Friends of the Behavioral Economics Club, this week we present the paper “Behavioral Economic Demand and Delay Discounting are Differentially Associated with Cigarette Dependance and Use in Adolescents”, by Cassidy, R. N.; Aston, E. R.; Tidey, J. W. and Colby, S. M. (2020), in which authors study whether a relation between the use of cigarettes in adolescents and behavioral economics exists, and if it is so, how can the latter help to reduce the number of young addicts.

Smoking is one of the most accepted forms of drug addiction in society. However, like alcoholism, the dimension of its magnitude is growing.

A matter of particular concern is how young people acquire this habit from such an early age.

Although it may surprise us, cigarette smoking by teenagers has reduced its rate to the lowest in decades. Only 9% of teens reported smoking daily in 2016.

Authors believe that this decline in youth smoking rates is due to tobacco control interventions, such as educational campaigns in the media.

The key would be in a decreasement in the initiation of smoking and not in the cessation of smoking.

However, increased use of electronic cigarettes or vapers has been shown to be associated with the onset of smoking. Therefore, these rates that until now have been decreasing, may be reversed in the future.

For this reason, authors consider that research on the behavioral mechanisms of young people who smoke is still very important. In addition, they consider that it is possible from behavioral economics to obtain explanations to better understand these mechanisms.

There is the called “Reinforcing Pathology model”. This model describes how two economic behavioral processes, such as a greater sensitivity to immediate rewards (discount for delay) and an excessive reward derived from the consumption of a substance (demand), relate to problematic patterns such as substance use.

This model proposes that people with substance use disorders may continuously experience the effects of delay discounting and demand. This is manifested by giving a high value to the substance together with the preference to receive it and use it immediately to receive the reward of consumption as soon as possible.

However, how this relates to the different faces of youth cigarette smoking has not been established.

Authors consider it necessary to point out that there is a conceptual difference between cigarette consumption and dependence. Consumption is a characteristic of dependence, but dependence is not just consumption: it is characterized by physical tolerance, abstinence symptoms if consumption is discontinued, and so on.

Although the role of these elements in adolescent cigarette smoking has not been investigated, there is previous literature on cannabis use in adults. In those studies, the frequency of consumption was significantly associated with the demand for cannabis, and dependence was associated with the discount for delay (that is, with the preference to receive the reward of consumption immediately).

The objective of the authors with their study was to test the hypotheses that arise because of the Reinforcing Pathology model. This hypothesis says that higher demand would be associated with both higher dependence and higher smoking, and a more pronounced delay discount would be associated with higher dependence, but not necessarily with higher smoking.

To do this, they gathered a sample of 50 adolescents who use tobacco daily. These young people were recruited through online advertisements, advertisements on buses, and sessions in high schools. They were between 15 and 19 years old, with an average age of 17.7.

They had to report their cigarettes smoked per day during the last month. In addition, they carried out a series of tests whose origin is found in tools of behavioral economics.

The results were very interesting. Although demand for cigarettes was associated with severity and consumption, the delay discount was an important predictor only for dependence. That is, only those young people with a strong dependence on tobacco significantly looked for the immediate reward of consumption.

The delay discount is based on the preference for immediate rewards over delayed rewards, which do not necessarily have to be the result of cigarette smoking.

Authors’ study suggests that the discount is related to the level of dependency, and this is consistent with the idea that a higher discount for delay can predict poorer treatment outcomes for young people, and a greater severity of dependency for adults.

However, while the delay discount is not an important predictor for demand, it does influence it in some way. Therefore, the discount would affect dependency in the first instance and demand secondarily.

Finally, authors add some last information: a greater amplitude of demand was associated with a higher level of consumption.

One limitation of the study is that the sample size is relatively small. Future research should replicate these findings with a larger sample.

Because adolescent smokers may be more susceptible to changes in their smoking trajectory, since their behavior may be more malleable due to their developmental stage, it is critical that there are new ways of understanding the onset, maintenance, and progression of smoking in them.

Behavioral economics suggests ways of treating and understanding the phenomenon that would undoubtedly be very useful for intervening with these young people.

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