Commentary: Delay discounting and smoking: robust correlation, but uncertain causation

In their systematic review, Barlow and colleagues1 report robust evidence that steep delay discounting (also known as time discounting), the tendency to prefer smaller short-term rewards over larger long-term rewards, is a risk factor for smoking and, more tentatively, for unsuccessful cessation. This extends previous work,2,3 in particular by incorporating evidence across the life course which captures different stages of smoking behaviour, from initiation through to cessation. Smokers discount the future more than non-smokers, and this predicts future smoking, and in particular decreased likelihood of successful smoking cessation. Critically, the authors highlight the lack of high-quality prospective data, despite dramatic growth in the number of studies on delay discounting and smoking published in recent years. It is likely that these associations are not unique to cigarette smoking and extend to other health behaviours, including use of other substances,2,3 obesity3 and attention-deficit hyperactivity disorder.3 For all of these conditions, three important questions remain unanswered.
Source: International Journal of Epidemiology - Category: Epidemiology Source Type: research