Cancer Patients Enrolled in a Smoking Cessation Clinical Trial: Characteristics and Correlates of Smoking Rate and Nicotine Dependence

Abstract

Introduction A substantial proportion of cancer patients continue to smoke after their diagnosis but few studies have evaluated correlates of nicotine dependence and smoking rate in this population, which could help guide smoking cessation interventions. Aim This study evaluated correlates of smoking rate and nicotine dependence among 207 cancer patients. Methods A cross-sectional analysis using multiple linear regression evaluated disease, demographic, affective, and tobacco-seeking correlates of smoking rate and nicotine dependence. Smoking rate was assessed using a timeline follow-back method. The Fagerström Test for Nicotine Dependence measured levels of nicotine dependence. Results A multiple linear regression predicting nicotine dependence showed an association with smoking to alleviate a sense of addiction from the Reasons for Smoking scale and tobacco-seeking behavior from the concurrent choice task (p < .05), but not with affect measured by the HADS and PANAS (p > .05). Multiple linear regression predicting prequit showed an association with smoking to alleviate addiction (p < .05). ANOVA showed that Caucasian participants reported greater rates of smoking compared to other races. Conclusions The results suggest that behavioral smoking cessation interventions that focus on helping patients to manage tobacco-seeking behavior, rather than mood management interventions, could help cancer patients quit smoking.

Contribution of cannabis-related cues to concurrent reinforcer choice in humans

“…Participants reporting more frequent cannabis use and more intense and inelastic cannabis demand showed a greater bias towards cannabis-cued selections. These associations between choice bias and clinical measures of substance use are consistent with the observation that performance on concurrent cue tasks relates to substance use frequency and severity in alcohol, cigarette, and cocaine use (Hardy and Hogarth, 2017;Hardy et al, 2018;Chase, 2011, 2012;Miele et al, 2018;Moeller et al, 2013;Moeller et al, 2009). More specifically, these findings are similar to a prior study documenting a relationship between tobacco cigarette demand and concurrent choice for tobacco-related reinforcers (Chase et al, 2013).…”

“…The specific impact that cannabis-related cues may have on subsequent decision-making processes and choice behavior remains unclear from existing work. Broadly speaking, research in alcohol, cigarette, and cocaine use suggests that explicit choice for substancerelated cues in a concurrent setting is associated with substance use frequency and severity (Hardy and Hogarth, 2017;Hardy et al, 2018;Chase, 2011, 2012;Miele et al, 2018;Moeller et al, 2013;Moeller et al, 2009). Moeller and colleagues (Moeller et al, 2013;Moeller et al, 2009), for example, have demonstrated that when participants are presented with a concurrent choice between a cocaine and non-drug image, individuals with cocaine use disorder choose to view more cocaine images than controls and that the percentage of image choice is associated with cocaine use frequency and severity (see review in Moeller and Stoops, 2015).…”

Addiction is driven by excessive goal-directed drug choice under negative affect: translational critique of habit and compulsion theory

“…Different designs use points for rewards [111,112], pictures of rewards [7,[113][114][115][116][117] or consumption of rewards [14,[118][119][120][121][122][123][124]. Preferential drug choice is reliably associated with the severity of dependence to heroin [125], cocaine [116,117,126,127], alcohol [10,15,26,112,113,115], and tobacco [15,111,114,124,128]. These associations have been found in both clinical [15,113,114,116,117,[125][126][127] and non-clinical samples [10, 26, 111-113, 115, 128].…”

“…Preferential drug choice is reliably associated with the severity of dependence to heroin [125], cocaine [116,117,126,127], alcohol [10,15,26,112,113,115], and tobacco [15,111,114,124,128]. These associations have been found in both clinical [15,113,114,116,117,[125][126][127] and non-clinical samples [10, 26, 111-113, 115, 128]. Percent drug choice also increases with latency to relapse [129], abstinence [7], depression and anxiety symptoms and self-reported drinking to cope with negative affect [10,15,113,115], and is decreased by health warnings and satiety [111,130,131], by raising the magnitude of the alternative reward [14,112,118,121,[132][133][134], and by increasing the effort [59], and delay of the drug choice [112,133,134].…”

The association between self-reported varenicline adherence and varenicline blood levels in a sample of cancer patients receiving treatment for tobacco dependence

“…To be eligible for the trial, participants were required to be >age 18 and to have: received a cancer diagnosis or cancer treatment within the past 5 years, reported daily smoking, and reported an interest in quitting smoking. Additional eligibility criteria and exclusion criteria are described elsewhere ( Miele et al, 2018 ; Price et al, 2017 ). For this study, data from 76 participants who provided blood for varenicline testing were used (only participants from the University of Pennsylvania site were asked to provide samples due to budget constraints).…”