While rates of young adult tobacco smoking have decreased in the past decade, a substantial minority of young adults continue to smoke. Achieving cessation before reaching 30 years of age appears to significantly reduce the early mortality associated with smoking, whereas continued smoking through young adulthood is associated with increased cancer risk, poorer pulmonary functioning and neurocognitive deficits. Cessation programs aimed at this population have generally produced low rates of sustained abstinence, signalling the need for improved treatments aimed at ameliorating impediments to abstinence, such as impulsivity and risk taking. Findings indicate that impulsive smokers have greater trouble achieving lasting cessation, perhaps through elevated levels of craving they appear to experience after ceasing tobacco use. Furthermore, stress-induced pre-cessation increases in risk taking were associated with lower rates of sustained cessation among adolescents taking part in a research trial [(Schepis et al., in press)]. Stress exposure may also mediate the relationship between impulsivity and poorer smoking cessation outcome, as evidence indicates that stress exposure increases impulsivity. Thus, this application will evaluate the relationships among impulsivity, risk taking, nicotine craving and withdrawal in nicotine abstinent and non-abstinent young adult tobacco smokers before and after participating in a personalized imagery stressor (Sinha et al., 1999). [Participants will also complete a 6-day relapse analogue paradigm, providing a clinically and ecologically relevant endpoint.] The specific aims of this application are to: (1) evaluate the influence of nicotine abstinence on stress-induced changes in impulsive responding, risk-taking, nicotine craving and nicotine withdrawal symptoms in young adult smokers;(2) identify the effects of [trait] impulsivity and risk taking on smoking-related processes among young adult smokers following stress exposure;[and (3) evaluate the effects of stress-related changes in response inhibition and risk taking on ability to maintain abstinence in a relapse analogue paradigm.] This Behavioral Science Track Award for Rapid Transition (PAR-09-239) application could make an innovative contribution to the tobacco research field through the first use of an experimental paradigm to investigate stress-related changes in impulsivity, risk taking, nicotine craving and nicotine withdrawal in nicotine abstinent and non-abstinent young adult smokers. This proposal has strong relevance for the stated mission of NIDA, given its emphasis on uncovering a potential cause of continued tobacco use in an understudied and potentially vulnerable population, young adult smokers who are impulsive and/or risk prone. The public health benefit of this application could be significant, as it could lead to improved cessation treatments in these groups, limiting the morbidity and mortality associated with tobacco smoking.
Young adult smoking is a major cause of early death and a significant socioeconomic burden. Many young adult smokers wish to quit, but most experience notable difficulty achieving lasting cessation. Thus, this proposal has great public health relevance, as it may uncover how higher levels of impulsivity and risk taking prevent some young adults from quitting smoking, leading to better treatments for these individuals.