PROJECT SUMMARY
This K08 research and training award will enable the PI to attain the substantive and methodological expertise
necessary to conduct independent research on nicotine use in young adults and to translate this knowledge to
clinical trial development. Dual use of electronic nicotine delivery system (ENDS) and combustible cigarettes is
the most prevalent pattern of tobacco use among US young adults (age 18–25). Characterizing shared,
distinct, and cross-conditioned processes that maintain dual use is essential for informing interventions against
smoking among vulnerable dual users. The incentive sensitization and affect processing models of drug
addiction highlight how drug cues and attentional bias for cues are central drivers of drug craving and use and
how negative affect strengthens these relationships. I propose to examine the degree to which these three
processes (cue-reactivity, attentional bias, and negative affect) underlie tobacco craving and in laboratory and
naturalistic settings among a sample of young adult dual users (n = 80). Significant innovations include
examining cross-product conditioning of cues in young adult dual users; integrating data across laboratory and
naturalistic settings; and identifying shared and distinct processes in ENDS versus combustible cigarettes. I will
examine the effects that in-vivo neutral, ENDS, or combustible cigarette cues have on craving for usual-brand
cigarettes or preferred ENDS devices in three laboratory sessions. A visual probe task will index attention bias;
participants will self-report positive and negative affect. EMA will be used to gather real-time data from the
same participants evaluating predictors of tobacco use and craving that correspond to laboratory measures
(mood, tobacco cues), as well as salient social and behavioral correlates. Person- and event-level effects of
cue reactivity, attentional bias, cross-product conditioning, and the interactive effect of negative affect will be
modeled using multilevel modeling. Results will elucidate the contribution of attentional, mood, and cue-related
processes to craving and dual use. Findings will inform development of two research projects: a longitudinal
study using survey, EMA, and laboratory methods to characterize the intra-individual behavioral processes
underlying transitions through smoking patterns (especially progression from ENDS to dual user); and
preparation for a clinical trial of a novel just-in-time adaptive intervention (JITAI) targeting dual users who are
either high or low in markers of vulnerability (e.g., cross-product reactivity). A final series of focus groups will
assess the receptivity and acceptability of prototype study-informed JITAI components. Highly skilled mentors,
including Kristina Jackson, Suzanne Colby, Andrea King, Tyler Wray, and Rachel Cassidy and collaborator
Christopher Kahler will provide guidance on training aims: (1) behavioral laboratory assessment methods; (2)
analysis and integration of laboratory and naturalistic data; and (3) translation of laboratory findings to JITAI.
Overall, the research and training outlined in this application informs key gaps in models of tobacco dual use,
and will prepare the PI to conduct independent research furthering scientific inquiry in this field.