Reitzel Lorraine R, Leventhal Adam M
Department of Educational Psychology, College of Education, University of Houston, Houston, TX;
Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA; Department of Psychology, University of Southern California Keck School of Medicine, Los Angeles, CA.
Nicotine Tob Res. 2014 Nov;16(11):1455-62. doi: 10.1093/ntr/ntu100. Epub 2014 Jun 16.
Socioeconomic status (SES) indicators are robustly associated with smoking behaviors. Yet, the psychological mechanisms underlying relations are unclear. This study merged the socioecological construct of SES with laboratory psychological science to investigate how income, education, and employment status predicted the reward value of smoking following tobacco abstinence among a diverse sample of adult daily smokers. We hypothesized that participants with lower SES (i.e., less education, lower income, and unemployed) would experience greater abstinence-induced enhancement of the reward value of smoking.
Adult smokers (N = 240; 68.7% male; 51.7% Black, 33.8% White, 7.1% Latino, and 7.5% other) attended 2 laboratory sessions (1 nonabstinent and 1 following 16-hr tobacco abstinence) involving behavioral assessment of (a) latency to smoking when delaying smoking was monetarily rewarded and (b) purchasing individual cigarettes. Generalized estimating equations were used to test the interaction between each SES variable (education, income, and employment) and abstinence state to illustrate whether participants with certain SES characteristics were more sensitive to the abstinence-induced enhancement of the relative reward value of smoking.
Participants who never attended college (vs. college attendees) exhibited greater abstinence-induced enhancement of the reward value of smoking, which was indicated by reduced willingness to delay smoking for money (ps = .03). Income and employment status did not moderate abstinence effects.
Less-educated smokers were particularly motivated to smoke during acute abstinence. Observed educational disparities in smoking behaviors and smoking cessation might reflect a biased valuation of immediate drug-related (over less immediate alternative) rewards. Future research should explore potential mediators of this association.
社会经济地位（SES）指标与吸烟行为密切相关。然而，两者关系背后的心理机制尚不清楚。本研究将SES的社会生态结构与实验室心理学相结合，以调查收入、教育程度和就业状况如何预测成年每日吸烟者多样化样本中戒烟后吸烟的奖励价值。我们假设社会经济地位较低的参与者（即教育程度较低、收入较低和失业者）在戒烟后会体验到吸烟奖励价值的更大增强。
成年吸烟者（N = 240；68.7%为男性；51.7%为黑人，33.8%为白人，7.1%为拉丁裔，7.5%为其他）参加了2次实验室测试（1次非戒烟测试和1次16小时戒烟后的测试），涉及以下行为评估：（a）当延迟吸烟有金钱奖励时吸烟的潜伏期，以及（b）购买单支香烟。使用广义估计方程来测试每个SES变量（教育程度、收入和就业）与戒烟状态之间的相互作用，以说明具有特定SES特征的参与者是否对戒烟引起的吸烟相对奖励价值的增强更敏感。
从未上过大学的参与者（与上过大学的参与者相比）在戒烟后表现出吸烟奖励价值的更大增强，这表现为为了钱而延迟吸烟的意愿降低（p值 = 0.03）。收入和就业状况并未调节戒烟效果。
受教育程度较低的吸烟者在急性戒烟期间特别有吸烟的动机。在吸烟行为和戒烟方面观察到的教育差异可能反映了对即时药物相关（相对于不太即时的替代）奖励的偏见性评估。未来的研究应探索这种关联的潜在中介因素。
