The effect of body image threat on smoking motivation among college women: Mediation by negative affect.

A recent experimental study found that activation of negative body image cognitions produced urges to smoke in young women (E. N. Lopez, D. J. Drobes, J. K. Thompson, & T. H. Brandon, 2008). This study intended to replicate and extend these experimental findings by examining the role of negative affect as a mediator of the relationship between body dissatisfaction and smoking urges. Female college smokers (N = 133) were randomly assigned to a body image challenge (trying on a bathing suit) or a control condition (evaluating a purse). State levels of urge to smoke, mood, and body dissatisfaction were assessed both pre- and postmanipulation. Trying on a bathing suit increased body dissatisfaction and reported urges to smoke, particularly those urges related to reducing negative affect. Additionally, state negative affect mediated the relationship between the body image manipulation and smoking urge. This study provides additional support, through an experimental design, that situational challenges to body image influence smoking motivation and that this effect occurs, at least in part, through increases in negative affect. Theoretical and applied implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relation between self-reported affect and drug urges and cravings in continuing and withdrawing smokers.

Investigated, in 2 experiments, the effects of withdrawal and stress on the affective correlates of urges to smoke. In both, habitual cigarette smokers were divided into continuing and withdrawing smoker groups. In the 1st study, 44 adults reported current mood, urge, and expectations over a 24-hr period. In the 2nd, a controlled laboratory study, urge, affect, and physiological data were obtained from continuing and withdrawing groups (N?=?64) exposed to high- or low-stress conditions. Urges among withdrawing smokers were positively associated with negative affect and negatively associated with positive affect; continuing smokers reported urges that were directly associated with positive affect and unrelated to negative affect. Stress and withdrawal produced urge and self-reports that were related to negative affect. Moreover, Ss who smoked after exposure to withdrawal and stress reported greater pleasure and arousal than did other Ss. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

High-dose transdermal nicotine and naltrexone: Effects on nicotine withdrawal, urges, smoking, and effects of smoking.

Although treatment with transdermal nicotine replacement (TNR) has improved smoking abstinence rates, higher doses of TNR could improve effects on urge to smoke, nicotine withdrawal, and reinforcement from smoking, and naltrexone might further reduce reinforcement and urges. A laboratory investigation with 134 smokers using a 3 × 2 parallel-group design evaluated the effects of TNR (42-mg, 21-mg, or 0-mg patch) as crossed with a single dose of naltrexone (50 mg) versus placebo on urge to smoke, withdrawal, and responses to an opportunity to smoke (intake, subjective effects) after 10 hr of deprivation. Urge and withdrawal were assessed both prior to and after cigarette cue exposure. Only 42 mg TNR, not 21 mg, prevented urge to smoke, heart rate change, and cue-elicited increase in withdrawal. Both 21 and 42 mg TNR blocked cue-elicited drop in heart rate and arterial pressure. Naltrexone reduced cue-elicited withdrawal symptoms but not urges to smoke or deprivation-induced withdrawal prior to cue exposure. Neither medication significantly affected carbon monoxide intake or subjective effects of smoking except that 42 mg TNR resulted in lower subjective physiological activation. No interaction effects were found, and no results differed by gender. Results suggest that starting smokers with 42 mg TNR may increase comfort during initial abstinence, but limited support is seen for naltrexone during smoking abstinence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Testing the influence of external and internal cues on smoking motivation using a community sample.

Exposing smokers to either external cues (e.g., pictures of cigarettes) or internal cues (e.g., negative affect induction) can induce urge to smoke and other behavioral and physiological responses. However, little is known about whether the two types of cues interact when presented in close proximity, as is likely the case in the real word. Additionally, potential moderators of cue reactivity have rarely been examined. Finally, few cue-reactivity studies have used representative samples of smokers. In a randomized 2 × 2 crossed factorial between-subjects design, the current study tested the effects of a negative affect cue intended to produce anxiety (speech preparation task) and an external smoking cue on urge and behavioral reactivity in a community sample of adult smokers (N = 175), and whether trait impulsivity moderated the effects. Both types of cues produced main effects on urges to smoke, despite the speech task failing to increase anxiety significantly. The speech task increased smoking urge related to anticipation of negative affect relief, whereas the external smoking cues increased urges related to anticipation of pleasure; however, the cues did not interact. Impulsivity measures predicted urge and other smoking-related variables, but did not moderate cue-reactivity. Results suggest independent rather than synergistic effects of these contributors to smoking motivation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Manipulation of smoking urges and affect through a brief-imagery procedure: Self-report, psychophysiological, and startle probe responses.

The extent to which sentence imagery elicits effects comparable to those produced by long narratives was investigated. Smokers imagined sentences with varying affective content and that either contained or were devoid of smoking cues. Physiological responses were monitored, and smokers rated their urges and affect. Startle responses were also collected as an index of negative affect processing. Smoking-cue sentences produced augmented urges and startle responding. Smoking material also elevated negative affect during imagery of positive affect sentences. The affect manipulation produced changes in self-reported affect and facial electromyography consistent with the affective valence of the sentences. This procedure is similar to narrative imagery in the manipulation of smoking urges and affect under laboratory conditions. Results support the hypothesis that smoking urges enhance negative affect processing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Early cessation success or failure among women attempting to quit smoking: Trajectories and volatility of urge and negative mood during the first postcessation week.

Aversive symptoms of abstinence from nicotine have been posited to lead to smoking relapse and research on temporal patterns of abstinence symptoms confirms this assumption. However, little is known about the association of symptom trajectories early after quitting with postcessation smoking or about the differential effects of tonic (background) versus phasic (temptation-related) symptom trajectories on smoking status. The current study examined trajectories of urge and negative mood among 300 women using the nicotine patch during the first postcessation week. Ecological momentary assessments collected randomly and during temptation episodes were analyzed using hierarchical linear modeling yielding four individual trajectory parameters: intercept (initial symptom level), linear slope (direction and rate of change), quadratic coefficient (curvature), and volatility (scatter). Early lapsers, who lapsed during the first postcessation week, exhibited more severe tonic urge and phasic negative mood immediately after quitting, and more volatile tonic and phasic urge compared to abstainers. Late lapsers, who were abstinent during the first week but lapsed by 1 month, exhibited more severe tonic urge immediately after quitting compared to abstainers. These results demonstrate the importance of early postcessation urge and negative affect and highlight the value of examining both tonic and phasic effects of abstinence from nicotine. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Induction of smoking urge through imaginal and in vivo procedures: Physiological and self-report manifestations.

This experiment assessed reactivity to imaginal and in vivo smoking and control cues. One hundred current smokers were assessed during 2 sessions separated by a 6-hr interval, and half of the participants were abstinent from smoking over this interval. Verbal and physiological reactivity measures were selected based on their relevance for several models of urge. Results indicated that imaginal and in vivo smoking cues were equally effective at eliciting high levels of self-reported urges. Smoking deprivation led to a general enhancement in urge report, rather than a specific increase to smoking cues. Physiological responding differed somewhat as a function of urge induction method, although autonomic responses to smoking cues were uniformly consistent with the direct effects of nicotine. There was no relationship between verbal and physiological urge indices. Implications of the findings for several contemporary models of drug urges are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of depressed mood on smoking cessation: Mediation by postcessation self-efficacy.

This study evaluated the relationship between precessation depressed mood and smoking abstinence and assessed the mediation of this effect by postcessation self-efficacy, urges to smoke, nicotine withdrawal, and coping behavior. The sample included 121 smokers previously treated in a randomized controlled trial involving behavior therapy and the nicotine patch. The results showed that precessation depressed mood was inversely related to 6-month abstinence. This effect remained significant after controlling for treatment, possible depression history, baseline smoking rates, and several other demographic factors. Postcessation self-efficacy, at the 2-, 4-, and 8-week postquit assessments, was the strongest mediator of the effects of precessation depressed mood on abstinence, accounting for 32%, 38%, and 48% of the effect of mood on abstinence, respectively. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hostility, cigarette smoking, and responses to a lab-based social stressor.

High-trait hostility is associated with persistent cigarette smoking. To better understand mechanisms that may account for this association, we examined the effects of acute smoking abstinence and delayed versus immediate smoking reinstatement on responses to a social stressor among 48 low hostile (LH) and 48 high hostile (HH) smokers. Participants completed two laboratory sessions, one before which they had smoked ad lib and one before which they had abstained for the prior 12 hr. During each session, participants completed a stressful speaking task and then smoked immediately after the stressor or after a 15-min delay. The effect of immediate versus delayed smoking reinstatement on recovery in negative mood was significantly moderated by hostility. When reinstatement was delayed, HH participants showed significant increases in negative mood over time, whereas LH participants showed little change. When reinstatement was immediate, HH and LH smokers showed similar significant decreases in negative mood. Smoking abstinence did not moderate hostility effects. Cigarette smoking may prevent continuing increases in negative mood after social stress in HH smokers, which may partially explain their low rates of quitting. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Affect, expectancies, urges, and smoking: Do they conform to models of drug motivation and relapse?

Social-learning models of drug motivation and relapse often include the constructs of affect and drug expectancies. Most research has taken a molar approach to examining relations between these constructs and level of drug use. An experiment examined the roles of affect and expectancies in multiple measures of situation-specific motivation to smoke tobacco. Undergraduate smokers (n?=?101) received either a positive or negative mood manipulation (false feedback on an intelligence test). Self-reported urge was influenced by both negative affect and expectancies for positive reinforcement from smoking. Actual consumption was related only to smoking expectancies and only among abstaining smokers. affect by expectancy interactions were also found. Findings support a limited role of affect and expectancies in smoking motivation. Poor coherence among the motivational indexes challenges the assumptions of existing models of drug motivation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gender differences in acute tobacco withdrawal: Effects on subjective, cognitive, and physiological measures.

Gender differences in tobacco withdrawal are of considerable clinical importance, but research findings on this topic have been mixed. Methodological variation in samples sizes, experimental design, and measures across studies may explain the inconsistent results. The current study examined whether male (n = 101) and female (n = 102) smokers (≥15 cigarettes/day) differed in abstinence-induced changes on a battery of self-report measures (withdrawal, affect, craving), cognitive performance tasks (attention, psychomotor performance), and physiological responses (heart rate, blood pressure, brain electroencephalogram). Participants attended 2 counterbalanced laboratory sessions, 1 following 12 hr of abstinence and the other following ad libitum smoking. Results showed that women reported greater abstinence-induced increases in negative affect, withdrawal-related distress, and urge to smoke to relieve withdrawal distress. In contrast, both genders reported similar abstinence-induced changes in positive affect and urge to smoke for pleasure. Men and women exhibited generally similar abstinence-induced changes in physiological and cognitive performance measures. In addition, gender did not moderate the association between withdrawal symptoms and baseline measures of smoking behavior and dependence. Abstinence-induced changes in withdrawal distress mediated the effect of gender on latency until the 1st cigarette of the day at trend levels ( p     

Nicotine–mecamylamine treatment for smoking cessation: The role of pre-cessation therapy.

The nicotinic antagonist mecamylamine was evaluated in a randomized smoking cessation trial. Four groups of participants (n?=?20 per group) received nicotine plus mecamylamine, nicotine alone, mecamylamine alone, or no drug for 4 weeks before cessation. After the quit-smoking date, all subjects received nicotine plus mecamylamine treatment for 6 weeks. Nicotine skin patches (21 mg/24 hr) and mecamylamine capsules (2.5–5.0 mg twice per day) were used. Precessation mecamylamine significantly prolonged the duration of continuous smoking abstinence; abstinence rates at the end of treatment were 47.5% with mecamylamine and 27.5% without mecamylamine. Nicotine + mecamylamine reduced ad lib smoking, smoking satisfaction, and craving more than either drug alone. Moreover, the orthostatic decrease in blood pressure caused by mecamylamine was offset by nicotine. Mecamylamine before smoking cessation may be an effective adjunct to nicotine patch therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Smoking patterns and dependence: Contrasting chippers and heavy smokers.

The authors used ecological momentary assessment to contrast smoking patterns among chippers (CHs; n = 26)--smokers who smoke despite an apparent absence of tobacco dependence--with those seen in heavy smokers (HSs; n = 28). Smoking and nonsmoking settings (activity, mood, etc.) were assessed by means of electronic diary. CHs were not social smokers; like HSs, they smoked half their cigarettes while alone. When smoking, CHs' urge levels equaled those of HSs; between cigarettes, CHs had few urges, whereas HSs reported moderate urges. CHs' smoking was particularly associated with indulgent activities: relaxation, socializing, eating, and drinking alcohol. Outside of these indulgent settings, CHs' (but not HSs') smoking was associated with negative affect. In idiographic analyses, CHs' smoking was under much stronger stimulus control than was that of HSs. The authors propose that the disappearance of stimulus control over use is a characteristic of dependence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alcohol and tobacco cessation in alcohol-dependent smokers: Analysis of real-time reports.

Alcohol-tobacco interactions and relapse precipitants were examined among alcohol-dependent smokers in a trial of concurrent alcohol and tobacco treatment. After discharge from treatment, participants completed 14 days of electronic diary (ED) assessments of mood, self-efficacy, urges to drink or smoke, and drinking and smoking behavior. ED data revealed an increase in frequency of alcohol urges after smoking episodes. Drinking relapse episodes were predicted by prior ED ratings of low self-efficacy to resist drinking and high urge to smoke. Smoking relapse episodes were predicted by high urge to smoke and high negative, high arousal mood. Results support a cross-substance cue reactivity model of multiple substance use and a limited-strength model, but not a cross-substance coping model. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of an implicit mood prime on the accessibility of smoking expectancies in college women.

This study examined whether an implicit mood prime would differentially affect the accessibility of self-generated smoking expectancies in women. One hundred nine ever-smokers were randomly assigned to receive either a positive or negative musical mood induction or a no-music control condition. Participants self-generated smoking expectancies, and the 1st responses were categorized as positive reinforcement, negative reinforcement, or negative consequence expectancies. Overall, participants generated mood-congruent smoking expectancies, suggesting that affect may act as a conditioned stimulus that elicits expectations of positive and negative reinforcement of smoking behavior. In addition, negative reinforcement expectancies were more frequently generated in current versus past smokers. Results are consistent with a situational-specificity hypothesis and memory-based models of affect and expectancies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)