1.22). The relationship between higher income inequality and greater odds for online gambling may be mediated by depressive and anxiety symptoms, psychosocial well-being, and school connectedness. Evidence points to further health consequences, such as online gambling participation, stemming from exposure to income inequality.

Loss aversion predicts cigarette smoking status across levels of sociodemographic characteristics.

Loss aversion (LA) is a tendency to be more sensitive to potential losses relative to similar gains. Low LA is associated with increased risk for cigarette smoking and use of other substances. Previous studies of LA and smoking risk controlled for potentially confounding influences of sociodemographic characteristics associated with smoking risk. The present study replicates these earlier observations while also examining the generality of the association between low LA and smoking risk within different levels of each of the five sociodemographic risk factors for smoking (age, educational attainment, gender, income, race/ethnicity). Parallel analyses were conducted using delay discounting (DD) as a positive control; DD is a decision-making bias regarding the rate at which rewards lose value with increasing delay to receipt. Participants were recruited using standard crowdsourcing methods and completed a sociodemographics questionnaire, a hypothetical gamble task measure of LA, and a monetary choice measure of DD. Low LA was associated with increased risk of cigarette smoking after accounting for the influence of sociodemographic characteristics and DD. Similarly, high DD was associated with increased risk of cigarette smoking after accounting for the influence of sociodemographic characteristics and LA. Further analyses showed that associations of LA with smoking risk or DD with smoking risk generally although not always remained significant within varying levels of the sociodemographic characteristics of interest. These results provide support for low LA as a reliable risk factor for smoking that has generality within and across sociodemographic characteristics and closely parallels associations observed with DD and smoking risk. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Exploring Socioeconomic, Demographic and Psychological Predictors of At-risk Gambling and Participation in Specific Gambling Activities: A Comparative Approach.

In this research, we aimed to provide a comparative examination of at-risk gambling and four types of gambling activities from the standpoint of socioeconomic, demographic and psychological factors. Using data collected from 7,385 adults aged 18-64 from Serbia, we investigated how specific variables contribute to the likelihood of participation in lottery playing, sports betting, casino games, and slot games across the three time frames (lifetime, last year, and last month), and at-risk gambling. Logistic regressions revealed that male sex, ages 18 to 34, drug use, harmful alcohol use, and elevated levels of distress were significant predictors of participation in any point of life in sports betting, casino games, and slot games, and at-risk gambling. Secondary education, residing in an urban area, and harmful alcohol use predicted - across three time frames - the engagement in lottery playing, sports betting, and slot games playing, respectively. Smoking, and specifically heavy smoking, was shown to be predictive of lifetime participation in all types of gambling, while having single marital status and being unemployed emerged as the factors increasing the odds for the last-month slot games playing. Notably, the 18 to 24 age cohort turned out to be the most vulnerable part of the population, as they displayed the largest odds for at-risk gambling, and both lifetime and last-year involvement in sports betting, casino games, and slot games playing. This highlights the necessity of targeted public health interventions for the young adult population and people who experiment or already experience problems related to substance use.

Self-regulation profiles in addictive behaviors among adolescents: A transdiagnostic approach.

Dual-pathway models suggest that poor self-regulation (immature regulatory combined with strong reactive processes) is an important factor underlying addictive behaviors among adolescents. This study examined whether there are different self-regulation profiles among community adolescents, and how these profiles are related to the presence, severity and comorbidity of different addictive behaviors. A community sample of 341 adolescents (54.5% female; 13-17 years) was recruited. Participants self-reported on regulatory (inhibitory control) and reactive (reward and punishment sensitivity) processes, as well as on different addictive behaviors (binge eating, tobacco-, cannabis- and alcohol use, gaming, gambling and pathological buying). A model-based clustering analysis found evidence for three meaningful profiles: 'impulsive/under-controlled', 'anxious' and 'protective'. The 'impulsive/under-controlled' profile was characterized by the highest prevalence and severity of cannabis use and the most severe alcohol use. The 'impulsive/under-controlled' and 'protective' profiles demonstrated the highest prevalence and severity of tobacco use, whereas the 'impulsive/under-controlled' and 'anxious' profiles showed the highest binge eating scores. Adolescents who reported more than three types of addictive behaviors generally belonged to the 'impulsive/under-controlled' profile. The profiles did not differ for gaming, gambling and pathological buying. The 'impulsive/under-controlled' profile emerged as the most vulnerable profile in the context of addictive behaviors (especially for binge eating and substance use).

Odds of gambling among adolescents: a secondary analysis of the cross-sectional European School Survey Project on Alcohol and Other Drugs.

BACKGROUND: Gambling among adolescents is associated with gambling disorder in adulthood. This study investigated factors associated with gambling and excessive gambling in adolescents. METHODS: This secondary analysis of the cross-sectional European School Survey Project on Alcohol and Other Drugs (ESPAD) used nationally representative data from the Irish cohort of the 2019 ESPAD wave. Data were collected between March and May 2019. We included 1949 students aged 15-16 years (946 [48·5%] male, 1003 [51·5%] female), with a response rate of 85%. We calculated past year gambling prevalence as the rate of those who had gambled for money on at least one of four games of chance (slot machines, cards or dice, the lottery, betting on sports or animals) in the past 12 months. An adapted version of the three-item Consumption Screen for Problem Gambling was used to identify excessive gambling (score ≥4). We carried out descriptive and logistic regression analyses using binary covariates with Stata v16.1. We included 19 variables in the multivariable analysis. Ethics approval was granted by Dublin Institute of Technology's Ethics Committee. Non-consent forms were issued to all parents to opt out. FINDINGS: Overall, 447 (23%) of 1949 students gambled in the past year, of whom 45 (10%) engaged in excessive gambling. Using a mutually adjusted multivariable logistic regression analysis, past year gambling was associated with alcohol use (adjusted odds ratio [aOR] 1·6, 95% CI 1·1-2·2), experiencing serious arguments (aOR 1·4, 1·1-1·9), and trouble with the police (aOR 1·9, 1·2-2·8). Female gender was a protective factor (aOR 0·6, 0·4-0·9). In the univariable analysis, excessive gambling was associated with gaming (OR 2·3, 1·0-5·1), tobacco use (2·1, 1·1-4·2), e-cigarette use (2·1, 1·1-4·1), heavy episodic drinking (2·7, 1·4-5·1), trouble with the police (2·8, 1·5-5·4, p<0·01), and deliberately hurting themselves (2·8, 1·4-5·6). Female gender (OR 0·3, 0·1-0·6) and social media use (0·4, 0·2-0·8) were protective factors. Excessive gambling was also associated with betting on sports and animals (OR 3·6, 1·6-8·4), slot machines (2·9, 1·5-5·8), card or dice (2·4, 1·2-4·6), and online gambling (4·2, 2·0-8·0). INTERPRETATION: A large proportion of 15-16 year olds in Ireland have gambled for money in the past year, with one in ten of those having engaged in excessive gambling. This number is likely to be underestimated due to recall and social desirability bias. Reducing the availability, access, and appeal of gambling products in Ireland should be addressed through ongoing gambling reform. FUNDING: Institute of Public Health.

Power and Other Commercial Determinants of Health: An Empirical Study of the Australian Food, Alcohol, and Gambling Industries.

BACKGROUND: Commercial determinants of health (CDoH) represent a critical frame for exploring undue corporate and commercial influence over health. Power lenses are integral to understanding CDoH. Impacts of food, alcohol, and gambling industries are observable CDoH outcomes. This study aims to inform understanding of the systems and institutions of commercial and/or corporate forces working within the Australian food, alcohol, and gambling industries that influence health and well-being, including broader discourses materialised via these systems and institutions. METHODS: Twenty semi-structured interviews were conducted with key-informants on Australian public policy processes. Interviewees were current and former politicians, political staff members, regulators and other public servants, industry representatives, lobbyists, journalists, and researchers with expertise and experience of the Australian food, alcohol, and/ or gambling industries. Interviews sought participants' perceptions of Australian food, alcohol, and gambling industries' similarities and differences, power and influence, relationships, and intervention opportunities and needs. RESULTS: Strategies and tactics used by Australian food, alcohol and gambling industries are similar, and similar to those of the tobacco industry. They wield considerable soft (eg, persuasive, preference-shaping) and hard (eg, coercive, political, and legal/economic) power. Perceptions of this power differed considerably according to participants' backgrounds. Participants framed their understanding of necessary interventions using orthodox neoliberal discourses, including limiting the role of government, emphasising education, consumer freedom, and personal choice. CONCLUSION: Food, alcohol, and gambling industries exercise powerful influences in Australian public policy processes, affecting population health and well-being. Per Wood and colleagues' framework, these manifest corporate, social, and ecological outcomes, and represent considerable instrumental, structural, and discursive power. We identify power as arising from discourse and material resources alike, along with relationships and complex industry networks. Addressing power is essential for reducing CDoH harms. Disrupting orthodox discourses and ideologies underpinning this should be a core focus of public health (PH) advocates and researchers alike.

Strategies to Improve Physical Activity and Nutrition Behaviours in Children and Adolescents: A Review.

Despite widespread acknowledgement of the multifarious health benefits of physical activity (PA), including prevention and control of obesity, an overwhelming majority of children and adolescents are not sufficiently active to realise such benefits. Concurrently, young people are significantly impacted by the rapid global rise of sedentarism, and suboptimal dietary patterns during key phases of development. Regrettably, the cumulative effects of unhealthy behaviours during the growing years predisposes young people to the early stages of several chronic conditions, including obesity. Clear and consistent approaches are urgently needed to improve eating and activity behaviours of children and adolescents. Based on existing evidence of "best bets" to prevent and control obesity and its comorbidities, we present a set of non-negotiable strategies as a 'road map' to achieving prevention and improving the health of children and adolescents.

Gambling, tobacco use, and health among individuals in substance use disorder treatment.

BACKGROUND AND OBJECTIVES: Gambling is highly comorbid with disordered use of tobacco and other drugs, and may increase relapse risk among substance use disorder (SUD) patients. We investigated associations between gambling and tobacco use behaviors among SUD patients to inform clinical care. METHODS: Patients (N = 651, 170 female) from 25 residential SUD treatment programs in California completed surveys about tobacco use, health, and gambling. Using multivariate regression, we examined associations between gambling, tobacco use behaviors, and mental and physical health. RESULTS: Past-year gamblers were more likely than non-gamblers to be current smokers (adjusted odds ratio [AOR] = 1.44, 95% confidence interval [CI] = 1.03, 2.01). Smokers who gambled had higher mean Heaviness of Smoking Index (HSI) scores (mean difference = +0.32, 95% CI = 0.04, 0.60), and more often reported smokeless tobacco use (AOR = 1.73, 95% CI = 1.16, 2.58), compared to non-gambling smokers. Past-year problem gamblers were more likely than all others (non-gamblers and non-problem gamblers) to be current smokers (AOR = 1.44, 95% CI = 1.08, 1.90) and to report high psychosocial stress (AOR = 1.87, 95% CI = 1.34, 2.61). Smokers with problem gambling also had higher HSI scores (mean difference = +0.54, 95% CI = 0.14, 0.95) compared to smokers without problem gambling. DISCUSSION AND CONCLUSIONS: Gambling and problem gambling were associated with tobacco use and heavier smoking. SUD patients with gambling comorbidity may be heavier smokers and may need concurrent treatment for tobacco use and problem gambling. SCIENTIFIC SIGNIFICANCE: This study provides novel data regarding gambling and tobacco use behaviors among SUD patients.

Unpredictable, intermittent access to sucrose or water promotes increased reward pursuit in rats.

Reward uncertainty can sensitize reward pathways, promoting increased reward-seeking and -taking behaviours. This is relevant to human conditions such as pathological gambling, eating disorders and drug addiction. In the context of addiction, preclinical self-administration procedures have been developed to model the intermittency of human drug use. These intermittent-access (IntA) procedures involve intermittent but predictable access to drug during self-administration sessions. However, human drug use typically involves intermittent and unpredictable drug access. We introduce a new procedure modeling unpredictable, intermittent access (UIntA) to a reinforcer, and we compare it to procedures that provide predictable reinforcer availability; continuous (ContA) or intermittent (IntA) access. Female rats self-administered water or liquid sucrose in daily hour-long sessions. IntA and ContA rats had access to a fixed volume of water or sucrose (0.1 ml), under a fixed ratio 3 schedule of reinforcement. IntA rats had predictable 5-min reinforcer ON and 25-min reinforcer OFF periods. ContA rats had 60 min of reinforcer access during each session. For UIntA rats, variation in the length of ON and OFF periods (1, 5 or 9 min/period), response requirement (variable ratio 3 schedule of reinforcement), reinforcer probability (50%) and quantity (0, 0.1 or 0.2 ml) introduced reward uncertainty. Following 14 daily self-administration sessions, UIntA rats showed the highest levels of responding for water or sucrose under progressive ratio conditions, responding under extinction conditions, and cue-induced reinstatement of sucrose seeking. Thus, unpredictable, intermittent reward access promotes increased reward pursuit. This has implications for modeling addiction and other disorders of increased reward seeking.

Development of gambling disorder after bariatric surgery: a call for research.

The relationship between bariatric surgery and alcohol use disorder (AUD) suggests that there may be a parallel connection between bariatric surgery and gambling disorder (GD), although this has never been researched before. Here, we describe observations suggesting that patients undergoing bariatric surgery may develop gambling disorders after surgery. Obese, older adults, and women may be at particular risk of developing GD because of their higher susceptibility to somatic comorbidities. We call for research addressing factors affecting the development of GD in patients undergoing bariatric surgery and how this could be prevented.

Enhanced Pavlovian-to-instrumental transfer in internet gaming disorder.

Background and aims: The Pavlovian-to-instrumental transfer (PIT) effect is a phenomenon that Pavlovian conditioned cues that could influence one's instrumental behavior. In several substance and behavioral addictions, such as tobacco use disorder and gambling disorder, addiction-related cues could promote independently trained instrumental drug-seeking/drug-taking behaviors, indicating a specific PIT effect. However, it is unclear whether Internet gaming disorder (IGD) would show a similar change in PIT effects as other addictions. The study aimed to explore the specific PIT effects in IGD. Methods: We administrated a PIT task to individuals with IGD (n = 40) and matched health controls (HCs, n = 50), and compared the magnitude of specific PIT effects between the two groups. The severity of the IGD symptoms was assessed by the Chinese version 9-item Internet Gaming Disorder Scale (IGDS) and the Internet Addiction Test (IAT). Results: We found that: (1) related to the HCs group, the IGD group showed enhanced specific PITgame effects, where gaming-related cues lead to an increased choice rate of gaming-related responses; (2) in the IGD group, the magnitude of specific PITgame effects were positively correlated with IAT scores (rho = 0.39, p = 0.014). Discussion and Conclusions: Individuals with IGD showed enhanced specific PIT effects related to HCs, which were associated with the severity of addictive symptoms. Our results highlighted the incentive salience of gaming-related cues in IGD.