Center for Alcohol and Addiction Studies, Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI.
Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI.
Nicotine Tob Res. 2020 Apr 17;22(4):492-497. doi: 10.1093/ntr/ntz002.
Most adolescent smokers report a desire to quit, and many have made several unsuccessful quit attempts; however, when adolescents attempt to quit, they often resume smoking quickly. This ecological study aimed to (1) characterize affective and situational precipitants of smoking lapses among adolescents and (2) explore the moderating influence of nicotine dependence severity on lapse precipitants.
Adolescent daily smokers (n = 166; ages 14-18 years) completed electronic diaries of cigarettes smoked, craving and affective states, and situational variables on handheld computers in their natural environment for 2 weeks following an unassisted quit attempt. On average, adolescents were moderately nicotine dependent (Modified Fagerström Tolerance Questionnaire [mFTQ] score = 4.9; SD = 1.6).
Craving was a significant episodic cue for lapse and stable influence on lapse, relating to 44% and 15% increased odds of lapse, respectively. High-arousal affective states-regardless of valence-were associated with 12%-13% increased odds of lapse. Low-arousal positive affective states were associated with 17% decreased odds of lapse. A 1-unit difference in a teen's mFTQ score related to 27% increased odds of lapse, but dependence severity did not moderate proximal lapse influences.
This report provides some of the first ecological data characterizing adolescent smoking lapses following a quit attempt. As in prior work with teens, lapses were nearly universal and quickly followed the quit attempt. Specific situational and affective contexts of smoking lapses for adolescents were implicated, indicating the need for cessation interventions to address craving and high-arousal affective states as precipitators of lapse in this high-risk group.
This report provides some of the first ecological data characterizing smoking lapses among teens attempting to quit smoking on their own. Like adults, adolescents face many barriers when making quit attempts. The present work provides ecological data to suggest that the experience of heightened arousal in teens' daily lives interferes with their efforts to quit smoking. Thus, this work highlights the importance of affective dysregulation, or amplitude of emotional feelings, for teen smoking lapses. Moment-to-moment fluctuation in craving was also implicated as a dynamic precipitator of smoking lapse in this high-risk group.
大多数青少年烟民都表示有戒烟的意愿，且很多人已经尝试过多次戒烟，但都没有成功；然而，当青少年尝试戒烟时，他们往往会很快复吸。本生态研究旨在：(1) 描述青少年吸烟复吸的情感和情境诱因；(2) 探讨尼古丁依赖严重程度对复吸诱因的调节作用。
166 名青少年每日吸烟者（年龄 14-18 岁）在自主戒烟尝试后，使用手持电脑在自然环境中完成了 2 周的电子香烟吸食记录、渴望和情感状态以及情境变量的日记。平均而言，青少年的尼古丁依赖程度处于中等水平（修正的 Fagerström 尼古丁依赖量表[mFTQ]得分为 4.9；标准差=1.6）。
渴望是复吸的一个重要偶发线索，对复吸具有稳定的影响，分别与复吸的几率增加 44%和 15%相关。无论情绪效价如何，高唤醒的情绪状态与复吸几率增加 12%-13%相关。低唤醒的正性情绪状态与复吸几率降低 17%相关。青少年 mFTQ 评分相差 1 分，复吸几率增加 27%，但依赖严重程度并未调节近期复吸的影响。
本报告提供了一些青少年在自主戒烟尝试后吸烟复吸的生态数据。与青少年以往的研究一样，复吸几乎是普遍存在的，且在戒烟尝试后很快就发生了。具体的吸烟复吸情境和情感背景与青少年有关，这表明需要针对青少年开展戒烟干预，以解决渴望和高唤醒情绪状态作为复吸的诱发因素。
本报告提供了一些关于青少年自主戒烟尝试后吸烟复吸的生态数据。与成年人一样，青少年在戒烟尝试时也面临着许多障碍。本研究提供了生态数据，表明青少年日常生活中的高度唤醒体验干扰了他们戒烟的努力。因此，这一工作强调了情绪失调（或情绪感受的幅度）对青少年吸烟复吸的重要性。在这一高风险群体中，渴望的即时波动也被认为是吸烟复吸的一个动态诱发因素。
