Momentary precipitants connecting stress and smoking lapse during a quit attempt.

Abstract

Objective: Most attempts at smoking cessation are unsuccessful, and stress is frequently characterized both as a momentary precipitant of smoking lapse and a predictor of subsequent changes in other key precipitants of lapse. The current study examined longitudinal associations among stress, multiple precipitants of lapse, and lapse among smokers attempting to quit. Method: Ecological momentary assessments (EMAs) were gathered from a multiethnic, gender-balanced sample of 370 adults enrolled in a smoking cessation program. EMAs (N ϭ 32,563) assessed smoking lapse and precipitants of lapse, including stress, negative affect, smoking urge, abstinence self-efficacy, motivation to quit, difficulty concentrating, coping outcome expectancies, and smoking outcome expectancies. A multilevel structural equation model simultaneously estimated within-subject paths from stress to multiple precipitants and subsequent smoking lapse. Indirect effects of stress to smoking lapse through precipitants were computed. Results: Results indicated that increased stress was significantly associated with all precipitants of lapse, consistent with a greater risk for lapse (i.e., increased negative affect, smoking urge, difficulty concentrating, and smoking outcome expectancies and reduced abstinence self-efficacy, motivation to quit, and coping outcome expectancies). All precipitants were significantly associated with subsequent lapse. Indirect effects indicated that stress was uniquely connected to lapse through negative affect, smoking urge, abstinence self-efficacy, coping outcome expectancies, and smoking outcome expectancies. Conclusions: Results of this study highlight the broad importance of stress for smoking lapse during a quit attempt. Smoking cessation programs should pay close attention to the role of stress in exacerbating key precipitants of lapse to improve cessation success rates.

Ecological Momentary Assessment of the Relationship between Positive Outcome Expectancies and Gambling Behaviour

“…These findings challenge the relapse prevention models, which emphasise the role of positive outcome expectancies as precipitants to relapse and posit that there are feedback loops between transient changes in positive outcome expectancies and gambling episodes [ 12 , 13 ]. They are also inconsistent with previous EMA substance use research demonstrating that these expectancies are phasic determinants of smoking and alcohol consumption [ 50 , 51 , 52 ] and previous cross-sectional research demonstrating a significant relationship between positive gambling outcome expectancies and problem gambling [ 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ].…”

“…Although EMA methodologies are increasingly being employed in the gambling field [ 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ], none have yet examined the relationships between situational (phasic) outcome expectancies and gambling behaviour. This is in contrast to other addictions literature, in which there is EMA evidence suggesting that positive outcome expectancies predict the occurrence and amount of smoking and alcohol consumption [ 50 , 51 , 52 , 53 ], moderate the relationships between other situational factors and the likelihood of drinking [ 53 ], play a mediating role between other situational factors and smoking/alcohol consumption [ 54 , 55 , 56 , 57 ], are associated with smoking self-efficacy and craving [ 58 ], and reduce non-smoking intentions [ 58 ].…”

Smoking and stress in the general population in Denmark

“…Evidence also indicates that perceived stress is a barrier for smoking cessation. Persons with high level of stress (PTSD) have lower odds of quitting 25 and in prospective studies of smokers enrolled in a smoking cessation program, stress predicted relapse 26 .…”

Psychosocial stress, bicultural identity integration, and bicultural self‐efficacy among Hispanic emerging adults

“…Psychosocial stress, also referred to as psychological stress, is the degree to which a person perceives that a situation exceeds their ability to cope (Cohen & Janicki-Deverts, 2012). Psychosocial stress (hereinafter simply referred to as stress) is a construct that can fluctuate quickly in response to a specific event (e.g., taking an exam) or change gradually in response to cumulative stimuli that can diminish the ability to cope (Barbosa-Leiker et al, 2013;Cambron, et al, 2019). Stress is highly correlated with symptoms of depression and anxiety; therefore, it has been suggested that these three constructs may form part of a broader construct (psychological distress; Henry & Crawford, 2005).…”