Objective-To examine the relationship between impulsivity and smoking cessation treatment response among adolescents.Methods-Thirty adolescent smokers participated in a high school based smoking cessation program combining contingency management and cognitive behavioral therapy. Self-report (Barratt Impulsiveness Scale (BIS-11); Kirby Delay Discounting Measure (DDM)) and behavioral (Experiential Discounting Task (EDT); Continuous Performance Task (CPT)) measures of impulsivity were assessed at treatment onset.Results-Sixteen participants (53%) were abstinent from smoking at completion of the four-week study. Compared to abstinent adolescents, those not achieving abstinence discounted monetary rewards more on the EDT and committed more commission errors on the CPT. Group differences were not observed on the BIS-11 or DDM.Conclusions-These preliminary results suggest that specific behavioral measures of impulsivity may be associated with the ability to initiate and/or maintain abstinence from smoking among adolescent smokers.

Marijuana use in adolescents is associated with many adverse outcomes, including neurobiological and health consequences. Despite this, little is known about gender differences in the correlates of adolescent marijuana use. This study attempted to fill this gap by examining gender differences in the correlates of lifetime and past 30-day marijuana use. Data from a cross-sectional statewide survey of adolescent risk behavior participation in Connecticut were analyzed using chi-square and hierarchical logistic regression methodologies to examine the demographic, psychosocial and risk behavior correlates of adolescent marijuana use. Gender-by-trait interactions were tested with hierarchical logistic regression. Of the 4523 participants (51.8% female, 75.8% Caucasian), 40.4% endorsed lifetime marijuana use and 24.5% endorsed past 30-day marijuana use. Risk behavior participation, particularly other substance use, had the most robust associations with lifetime and past 30-day adolescent marijuana use; participation in extracurricular activities appeared protective. Gender interactions were observed for African-American, Asian or other race and participation in extracurricular activities; in these three cases, males had a greater likelihood of use. They were also observed for having a job (lifetime use only), with females having elevated odds, and past 30-day cigarette smoking (past 30-day use only), with males having elevated odds. Finally, there was preliminary evidence of a faster transition from initiation of marijuana use to regular use in females, as compared to males. These results indicate important gender differences in the correlates of marijuana use in adolescents, and these findings may facilitate the development of gender-informed prevention and early intervention programs for adolescent marijuana use.

This pilot study evaluated the use of contingency management (CM) procedures in combination with cognitive-behavioral therapy (CBT) for smoking cessation in adolescents. Twenty-eight treatment-seeking adolescent smokers participated in a 1-month, school-based smoking cessation program and were randomly assigned to receive either CM with weekly CBT or CBT alone. In the CM+CBT group, biochemical verification of abstinence was obtained twice daily during the first 2 weeks, followed by daily appointments during the 3rd week and once every other day during the 4th week. Participants were monetarily reinforced for abstinence on an escalating magnitude schedule with a reset contingency. At the end of 1 week and 1 month of treatment, abstinence verified using quantitative urine cotinine levels was higher in participants in the CM+CBT group (1 week: 76.7%; 1 month: 53.0%) when compared with the CBT-alone group (1 week: 7.2%; 4 weeks: 0%). These preliminary results provide a strong initial signal supporting the utility of CM techniques for smoking cessation in adolescents and demonstrate the feasibility of implementing such a program in a school setting.

Objectives-This study attempted to evaluate whether impulsive sensation seeking mediated the relationship between parental alcohol problems and offspring alcohol and tobacco use.Methods-Participants were Connecticut high school students (n = 2733) completing a survey of high-risk behaviors. Variables of interest included past month alcohol use, past month binge alcohol use, frequency of past month alcohol use, past month tobacco use, having a biological parent with an alcohol problem, and score on the impulsive sensation seeking (ImpSS) scale from the ZuckermanKuhlman Personality Questionnaire -Form III.Results-ImpSS scores were elevated in past month users of alcohol, binge users of alcohol, users of both tobacco and alcohol, and they increased with increasing frequency of past month alcohol use. Also, parental history of alcohol use increased the likelihood of past month alcohol use, binge use, use of both tobacco and alcohol, and higher levels of past month alcohol use. Mediational analyses did not appear to support the hypothesis that impulsive sensation seeking mediates the relationship between parental history of alcohol problems and alcohol and tobacco use in offspring.Conclusions-Impulsive sensation seeking and parental history of alcohol problems appear to be independent factors that contribute to the co-occurrence of alcohol and tobacco use in adolescents. These findings can inform prevention and treatment efforts. KeywordsAlcohol; tobacco; adolescent; impulsive behavior; sensation seeking Impulsivity and sensation seeking are personality traits that appear to influence risk-taking generally, and substance use processes more specifically. Moeller and colleagues 1 have defined impulsivity as a tendency to act quickly without thinking ahead about consequences; Zuckerman 2 has defined sensation seeking as a tendency to take risks in order to seek out novel, stimulating experiences. Both impulsivity and sensation seeking are positively correlated with current alcohol use and current heavy episodic alcohol use among adults and adolescents, [3][4][5][6] and both traits have been hypothesized to play a role in the initiation of alcohol use and in alcohol use disorder (AUD) development. 7,8 Corresponding Author: Ty S. Schepis, Ph.D., Department of Psychiatry, Yale University School of Medicine, 34 Park Street, New Haven, CT 06519, Among adolescents, higher sensation seeking levels have been associated with regular alcohol use in a large cross-national sample, 9 and appear to predict longitudinal increases in alcohol use over a three year period. 10 Furthermore, it appears that interventions that target sensation seeking in adolescents can delay the onset and progression of alcohol use and binge use. 11 In all, sensation seeking appears to exert direct and indirect promotional effects on alcohol use, 3, 12, 13 and a meta-analysis using 61 pooled studies found that sensation seeking had a small to moderate effect size on promoting alcohol use. 14 Examinations of impulsivity have also found that it is ass...

This pilot study evaluated the optimal format of cognitive behavioral therapy (CBT) to combine with contingency management (CM) in a four-week, high school-based smoking cessation program. Thirty-four adolescent smokers received a standard weekly version of CBT or a frequent brief behavioral intervention. Results indicate a trend toward a higher seven-day point prevalence end-of-treatment abstinence rate and percent days abstinent during treatment in the CBT condition. In addition, significantly more participants in the CBT group completed treatment. These preliminary results suggest that when combined with CM, the standard weekly format of CBT is more acceptable to adolescent smokers.