Smoking is Associated with Worse Mood on Stressful Days: Results from a National Diary Study

Abstract

Background Many smokers report smoking because it helps them modulate their negative affect (NA). The stress induction model of smoking suggests, however, that smoking causes stress and concomitant NA. Empirical support for the stress induction model has primarily derived from retrospective reports and experimental manipulations with non-representative samples of smokers. Moreover, prior studies have typically not considered contextual factors (e.g., daily stressors) that may impact the smoking-NA relationship. Purpose The aim of this study was to assess the stress induction model of smoking using a prospective design in a nationally representative sample of smokers, while simultaneously examining the impact of daily stressors on the relationship between smoking and NA. We hypothesized that smoking and NA would be positively related, and this relationship would be intensified by exposure to daily stressors. Methods A national sample of middle-aged smokers (N = 256) were called on eight consecutive evenings to assess stressor exposure and intensity. Participants also reported on their daily NA and indicated the number of cigarettes they smoked. Analyses were conducted using hierarchical linear modelling (HLM) to determine the relationship between daily smoking, NA, and stress. Results Smoking more than usual was associated with increased NA on days when respondents were exposed to any stressors. Smoking more than usual had no effect on NA on days when no stressors were encountered. Moreover, the moderating effect of stressor exposure remained significant even after controlling for the number and intensity of daily stressors reported. Conclusions While smokers report that smoking alleviates their NA, our study suggests that the exact opposite may occur, particularly on stressful days. When smokers smoke more than usual on days when the encounter stress they are likely to feel emotionally worse off.

Psychosocial stress and cigarette smoking persistence, cessation, and relapse over 9–10 years: a prospective study of middle-aged adults in the United States

“…Smokers commonly report smoking because it helps them to regulate their mood and to mitigate negative affect when confronted with stressors [19,41]. In contrast to both of these models, the stress induction model of smoking proposes that smoking actually causes stress and negative affect [41].…”

“…In contrast to both of these models, the stress induction model of smoking proposes that smoking actually causes stress and negative affect [41]. To address this possibility, we performed a sensitivity analysis to examine whether our findings were maintained following adjustment for negative affect, since negative affect could theoretically function as a mediator of the relationship between stress and smoking or a confounder of this association.…”

Smoking, nicotine and neuropsychiatric disorders

“…The permanent state of systemic inflammation and/or the chronic hypoxia that are hallmarks of COPD may explain the elevated rate of mood disorders in the COPD population (see details in Decramer et al, 2008). Another theory states that smoking may provoke mood disturbances in smokers because of the appearances of acute NIC deprivation periods several times a day, and -in consonance with this -several studies found that smoking cessation is associated with decreased levels of stress and anxiety in the long run (Parrott, 2006;Aronson et al, 2008). A recent investigation by Aronson et al (2008) has strengthened this theory, as the authors found -in contrast to the experiences of smokers -that heavy smoking is associated with greater negative affects, and this association is more pronounced on stressful days (Aronson et al, 2008).…”

Pain, nicotine, and smoking: Research findings and mechanistic considerations.

“…Indeed, stress and negative affect may promote self-administration of nicotine, even in the absence of true emotion-modulating effects (Kassel, Stroud, & Paronis, 2003). In a seminal review of smoking, stress, and negative affect, Kassel et al (2003) concluded that tobacco-dependent smokers consistently endorse increased smoking in response to self-reported stress and negative affect (e.g., Aronson, Almeida, Stawski, Klein, & Kozlowski, 2008; Creson, Schmitz, & Arnoutovic, 1996; Hellerstedt & Jeffery, 1997; Steptoe, Wardle, Pollard, Canaan, & Davies, 1996), and that various manifestations of negative affect often precede smoking lapses and relapse to regular smoking among those attempting to quit (e.g., Brandon, Tiffany, Obremski, & Baker, 1990; Cummings, Jaen, & Giovino, 1985; Shiffman, 1982). The results of data collected in naturalistic settings corroborate these findings, with perceived stress shown to trigger smoking urges/cigarette consumption (Todd, 2004), and smoking lapses among recent quitters (Shiffman, Paty, Gnys, Kassel, & Hickcox, 1996).…”