RESUMO
Over half of problem gamblers (PGs; i.e., individuals with an impulse to gamble despite negative consequences) experience a substance use disorder. Explanations for this high rate of comorbidity have included shared clinical and personality factors. While gambling has been associated with substance use disorders in general, relatively few studies have examined the comorbidity of gambling and cocaine use disorders. The current study aimed to address this gap in the literature by comparing the demographic (age, gender, ethnicity, marital status, educational attainment, and employment status), gambling (time and money spent gambling, gambling severity, and motives for gambling), psychological (depression, anxiety, stress, alcohol consumption, nicotine dependency) and personality (trait impulsivity) correlates in a sample of community gamblers with varying degrees of cocaine use; never, recreational, and problematic use as measured by the WHO Alcohol, Smoking and Substance Involvement Screening Test Version 3 (ASSIST-V3.0). Of the 562 participants, 9.3% (N = 51), reported problematic cocaine use. No differences were found between groups for demographic factors. Problematic cocaine users (PCUs) were more likely to be PGs in comparison to recreational users, and never users. They also presented with increased levels of trait impulsivity, depression, anxiety, stress, and alcohol consumption. These results emphasize the need for increased focus on comorbidity and treatment approaches specifically tailored for individuals with PG and PCU.
Assuntos
Transtornos Relacionados ao Uso de Cocaína/epidemiologia , Jogo de Azar/epidemiologia , Comportamento Impulsivo , Personalidade , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Ansiedade/epidemiologia , Transtornos Relacionados ao Uso de Cocaína/psicologia , Comorbidade , Depressão/epidemiologia , Emprego , Feminino , Jogo de Azar/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Transtornos da Personalidade/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologiaRESUMO
BACKGROUND: Women attempt to quit smoking less often than men and are less likely to maintain abstinence. Reproductive hormones have been postulated as a reason for this sex difference, though this remains to be clarified. Research suggests that estradiol and progesterone may influence nicotine addiction, though various methodologies have led to inconsistent findings. The current study aimed to directly examine the effect of reproductive hormones on women's smoking behavior. METHODS: Over the course of one menstrual cycle, twenty-one female smokers recorded the number of cigarettes smoked in a day, as well as their perceived need for and enjoyment of cigarettes smoked. Additionally, they provided 12 urine samples for the measurement of the urinary metabolites of estradiol (estrone-3-glucuronide, E1G) and progesterone (pregnanediol glucuronide, PdG). Multilevel modeling was used to examine the effects of hormone levels as well as hormone change on smoking outcomes. RESULTS: When PdG levels were low, they were inversely associated with daily cigarettes smoked. Furthermore, E1G level was negatively associated with both self-reported need for and enjoyment of cigarettes smoked but not the number of cigarettes smoked. Examining the effect of hormonal change on smoking outcomes revealed a significant interaction between change in PdG and E1G on number of cigarettes smoked such that only a simultaneous drop or increase in both hormones was associated with a greater number of cigarettes. Hormonal change effects on need for and enjoyment of cigarettes were not significant. CONCLUSIONS: The present study suggests that (1) elevated progesterone levels lessen the propensity to smoke in women, (2) estrogen levels influence women's subjective experience of smoking, and (3) simultaneous drops or increases in these hormones are associated with increased smoking.