Microaggression Impact Assessment for Smoking Behavior

Recruiting in Palo Alto (17 mi)

Overseen by Brooke Y Kauffman, Ph.D.

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: University of Houston

Disqualifiers: Psychotic symptoms, Suicidality, Pregnancy

No Placebo Group

Trial Summary

What is the purpose of this trial?

The purpose of this study is to examine whether microaggressions relate to multimodal facets of smoking behavior, subjective withdrawal, and urge/craving. Additionally, the second aim is to examine whether smoking deprivation moderates the relation between microaggressions and multiple facets of smoking behavior, subjective withdrawal, and urge/craving.

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Microaggression Recall and Relapse Analogue Task for smoking behavior?

The study on nicotine deprivation and attentional bias suggests that addressing discrimination-related stressors, like microaggressions, could be important in smoking interventions for African American adults. This implies that treatments focusing on microaggression recall might help reduce smoking by managing stress and attentional biases linked to discrimination. ^{1 2 3 4 5}

How does the treatment in the Microaggression Impact Assessment for Smoking Behavior trial differ from other smoking cessation treatments?

This treatment is unique because it focuses on the impact of microaggressions (subtle, often unintentional discriminatory comments or actions) on smoking behavior, which is not typically addressed in standard smoking cessation treatments. It may explore how these social and emotional factors influence smoking habits, offering a novel approach compared to traditional methods that primarily target nicotine addiction or behavioral cues. ^{6 7 8 9 10}

Research Team

Brooke Y Kauffman, Ph.D.

Principal Investigator

University of Houston

Eligibility Criteria

This trial is for Hispanic or Latino adults who smoke at least 5 cigarettes a day, have been smoking regularly for over a year, and have experienced microaggressions in the past 6 months. Participants must be at least 18 years old and able to give informed consent. Those with active suicidal thoughts cannot join.

Inclusion Criteria

You consider yourself to be of Hispanic or Latino ethnicity.

You identify yourself as Hispanic or Latino.

Able to provide written, informed consent

Exclusion Criteria

You are currently experiencing suicidal thoughts or have plans to harm yourself.

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Experimental Sessions

Participants attend two counterbalanced experimental sessions: Smoking Deprivation (16 hours of smoking abstinence) and Smoking as Usual.

2 weeks

2 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after experimental sessions

4 weeks

Treatment Details

Interventions

• Microaggression Recall and Relapse Analogue Task (Behavioral Intervention)

Trial Overview The study investigates how experiencing microaggressions might affect smoking behavior, withdrawal symptoms, and cravings among Latinx smokers. It also looks into whether not smoking for a while changes these effects.

Participant Groups

Group I: Smoking as Usual Experimental Treatment 1 Intervention

Smoking as usual prior to experimental visit.

Group II: Smoking Deprivation Experimental Treatment 1 Intervention

16 hours of smoking abstinence prior to experimental visit.

Who Is Running the Clinical Trial?

University of Houston

Lead Sponsor

Trials

155

Recruited

48,600+

Norman Sussman

University of Houston

Chief Medical Officer since 2020

MD from Baylor College of Medicine

Tom Luby

University of Houston

Chief Executive Officer since 2019

PhD in Immunology from the Sackler School of Biomedical Sciences, Tufts University

Findings from Research

In a study involving 222 Hispanic/Latinx adult smokers, those using the Acceptance and Commitment Therapy (ACT)-based website WebQuit.org had significantly higher smoking cessation rates at 12 months (40%) compared to those using the US Clinical Practice Guidelines-based website Smokefree.gov (25%).

Participants using WebQuit engaged more with the website, spending more time on it, which suggests that digital interventions like WebQuit may be effective in helping Hispanic/Latinx adults quit smoking, although the increased engagement did not directly correlate with higher quit rates.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Web-delivered Acceptance and Commitment Therapy (ACT) for smoking cessation: Is it engaging and efficacious for US Hispanic/Latinx adult smokers? Kwon, DM., Santiago-Torres, M., Mull, KE., et al.[2023]

A novel nicotine Approach-Avoidance-Task (AAT) training significantly modified the automatic approach bias towards nicotine-related cues in smokers, suggesting it can influence addictive behaviors.

The AAT training led to a greater reduction in nicotine consumption at a three-month follow-up compared to a sham training, indicating its potential as an effective long-term intervention for reducing smoking in psychiatric patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Approach bias modification in inpatient psychiatric smokers. Machulska, A., Zlomuzica, A., Rinck, M., et al.[2017]

In a study involving 35 smokers and 25 nonsmokers, smokers exhibited varying emotional responses to smoking cues based on their withdrawal symptoms and motivation to smoke, indicating that these factors influence their automatic reactions.

Nonsmokers consistently showed negative emotional responses to smoking cues, while smokers with withdrawal symptoms had positive responses, supporting theories that smoking cues can acquire positive reward value through conditioning.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Automatic affective responses to smoking cues. Payne, BK., McClernon, FJ., Dobbins, IG.[2022]

In a study of 158 smokers, those using a high-dose nicotine patch (35 mg) showed reduced attentional bias towards smoking-related cues, indicating that the patch may help mitigate distractions that lead to relapse during the first day of quitting.

Smokers who displayed greater attentional bias towards smoking-related words were more likely to relapse shortly after quitting, suggesting that attentional bias could be a key factor in smoking dependence and relapse risk.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Attentional bias predicts outcome in smoking cessation. Waters, AJ., Shiffman, S., Sayette, MA., et al.[2022]

Cigarette smokers with high trait hostility (HH) showed impaired socioaffective processing, particularly in their ability to categorize angry faces, compared to those with low hostility (LH), indicating a potential link between hostility and emotional processing biases.

The Emotional Interference Gender Identification Task (EIGIT) revealed that both groups were slower and less accurate with angry faces, but HH participants had fewer errors, suggesting that high hostility may affect how individuals process emotional cues, which could be relevant for understanding health-related behaviors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Examining socioaffective processing biases in cigarette smokers with high versus low trait hostility. Leventhal, AM., Kahler, CW.[2021]

In a study involving 304 smokers who tracked their smoking behavior over one week, it was found that smoking was strongly linked to smoking urges and moderately associated with factors like coffee and food consumption, as well as the presence of other smokers.

Interestingly, the study revealed that emotional states (both negative and positive) had little impact on smoking behavior, suggesting that situational cues and urges play a more significant role in smoking habits among heavy smokers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Immediate antecedents of cigarette smoking: an analysis from ecological momentary assessment. Shiffman, S., Gwaltney, CJ., Balabanis, MH., et al.[2022]

In a study of 607 African American smokers, higher perceived exposure to discrimination was linked to increased tobacco withdrawal symptoms, particularly heightened urges to smoke and negative mood states after 16 hours of tobacco deprivation.

The associations were modest, suggesting that while discrimination may influence withdrawal experiences, it does not strongly predict all aspects of smoking behavior or cravings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Association of frequency of perceived exposure to discrimination with tobacco withdrawal symptoms and smoking lapse behavior in African Americans. Bello, MS., Liautaud, MM., De La Cerda, JT., et al.[2023]

Daily smokers (34 participants) showed a more positive implicit response to smoking-related cues compared to neutral cues, while occasional smokers (19 participants) did not exhibit this difference, suggesting that daily smoking may enhance the emotional appeal of smoking-related stimuli.

The study found that daily smokers' implicit responses to active smoking cues were linked to their motivation for cognitive enhancement, indicating that these cues could play a significant role in sustaining smoking behavior among daily smokers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A comparison of daily and occasional smokers' implicit affective responses to smoking cues. Haight, J., Dickter, CL., Forestell, CA.[2015]

References

1. United States pubmed.ncbi.nlm.nih.gov

Nicotine deprivation amplifies attentional bias toward racial discrimination stimuli in African American adults who smoke cigarettes. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

Web-delivered Acceptance and Commitment Therapy (ACT) for smoking cessation: Is it engaging and efficacious for US Hispanic/Latinx adult smokers? [2023]

3. England pubmed.ncbi.nlm.nih.gov

Approach bias modification in inpatient psychiatric smokers. [2017]

4. United States pubmed.ncbi.nlm.nih.gov

Automatic affective responses to smoking cues. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Association between smoking-related attentional bias and craving measured in the clinic and in the natural environment. [2023]

6. United States pubmed.ncbi.nlm.nih.gov

Attentional bias predicts outcome in smoking cessation. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Examining socioaffective processing biases in cigarette smokers with high versus low trait hostility. [2021]

8. United States pubmed.ncbi.nlm.nih.gov

Immediate antecedents of cigarette smoking: an analysis from ecological momentary assessment. [2022]

9. England pubmed.ncbi.nlm.nih.gov

Association of frequency of perceived exposure to discrimination with tobacco withdrawal symptoms and smoking lapse behavior in African Americans. [2023]

10. England pubmed.ncbi.nlm.nih.gov

A comparison of daily and occasional smokers' implicit affective responses to smoking cues. [2015]