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Dynamic Influences on Smoking Relapse Process

Authors


  • The research reported herein was supported by grant DA06084 from the National Institute on Drug Abuse. Many people collaborated on the research program reported here. The invaluable contributions of Jean Paty, Chad Gwaltney, Maryann Gnys, Mary Hickcox, Jon Kassel, Andrew Waters, Mark Balabanis, Celeste Elash, Walter Perz, John Engberg, Qianyu Dang, Tom Richards, Ken Liu, Matthew McKeever, Stephanie Paton, and Yolanda DiBucci are gratefully recognized. Deborah Scharf and Audrey Woosnam provided helpful editorial assistance. Arthur Stone and Michael Sayette provided helpful comments on the manuscript, as well as years of valuable academic colleagueship.

  • Saul Shiffman is a cofounder of invivodata, inc., which provides electronic diaries for research, and also is involved in the development of nicotine medications for smoking cessation. Correspondence regarding this article may be sent to: Saul Shiffman, Smoking Research Group, Department of Psychology, University of Pittsburgh, 130 N. Bellefield Ave. (Suite 510), Pittsburgh, PA 15213, 3 Bethesda Metro Center, Suite 1400, Bethesda, MD; E-mail: shiffman@pinneyassociates.com

Abstract

Abstract This article describes a program of research applying Ecological Momentary Assessment (EMA) methods to study relapse to cigarette smoking, with a particular focus on the role of negative affect (NA) and self-efficacy (SE). Day-to-day changes in mood and stress did not predict lapse risk, but more proximal changes in affect were associated with lapses: Many lapses were marked by intense NA and by NA increases in the preceding hours. Individual differences in baseline SE predicted lapse risk, but daily SE was relatively stable during abstinence and did not influence lapse risk. However, lapses resulted in immediate drops in SE, and day-to-day changes in postlapse SE predicted progression to relapse, even after accounting for concurrent smoking. SE showed momentary drops associated with NA, but only among smokers with low baseline SE. Individual differences in baseline SE were only expressed situationally under conditions of NA. The findings highlight the importance of dynamic changes in background conditions and in immediate states as important influences on lapses and relapse and also suggest the importance of considering person by situation interactions.

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