Pain as a motivator of smoking: Effects of pain induction on smoking urge and behavior.

Tobacco smoking has been associated with the development and exacerbation of chronically painful conditions. Conversely, there is reason to believe that smokers may be motivated to use tobacco as a means of coping with their pain. To date, no controlled, experimental studies have tested for a causal relationship between pain and smoking motivation. The primary aim of the current study was to test the hypothesis that laboratory-induced cold pressor pain would enhance smoking motivation, as measured by self-reported urge to smoke and observation of immediate smoking behavior. Smokers (N = 132) were randomly assigned to either pain or no pain conditions. Results indicated that situational pain increased urge ratings and produced shorter latencies to smoke. The relationship between pain and increased urge to smoke was partially mediated by pain-induced negative affect. The relationship between pain and shorter latency to smoke was fully mediated by pain-induced urge to smoke. This study provides the 1st experimental evidence that situational pain can be a potent motivator of smoking. (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)     

A fine-grained analysis of the role of self-efficacy in self-initiated attempts to quit smoking.

The relation between self-efficacy ratings and smoking behavior was explored among 36 people who were trying to quit smoking on their own. Ss self-monitored high-risk situations, coping efforts to withstand the temptation to smoke, and self-efficacy in coping with similar temptations for 4 weeks after quitting. Self-efficacy ratings were significantly related to the outcome of these situations, with Ss reporting higher efficacy ratings after situations in which they did not smoke as opposed to those in which they did smoke. Self-efficacy was predictive of smoking outcome, but there was considerable intersubject variability in the strength of the relation between efficacy and smoking behavior. Both efficacy and previous smoking behavior predicted smoking outcome equally well, however. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cigarette smoking under stress: the role of coping expectancies among smokers in a clinic-based smoking cessation program

This study examined 2 expectancies to explain smoking under stress: smokers' expectations about their ability to cope with stress while remaining abstinent and their expectations about the stress-ameliorating and coping benefits of smoking under stress. The interaction of the expectancies concurrently predicted smoking urge under stress, which, in turn, predicted subsequent smoking. The interaction of posttreatment expectancies prospectively predicted smoking status 3 months after treatment, although the coping benefits of smoking expectancy effect was reversed. Expectations about coping ability increased and expectations about the coping benefits of smoking decreased as a function of participating in a smoking cessation program. The discrepant concurrent and prospective findings, reasons that coping expectancies are associated with smoking under stress, and treatment implications are discussed.     

Attention bias in nicotine withdrawal and under stress.

Drug motivation models postulate that attention biasing toward smoking-related cues is a cognitive mechanism supporting continued or renewed drug use, and they predict that drug use history, deprivation, and distress should modulate the extent of this bias. The present study used the modified Stroop paradigm to extend past research regarding attention biasing toward smoking and unpleasant, pleasant, and neutral words among adult nonsmokers and daily smokers. Both nonsmokers and smokers showed differential attention toward unpleasant and pleasant cues, particularly pleasant cues, but did not show a unique bias toward smoking-related stimuli. Results suggested that, among smokers, nicotine deprivation and exogenous stress (threat of electric shock) have a nonadditive effect on attention toward pleasant cues but no effect on attention to smoking cues specifically. Similarly, instructing smokers that they would have an opportunity to smoke did not significantly increase the bias of nicotine-deprived smokers' attention toward smoking-related cues, relative to arousing unpleasant and pleasant cues. Overall, results suggest that smokers' attention may be biased toward both smoking-related and other salient cues when deprived of nicotine and anticipating an opportunity to smoke. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The influence of situation and coping on relapse crisis outcomes after smoking cessation.

Examines the influence of situational characteristics and coping on the outcome of a relapse crisis for 232 Ss followed for 1 month after a self-initiated smoking cessation attempt. Survival of a relapse crisis was most strongly related to the number of coping strategies used. All coping strategies were equally effective; furthermore, combining cognitive and behavioral coping strategies was not more effective than using multiple cognitive or multiple behavioral strategies. During the second half of the follow-up period (Weeks 3 and 4 postcessation), the presence of smokers resulted in a decreased likelihood of coping and an increased likelihood of smoking. In addition, active coping was marginally related to higher baseline levels of motivation to quit. When motivation and the presence of smokers were controlled, however, coping still significantly predicted outcome. Results are discussed with reference to previous relapse studies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cigarette mentholation increases smokers' exhaled carbon monoxide levels.

12 male smokers participated in 3 controlled-dose smoking sessions spaced 1 wk apart. In each session, Ss inhaled 1,200 cc of cigarette smoke. Menthol dosage varied across sessions, such that Ss smoked experimental cigarettes that had been injected with 0, 4, or 8 mg of menthol. Exhaled CO levels increased concomitantly with menthol dosage. There were no differences in smoking topography across the 3 conditions. The ability of menthol to increase the toxicity of cigarette smoke by raising CO levels is discussed. Results suggest that menthol cigarette preference may account for some of the racial differences in smoking behavior and smoking-related outcomes found in past literature. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Expectancy priming of smoking cessation messages enhances the placebo effect of tailored interventions.

Objective: Previous research (Webb, Simmons, & Brandon, 2005) suggested that smokers' reactions to self-help materials were more positive if they believed that the materials had been personally tailored to their individual characteristics and if they held expectancies that tailored interventions are superior to standard, or generic, interventions. The authors' objective in the current study was to replicate and extend this research by testing the efficacy expectancy priming before intervention delivery. Design: In a 2 × 2 factorial experiment, 210 smokers (M = 23 cigarettes/day) recruited from the community (62% female; 92% Caucasian; mean age = 49) were randomly assigned to 1 of 4 conditions: placebo-tailored intervention/no priming, placebo-tailored intervention/priming, standard intervention/no priming, or standard intervention/priming. The tailoring-related expectancies of participants' in the priming conditions were primed before they were presented with the respective intervention booklets. Main Outcome Measures: Content evaluations, readiness to quit smoking, cessation self-efficacy, smoking-related knowledge, and progress toward quitting (behavior changes). Assessments occurred by mail at baseline and at 1-month postintervention. Results: Similar to the earlier study, the placebo-tailored booklets produced superior evaluations and smoking-related cognitive and behavioral changes. Moreover, the pretreatment expectancy priming successfully altered participants' tailoring-related expectancies and also produced superior evaluations and outcomes. Conclusion: Findings support a causal role of tailoring-related expectancies on the efficacy of tailored interventions and suggest that interventions can be enhanced via expectancy priming. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Resisting temptations to smoke: Results from within-subjects analyses.

Within-subjects analyses were used to examine differences between resisted temptations to smoke (either a specific close call or the most common temptation) and smoking lapses among 130 participants lapsing within 1 month after a self-initiated quit attempt. Participants were more likely to report coping during resisted temptations than during lapses; those who reported coping in both were more likely to report using multiple strategies and combining cognitive and behavioral strategies during the resisted temptation. Participants were more likely to report that the lapse was precipitated by others smoking, but this difference was not significant when the sample was restricted to those reporting a specific close call. No other statistically significant differences were found. Results support previous findings that the use or nonuse of coping strategies during a temptation to smoke is the variable most strongly associated with its outcome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Do desirability ratings moderate the validity of probability ratings on the Smoking Consequences Questionnaire.

Smokers' responses to the Smoking Consequences Questionnaire--Adult (A. L. Copeland, T. H. Brandon, and E. P. Quinn, 1995) were used to determine whether smoking outcome expectancies are moderated by subjective evaluations (desirability ratings) in their effect on smoking-related variables. Hierarchical regression in a reanalysis of data from A. L. Copeland et al indicated that the product of probability and desirability ratings accounted for a significant amount of variance in smoking rate, nicotine dependence, saliva cotinine, and posttreatment smoking status above that accounted for by probability and desirability ratings alone. Results indicate that desirability ratings serve as moderators to probability ratings in explaining current smoking, nicotine dependence, and continued smoking. Effects were modest in magnitude but suggest that it may be important to address subjective evaluations of outcomes in smoking cessation and relapse prevention efforts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attentional bias for smoking and affective stimuli: A Stroop task study.

Prior research has demonstrated attentional biases to smoking-related cues among smokers, and several lines of research suggest strong ties between smoking and negative affect. The authors tested attentional biases to both smoking and affective cues in 27 smokers using an emotional Stroop paradigm, and examined the relationship between these forms of attentional bias. Findings indicated significant attentional biases to smoking-related and negative-affect words, but not positive-affect words. In addition, there was a significant correlation between the degree of attentional bias to smoking and negative-affect words. These data provide evidence of a close association between smoking-related and affective cue processing from a cognitive perspective. Potential theoretical and clinical implications for these findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Constructing a short form of the Smoking Consequences Questionnaire with adolescents and young adults.

The goal of the present studies was to construct and validate a short form of the 50-item Smoking Consequences Questionnaire (SCQ; T. H. Brandon & T. B. Baker, 1991), a measure of smoking outcome expectancies. In Study 1, a 21-item short form (S-SCQ) was derived from a sample of 107 young adults previously treated for substance abuse. In Study 2, the measure was cross-validated on 125 adolescents in treatment for substance abuse. Confirmatory factor analyses revealed good model fit and factorial invariance for the 4 S-SCQ subscales across both samples. Validation analyses on each sample found that subscale scores generally correlated significantly with smoking-related variables. The present studies provide initial evidence for the utility of the S-SCQ when used with young adults and adolescents. (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)     

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)     

Effects of nicotine dose, instructional set, and outcome expectancies on the subjective effects of smoking in the presence of a stressor.

The balanced placebo design (BPD) was used to evaluate the independent effects of nicotine dose and smoking-related expectancies on self-reported anxiety, urge to smoke, and withdrawal symptoms. After anxious mood was induced, participants smoked either a de-nicotinized cigarette or one with standard nicotine content. Nicotine dose was crossed with instructions that the cigarette was either de-nicotinized or standard. Nicotine cigarettes produced greater anxiety reduction than de-nicotinized cigarettes. Nicotine instructions attenuated anxiety only among those who held relevant expectancies. Nicotine dose and instructional set interacted such that either nicotine cigarettes or instructions that the cigarettes contained nicotine were sufficient to reduce urge to smoke. Implications of these findings and methodological issues regarding use of the BPD with cigarettes are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reactivity to instructed smoking availability and environmental cues: Evidence with urge and reaction time.

Reactivity to drug-related cues has been proposed as a possible mechanism to explain maintenance of drug use and relapse. This study examined whether cognitions associated with drug use (the belief that nicotine is available for use) also elicit reactivity. Smokers (N?=?132) were randomly assigned in a 2 (Smoking Availability)?×?2 (Smoking Stimuli) factorial design. Reactivity was measured by self-reported urge and probe reaction time. A main effect for availability was found in that participants who had been told that they could smoke shortly reported greater urges than those who had been told that smoking would not be permitted for 3 hr. Moreover, smoking-related stimuli produced increases in urge ratings only when participants had been told that smoking would be available shortly. Probe reaction time, in contrast, increased in the presence of smoking stimuli only when participants were told that cigarettes were unavailable. The theoretical and treatment implications of drug availability as a moderator of cue reactivity, as well as the utility of reaction time as an index of drug use motivation, are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maternal socialization of adolescent smoking: Intergenerational transmission of smoking-related beliefs.

A longitudinal, multigenerational design was used to test the intergenerational transmission of smoking and the hypothesized correlated transmission of smoking-related beliefs. The study assessed a sample of 192 mother–adolescent pairs to test whether mothers' beliefs about smoking were related to their children's beliefs and whether mothers' beliefs could account for the relation between mother and child smoking. Structural equation modeling showed strong evidence for the intergenerational transmission of smoking, and smoking-related beliefs were related to smoking in both generations. However, there was no evidence for the intergenerational transmission of smoking-related beliefs. Rather, adolescents' beliefs were related to their own smoking experience and to their mothers' smoking behavior. These results suggest that parents influence their children more through their behavior than through the beliefs that they hold. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Negative affect combines with smoking outcome expectancies to predict smoking behavior over time.

The present study examined whether the tendency to experience negative affective states combines with smoking outcome expectancies to predict smoking behavior over time. Participants were 121 young adults and resource people recruited from 3 alcohol and drug treatment programs and through community advertisements. Each participant completed 3 interviews over a 4-year period. Results indicated that dispositional negative affect and positive smoking expectancies were significantly correlated with smoking behavior both within and across time. Expectations of positive and negative reinforcement partially mediated negative affect's relation with smoking across time. Positive expectancies did not function as a moderator of negative affect's relation with smoking behavior. These results represent an important step in incorporating smoking outcome expectancies into multivariate models of smoking risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship among alcohol use, depression, smoking behavior, and motivation to quit smoking with hospitalized smokers.

Relationships among depression, alcohol use, and motivation to quit smoking were examined in a sample of 350 hospitalized smokers. Multivariate multiple regression and logistic regression analyses indicated that participants with depressed mood were more likely to have a history of problematic drinking. Participants with depressed mood and a history of problematic drinking were more likely to be nicotine dependent and anticipated greater difficulty refraining from smoking while hospitalized. Alcohol use in heavier amounts was associated with a decreased concern with negative aspects of smoking, whereas history of depression was associated with increased concern in that area. Finally, current drinking was associated with increased confidence in quitting in 1 month whereas depressed mood was associated with decreased confidence in quitting. Overall, depression and alcohol use had stronger associations with smoking-related variables than with smoking cessation motivation variables. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationships between stages of change in cigarette smokers and healthy lifestyle behaviors in a population of young military personnel during forced smoking abstinence.

This study evaluated the relationships between stages of change and related health behaviors in a population of smokers forced to quit smoking. Participants were 10,136 Air Force recruits who were in basic military training (BMT) and who were not allowed to smoke because of a ban on smoking during BMT. Participants were surveyed about their smoking history, their motivation and readiness to remain smoke free after BMT, and their behavior on 5 target health areas. Results indicated that smoking history best predicted stage of change. Though there were few gender differences, several ethnic differences emerged. These results suggest that, although stages of change involve both a cognitive and behavioral component, removing the behavioral component (smoking) through a smoking ban does not reduce the construct validity of the transtheoretical model. (PsycINFO Database Record (c) 2010 APA, all rights reserved)