Suchitra Krishnan-Sarin's research while affiliated with Yale-New Haven Hospital and other places

Publications (315)

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Introduction: Restricting available e-cigarette flavours to only tobacco and menthol may reduce appeal among youth; it is unknown how flavour restrictions impact adults using e-cigarettes to quit smoking cigarettes. Methods: Online US survey data were collected in summer 2021 from 857 adults who reported using e-cigarettes in a recent attempt to...
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This study determined whether young adults' perceptions of how tobacco free nicotine (TFN) compared to tobacco-derived nicotine (TDN) were associated with curiosity to try or use TFN e-cigarettes. U.S. young adults aged 18–25 years (n = 1176) completed an online survey in October 2021. Survey questions assessed TFN awareness, curiosity, use, and pe...
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Problematic use of the internet (PUI) and self-injurious behaviors (SIB) associate in adolescents and both relate to impulsivity. However, studies have not examined whether difficulties in impulse control are shared in adolescents with PUI and SIB, and how PUI relates to SIB frequency and impairment. Here, exploratory factor analysis was performed...
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Introduction: Black communities are targeted by more cigarette advertisements than White communities and racial discrimination among Black people is related to cigarette use. However, little is known about these factors with non-cigarette tobacco product use among Black adults. Therefore, this study assessed the association of non-cigarette advert...
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Recreational and problem gambling have been linked with adverse health and functioning outcomes among adolescents. Youth may gamble and engage in other risk-taking behaviors in casinos. There are limited data available regarding casino gambling in high-school students, and factors linked to adolescent gambling in casinos have yet to be systematical...
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Prior research suggests that flavors can influence the pharmacological effects of nicotine. We used commercially available JUUL pods to examine whether preferred menthol versus tobacco flavor increased the addictive potential of nicotine per se. This study recruited 15 regular JUUL e-cigarette users to complete a 2 × 2 factorial crossover trial usi...
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Background Nicotine pouches containing synthetic nicotine or tobacco-derived nicotine (TDN) are available in the United States. Synthetic nicotine pouches often are marketed as “tobacco-free nicotine” (TFN), which may alter risk perceptions and/or product appeal. This study examined young adults’ perceptions about TFN versus TDN pouches and associa...
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Problematic video gaming (PVG) and problematic shopping (PS) are addictive behaviors prevalent in adolescents, characterized by positive and negative reinforcement, and associated with psychosocial impairment. This study examined how PS and PVG relate in adolescents. It also examined how PS interacts with PVG in relation to health/functioning measu...
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Introduction: E-cigarettes are increasingly being marketed as containing tobacco-free nicotine (TFN). There is no data examining use of TFN e-cigarettes by young adults and how use may differ from non-TFN e-cigarettes. The current study aims to characterize young adult TFN e-cigarette use and examine differences between those who report using TFN...
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Heterogeneity in the clinical presentation of SARS-CoV-2 infection and COVID-19 progression underscores the urgent need to identify individual-level susceptibility factors that affect infection vulnerability and disease severity. Tobacco product use is a potential susceptibility factor. In this Personal View, we provide an overview of the findings...
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Introduction Flavored electronic nicotine delivery systems (ENDS) and tobacco products are associated with initiation and progression of tobacco use. With recent restrictions around flavored products, it is critical to measure both the product and the flavor being used. The Tobacco Centers of Regulatory Science (TCORS) Flavored Tobacco Products Mea...
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Introduction Given high youth e-cigarette use, it is important to investigate how traits, like impulsivity, may be associated with youth e-cigarette use behaviors. The study aim is to determine if impulsivity is associated with trying more e-cigarette flavors and device types, and greater frequency of e-cigarette use. Method Cross sectional survey...
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The desire to escape from pressures/anxiety represents an important motivation for problematic engagement with short-term rewarding behaviors that could contribute to the development of recognized and candidate behavioral addictions, including problematic shopping, a prevalent condition among youth in the U.S.A. characterized by excessive shopping...
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Background “Tobacco-free” nicotine (TFN) e-cigarettes and nicotine pouches containing synthetic nicotine are increasingly available. The term TFN may lead to reduced risk perceptions and increased use intentions relative to tobacco-derived nicotine products. Effectively communicating messages about TFN may depend on the public’s ability to differen...
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Background: The relationship between alcohol and pain is complex. Associations between pain and AUD vary by race, but the underlying biological basis is not understood. We examined the association of the kappa opioid receptor (KOR) with responses to the cold-pressor test (CPT), before and after treatment with the opioid antagonist naltrexone, amon...
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Introduction Menthol cigarette use contributes to disproportionate tobacco-related health disparities amongst minoritized race/ethnic groups. E-cigarettes are available in flavors such as menthol and may be a less harmful substitute among adults who smoke. Yet little is known about e-cigarette flavor preference and reasons for use by race/ethnicity...
Article
Gambling and anxiety are major public health concerns in adolescents and have been linked to emotion dysregulation and mood-modulating behaviors. While previous studies have shown links between positively reinforcing excitement-motivated gambling, health and functioning measures, and gambling perception and behavioral correlates in adolescents, few...
Article
Importance: Multiple nicotine product use (MNPU) among youths is a significant public health concern. Much remains unknown about the patterns of MNPU in youths, including how socioecological factors influence trajectories of MNPU, which may inform targeted prevention. Objective: To identify longitudinal trajectories of MNPU and characterize them...
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Background Nicotine vaping and cannabis use are common among youth. Among youth who use e-cigarettes, little is known about how and why they use cannabis and patterns of cannabis and nicotine co-use. Given the popularity of both products among youth, the study aim is to utilize qualitative data to better understand cannabis use among youth who use...
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Introduction E-cigarette liquid nicotine concentrations typically are labeled as mg/mL or percent, which poorly convey nicotine strength to users. We evaluated whether four novel nicotine concentration labels better convey information about nicotine strength and addictiveness. Methods Adolescents and young adults (N=826) completed an online survey...
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Objective A pressing tobacco policy concern is how to help smokers who have little interest in quitting cigarettes, a group that often suffers severe health consequences. By switching from cigarettes to e-cigarettes, they could obtain nicotine, potentially with less harm. We examined if policy-relevant attributes of cigarettes/e-cigarettes might en...
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Introduction To understand whether using a certain e-cigarette device is more strongly associated with risk of combustible tobacco use among youth. Methods We conducted multivariable logistic regression analyses using cross-sectional data from 4 samples of youth in Connecticut and California (N=10,482; ages 13-24), separately for each study using...
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Cannabis and tobacco use and related disorders have been separately associated with sensitivity to reward (SR), sensitivity to punishment (SP), and impulsivity. Given the frequent co-occurrence of cannabis and tobacco consumption in adolescents, it is important to understand how SR, SP, and impulsivity may relate to both cannabis use and tobacco us...
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Gambling on the lottery is a prevalent behavior, and lottery products are increasingly available in online and electronic formats. As lottery-purchasing is prevalent in adolescents, this study systematically examined relationships between lottery-purchasing and problem-gambling severity and gambling perceptions and attitudes, as well as differences...
Article
Background Assessing youth vaping expectancies using a psychometrically sound measure can improve understanding of e-cigarette susceptibility and use. Methods We evaluated the psychometric properties of the Short-Form Vaping Consequences Questionnaire (SF-VCQ), an expectancy measure previously validated with adults, within a sample of 1,753 high s...
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Background A hyper-engaged habit system may be common in alcohol use disorders (AUDs). Regarding drinking patterns, habit may be expressed as higher levels of drinking autoregression, where previous day drinking is correlated with next day drinking. This study utilized dynamic structural equation models (DSEM) with intensive longitudinal data to un...
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Background: Dual use of e-cigarettes and combustible tobacco products is common in young adults. We aimed to explore how ratings of subjective and contextual factors differed between discrete episodes of e-cigarette use vs. combustible tobacco product smoking among a sample of young adults. Methods: Young adults (N = 29, ages 18-30) who used e-c...
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Purpose E-cigarette use is a problem among youth, yet few vaping cessation programs exist. This study aimed to understand what youth want in a school-based vaping cessation program to inform intervention development. Methods We conducted 8 focus groups in Fall 2019 with Connecticut high school youth (N=4-10 adolescents per group, total N=62, 50% f...
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Introduction E-liquid flavor is typically presented by flavor category (e.g. menthol, mint, fruit, dessert). Cooling sensations produced by flavor additives such as menthol enhance appeal of e-cigarettes among youth, but not all e-liquids that produce cooling sensations are labeled as menthol. Sensory experiences produced by flavors may allow for a...
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Background Vaping is the second most common modality of using cannabis following smoking. We examined differences in demographics and substance use behaviors between adolescent cannabis vapers and those exclusively using other cannabis modalities. Methods In 2019, 4875 students from six Connecticut high schools completed school-wide, online survey...
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The efficacy of naltrexone to treat alcohol use disorder (AUD) is modest. A better understanding of the neurobiology underlying naltrexone effects could optimize treatments. We evaluated the occupancy of the kappa opioid receptor (KOR) by naltrexone measured with [¹¹C]-LY2795050 positron emission tomography (PET) as a predictor of response to naltr...
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More effective treatments to reduce pathological alcohol drinking are needed. The glutamatergic system and the NMDA receptor (NMDAR), in particular, are implicated in behavioral and molecular consequences of chronic alcohol use, making the NMDAR a promising target for novel pharmacotherapeutics. Ethanol exposure upregulates Fyn, a protein tyrosine...
Article
The purpose of this study is to evaluate the association of electronic nicotine product (ENP) use and its respiratory manifestations in a nationally representative sample of adolescents in the US. Cross-sectional evidence from 9750 adolescents in wave 3 (October 2015-October 2016) of the Population Assessment of Tobacco and Health (PATH) survey was...
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E-cigarette use among adolescents and young adults has been associated with adverse respiratory symptoms, including symptoms of asthma and bronchitis. This investigation examined whether such associations differ by primary type of e-cigarette device used. This cross-sectional study included data from four study populations in California and Connect...
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Background: Family history of alcohol use disorder; AUD (FH +) and impulsivity-related traits are known risk factors for problem drinking that have been investigated in predominately White samples. This cross-sectional study examined whether these risk factors vary by sex in the overall, majority White sample and in a Black subsample. Method: A...
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Young adult never cigarette smokers with disabilities may be at particular risk for adopting e-cigarettes, but little attention has been paid to these people. This study examines the associations between different types of disability and e-cigarette use in this population. Young adult never-smokers from the 2016–2017 Behavioral Risk Factor Surveill...
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Gaming is popular among youth and gaming disorders have been introduced recently into psychiatric nomenclature systems. Motivations underlying gaming may include involvement to reduce negative emotional states and thus may link to psychiatric and overall health. Thus, the extent to which adolescents engage in gaming to relieve anxiety warrants addi...
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Impairments in feedback processing, often associated with risk-taking behavior, may have implications for development of substance abuse in adolescents. The most commonly used substances by adolescents include tobacco and cannabis, with some individuals using both substances, potentially heightening risk. Our objective was to examine feedback proce...
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Introduction Nicotine in e-cigarettes typically is labeled as mg/ml or percent nicotine, but these metrics may be difficult to understand. We examined whether adults who use e-cigarettes accurately can compare nicotine concentrations presented as mg/ml and percent and/or can identify the strength of concentrations presented using these metrics. Me...
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Motivational characteristics such as excitement-seeking are key components of models of addiction, including problem gambling. Previous studies have established associations between excitement-seeking and problem gambling in youth. However, these studies have employed dimensional psychological assessments which are unlikely to be routinely administ...
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Objective Recent findings have examined the factor structure and associated correlates of three neurofunctional domains, Executive Function, Incentive Salience, and Negative Emotionality in the development and maintenance of alcohol use disorders in a clinical sample. The current study sought to replicate and extend prior work by testing this three...
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Differences in corticostriatal neural activity during feedback processing of rewards and losses have been separately related to cannabis and tobacco use but remain understudied relative to co-use in adolescents. Using high-density EEG (128 electrode system, 1000 Hz sampling), we examined event-related potentials (ERPs) elicited by monetary reward,...
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In recent years, the tobacco use landscape among youth has changed greatly, underscoring a need to understand current tobacco product initiation patterns. This study aimed to examine if adolescents’ first tobacco product tried differs by race/ethnicity and socioeconomic status (SES). Cross-sectional survey data were collected from 6 Connecticut hig...
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Introduction: E-cigarette/e-liquid nicotine concentrations typically are labeled as mg/ml or percent nicotine. We examined whether these metrics accurately convey nicotine strength to young e-cigarette users and if youth can compare concentrations presented in mg/ml and percent nicotine. Methods: 821 adolescent and young adult e-cigarette users...
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Introduction The purpose of this study was to evaluate a pilot preoperative contingency management intervention for smoking abstinence. Methods This multisite pilot study was conducted at 2 cancer center-based tobacco treatment programs. Participants who were smoking, diagnosed with or suspected to have any type of operable cancer, and had a surgi...
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Objectives In November 2018, JUUL, Inc. restricted sales of mango, fruit medley, crème brûlée, and cucumber pods to its website. Physical/online sales of tobacco, menthol, and mint pods continued. We examined rates of adolescent JUUL device and flavored pod use before and after restrictions were implemented to examine their potential impact. Metho...
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Background and aims: Self-injurious behaviors (SIBs) and problematic shopping (PS) are both prevalent in adolescents. These behaviors have been proposed as behavioral addictions and linked to impulsivity (Imp) and sensation-seeking (SS). They are also associated with negative mental health and psychosocial measures. This study examined relationshi...
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Background Adolescent e-cigarette use has increased recently; however, little is known about trends in use of specific devices by youth. This study aims to 1) compare rates of e-cigarette device use over time, 2) examine changes in frequency of device use, and 3) identify predictors of device use. Methods Cross-sectional surveys were distributed s...
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Introduction JUUL, a closed system e-cigarette with disposable pods, is popular among youth, with positive attributes of this product linked to current use by youth. However, many youth try JUUL and do not continue using; understanding differences in the appeal of this device between current users and those who chose not to continue use can inform...
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Background E-cigarette use among adolescents is increasingly popular and a growing public health concern. Objectives To examine how individual e-cigarette use perceptions differ between adolescents based on e-cigarette use status and susceptibility to future use of e-cigarettes. Methods Data were collected using surveys administered across eight...
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Introduction Adolescents are using e-cigarettes at high rates and there is limited information on how to help them quit. We aimed to inform e-cigarette cessation interventions by understanding why adolescents use and dislike e-cigarettes and their quit experiences. Methods Six focus groups with current users (i.e., past-month use) and 2 focus grou...
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Ordinal data (eg, "low," "medium," "high"; graded response on a Likert scale) with an additional "don't know" category are frequently encountered in the medical, social, and behavioral science literature. The handling of a "don't know" option presents unique challenges as it often "destroys" the ordinal nature of the data. Commonly, nominal models...
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Electronic cigarettes are the tobacco products most commonly used by youths in the United States. The use of e-cigarettes, also known as vaping or JUULing, is a public health epidemic. This collection offers reviews and research to assist pediatric health care providers in identifying and treating adolescent use and exposure to e-cigarettes. https:...
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Introduction: Waterpipe use remains popular among youth with the availability of flavored shisha tobacco being one of the main drivers of waterpipe use. While waterpipe mainstream toxicant emissions are well-understood, less is known about the carryover of flavorants such as vanillin, benzaldehyde, and eugenol. In this study, flavored waterpipe to...
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Introduction Preliminary evidence suggests adolescents use e-cigarettes in school. However, little is known about the types of devices that are used in schools, where they are used, and who uses them. Knowledge about these issues is critical to inform school regulations. Methods Cross-sectional surveys were conducted in 6 Connecticut high schools...
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Introduction The rise of vaping in adolescents, the recent entrance of new inhaled nicotine products such as iQOS on the market and e-cigarette or vaping product use-associated lung injury cases has created concern for the use of inhaled non-combustible nicotine products. This narrative review discusses recent experimental in vivo studies that util...
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Background ‘Juul’ is the dominant US e-cigarette brand and was recently introduced to Canada, UK, France, Germany and Italy, with several flavours available across countries. US/Canadian products are sold with 5%, 3% and 1.5% (Canada only) nicotine content, whereas European Union (EU) regulation limits nicotine content to 1.7%. The differential nic...
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E-cigarettes are popular among adolescents. Given that flavors enhance e-cigarette appeal, this study examined the influence of flavors on nicotine in e-cigarettes. Youth e-cigarette users (average 26.2 days [SD = 3.6] in past 28 days) were randomized to use e-cigarettes containing 6 or 12 mg/mL of freebase nicotine and completed 4 test sessions. D...
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Background In‐laboratory drinking sessions that allow direct assessment of drinking and craving are an emerging method for testing novel pharmacotherapy compounds and behavioral interventions for alcohol use disorders. Despite wide implementation, limited evidence supports the concordance between drinking in the laboratory and in a natural setting....
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Introduction: Evaluations of multiple tobacco product use and temporal changes in patterns of use are complicated by the large number of combinations and transitions. Visualization tools could easily identify most common patterns and transitions. Methods: Set intersection bar plots describe ever use of five tobacco products among 12-17 years old...
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Introduction E-cigarettes appeal to adolescents because of alternative uses, such as dripping (i.e., applying e-liquid directly on the atomizer) and conducting vape tricks (i.e., creating shapes from exhaled aerosol). However, little is known about these behaviors and adolescents who engage in these behaviors. Methods Using cross-sectional surveys...
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Background: There are thousands of e-liquid flavors available, and some are named after alcohol beverages (e.g., "pina colada"). It is unclear whether use of e-liquids with alcohol beverage names is associated with adolescent alcohol use. E-cigarettes and alcohol are co-used in adolescents; therefore, it is important to investigate these associati...
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Gambling is prevalent among adolescents and adolescents are vulnerable to experiencing gambling-related problems. Although problem gambling and suicidal behavior have been linked in adults and self-injurious behaviors may predict future suicidality, prior studies have not investigated relationships between problem-gambling severity and self-injurio...
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The use of electronic cigarettes or e-cigarettes has grown in popularity over the last decade without extensive preclinical toxicology testing or long-term safety trials.¹ In the e-cigarette marketplace, there are thousands of combinations of constituents that can comprise e-liquids, including flavors, nicotine, tetrahydrocannabinol (THC), cannabid...
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Introduction: Cannabis - including blunts (cannabis rolled in tobacco-containing cigar casing) - is commonly the first substance used among adolescents, and may increase the likelihood of subsequent initiation of combustible tobacco products. Methods: Data were pooled from two prospective studies of adolescents in California and Connecticut (tot...
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Rates of certain tobacco products have decreased over the past decade, but nicotine use disorder is still prevalent among adolescents. New trends in tobacco use, such as in the use of electronic cigarettes, are creating alarm. This article reviews nicotine addiction and measurement in adolescents, along with potential health risks and comorbidities...
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Background: Naltrexone is a nonselective opioid receptor antagonist used as a treatment for alcohol use disorder. However, only modest clinical effects have been observed, possibly because of limited knowledge about the biological variables affecting the efficacy of naltrexone. We investigated the potential role of the kappa opioid receptor (KOR)...
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Introduction: Most tobacco use is initiated during adolescence and susceptibility is an important predictor of initiation. Research is needed to understand susceptibility across tobacco products among youth to inform prevention efforts. Methods: We surveyed 2,945 students from four Southeastern Connecticut high schools in 2017. We assessed susce...
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Background: Extensive research indicates that having a positive family history of alcohol use disorder (FHP) and impulsivity are two risk factors for problem drinking. To our knowledge, no study has investigated which facets of impulsivity interact with family history to increase risk for problem drinking. The goal of this study was to 1) examine...
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Introduction Menthol cigarette use remains a serious public health problem, prompting the consideration of tobacco regulatory efforts to ban menthol cigarettes. The current study uses a novel empirical design to model the potential effects of a ban of menthol cigarettes on smoking behaviour among current menthol smokers. Methods 29 non-treatment-s...