Price elasticity of demand for cigarettes among youths in high-income countries: a systematic review

Aims: Smoking in youth remains a major public health issue. As increasing tobacco prices is considered one of the most effective prevention strategies, examining youth’s responsiveness to price changes on cigarettes will provide crucial knowledge. This study aims systematically to review research examining the price elasticity of demand for cigarettes among youths (<30 years of age) in high-income countries. Methods: Searches were conducted in three databases (Web of Science, Pubmed and Scopus). Inclusion criteria were publications within the past 10 years (2011–2021) written in English and with a population of youths below 30 years of age, concerning price elasticity of demand for cigarettes and from high-income countries. Searches were screened by two independent reviewers and the quality of studies was assessed using a quality assessment tool. Results: Four outcomes related to price elasticity of demand for cigarettes were examined in six studies included in this review; that is, cigarette initiation, consumption, prevalence and cessation. Overall, findings indicate that increasing tobacco prices affect youth tobacco use. The effect was associated with gender and age; young women were more price sensitive concerning smoking initiation, whereas young men were more price sensitive concerning cigarette prevalence and consumption. Moreover, younger age was associated with higher price elasticity. Conclusions: Estimates for price elasticity varied across the included studies. This may be caused by differences in data sources, collection methods used and country of origin. Most included studies were of older date. Therefore, to make reliable predictions of the expected effects of increased tobacco prices, further examinations of up-to-date and locally embedded measures are required.

A-130 Validity-10, Remaining-12 and Total NSI Scores as Measures of Symptom Validity in Service Members with a History of mTBI

Objective The Neurobehavioral Symptom Inventory (NSI), a commonly used self-report measure of concussive symptoms, is frequently employed throughout the Defense Health Agency. Embedded measures of symptom validity have been developed that include the Validity-10 and total NSI score. A recent investigation in a small sample of veterans (n = 45) suggested that the 12 items on the NSI that do not contribute to the Validity-10 (Remaining-12) perform in a manner similar to the Validity-10. The current study sought to evaluate the classification accuracy of the Validity-10, Remaining-12 and total NSI score in a larger sample to assess the relative utility of each. Method The NSI and MMPI-2-RF scores of 255 active duty Service Members and Veterans seen ≥4 months after mild Traumatic Brain Injury (mTBI) were evaluated. MMPI-2-RF criterion were defined as over-reporting (&gt;79 on Fs, RBS, and/or FBS-r; &gt;78 on F-r; &gt;69 on Fp-r) and invalid (&gt;119 on F; &gt;99 on all other scales). Results Correlations between all MMPI-2-RF over-report scales and the Validity-10, Remaining-12, and NSI total were roughly commensurate and significant at the p &lt; 0.001 level. AUC values for the RF over-report protocols were as followings: Validity-10 = 0.87, Remaining-12 = 0.89, NSI total = 0.89. AUC values for invalid RF protocols were as follows: Validity-10 = 0.91, Remaining-12 = 0.92, NSI total = 0.93. Conclusions The current findings indicate reasonable and equivalent classification accuracies for the Validity-10, Remaining-12, and NSI total score. These data can be taken to suggest that there is limited uniqueness of the Validity-10 relative to the remaining NSI items.

RBANS Validity Measures and the TOMM in Veterans Undergoing Seizure Monitoring

Objective To assess the validity of embedded measures of performance validity, the effort index (EI) and effort scale (ES) of the repeatable battery for the assessment of neuropsychological status (RBANS), in Veterans with seizures; to compare the frequency of failure on the test of memory malingering (TOMM) in patients with epileptic versus psychogenic nonepileptic seizures (PNES). Methods Seizure diagnosis was established for 309 participants in epilepsy monitoring units using conventional diagnostic criteria who completed both the TOMM and RBANS. The criterion for performance invalidity was failure on any trial of the TOMM. We examined multiple EI and ES cutoffs to establish optimal sensitivity and specificity. Results An RBANS EI cutoff score of greater than three was optimal with specificity of .98, sensitivity of.19, and positive Likelihood Ratio of 10 but was not useful when below this cutoff. Confidence intervals indicate the need for confirmation of a failed EI with another performance validity test (PVT). No ES cutoff had sufficient specificity for clinical use. Invalid TOMM performance but not invalid RBANS performance was significantly more common in persons with PNES than in persons with epileptic seizures. Conclusions In Veterans undergoing seizure monitoring, the RBANS EI was useful as a screen when positive that requires confirmation with another PVT. The RBANS ES was not useful. Invalid performance on the TOMM was more common in persons with PNES than in persons with epileptic seizures.

A-223 Hopkins Verbal Learning Test-Revised (HVLT-R) and Brief Visuospatial Memory Test-Revised (BVMT-R) Embedded Performance Validity Analyses in a Healthy Non-Clinical Sample

Objective The Hopkins Verbal Learning Test–Revised (HVLT-R) and Brief Visuospatial Memory Test-Revised (BVMT-R) are memory tests with embedded measures of performance validity (Recognition Discrimination [RD] and Discrimination Index [DI], respectively). We evaluated whether cognitive ability and age influenced embedded measures of effort. Methods Participants included 30 young adults (YA) and 29 older adults (dichotomized into unimpaired [OAu] and impaired [OAi]). Participants completed a medication management ability assessment (MMAA), daily memory lapses survey (DM), digit span, and the Transverse Patterning (TP) and Reversal Learning (RL) computerized tests. Two Repeated-Measures MANOVAs were conducted to determine if Passing PVT and Age/Cognitive Ability influenced performance. An ROC analysis was conducted for HVLT-RD and BVMT-DI to determine pass/fail, and false positives/negatives on embedded measures. Results Those in the YA group who failed RDS (YA-fail), performed better than OAi-fail and OAi-pass groups on RT Errors (p &lt; .0001). On TP Errors, the YA group differed from all four OA groups (p &lt; .0001). On MMAA a significant difference was observed between OAi-fail and all other groups (p &lt; .001). On RD, YA groups differed from both OAi groups (p = .0008). On DI, the YA groups differed from the OAi-fail group (p = .002). A logistic regression classified 43/57 participants successfully into the three cognitive groups using the six predictors (χ2 = 55.73, p &lt; .0001, R2 = .468). RT Errors and TP were significant (Likelihood χ2 = 7.25, p = .027). Conclusion HVLT-RD failed to detect validity for OAi, as did BVMT-DI for YA and OAu. Instead, impairment effects are seen on HVLT-RD and BVMT-DI where YA groups differed from some combination of both/one of the OA groups.

A-226 Identifying Performance Validity Indices within the NIH Toolbox

Objective The National Institute of Health Toolbox–Cognitive Battery (NIHTB-CB) is a rigorously developed, state-of-the-art neuropsychological screening battery. However, one of its current limitations is the lack of any embedded measures of performance validity. To address this critical gap, the current project explored the relevant literature to determine which NIHTB-CB indices might be most suitable for further investigation. Data Selection A targeted literature review was conducted to explore the development of embedded indicators of performance validity within contemporary neuropsychological batteries. The most foundational and scientifically rigorous literature was gathered using targeted search terms in PsycInfo and Google Scholar. Data Synthesis This selected literature base was reviewed and compared to relevant NIHTB-CB indices. The most suitable indices within the NIHTB-CB appear to include: (1) a pattern of responding on the recognition trial for the Picture Sequence Memory Test that is inconsistent with that of individuals with known brain damage; (2) a severely impaired score on the Picture Vocabulary Test and the Oral Reading Recognition Test; (3) the frequency and length of unusual reaction time differences on the Pattern Comparison Processing Speed Test; and (4) overall performance comparisons with groups with known brain injury or illness. Conclusions Several indices within the NIHTB-CB hold great promise as performance validity indicators. Future research is needed to establish the validity of these indices using simulation and known-group designs. Establishing indicators of performance validity within the NIHTB-CB will result in more rigorous clinical research and improved clinical practice.

Predictive Validity of Curriculum-Embedded Measures on Outcomes of Kindergarteners Identified as At Risk for Reading Difficulty

This study examined the predictive validity of formative assessments embedded in a Tier 2 intervention curriculum for kindergarten students identified as at risk for reading difficulty. We examined when (i.e., months during the school year) measures could predict reading outcomes gathered at the end of kindergarten and whether the predictive validity of measures changed across the kindergarten year. Participants consisted of 137 kindergarten students whose reading development was assessed four times from October to February. Measures aligned with content taught in the curriculum and assessed a range of phonologic, alphabetic, and word-reading skills. Results from structural equation modeling indicate that 36.3% to 65.2% of the variance was explained on the latent decoding outcome and 62.0% to 86.8% on the latent phonological outcome across the four time points. Furthermore, the predictive validity of specific skills increased over the kindergarten year, with more complicated tasks (e.g., word segmentation) becoming more predictive at subsequent measurement occasions. Results suggest that curriculum-embedded measures may be viable tools for assessing and predicting reading performance.