Effects of flavour and modified risk claims on nicotine pouch perceptions and use intentions among young adults who use inhalable nicotine and tobacco products: a randomised controlled trial.

BACKGROUND: Availability of flavours and potential modified risk tobacco product (MRTP) claims may influence young adults' (YAs') perceptions of and intentions to use nicotine pouches ('pouches'). METHODS: YAs aged 21-34 years (N=47, M age=24.5, SD=3.1) with past-month nicotine/tobacco use (10.6% cigarette-only, 51.1% e-cigarette-only, 38.3% dual use) and no intention to quit were randomised to self-administer four Zyn 3 mg nicotine pouches in a 4 (flavour; within-subjects: smooth, mint, menthol, citrus) × 2 (MRTP claim on packaging; between subjects: present or absent) mixed-factorial design. After self-administering each pouch, participants reported appeal, use intentions and perceived harm compared with cigarettes and e-cigarettes. Three mixed-factorial analysis of variances (ANOVAs) examined main and interactive effects of flavour and MRTP claim on appeal, use intentions and comparative harm perceptions. RESULTS: Mint (M=55.9, SD=26.4), menthol (M=49.7, SD=26.8) and citrus (M=46.6, SD=24.8) flavours were significantly more appealing than smooth (M=37.6, SD=25.4; p<0.001). MRTP claim did not significantly affect product appeal (p=0.376). Use intentions were greater for mint (M=2.6, SD=1.3) and menthol (M=2.0, SD=1.1) flavours than smooth (M=1.8, SD=1.0; p=0.002). Flavour did not affect comparative harm perceptions (p values>0.418). MRTP claims increased use intention (p=0.032) and perceptions of pouches as less harmful than cigarettes (p=0.011), but did not affect perceived harm relative to e-cigarettes (p=0.142). Flavour × MRTP claim interactions were not significant. CONCLUSIONS: Flavoured (vs smooth) pouches were more appealing to YAs. MRTP claims reduced perceived harm of pouches compared with cigarettes; however, intentions to switch were low. To protect YAs' health, regulatory restrictions could target flavours and MRTP claims.

Effects of 'Ice' flavoured e-cigarettes with synthetic cooling agent WS-23 or menthol on user-reported appeal and sensory attributes.

BACKGROUND: This clinical experiment tested the effects of exposure to e-cigarettes with WS-23 or menthol cooling additives on user appeal and sensory attributes, and, secondarily, whether WS-23 effects generalised across base characterising flavour, nicotine concentration, or nicotine/tobacco product use status. METHODS: In this within-participant double-blind experiment, adult tobacco/nicotine users administered standardised puffs of 18 different e-cigarette solutions in randomised sequences using a pod-style device. Each of three base characterising e-cigarette flavour solutions ('bold tobacco', 'mango,' 'wintergreen') in both 2% and 4% concentrations of nicotine benzoate salt were manipulated by adding either: (1) Menthol (0.5%), (2) WS-23 (0.75%) or (3) No cooling agent. After each administration, participants rated 3 appeal and 5 sensory attributes (0-100 scales). RESULTS: Participants (n=84; M(SD)=38.6 (13.6) years old) were either exclusive e-cigarette (25.0%), cigarette (36.9%) or dual (38.1%) users. WS-23 versus no coolant products produced higher liking, willingness to use again, smoothness, and coolness and lower disliking, bitterness, and harshness ratings (|B|difference range: 4.8 to 20.1; ps<0.005). Menthol (vs no coolant) increased willingness to use again and reduced harshness and coolness (ps<0.05). Flavours with WS-23 (vs menthol) were rated as smoother, cooler and less harsh (ps<0.05). Coolant effects did not differ by base flavour, nicotine concentration, or tobacco use status. CONCLUSIONS: Adding synthetic coolant WS-23 to e-cigarettes appears to make the vaping user experience more appealing, regardless of characterising base flavour. Regulatory agencies should be aware that the manufacturing process of adding synthetic coolants may increase the attractiveness of various e-cigarette products.Cite Now.

Appeal of e-cigarette flavors: Differences between never and ever use of combustible cigarettes.

BACKGROUND: Characterizing the appeal of flavored e-cigarette solutions by tobacco product use status can inform regulations to reduce vaping in those who never smoked without discouraging adopting e-cigarettes as a quit-smoking aid. METHODS: Adults aged 21+ who currently use tobacco products (N = 119) self-administered standardized puffs of eight non-tobacco flavored and two tobacco-flavored e-cigarette solutions using a pod-style device. Participants rated appeal (0-100 scale) following each administration. Mean differences in flavor appeal ratings were compared between four groups: people who never smoked/currently vape, formerly smoked/currently vape, currently smoke/currently vape, and currently smoke/do not vape (with interest in vaping). RESULTS: The Global Flavor (all non-tobacco vs. tobacco)×Group interaction (p = .028) revealed higher appeal for non-tobacco vs. tobacco flavors in adults who never smoked/currently vape (B[95 %CI] = 13.6[4.1-23.1]), formerly smoked/currently vape (B[95 %CI] = 11.6[4.2-18.9]), and currently smoke/currently vape (B[95 %CI] = 9.3[2.5-11.6]), but not adults who currently smoke/never vaped (B[95 %CI] = -0.1[-5.1 to 4.9]). In flavor-specific analyses, adults who never smoked/currently vape rated strawberry (p = .022), peppermint (p = .028), and menthol (p = .028) more appealing than tobacco flavors. Among adults who formerly smoked/currently vape, strawberry (p < .001), peppermint (p = .009), and vanilla (p = .009), were more appealing than tobacco. Adults who currently smoked/currently vape rated peppermint (p = .022) and vanilla (p = .009) as more appealing than tobacco. No non-tobacco flavors were more appealing than tobacco in adults who currently smoke/never vaped. CONCLUSIONS: E-cigarette sales restrictions on non-tobacco flavors, including menthol, may eliminate products preferred by adults who vape, including those who never smoked, without discouraging adults who currently smoke and never vaped from trying e-cigarettes.

Dose-response effects of two nicotine salt formulations on electronic cigarette appeal and sensory attributes.

OBJECTIVES: Various organic acids are used to create nicotine salt formulations, which may improve the appeal and sensory experience of vaping electronic cigarettes (e-cigarettes). This clinical experiment examined the effects of partially and highly protonated forms of two nicotine salt formulations (nicotine lactate and benzoate) versus free-base (no acid additive) on the appeal and sensory attributes of e-cigarettes. METHODS: Current adult tobacco product users (n=116) participated in an online remote double-blind within-subject randomised experiment involving standardised self-administration of e-cigarette solutions varying in nicotine formulation (free-base, 50% nicotine lactate -1:2 lactic acid to nicotine molar ratio, 100% nicotine lactate - 1:1 ratio, 50% nicotine benzoate and 100% nicotine benzoate). Each formulation had equivalent nicotine concentrations (27.0-33.0 mg/mL) and was administered in four flavours in a pod-style device. After each administration, participants rated appeal (liking, disliking and willingness to use again) and sensory attributes (0-100 scale). RESULTS: Compared with free-base nicotine, 50% and 100% nicotine lactate and benzoate yielded higher appeal, smoothness and sweetness and lower harshness and bitterness. Dose-response analyses found 100% vs 50% nicotine salt improved appeal, smoothness, bitterness and harshness for nicotine lactate and sweetness, smoothness and harshness for nicotine benzoate. Solutions with higher pH were associated with worse appeal and sensory attributes across nicotine formulations. Nicotine formulation effects did not differ by tobacco use status and flavours. CONCLUSION: Restricting benzoic acid or lactic acid additives or setting minimal pHs in e-cigarettes merits consideration in regulations designed to reduce vaping among populations deterred from using e-cigarettes with aversive sensory properties. TRIAL REGISTRATION NUMBER: This study was registered under ClinicalTrials.gov Identifier: NCT03742817 under the title 'Effects of e-Cigarettes on Perceptions and Behavior'.

Perceived Discrimination, Experiential Avoidance, and Mental Health among Hispanic Adults in Primary Care.

The Hispanic population is the largest minority group in the United States and frequently experiences racial discrimination and mental health difficulties. Prior work suggests that perceived racial discrimination is a significant risk factor for poorer mental health among Hispanic in the United States. However, little work has investigated how perceived racial discrimination relates to anxiety and depression among Hispanic adults. Thus, the current study evaluated the explanatory role of experiential avoidance in the relation between perceived racial discrimination and anxiety/depressive symptoms and disorders among Hispanic adults in primary care. Participants included 202 Spanish-speaking adults (Mage = 38.99, SD = 12.43, 86.1% female) attending a community-based Federally Qualified Health Center. Results were consistent with the hypothesis that perceived racial discrimination had a significant indirect effect on depression, social anxiety, and anxious arousal symptoms as well as the number of mood and anxiety disorders through experiential avoidance. These findings suggest future work should continue to explore experiential avoidance in the association between perceived racial discrimination and other psychiatric and medical problems among the Hispanic population.

Drug and alcohol dependence acute effects of pod-style e-cigarettes in vaping-naïve smokers.

BACKGROUND: This study investigated the acute effects of exposure to pod-style e-cigarettes on subjective, behavioral, and physiological outcomes indicative of the potential to encourage vaping-naïve smokers to switch to e-cigarettes. METHODS: In a within-subject experiment, never-vaping adult smokers interested in trying e-cigarettes (n = 24) completed 4 laboratory visits following 16-hr tobacco abstinence. Visits involved controlled puffing from preferred brand cigarettes (OwnCig) or a standardized pod-style e-cigarette with either no nicotine (NoNic), nicotine freebase (NicFreebase; 0.5% nicotine concentration), or nicotine salt (NicSalt E-Cig; 2.8% concentration) solutions. Outcomes included smoking urge, mood, user experience, plasma nicotine, and a behavioral task assessing ability to delay smoking. RESULTS: NoNic, NicFreebase, and NicSalt pod-style e-cigarettes were significantly less effective than OwnCig at reducing smoking urge and increasing plasma nicotine, positive affect, satisfying user experience ratings, and ability to delay smoking on the behavioral task. Differences among pod-style e-cigarette conditions were limited to: (a) NicFreebase (vs. NoNic) preferentially suppressed participants' urge to smoke to alleviate negative mood, (b) NicFreebase (vs. NicSalt) slightly preferentially increased plasma nicotine; and (c) NicFreebase and NicSalt (vs. NoNic) produced higher aversive user experience ratings. CONCLUSIONS: In tobacco deprived smokers' initial vaping experience, controlled administration of certain pod-style e-cigarettes with 0.5% NicFreebase or 2.8% NicSalt may be deficient comparators to cigarettes in terms of their capacity to acutely improve mood, deliver nicotine, suppress smoking motivation, and offer a satisfying user experience. Future research is needed to test pod-style e-cigarettes with higher nicotine doses and confirm whether NicFreebase vs. NicSalt enhances nicotine absorption.

Effect of Exposure to e-Cigarettes With Salt vs Free-Base Nicotine on the Appeal and Sensory Experience of Vaping: A Randomized Clinical Trial.

Importance: Alkaline free-base nicotine is bitter and a respiratory irritant. High-nicotine electronic cigarette (e-cigarette) products contain acid additives that change nicotine from a free-base to a protonated salt chemical form, which could improve the sensory experience of vaping, particularly among never smokers unaccustomed to inhaling free-base nicotine. Objective: To determine whether exposure to e-cigarettes with salt vs free-base nicotine formulations improves the appeal and sensory experience of vaping e-cigarettes and whether nicotine formulation effects differ by e-cigarette flavor and ever combustible cigarette smoking status. Design, Setting, and Participants: Single-visit double-blind within-participant randomized clinical trial was conducted in an academic medical center outpatient clinical research facility in Southern California. Participants were 119 individuals with past 30-day e-cigarette or combustible cigarette use aged 21 years or older recruited from November 2019 to March 2020. Interventions: Participants self-administered standardized puffs of each 10 differently flavored e-cigarette solutions using a pod-style device. Each flavor was administered in salt (benzoic acid added) and free-base (no benzoic acid) nicotine formulations with commensurate nicotine concentrations (mean, 23.6 mg/mL). The 20 solutions were administered in randomly assigned sequences. Immediately after puffing each solution, participants rated appeal and sensory attributes. Main Outcomes and Measures: Self-reported appeal (mean of like, dislike [reverse-scored], and willingness to use again ratings) and 4 sensory attributes (sweetness, smoothness, bitterness, and harshness; analyzed individually) on visual analog scales with not at all and extremely anchors (range, 0-100). Results: Of the 119 participants; 39 (32.8%) were female. The mean (SD) age was 42.1 (14.4) years; 105 (88.2%) were ever combustible cigarette smokers, and 66 (55.5%) were current e-cigarette users. Salt vs free-base nicotine formulations produced higher ratings of appeal (salt vs free-base mean difference effect estimate: b = 12.0; 95% CI, 9.9-14.1; P < .001), sweetness (b = 9.3; 95% CI, 7.1-11.4; P < .001), and smoothness (b = 17.4; 95% CI, 15.2-19.6; P < .001) and lower ratings of bitterness (b = -13.3; 95% CI, -15.4 to -11.2; P < .001) and harshness (b = -21.0; 95% CI, -23.2 to -18.7; P < .001). Nicotine formulation effects largely generalized across different flavors and the smoothness-enhancing and harshness-reducing effects of nicotine salt were stronger in never vs ever cigarette smokers. Conclusions and Relevance: In this randomized clinical trial of adult current nicotine or tobacco product users, controlled exposure to e-cigarette puffs with salt vs free-base nicotine formulations appeared to increase product appeal and improve the sensory experience of vaping, particularly among never smokers. Regulatory policies limiting acid additives in e-cigarettes might reduce the appeal of high-nicotine e-cigarettes among populations deterred from vaping e-cigarettes that emit harsh aerosol. Trial Registration: ClinicalTrials.gov Identifier: NCT04399031.

Emotion dysregulation, fatigue, and electronic cigarette expectancies.

Emotion dysregulation and the experience of fatigue have both been linked to the maintenance of substance use. However, limited empirical data has evaluated individual differences in these constructs in terms of e-cigarette use expectancies. The present study examined a theoretically relevant model focused on whether the experience of more severe fatigue explains, in part, the relation between individual differences in emotion dysregulation and positive and negative e-cigarette expectancies among 525 adult e-cigarette users (50.9% female, Mage = 35.25 years, SD = 10.10). It was hypothesized that emotion dysregulation, via fatigue severity, would significantly predict greater positive and negative e-cigarette expectancies, which was examined in two separate mediation models. Fatigue severity significantly explained, in part, the relation between emotion dysregulation and positive (b = 0.02, CI [0.01, 0.02]) and negative expectancies of e-cigarette use (b = 0.02, 95% CI [0.02, 0.03]). The current findings suggest that the experience of fatigue helps explain the relation between emotion dysregulation and positive and negative e-cigarette expectancies among adult e-cigarette users. Future work is needed to explicate how reducing fatigue severity in the context of emotion dysregulation may change expectancies about e-cigarette expectancies.

Anxiety sensitivity and acculturative stress: Concurrent relations to mental health among Spanish-speaking Latinx in primary care.

The Latinx population suffers from mental health inequalities. Although past work has implicated acculturative stress and anxiety sensitivity as important individual difference factors for anxiety and depression in this group, it is presently unclear how they work together to influence more severe anxiety and depressive symptom expression among Latinx. To help address this gap in the existing literature, the current study evaluated the role of concurrent anxiety sensitivity and acculturative stress, in terms of anxiety and depressive symptoms and disorders, in a Latinx population in a primary care setting. Participants included 142 Latinx individuals (86.7% female; Mage = 39.66, SD = 11.34). After accounting for shared variance, the results indicated that both anxiety sensitivity and acculturative stress were significantly associated with anxious arousal symptoms, social anxiety, and depressive symptoms. However, anxiety sensitivity, but not acculturative stress, was significantly related to a number of mood and anxiety disorders. These findings suggest the importance of assessing both anxiety sensitivity and acculturative stress in routine mental health screening, as both factors may be related to poorer psychological health among this group.

Worry among Latinx college students: relations to anxious arousal, social anxiety, general depression, and insomnia.

OBJECTIVE: Latinx young adults in college (ages 18-25 years) are at a heightened risk for health disparities and there is a need to understand individual-based characteristics that are related to such health inequalities including anxiety, depression, and sleep disturbances. The cross-sectional current study investigated the role of worry in relation to anxious arousal, social anxiety, general depression, and insomnia among Latinx college students. Participants/Method: Participants included 401 (Mage = 21 years; SD =2.01; 83% female) Latinx students at a large, southwestern university. Results: Results indicated that greater levels of worry were related to increased levels of anxious arousal, social anxiety, general depression, and insomnia. These findings were evident above and beyond variance accounted for by age, sex, and subjective social status. Conclusions: The current investigation suggests that elevated levels of worry among Latinx young adults may be associated with greater levels of anxiety, depression, and insomnia.

Pain intensity, pain-related anxiety, and somatic and mental health symptoms: a test among latinx young adults.

Latinx individuals demonstrate significant pain-related health disparities compared to other racial/ethnic groups. Moreover, young adulthood (18-25 years of age) is a primary developmental window wherein pain-related health problems are first encountered and may be related to more severe somatic and mental health symptoms. Pain-related anxiety may be one mechanistic construct linking individual differences in the experience of pain intensity to poorer somatic experiences and mental health among Latinx young adults. Thus, the current study examined pain-related anxiety as an explanatory factor underlying the relationship between pain intensity and body vigilance, perceptions of health, worry, anxious arousal, and depressive symptoms among Latinx young adults. Participants included 401 Latinx young adults (Mage = 21 years; SD = 2.02; age range: 18-25 years; 83% female) at a large, southwestern university. Results revealed that individual differences in pain intensity had a significant indirect effect on the studied somatic and negative affect variables through pain-related anxiety. These novel findings suggest future work should continue to explore pain-related anxiety in the association between the experience of pain and somatic and mental health among Latinx young adults.

Exploring positive expectancies and quit status among adult electronic cigarette users.

Initial research on electronic cigarette (e-cigarette) use suggests differences exist in levels of use, beliefs, and cessation difficulties among users. However, little research has explored how these factors interact to confer worse e-cigarette outcomes. The current study examined the association between positive expectancies of e-cigarette use and e-cigarette processes among 544 (51.1% female; Mage = 35.4 years, SD = 10.12) adult e-cigarette users who had and had not attempted to quit e-cigarettes, a defining characteristic believed to distinguish those with and without greater e-cigarette quit difficulty. Results indicated that greater positive outcome expectancies of e-cigarette use were significantly related to increased perceived risks, benefits, and barriers to quitting. The strength of the associations was stronger for those who reported past quit attempts compared to those who never attempted quitting. Overall, the current study highlights the potentially important role that positive expectancies for e-cigarette use and quit attempt status play in e-cigarette processes. Findings suggest a possible need to contextualize positive expectancies for e-cigarette use within future e-cigarette cessation tactics and tailoring treatments based on quit attempt status.

Acculturative Stress, Anxiety Sensitivity, and Smoking among Spanish-Speaking Latinx Adult Smokers.

Objectives: Although acculturative stress is a known individual difference factor related to poor health, little is understood about its relationship to smoking among Latinx adults. One transdiagnostic factor that may serve a mediational role in the relation between acculturative stress and smoking is anxiety sensitivity. The current study evaluated whether anxiety sensitivity mediated the relations between acculturative stress and smoking among a large sample of adult Spanish-speaking Latinx smokers. Method: Participants were 359 Spanish-speaking Latinx daily smokers (58.8% female, Mage= 33.2 years, SD = 9.7) who provided self-report data on acculturative stress, anxiety sensitivity, and smoking outcomes of cigarette dependence, perceived barriers for quitting cigarettes, and severity of problems during past quit attempts. Independent mediation models were conducted for each smoking outcome, with acculturative stress entered as the predictor and anxiety sensitivity entered as the proposed explanatory factor. Results: There were statistically significant indirect effects of acculturative stress via anxiety sensitivity in relation to cigarette dependence, perceived barriers for quitting cigarettes, and severity of problems during past quit attempts. Conclusions: The present findings provide novel evidence that anxiety sensitivity serves a mediational role in relations between acculturative stress and smoking outcomes among Latinx adult smokers.

Anxiety symptoms and smoking among Latinx adult smokers: the importance of sensitivity to internal cues in terms of dependence, barriers for quitting, and quit problems.

Anxiety symptoms are one of the most common forms of psychological distress among Latinx individuals and related to poorer cessation outcomes among non-Latinx Whites. Yet, little is known about the relationship between anxiety symptoms and smoking among Latinx smokers. The current study evaluated sensitivity to internal anxiety-related sensations (anxiety sensitivity) as an explanatory variable in the relation between anxiety symptoms and cigarette dependence, perceived barriers for quitting, and severity of problems experienced during prior quit attempts. Participants included 363 Spanish-speaking Latinx daily smokers (58.7% female, Mage = 33.3 years, SD = 9.8). Results revealed that anxiety symptoms were indirectly associated with cigarette dependence, perceived barriers for cessation, and problems experienced during past quit attempts through anxiety sensitivity. The findings suggest that anxiety sensitivity is a potential mechanism in anxiety symptom-smoking relations among Latinx adult smokers.

Subjective sleep quality and electronic cigarette dependence, perceived risks of use, and perceptions about quitting electronic cigarettes.

INTRODUCTION: Although subjective sleep quality has been associated with combustible cigarette use, little is known about its role in electronic cigarette (e-cigarette) use or beliefs about use. To address this gap, the current study examined subjective sleep quality among adult e-cigarette users in relation to e-cigarette dependence, perceived risks of e-cigarette use, and perceived barriers for quitting e-cigarettes. METHODS: A cross-section design was employed. Participants included 304 e-cigarette users (53.6% female, Mage = 36.7 years,SD = 10.3, 75% were combustible cigarette users) using a Qualtrics platform. RESULTS: Results indicated that poorer subjective sleep quality was significantly related to greater e-cigarette dependence and perceived barriers for quitting e-cigarettes (ΔR2 = 0.06, p < .001 for each model) but was not significantly associated with perceived risks of e-cigarette use. CONCLUSIONS: This work provides novel evidence for the potential role of subjective sleep quality in e-cigarette dependence and beliefs about quitting. To the extent sleep quality is related to e-cigarette addiction and cognition, it represents an important construct to assess and target for change in efforts to facilitate change in e-cigarette dependence and perceived barriers for quitting. IMPLICATIONS: This study is among the first data to link subjective sleep quality to e-cigarette dependence and beliefs about risk of use and perceptions about barriers for quitting among adults. Similar to results found for combustible cigarettes, these findings suggest that subjective sleep quality may be important to consider in efforts to facilitate change in e-cigarette dependence and perceived barriers for quitting.

Pain-Related Anxiety Among Latinx College Students: Relations to Body Vigilance, Worry, Anxious Arousal, and General Depression.

Latinx young adults in college (ages 18-25 years) are at an elevated risk for somatic and mental health disparities. Although the experience of pain is among the most common health complaints among Latinx young adults, there is no scientific information about how cognitive-based responses to pain relate to somatic vigilance and mental health among this group. The current study therefore investigated the explanatory role of pain-related anxiety (worry about negative consequences of pain) in terms of body vigilance, worry, anxious arousal, and general depression among Latinx young adults. Participants were Latinx college students (Mage = 21 years; SD = 2.02; 83% female) at a large, southwestern university. Results indicated that greater levels of pain-related anxiety were associated with significantly greater bodily vigilance, worry, anxious arousal, and general depression after adjusting for age, gender, physical functioning, subjective social status, and pain intensity. The current investigation suggests that Latinx young adults who experience elevated levels of pain-related anxiety may be at greater risk for somatic hypervigilance and negative affect symptoms. Therefore, reducing pain-related anxiety among Latinx young adults may be an important therapeutic strategy in efforts to reduce somatic and mental health disparities among this group.

Differential Effects of Anxiety Sensitivity on E-Cigarettes Processes: The Importance of E-Cigarette Quit Attempt History.

BACKGROUND AND OBJECTIVES: Electronic cigarettes (e-cigarettes) are recognized as a prevalent form of substance use among adults in the United States. The rise in e-cigarette use has motivated research to identify subgroups of the population that may be particularly vulnerable to e-cigarette use and its associated harm. Individuals with elevated psychological vulnerability are one such group more at risk for being a lifetime or current e-cigarette user. Yet, little is known about how factors of psychological vulnerability relate to perceptions of e-cigarette use within the context of e-cigarette quit attempts. The current study evaluated the differential relations of anxiety sensitivity (AS), a core affective vulnerability factor, on several relevant e-cigarette processes across those with and without a previous attempt to quit using e-cigarettes. METHODS: Our sample consisted of 547 current e-cigarette users (51% female, Mage = 35.38 years, SD = 10.1). RESULTS: Results indicated that AS significantly related to greater perceived risks, benefits, and positive outcome expectancies of e-cigarette use among current e-cigarette users who reported at least one attempt to quit e-cigarettes but was unrelated among those who had never attempted to quit. DISCUSSION AND CONCLUSIONS: Findings identify e-cigarette users who fail to quit as a potential vulnerable subgroup of users who experience more strongly held perceptions about e-cigarettes because of increased AS. SCIENTIFIC SIGNIFICANCE: This work provides initial evidence for a conceptual model in which levels of AS and e-cigarette processes are strengthened by and differ across e-cigarette quit attempt history. (Am J Addict 2019;28:390-397).

Emotion dysregulation and smoking outcome expectancies among Spanish-speaking Latinx adult cigarette smokers in the United States.

Although smoking expectancies are associated with numerous aspects of smoking among non-Latinx Whites, far less is known about how individual differences in emotion dysregulation relate to smoking expectancies among Latinx smokers. The present investigation therefore evaluated the role of emotion dysregulation in smoking outcome expectancies among Latinx adult smokers. Participants were 363 Spanish-speaking Latinx daily smokers (58.7% female, Mage = 33.3 years, SD = 9.81). Emotion dysregulation was significantly related to both negative reinforcement and negative personal consequences for smoking. These effects were moderate in magnitude and evident after adjusting for the variance associated with a wide range of factors. Unexpectedly, emotion dysregulation was also related to expectancies of appetite control and positive reinforcement. This study provides the first empirical evidence that emotion dysregulation is associated with a broad range of smoking outcome expectancies among Latinx smokers. Emotion dysregulation may be an important, yet underrecognized, smoking-cessation treatment target for Latinx smokers. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Worry Among Latinx Young Adults: Relations to Pain Experience, Pain-Related Anxiety, and Perceived Health.

Latinx are one of the largest and most rapidly growing segments of the United States (U.S.) population that is significantly impacted by health disparities, including somatic health problems. Young Latinx adults (ages 18-25 years) are at a greater risk for being affected by such health inequalities and there is a need to understand individual-based differences that may contribute to and maintain somatic symptoms, including pain experience, pain beliefs, and perceptions of health. Thus, the current study investigated the explanatory role of worry in association between pain intensity, pain disability, pain-related anxiety, and perceived health among Latinx college students. Participants included 401 (Mage = 21 years; SD = 2.02; 83% female) Latinx students at a large, southwestern university. Results indicated that greater levels of worry were related to increased levels of pain intensity, pain disability, pain-related anxiety, and lower levels of perceived health. These findings were evident above and beyond variance accounted for by gender, age, physical functioning, and subjective social status. Overall, the results from the present investigation suggest that there is greater risk for more severe pain experiences, maladaptive beliefs regarding pain, and worse perceptions of health status among Latinx young adults who experience elevated levels of worry.

Fatigue severity and electronic cigarette beliefs and use behavior.

Electronic cigarette (e-cigarette) use has risen dramatically in the United States. Clinically significant fatigue may represent one previously unexplored individual difference factor related to e-cigarette use patterns and e-cigarette specific cognitive processes. Fatigue reflects the experience of being tired, lacking energy, and feeling exhausted. Although fatigue is a normal bodily response, severe or chronic fatigue is maladaptive. Thus, the current study sought to evaluate clinically significant fatigue and its relation to perceived barriers for quitting e-cigarettes, perceived risks and perceived benefits of e-cigarette use, and e-cigarette dependence among 625 adult e-cigarette smokers (51.8% female, Mage = 34.91 years, SD = 10.29). Results indicated that severe fatigue was significantly related to greater perceived barriers to quitting (p < .001), perceived risks (p < .001) and perceived benefits (p < .001) of e-cigarette use, and greater e-cigarette dependence (p < .001); effects that were evident after adjusting for a range of other factors (e.g., combustible cigarette use, pain severity). These novel empirical results highlight the severity of fatigue as a potentially important construct in efforts to better understand beliefs related to e-cigarette use and e-cigarette dependence.