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13-12-93 12:19I 344 P02 PROJECT APPLICATTON SHORT TITLE: Patterns of Legal Substance Use in Adults APPLICANT: Professor David M. Warburton, C.Psychol. ADMINISTERING AUTHORITY: Finance Office, University of Reading, Reading, RG6 2AH, United Kingdom. LOCATION OF PROJECT: Human Psychopharmacology Group, Department of Psychology, University of Reading, Reading, RG6 2AL, United Kingdom. ABSTRACT OF RESEARCH: The goal of our research will be to relate the person's substance use to their attempts to control their psychological state (i.e. affect management). The aim will be to analyse the positive contribution of pleasure to mood as well as the control of negative states. Our focus will be on legally used substance, (alcohol, caffeine, chocolate, food, tea, tobacco, and including over-the-counter medication), and examine the processes underlying the use of substances. Data will be collected by survey and will be carried out to determine the patterns of use and motive for use, both positive and negative. In addition, information will be collected on personality variables, attitudes to health, other methods of coping. PROPOSED STARTING DATE: Early January, 1994 PROPOSED DURATION: Initial Phase - 3 months; Phase 2 - 9 months SUMMARY OF ESTIMATED COSTS: Phase I - 3 Months Phase 11 - 9 Months £11„000 Full official Address of Project Human Psychopharmacology Group, Department of Psychology, University of Reading, Reading, RG6 2AL, UNITED KINGDOM. £21,000 Leader Telephone 44-734-667872 or 44-734-318527 FAX 44-734-316604 or 44-734-667872 Signature of Project Leader: Date / 3/, ~l a 3

ovrW.na.a v. ...... _ ..._ _ ,,..,_ Full Time Research Assistant with Honours Degree in Psychology; Project Leader - Average of four hours per week.

13-12-93 12:18 ESTIMATE COSTS - DETAIL 344 R03 Project Costs Calculated on Annual Basis Pay Costs Salary £12,828 National Insurance € 1,037 Superannuation £ 2,362 Total E16,227 Canswiaables Gift Tokens for £ 5,000 Completed Forms; Postage Capital Equipment NIL Travel Expenses Visits to Sponsors INVOICED DIRECTLY Consultancy Statistical; £1,630 Ad Hoc Clerical. overlleads ( 40$ ) Administration; E9,143 Computer Time; Heating; Light; Space Rental; Project Leader's Time. 11C TOTAL PROJECT COSTS £32,000 C'7 INVOICING QUARTERLY IN ADVANCE

13-12-93 12!19 APPSNDIx A: rUxrcSh vr` JiNYESTIGATION 344 P04. The aim of our research will hp to relate the person's substance use to their attempts to cociirul Lheir psychological state (i.e. affect managemcnt). The aim will be to analy8a the positive contribution of pleasure to mood as well as the control of negative states whlch are produced by the challenges of ovsryday life. Evidence from the use of single sub3tanoes suggest that substance use is a stratAgy hy whi~r.h individuals maintain their biochemical state and so their psychological state in optimal balance (i.e. affect management). Our focus will be on legally used 3ubctances, (alcohol, caffeine, chocolate, food, tea, tobarr.o, and including over-the-counter medication), emphasizin_y the uc,muonalities of, and difforenoes bctween, prooeesco underlying the use of these substances. There is considerable variability in substanae use across different situations and so it will not be possible to classity an Sndividual's coping style in terms of ehe use of a sinyle substance. Nevertheless, individualc ahould be able to describe consistencies over time in their probability of using particular substance use strategies. krom these responses, it will be possible to define patterns for single individuals and patterna for different groups. It is anticipated that A ntrmhar of different patterns will emerge- some will involve dluuhul use, some will include coffee use, some will involve candiee and so on. The emphasis of the project will be against stereotyping users as "devi'ant". On the contrary, it is believed that the analysis will show that it is the total abstainer from substance use who is abnormal_ I

13-12-93 12:19 APPENDIX B: BACKGROUND TO PROPOSED INVESTIGATION 344 P06 There is evidence that people use substances such as alcohol, chocolate, coffee, tea and tobacco to help them in their everyday life, including coping with thP strpssors of modern society. The purpose of this proposal is 6c suggest ways of delinoatinQ patterns of oubstanoc uac and the reasons why specific patterns may be adopted. Although substance use is a multifectorial proc:aa's, involving social, psychological and biologioal factors, our research goal will be to relate sub9tanCA use to everyday life. Our few:us will hP on legally used substances, (alcohol, caffeine, chocolate, food, tea, tobacco, and including over-the-counter modication), emphasizing both the commonalities of, and differences between, the processes underlying the use of substances. Previous research has mainly been concentrated on alcohol and cigarettes and thcrc i-- quite a body of empirical evidance available in those areas. In addition, there is some evidence of a relation between emotional states and eoting (Bauoom and Aiken, 198'1; Doell and Hawkin9, 1982; Leon and Chamberlain, 1973; SJCberg and Persson, 1979), which is consistent with the thoorotioal framework, which will be outlined. However, there is a lack of evidence on tho use of other substances. More importantly, therP is no work on the relationship between the use of different substances in the same individual, exccpt for aasoci',ationn, such as alcohol, caffeine use and smoking (a.U. Thnmpson and Warburton, 1993). SUBSTANCE USE AS A CONTROL MECHANISM The conceptual framework for control and subatsnoc use ie based on a centra] assumption. This assumption iA that substances may be used to control a person's psycholugical state for two independent reacon3; thcy can reduce negative affect or can increase positive affect di~rectl'y or indirectly. Although these dual functions of a substance have been described as paradoxical (Gilbert,, 1979), there is evidence that subatanca use can accomplish both functions for an individual. In order to develop thA thpnratical basis of substance use as a mechanism for coplng with life ytressors, it is necessary to consider the structure of psychological well-being. Overall well-being is determined by independent dimensions of positive affect and negative affect. This proposition is supported by reAAwrch In a variety of settings (for a review, see Di'engr, 1984). It is important to note the implication that positive mood is not simply thc ab3cncc of negative mood, or vice verea. Instead,, each appears to derive from different types of variables and occurrences. This proposition is outlined in the following Diagrsm.

13-12=93 12:2e STATE CONTROL AND SUBSTANCE USE: A CONCEPTUAL FRAMEWORK Neurochemical State Situational demands -I Low Arousal, Depression Agitation, Anxiety, Anger Control Response Substance use to improve positive affect Substance use to decrease negative affect 344 P0E The evidence suggests that substance use may indeed accomplish both functions: minimizing negative mood and maximizing positive mood. A considerable body of evidence indicates that cigarette smoking or alcohol use, for example, serve a direct stress- reduction function (Abrams, 1983; Leventhal and Cieary, 1980). In addition, this evidence also indicates that substance use may serve to increase positive affect through providing physically pleasurable sensations and achieving feelings of relaxation (Warburton, Revell and Walters, 1988). In order to illustrate the role of a substance for both reducing negative affect and increasing positive affect, evidence on smoking is considered in detail in the next Section. MOTIVATIONS FOR SMOKING BEHAVIOUR One body of evidence derives from~studies of smoking motivation, where investigators ask smokers about the reason for their smoking. Remarkable consistency has been found across studies that have factor-analyzed such reports, these have found two higher order dimensions of smoking motivation, each comprising several related motives concerning negative or positive-affect management (McKennell, 1973; Russell et al, 1974; Stanaway and Watson, 1980; Warburton, Revell and Thompson, 1991). One higher order dimension includes sub-scales indicating that smoking is used to reduce anxiety, tension, nervous irritation, and stress. The second general dimension is based on sub-scales indicating that smoking is used for stimulation, in social situations, or to provide pleasure or taste. It is important to note that these factor-analytic studies identify different motives for smoking, not necessarily different types of smokers. The general failure to find easily separate subgroups of cigarette smokers suggests that people smoke for

13-12-93 12:20 344 Pfa''1 both reasons, at different times and in different situattons. Individuals will self-regulate the plasma level of nicotine in order to produce effect managament effocta that ara consi,tent with theirr mompntAry nPPr7S. Corresponding to ctudies of people's stated mntivea for smokinq, similar findings have been obtained in studies that examine the siluations in which people wish to smoko (Beet and Biakati8n, 1978; Frith, 1471t Stanaway and Watsnn„ 1980; wWarburton, Revell and Thompson, 1991). These surveys show that people not only want to smoke in stressful and negative situations, but also whilla they also 1ikP rPlAxing„ happy and social situations. In laboratory studins, we have asSesgad the mood effects of smoking with visual analogue scales (Warburton et a1, 1988). Puff-by-puff, subjects rcportcd that they became calmer, more tranquiu, more snciahlP, more friendly, more contented, more relaxed and hesppier. Non-nicotine cigarettes produced no improvements, suggesting that the effects were duei to nicotine. The mood changes were correlated with plasma nicotine so that, as plasma nicotine incroased throughnut the ciQarette, the mood changes increased (Warburton, 1989). When a second cigarette was given 30 minute later, (i.e. no nicotine deprivati'on), the pre- smoking mood level was below that achieved at the end of the first cigarette changes, but during smoking, it increased until it was above the level that was achieved wt the end of thg first cigarette. Parallel Studies of performance and smoking or nicotine have shown that they improve intormation processing oapaoity (For review sBe Warburton, 1990). The results do not depend on deprivation from nicotine. They are found in nvn-smokers and so the effects cannot be attributed to thc reversal of withdrawal. These findinyy have been fitLe(i tu a Functional Model of nicotine use (Warburton, 1987; 1988; 1989), which argues that smoking is used as a resource and that it i's a purposive activity. This view is ®n extension of the idea that smoking was a ooping strategy (Warburton, 1980; W'arburton„ Wasnee, and Revell, 1982; Wesnes, Warburton, and Revell, 1984; Revell, Warburton, and Wesnes, 1985). This approach, can be Lil.et3liikec1 with the Control Model which ves outlined earlier. Smoking for mood changes can be Direct Action to deal with a current high anxiety situation or in antieipation of a futuro otressor, minimizing negative mood. Smoking for enhanced information processing in work fiituatione is also an active attempt Lu confront work problems (Direct Action) and so maximizing positive mood. Smoking for Relaxation and Pleasure- seeking involves active attempts to provide positive experiences,. maximizing positive mood. They can be seen as strategies during tha day at rpst breaks or at the end of the day to cnunteract the negative induC:ed by already experienced stressors. _J n CA 4A cc ~ CD

13-12-93 12:21 344! P0B Thus, smoking is an activity with many important psychological benefits in everyday life. It is not an irrational behaviour, but the behaviour is adopted because it enables the user to cope effectively and so enhance their life, at a personal and inter- personal level. It can be seen as a psychological resource that the individual uses smoking to control their psychological state (Warburton, 1987; Warburton, 1988; Warburton, et al, 1988). Controllable, predictable effects are more pleasurable than effects which are produced without control (Warburton, 1990b):. All aspects of smoking contribute to this feeling that the smoker has that they are in control of their own life - a feeling that is very important to the smoker (see Warburton, Revell and Thompson, 1991). MOTIVATIONS FOR ALCOHOL USE A similar dual process is indicated by studies of alcohol use. Epidemiological research (Neff and Husaini, 1982; Pearlin and Radabaugh, 1976) has indicated a relationship between stressors and heavy alcohol use. Studies of reported effects of alcohol consumption indicate a group of effects similar to that observed for smoking situations (Christiansen, Goldman and Inn, 1982; Southwick, Steele, Marlatt and Lindell, 1981; Stone, Lennox and Neale, 1985). One major set of factors represents the feeling that alcohol will reduce tension, provide relaxation and divert a person from worrying about problems, a dimension that has usually been termed tension reduction. A more diverse group of factors represents pleasurable effects of alcohol use, including positive mood effects and increased enjoyment of social situations, together with some cognitive effects such as enhanced sense of personal power and optimism about the future. In much of this research, the focus has been on "heavy" alcohol users and not moderate users and so the emphasis has been on the Withdrawal or Escapist functions of alcohol use, which are seen as maladaptive. However, moderate alcohol use can be viewed as an effective coping strategy, which enables a person to cope with stressful social interactions (Direct Action). Alcohol use for Relaxation and Pleasure-seeking can be viewed as a Direct Action coping strategy for unwinding at the end of the day after everyday problems. Thus motivation for moderate alcohol use has had almost no research devoted to it, except for a survey which we conducted some years ago (Revell, Wesnes, and Warburton, 1984). In the study, alcohol use was related to a desire to solve problems without the help of others. It was seen particular as a strategy for coping with anxiety (negative affect minimization)~. Q (L'

13-12-93 12:22 MOTIVATIONS FOR CAFFEINE USE 344 P09 Caffeine users reported feellnrJs of increased alertness and wakefulness and enhanced abillty to work and oonoontrate (Goldstein and Kaizcr, 1969; Goldstein, Kaizer and Whitby, 1969; Zwyghuizen-Doorenbos et al. 1990). These experiences of users have been confirmed in placebo-controlled laboratory studies. Caffaine dacreasos reaction time (Lieberman et al. 1987; Clubley et al. 1979; Kerr, Sherwood and Hiculmarch, 1991) end enhances information processing (8dttig and Suzzi, 1986; 8llttig et al, 1984; Frawer and Ladpr, 1991; Smith et al, 1990). In our own recent research, we found improvp.mPnts in information processing with 75 mg of caffeine, equivalent to an average cup of coffee. For correct detections in the attontional test, the overall analysis of variance ehnwad a significant effect of caffeine and a significant internution between caffeine and time on the test. For reaction times on the samA test, the significant results were an enhanCement by caffeine end the interaction between caffeine and time on the test. For the logic test, a significant effect of caffQinP nn the number correct was found, but not on reaction time. oii l.he Mood Scales, there were stati©tioally significant increaeee on the happiness scA1Aa (i.e. friendliness, contentedness and happiness) and also the subjects were calmer and Less tense. The improvements in infOrmation processiny with these doses is oonsiotont with the finding3 of Lieberman at al (1987) with aimilar doses and Anhanc.pmpnt without deprivation of Jarvis (1993). No mood chanye5 were round by Liebermen et al (1987), but Swift and Tiplady (1985) found mood improvempnt in young people with a dose of 200 mg, 50 mg larger than our highest dose. MOTIVATIONS FOR CHOCOLATE USE Almost no work has been done on chocolate use, although there has been some speculation in the popular magazines on its "addiotive" properties. Our own work suggests that calmness and happiness increase after three or four pieces of choc:olate. MOTIVATIONS FOR THE USE OF OVER-THE-COUNTER MEUICATION' The use of over-the-counter medication was discussed in an early paper (Warburton, 1980), but the relationship with other substances has only been examined in a very preliminary faOhion for nurses euposed to stressors. However, the indications were that ovESz--the-counter medication (also smoking and alcohol use) was higher in individualo who ooorod higher on internal control on the Rotter internal-External Control Scale (Rotter. 1966).