To identify whether time and risk preference predicts relapse among smokers trying to quit.
A cohort study of smokers who had recently started to quit. Time and risk preference parameters were estimated using a discrete choice experiment (DCE).
A total of 689 smokers who began quitting smoking within the previous month.
Time discount rate, coefficient of risk-aversion measured at study entry and duration of smoking cessation measured for 6 months.
In the unadjusted model, Cox's proportional hazard regression showed that those with a high time discount rate were more likely to relapse [hazard ratio: 1.18, 95% confidence interval (CI): 1.11-1.25]. A high coefficient of risk-aversion reduced the hazard of relapse (0.96, 0.96-0.97). When adjusted for other predictors of relapse (age, gender, self-efficacy of quitting, health status, mood variation, past quitting experience, the use of nicotine replacement therapy, nicotine dependence), the hazard ratios of time discount rate and the coefficient of risk-aversion is 1.17 (95% CI: 1.10-1.24) and 0.98 (95% CI: 0.97-0.99), respectively.
Those who emphasize future rewards (time-patient preference) and those who give more importance to rewards that are certain (higher risk-aversion) were significantly more likely to continue to abstain from smoking.
"A higher time preference rate and lower risk aversion coefficient was associated with increased likelihood of smoking (Ida and Goto 2009a, b). The discrete choice method offers more information than studies which use time preference proxies to determine associations between behaviours and time preferences (Goto et al. 2009). Additionally, use of time preference proxies can potentially confound the analysis because some behaviours (e.g., smoking) that are associated with time preferences may also be associated with risk aversion. "
"In addition, one might argue that specific behavioral variables or brain responses rather than the combination of several variables representing different constructs might explain more variance in early drinking onset. For example, risk seeking was shown to be associated with increased risk for relapse (eg, Goto et al, 2009) and might be a vulnerability factor for substance abuse. In addition, previous studies reported a dysfunction in reward-related brain regions such as the ventral striatum in addiction, with decreased activation in response to non-drug rewards (eg, Wrase et al, 2007). "
[Show abstract][Hide abstract] ABSTRACT: Individual variation in reward sensitivity may have an important role in early substance use and subsequent development of substance abuse. This may be especially important during adolescence, a transition period marked by approach behavior and a propensity toward risk taking, novelty seeking and alteration of the social landscape. However, little is known about the relative contribution of personality, behavior, and brain responses for prediction of alcohol use in adolescents. In this study, we applied factor analyses and structural equation modeling to reward-related brain responses assessed by functional magnetic resonance imaging during a monetary incentive delay task. In addition, novelty seeking, sensation seeking, impulsivity, extraversion, and behavioral measures of risk taking were entered as predictors of early onset of drinking in a sample of 14-year-old healthy adolescents (N=324). Reward-associated behavior, personality, and brain responses all contributed to alcohol intake with personality explaining a higher proportion of the variance than behavior and brain responses. When only the ventral striatum was used, a small non-significant contribution to the prediction of early alcohol use was found. These data suggest that the role of reward-related brain activation may be more important in addiction than initiation of early drinking, where personality traits and reward-related behaviors were more significant. With up to 26% of explained variance, the interrelation of reward-related personality traits, behavior, and neural response patterns may convey risk for later alcohol abuse in adolescence, and thus may be identified as a vulnerability factor for the development of substance use disorders.
Neuropsychopharmacology: official publication of the American College of Neuropsychopharmacology 11/2011; 37(4):986-95. DOI:10.1038/npp.2011.282 · 7.05 Impact Factor
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