Development and Psychometric Evaluation of a Novel Measure of Nicotine E-cigarette Withdrawal for use with Adolescents and Young Adults.

INTRODUCTION: Nicotine withdrawal is a well-established construct that prompts continued nicotine product use and contributes to failed cessation efforts. Despite ongoing public health concerns about nicotine e-cigarette use in adolescents and young adults (AYAs), no psychometrically-sound measure of nicotine e-cigarette withdrawal exists for this population. METHODS: A mixed methods approach comprising a literature review to identify existing nicotine withdrawal items; subject matter expert feedback on existing items and novel item generation; cognitive interviews assessing the measure's instructions, items, and response options; and a large quantitative validation survey (N = 997) was employed to develop the novel retrospective measure of nicotine e-cigarette withdrawal. RESULTS: A 25-item solution comprising four subscales - Negative Affect, Negative Physical Symptoms, Craving, and Appetite/Food - and an Overall Withdrawal score was supported. Internal reliability was excellent (mean alpha = 0.91), and scalar measurement invariance was reached for all subgroups tested (e.g., sex, age, exclusive e-cigarette use versus dual tobacco product use, daily versus non-daily nicotine vaping). Overall Withdrawal and its subscales evidenced concurrent validity with time to first vape in the morning, e-cigarette dependence, and previous vaping cessation attempts, although not each subscale was associated with each outcome. Importantly, cross-sectional incremental validity analyses indicated that retrospective withdrawal accounted for variance in each outcome above and beyond e-cigarette dependence. CONCLUSIONS: The novel retrospective AYA Nicotine E-cigarette Withdrawal Scale (AYA NEWS) evidenced strong psychometric properties for use in this population. Future research can determine whether the AYA NEWS can be used to assess acute e-cigarette nicotine withdrawal. IMPLICATIONS: While e-cigarette use remains the most prevalent form of nicotine product use among adolescents and young adults, there are limited options for psychometrically-sound measures of e-cigarette-related constructs in this population. Withdrawal from nicotine is associated with failed cessation attempts and continued use of nicotine-containing products, making it a critical construct within tobacco-related research. This study outlines the development and preliminary psychometric evaluation of a novel, retrospective measure of nicotine e-cigarette withdrawal. Study findings support using the Adolescent and Young Adult Nicotine E-cigarette Withdrawal Scale (AYA NEWS) to assess retrospective withdrawal from nicotine e-cigarettes in young people.

Advanced spatial knowledge of target location eliminates age-related differences in early sensorimotor learning.

Motor learning has been shown to decline in healthy aging, particularly in the early stages of acquisition. There is now ample evidence that motor learning relies on multiple interacting learning processes that operate on different timescales, but the specific cognitive mechanisms that contribute to motor learning remain unclear. Working memory resources appear to be particularly important during the early stages of motor learning, and declines in early motor learning have been associated with working memory performance in older adults. We examined whether age differences in the early stages of motor learning could be reduced or eliminated by reducing the spatial working memory demands during a force-field adaptation task. Groups of younger and older adults made center-out reaching movements to spatial targets either in a repeating four-element sequence, or in a random order. Participants also performed a battery of cognitive tests to further investigate the potential involvement of associative memory, spatial working memory, and procedural learning mechanisms in the early stage of motor learning. Although all groups adapted their movements equally well by the end of the learning phase, older adults only adapted as quickly as younger adults in the sequence condition, with the older adults in the random group exhibiting slower learning in the earliest stage of motor learning. Across all participants, early motor learning performance was correlated with recognition memory performance on an associative memory test. Within the younger random group, who were able to adapt as quickly as the sequence groups, early motor learning performance was also correlated with performance on a test of procedural learning. These findings suggest that age differences in early stages of motor learning can be eliminated if the spatial working memory demands involved in a motor learning task are limited. Moreover, the results suggest that multiple cognitive resources may be utilized during the early stage of learning, and younger adults may be more flexible than older adults in the recruitment of additional cognitive resources to support learning when spatial working memory demands are high.

Demographic and substance use-related differences among high school adolescents who vape cannabis versus use other cannabis modalities.

BACKGROUND: Vaping is the second most common modality of using cannabis following smoking. We examined differences in demographics and substance use behaviors between adolescent cannabis vapers and those exclusively using other cannabis modalities. METHODS: In 2019, 4875 students from six Connecticut high schools completed school-wide, online surveys. Past-month cannabis users (n = 931; 52.8% female, 16.38(1.27) years old, 44.9% non-Hispanic White) reported on cannabis modalities used (e.g., combustible, vaporizable, edible) and were classified as cannabis vapers or non-vapers. Cannabis vapers reported on device type used to vape cannabis: a cannabis-specific device or modified/hacked e-cigarette. Unadjusted and adjusted relationships were examined to identify demographic and substance-related differences between cannabis vapers and non-vapers. RESULTS: 56.3% of past-month cannabis users reported vaping cannabis. Cannabis vapers reported using both cannabis-specific vaporizers (91.9%) and modifying/hacking e-cigarettes (23.7%). Cannabis vapers, relative to other cannabis users, were more likely to be male, White, initiate cannabis use at a younger age; endorse past-month use of all cannabis modalities, alcohol, and e-cigarettes; and report smoking and dabbing cannabis more frequently; consuming more drinks per drinking day; and using e-cigarettes at a younger age and more frequently. CONCLUSIONS: Relative to other cannabis modalities, vaping was associated with increased use of several cannabis products and other substances. Adolescent past-month cannabis users reported modifying e-cigarettes to vape cannabis. Findings suggest that regulations should be implemented to prevent e-cigarettes from being modifiable for use with cannabis and highlight the importance of assessing different cannabis use modalities, as vaping was associated with distinct substance-related risks.