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Background: Cigarette smokers show greater delay discounting (devaluation of delayed consequences) than non-smokers, suggesting that rapid devaluation of the future contributes to tobacco use through a mechanism in which tobacco-related health consequences are too delayed to discourage smoking. However, little work has quantified delay discounting in relation to electronic cigarette (EC) use, a tobacco product that many users believe to pose fewer negative health consequences than cigarettes., Methods: We assessed discounting of delayed monetary rewards in a web-based sample of 976 participants, stratified by both EC use (current and never) and cigarette use (current, former, and never)., Results: Controlling for demographic variance, current EC users generally showed greater discounting than never EC users (p = .019). Current cigarette smokers also showed greater discounting than former and never smokers (p < .001). However, the between-group difference for EC use was much smaller (η p 2  = .006) than for cigarette use (η p 2  = .026). Moreover, differences in discounting in relation to EC use were not statistically apparent in most pairwise comparisons. Most notably, the difference between former smokers who achieved smoking cessation by transitioning to ECs (i.e., exclusive EC users) and those who have never used ECs or cigarettes was nonsignificant and small (η p 2  = .010)., Conclusions: The smaller effect size for the association between delay discounting and current EC use, relative to current cigarette use, suggests that public perception of ECs as a safer alternative to cigarettes attenuates the role of delay discounting in decisions to use ECs., (Copyright © 2018. Published by Elsevier B.V.)

Background: Smoking cessation fatigue, or tiredness of attempting to quit smoking, has been posited as a latent construct encompassing loss of motivation, loss of hope in cessation success, decreased self-efficacy, and exhaustion of self-control resources. Despite the potential clinical impact of characterizing cessation fatigue, there is currently no validated measure to assess it. Using a rational scale development approach, we developed a cessation fatigue measure and examined its reliability and construct validity in relation to a) smokers' experience of a recently failed quit attempt (QA) and b) readiness to engage in a subsequent QA., Methods: Data were drawn from an online cross-sectional survey of 484 smokers who relapsed from a QA within the past 30days., Results: Exploratory factor analysis identified three factors within the 17-item Cessation Fatigue Scale (CFS), which we labeled: emotional exhaustion, pessimism, and devaluation. High internal consistency was observed for each factor and across the full scale. As expected, CFS overall was positively associated with withdrawal severity and difficulty quitting. CFS was negatively associated with previously validated measures of intention to quit, self-efficacy, and abstinence-related motivational engagement, even after adjusting for nicotine dependence., Conclusions: Findings provide initial validation for a new tool to assess cessation fatigue and contribute needed information on a theory-driven component of cessation-related motivation and relapse risk., (Copyright © 2017. Published by Elsevier B.V.)

Background: Much attention has been directed towards the possible effects of e-cigarette advertisements on adolescent never smokers. However, e-cigarette advertising may also influence perceptions and behaviours of adult smokers. The aim of our study was to examine whether noticing e-cigarette advertisements is associated with current use of e-cigarettes, disapproval of smoking, quit smoking attempts, and quit smoking success., Methods: We used longitudinal data from two survey waves of the ITC Netherlands Survey among smokers aged 16 years and older (n=1198). Respondents were asked whether they noticed e-cigarettes being advertised on television, on the radio, and in newspapers or magazines in the previous 6 months., Results: There was a significant increase in noticing e-cigarette advertisements between 2013 (13.3%) and 2014 (36.0%), across all media. The largest increase was for television advertisements. There was also a substantial increase in current use of e-cigarettes (from 3.1% to 13.3%), but this was not related to noticing advertisements in traditional media (OR=0.99, p=0.937). Noticing advertisements was bivariately associated with more disapproval of smoking (Beta=0.05, p=0.019) and with a higher likelihood of attempting to quit smoking (OR=1.37, p=0.038), but these associations did not reach significance in multivariate analyses. There was no significant association between noticing advertisements and quit smoking success in either the bivariate or multivariate regression analysis (OR=0.92, p=0.807)., Conclusion: Noticing e-cigarette advertisements increased sharply in the Netherlands between 2013 and 2014 along with increased e-cigarette use, but the two appear unrelated. The advertisements did not seem to have adverse effects on disapproval of smoking and smoking cessation., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Effective management of chronic diseases involves sustained changes in health behavior, which often requires substantial effort and patient burden. As treatment burden is associated with reduced adherence across several chronic conditions, its assessment and treatment are important clinical priorities. The balance between patient demands and capacity (e.g., coping resources) may be indexed by patients' subjective experience of treatment fatigue. We present a modified workload-capacity model that incorporates evidence that treatment fatigue may 1) be caused by increased workload due to treatment burden (e.g., intensity, complications) and 2) undermine adherence. Emerging technology-based interventions may be well-suited to reduce treatment burden, prevent treatment fatigue, and increase treatment adherence.