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Firm behavior in a market with addiction: the case of cigarettes.

This paper investigates firm behavior when demand is linked over time. Among other things, the theoretical section shows that if firms are forward-looking, anticipated future events can affect current consumption of an 'addictive' good even when consumers are completely myopic. The empirical part of the paper reports a simulation of the 1983 federal cigarette excise tax increase. Both myopic and rational models of consumer demand give roughly the same predictions for per capita consumption, but neither model does very well predicting actual consumption. The problem appears to lie in the prediction of price, suggesting that supply considerations are important.

Choice Behavior↗

Psychological intervention and antidepressant treatment in smoking cessation.

BACKGROUND: Sustained-release bupropion hydrochloride and nortriptyline hydrochloride have been shown to be efficacious in the treatment of cigarette smoking. It is not known whether psychological intervention increases the efficacy of these antidepressants. This study compared both drugs with placebo. It also examined the efficacy of these 2 drugs and placebo with and without psychological intervention. METHODS: This was a 2 (medical management vs psychological intervention) x 3 (bupropion vs nortriptyline vs placebo) randomized trial. Participants were 220 cigarette smokers. Outcome measures were biologically verified abstinence from cigarettes at weeks 12, 24, 36, and 52. RESULTS: Psychological intervention produced higher 7-day point-prevalence rates of biochemically verified abstinence than did medical management alone. With the use of point-prevalence abstinence, both nortriptyline and bupropion were more efficacious than placebo. On rates of 1-year continuous abstinence, the 2 drugs did not differ from each other or from placebo. Psychological intervention did not differ from medical management alone on rates of 1-year continuous abstinence. CONCLUSIONS: Both nortriptyline and bupropion are efficacious in producing abstinence in cigarette smokers. Similarly, psychological intervention produces better abstinence rates than simple medical management. Both drugs, and psychological intervention, have limited efficacy in producing sustained abstinence. The data also suggest that combined psychological intervention and antidepressant drug treatment may not be more effective than antidepressant drug treatment alone.

Adult↗

Smoking cessation: an application of theory of planned behavior to understanding progress through stages of change.

The purpose of this research was to investigate variables relevant to smoking cessation early in the process of change through an application of the Theory of Planned Behavior [Ajzen, I. (1985). From intentions to actions: A theory of planned behavior. In J. Kuhl and J. Beckman (Eds). Action-control: From cognition to behavior (pp.11-39). Heidelberg: Springer.] to the temporal structure provided by the Transtheoretical Model. Study 1 was a preliminary elicitation study (n=68) conducted to ground the concepts used in the model testing in Study 2 [Ajzen, I., Fishbein, M. (1980). Understanding attitudes and predicting social behavior, Englewood Cliffs, NJ: Prentice-Hall.]. Study 2 tested the proposed model fit with data from a sample of 230 adult smokers. Structural equation modeling did not support the Theory of Planned Behavior as a model of motivation for progress through the stages of change and highlighted measurement issues with perceived behavioral control. A modified model using the Theory of Reasoned Action provided a good fit to the data, accounting for approximately 64% of the variance in intention to quit smoking and stage of change. This research addresses the need for a more complete theoretical rationale for progress through stages of change.

Adult↗

Behavioral economic analysis of opioid consumption in heroin-dependent individuals: effects of unit price and pre-session drug supply.

Behavioral economic analysis has been used to investigate factors underlying drug consumption in laboratory animals and, increasingly, in human drug abusers. However, there are few studies in heroin abusers, especially those who are not in treatment; such studies may be valuable for understanding the mechanisms of persistent drug use. This study investigated effects of unit price (UP) and pre-session supply of hydromorphone (HYD) on choice and consumption of HYD. Heroin-dependent research volunteers (n=13) stabilized on buprenorphine 8 mg/day completed this eight-session inpatient study. In sessions 1-2, participants sampled two total HYD doses (12 and 24 mg IM) that could be earned in later sessions. In each of the final six sessions, volunteers were given access to a 12-trial choice progressive ratio schedule lasting 3h. On each trial, volunteers could earn a HYD unit dose (1 or 2 mg, for a maximum of 12 or 24 mg, respectively) or money (US dollars 2, for a maximum of US dollars 24). Fixed ratio requirements increased exponentially, generating 24 unit prices for behavioral economic analysis. Before some choice sessions, volunteers could choose (FR 1) to receive extra HYD (12 or 24 mg; at 0915), whereas on other days no supplement was available. HYD choice and peak responding (breakpoint, O(max)) measures increased with unit dose, decreased with pre-session supplements, and were greater among volunteers who used cocaine prior to the experiment. Taking pre-session supplements decreased P(max) and made group-percent HYD consumption more demand-elastic. Consumption was functionally equivalent at differing FR/unit dose combinations. Thus, opioid demand in heroin-dependent individuals not in treatment is a function of drug supply, unit price, and cocaine use.

Adolescent↗

Opioid modulation of taste hedonics within the ventral striatum.

There is a long-standing interest in the role of endogenous opioid peptides in feeding behavior and, in particular, in the modulation of food reward and palatability. Since drugs such as heroin, morphine, alcohol, and cannabinoids, interact with this system, there may be important common neural substrates between food and drug reward with regard to the brain's opioid systems. In this paper, we review the proposed functional role of opioid neurotransmission and mu opiate receptors within the nucleus accumbens and surrounding ventral striatum. Opioid compounds, particularly those selective for the mu receptor, induce a potent increase in food intake, sucrose, salt, saccharin, and ethanol intake. We have explored this phenomenon with regard to macronutrient selection, regional specificity, role of output structures, Fos mapping, analysis of motivational state, and enkephalin gene expression. We hypothesize that opioid-mediated mechanisms within ventral striatal medium spiny neurons mediate the affective or hedonic response to food ('liking' or food 'pleasure'). A further refinement of this hypothesis is that activation of ventral striatal opioids specifically encodes positive affect induced by tasty and/or calorically dense foods (such as sugar and fat), and promotes behaviors associated with this enhanced palatability. It is proposed that this brain mechanism was beneficial in evolutionary development for ensuring the consumption of relatively scarce, high-energy food sources. However, in modern times, with unlimited supplies of high-calorie food, it has contributed to the present epidemic of obesity.

Animals↗

Longitudinal patterns of tobacco smoking from childhood to middle age.

This study described the development of tobacco smoking of subjects between ages 12 and 36 using prospectively collected self-reports of 212 Swedish men and women born in the 1950s. Smoking habits were studied in terms of stability, longitudinal patterns of smoking, and the relation between age of initiation and later smoking. Findings showed that light smoking (up to 6 cigarettes/day) did not remain stable after adolescence. Typical development patterns from age 15 to age 36 included staying a nonsmoker; smoking intensely (>10 cigarettes/day) and continuing into adulthood; smoking less intensely for some periods; or smoking intensely and quitting before age 36. Differences in age at smoking initiation were related to later habitual smoking only when participants reported initiation had occurred after age 12.

Adolescent↗

Serotonin dysfunction in pathological gamblers: increased prolactin response to oral m-CPP versus placebo.

OBJECTIVE: Acute administration of the partial serotonin (5-HT) agonist meta-chlorophenylpiperazine (m-CPP), that is used also as a street drug, has been reported to induce a "high" and craving response in various impulsive and substance addiction disorders. INTRODUCTION: To clarify altered 5-HT metabolism in pathological gamblers and to explore the specific role of serotonergic system in non-substance addictions, we assessed behavioral ("high" and "craving") and neuroendocrine (prolactin and cortisol) responses to an oral single dose of m-CPP and placebo in pathological gamblers and matched controls. Moreover, the relationship between neuroendocrine outcome and clinical severity has been assessed. METHOD: Twenty-six pathological gamblers and 26 healthy control subjects enter a double-blind, placebo-controlled-crossed administration of orally dose m-CPP 0.5 mg/kg. Outcome measures included prolactin and cortisol levels, gambling severity, mood, craving and "high" scales. RESULTS: Pathological gamblers had significantly increased prolactin response compared to controls at 180 minutes and at 210 minutes post-administration. Greater pathological gamblers severity correlated with increased neuroendocrine responsiveness to m-CCP, suggesting greater 5-HT dysregulation. Pathological gambling patients had a significantly increased "high" sensation after m-CPP administration compared with control. CONCLUSION: These results provide additional evidence for 5-HT disturbance in pathological gamblers and they support the hypotheses that the role of the 5-HT dysfunction related to the experience of "high" might represent the pathway that leads to dyscontrolled behavior in pathological gamblers. Furthermore, the "high" feeling induced by m-CPP in pathological subjects may represent a marker of vulnerability to both behavioral and substance addictions.

Adult↗

The development of a conditioned place preference to morphine: effects of microinjections into various CNS sites.

Experiment 1 examined whether microinjections of morphine (1 microg in 0.5 microl over 1 min x 2 pairings) into 13 different CNS sites produced a conditioned place preference (CPP). Injections into the lateral ventricles (LV), ventral tegmental area (VTA), or periaqueductal gray (PAG) produced a CPP; injections 1 mm dorsal to the PAG or VTA, or into the caudate putamen, medial frontal cortex, hippocampus, lateral nucleus of the amygdala, lateral hypothalamus, pedunculopontine tegmental nucleus, posterior hypothalamus, ventral palladium, or nucleus accumbens septi (core or shell) did not. In Experiment 2, morphine 0.2 microg produced a CPP when injected into the VTA but not in the PAG, while 5.0 microg was effective in both sites. The CPP induced by systemic morphine (4 mg/kg x 1 pairing) was blocked by naloxone methiodide (NM) injected (2 nmol in 0.5 microl) into the VTA. PAG injections of 2 nmol reduced, and 5 nmol NM eliminated, the CPP. The results confirm that morphine injections into the VTA or the PAG are rewarding, that blockade of opioid receptors in either site disrupts a morphine-induced CPP, and that the VTA is more sensitive to both effects.

Animals↗

Preference for violent electronic games, self-concept, and gender differences in young children.

Electronic game-playing has been linked to adjustment problems in player subgroups. This study examined relationships among time commitment, gender, preference for violent games, and self-concept in 364 fourth and fifth graders. Main effects were identified for game preference and gender, with stronger preference for violent games being associated with lower self-perceived behavioral conduct. Implications for future research are discussed.

Behavior, Addictive↗

Behavioural and biochemical evidence for interactions between Delta 9-tetrahydrocannabinol and nicotine.

Behavioural and pharmacological effects of Delta9-tetrahydrocannabinol (THC) and nicotine are well known. However, the possible interactions between these two drugs of abuse remain unclear in spite of the current association of cannabis and tobacco in humans. The present study was designed to analyse the consequences of nicotine administration on THC-induced acute behavioural and biochemical responses, tolerance and physical dependence. Nicotine strongly facilitated hypothermia, antinociception and hypolocomotion induced by the acute administration of THC. Furthermore, the co-administration of sub-threshold doses of THC and nicotine produced an anxiolytic-like response in the light - dark box and in the open-field test as well as a significant conditioned place preference. Animals co-treated with nicotine and THC displayed an attenuation in THC tolerance and an enhancement in the somatic expression of cannabinoid antagonist-precipitated THC withdrawal. THC and nicotine administration induced c-Fos expression in several brain structures. Co-administration of both compounds enhanced c-Fos expression in the shell of the nucleus accumbens, central and basolateral nucleus of the amygdala, dorso-lateral bed nucleus of the stria terminalis, cingular and piriform cortex, and paraventricular nucleus of the hypothalamus. These results clearly demonstrate the existence of a functional interaction between THC and nicotine. The facilitation of THC-induced acute pharmacological and biochemical responses, tolerance and physical dependence by nicotine could play an important role in the development of addictive processes.

Animals↗

Workplace worries: a preliminary look at online sexual activities at the office-emerging issues for clinicians and employers.

Concerns about the impact of online sexual activities (OSA) on work-life are drastically increasing. This study examined 3,466 respondents who reported OSA, 18.5% of whom reported engaging in OSA at work. They were compared with the 81.5% who engaged in OSA at home, on average time spent in OSA, workplace policies regarding OSA, and relationship status. Two themes were identified and discussed: opportunity and sexual distress. Our findings indicate that participants are cognizant of issues of opportunity (e.g., the OSA from home group was more likely to indicate their workplace has established policies regarding OSA), and privacy, representing an important aspect of this theme (e.g., participants engaging in OSA at work were found to be twice as likely to have extra-marital affairs, compared with the OSA from home group). Secondly, our data suggests that many participants, especially from the OSA at work group, experience OSA-related distress. Engaging in OSA at the workplace may result in decreased productivity, issues of sexual harassment, and concerns about employee well-being. Clearly stated and consistently enforced policies regulating OSA are likely to mitigate workplace OSA. However, a significant minority of employees may have difficulties curbing OSA. Therefore, more sophisticated strategies to deal with workplace OSA should be established. Additional implications of importance for organizations and mental health professionals who support them are discussed.

Behavior, Addictive↗

Craving and relapse measurement in alcoholism.

This paper attempts to summarize the measurement of craving with four different craving instruments and to relate this to definitions and measurement of relapse. The definitions of relapse may vary between studies and researchers, but are usually well defined. Five commonly used methods to measure relapse are: (1) quantity/frequency of drinking; (2) cumulative duration of abstinence (CDA); (3) post-withdrawal abstinent period; (4) stable recovery period; (5) the time line follow-back method. The definition of craving is much less clear and is mostly described as an emotional-motivational state or as obsessive-compulsive behaviour. Four self-rating instruments are briefly discussed and compared: the Obsessive-Compulsive Drinking Scale, OCDS, the Lübeck Craving Scale, LCRR, the Alcohol Craving Questionnaire, ACQ-Now-SF-R, and ordinal scales (e.g. visual analogue, Likert, or verbal descriptive scales). These instruments measure different aspects or dimensions of craving over different periods. The different dimensions measured suggest that there is still a need to conceptualize a standard interpretation of the word craving. There is a need also to measure an emotional-motivational dimension, a cognitive-behavioural dimension, expectancies, and effects on positive and negative reinforcement with different instruments or with one multidimensional instrument. It is suggested that different patients are expected to have different craving profiles.

Alcoholism↗