Does smoking abstinence self-efficacy vary across situations? Identifying context-specificity within the Relapse Situation Efficacy Questionnaire.

According to self-efficacy and relapse theories. abstinence self-efficacy (ASE) ratings should be context-specific: they should vary across situations. This variability may be important, as it could signal high-risk for relapse situations. In this study, confirmatory factor analysis was used to identify situational variability in a novel ASE assessment (Relapse Situation Efficacy Questionnaire. or RSEQ). Results supported a hierarchical structure, where both context-specific and unidimensional measures of ASE exist within the assessment. Context-specific factors included Negative Affect, Positive Affect, Restrictive Situations (to smoking). Idle Time, Social-Food Situations, Low Arousal, and Craving. Multiple context-specific factors and the aggregate factor predicted cessation outcome, even after controlling for concurrent smoking rate. However, the context rated with the least confidence proved to be the best outcome predictor, suggesting the existence of "Achilles' heel" situations. These data indicate the internal and predictive validity of the RSEQ.

Generalized expectancies for negative mood regulation and problem drinking among college students.

OBJECTIVE: Motivational models of alcohol use often invoke constructs derived from social-learning theory, including coping styles, drinking motives and affective distress. To date, no study has assessed the potential role of negative mood regulation (NMR) expectancies (the extent to which one holds positive expectations of one's ability to cope with negative affect) in promoting problematic drinking behavior. This study evaluated the relationship between NMR expectancies and problem-related drinking while controlling for the influence of alcohol consumption, coping behaviors, drinking motives, demographic variables and affective distress. METHOD: Participants (N = 136, 80% female) were college undergraduates who completed a battery of self-report questionnaires on two occasions that were separated by 8 weeks. RESULTS: Initial correlational analyses indicated a strong (negative) association between NMR expectancies and problem drinking behavior. Findings from separate hierarchical regression analyses demonstrated that NMR expectancies add significantly to the variance in predicting problem drinking, even when accounting for age and gender, alcohol consumption and, in respective analyses, coping styles, affective distress and drinking motives. Finally, simultaneous regression analyses showed that when all variables were considered together, only NMR expectancies, alcohol consumption and drinking-to-cope emerged as significant predictors of problem drinking. CONCLUSIONS: These findings highlight the potential importance of NMR expectancies as a risk factor for problem drinking, above and beyond the risk posed by traditionally studied variables (e.g., depression and anxiety, coping repertoire and drinking motives). Results are interpreted within a self-regulation framework of alcohol consumption.

Smoking, anxiety, and attention: support for the role of nicotine in attentionally mediated anxiolysis.

Based on J.D. Kassel and S. Shiffman's (1997) study, the hypothesis was tested that cigarette smoking's anxiolytic effects are attentionally mediated and depend on the presence of benign distraction. This study explored whether the attentionally mediated anxiolytic effects of smoking observed in the J. D. Kassel and S. Shiffman (1997) study could be replicated and are attributable to nicotine. The study examined the effect on anxiety of smoking a high- or low-yield nicotine cigarette with or without a current distraction in 67 smokers. As predicted, only those who smoked a high-yield cigarette paired with participation in a distracting activity experienced a significant reduction in anxiety. Those who smoked a high-yield cigarette in the absence of distraction experienced a slight exacerbation of anxiety. These findings suggest that nicotine--not the behavioral or sensory aspects of smoking--interacts with distraction and leads to alleviation of anxiety.

Attentional mediation of cigarette smoking's effect on anxiety.

It was hypothesized that smoking's calming effects are cognitively mediated and depend on the presence of a benign distractor, smoking narrows the focus of attention, thereby reducing anxiety by facilitating distraction from stressful cognitions (cf. C. M. Steele & R. A. Josephs's [1988] attention-allocation model of alcohol reinforcement). This notion was tested by examining the effect of smoking (vs. not smoking) on anxiety with and without a concurrent distraction in 82 smokers; distraction effects were also assessed in 42 nonsmokers. As predicted, smoking reduced anxiety only when paired with a distractor. Further, these findings could not be explained by direct nicotine effects or nicotine withdrawal. Several measures of attention allocation failed to confirm the hypothesized cognitive mechanisms, however. Implications of the findings are discussed.

Remember that? A comparison of real-time versus retrospective recall of smoking lapses.

Research and treatment assessments often rely on retrospective recall of events. The accuracy of recall was tested using accounts of smoking lapse episodes from 127 participants who had quit smoking, and lapses and temptations were recorded in near-real time using a hand-held computer. These computer records were compared with retrospective accounts elicited 12 weeks later, with a focus on recall of lapses in 4 content domains: mood, activity, episode Triggers, and abstinence violation effects. Recall of lapses was quite poor: Average kappas for items ranged from 0.18 to 0.27. Mean profile rs assessing recall for the overall pattern of behavior were .36, .30, .33, and .44 for these domains, respectively. In recall, participants overestimated their negative affect and the number of cigarettes they had smoked during the lapse, and their recall was influenced by current smoking status. The findings suggest caution in the use of recall in research and intervention.

A day at a time: predicting smoking lapse from daily urge.

Smokers who recently quit (N = 214) monitored smoking urges for up to 26 days after quitting. Computers administered 4-5 assessments daily at random times; participants rated urges on waking and when they experienced temptation episodes. Urge intensity after cessation did not generally exceed urges reported during baseline ad lib smoking. Urge intensity and temptation frequency consistently declined over the quit period. Controlling for urge intensity at baseline, all daily urge intensity measures predicted lapse the following day in proportional hazards survival analyses. Average duration of temptation episodes also predicted lapses; frequency of temptation did not. To isolate the effect of day-to-day variations in urges, participants' nicotine dependence and urge intensity on quit day were controlled for. Only urge intensity at waking still predicted lapse risk; this was not because of this measured being closer in time to the day's lapses. Among lapsers, urge intensity at waking and in temptations rose preceding a lapse.

Smoking and attention: a review and reformulation of the stimulus-filter hypothesis.

An accumulation of evidence suggests that smoking may be reinforcing, in part, due to nicotine's capacity to enhance attentional processing. Correspondingly, the stimulus-filter model of nicotine reinforcement asserts that nicotine facilitates cognitive performance by acting as a stimulus-barrier, thereby screening irrelevant and annoying stimuli from the smoker's awareness. A review of the available data suggests that while nicotine does appear to reliably enhance sustained, divided, and focused attention, the stimulus-filter model falls short of adequately explaining the findings. An alternative, attention, allocation model of nicotine reinforcement is reviewed, the tenets of which suggest that nicotine differentially augments attentional processing via its propensity to: (a) induce attentional narrowing, and (b) increase perceptual processing capacity. The motivational implications of the model, including smokers' use of nicotine to dampen stress, are discussed.

Individual differences in the context of smoking lapse episodes.

Research on relapse has often focused either on the momentary context of lapses or on stable traits that predict who will relapse. We examine the relation between the two, analyzing how individual differences relate to characteristics of initial lapses, which were recorded nearly in real time by 105 smokers using hand-held computers. More nicotine-dependent smokers lapsed under more negative affect and more intense urges, but they did not smoke more in the initial lapse. Questionnaire measures of negative affect smoking did not predict negative affect lapses. Smokers who lapsed when drinking were less nicotine dependent, but they had a history of smoking while drinking, as assessed by computer monitoring. Smokers who attempted coping but lapsed nevertheless reported less active coping styles on the Ways of Coping questionnaire. The results demonstrate the interplay between individual traits and contextual influences in smoking relapse, and they particularly highlight the role of nicotine dependence in relation to contextual factors.

Temptations to smoke after quitting: a comparison of lapsers and maintainers.

This study addresses whether characteristics of temptations to smoke differ for participants who quit smoking and maintain abstinence compared to those who quit and then lapse. Participants used hand-held computers to record temptations and were beeped at random for base-rate assessments. We used generalized estimating equations to compare 1,851 temptation episodes and 5,192 random assessments recorded by 151 participants (116 lapsers, 35 maintainers) over 1-23 days of abstinence. Compared to randomly sampled occasions, temptations were marked by greater negative affect, restlessness, attention disturbance, and exposure to smoking cues; participants were also more likely to be eating or drinking during temptations. Temptations reported by lapsers and maintainers did not differ in any respect, including their reported coping. The results highlight situational variance over individual differences.

Progression from a smoking lapse to relapse: prediction from abstinence violation effects, nicotine dependence, and lapse characteristics.

Determinants of progression from an initial smoking lapse to relapse, using prospective data from 133 participants were examined. Participants used palm-top computers to record their first lapse, and their reaction to it, within minutes of the event, and were followed for 3 months to assess subsequent smoking. Indicators of the Abstinence Violation Effect--self-efficacy, attributions, and affective reactions to the lapse--generally failed to predict progression to relapse, but participants who felt like giving up after the first lapse progressed more rapidly to a second lapse. Participants who attempted restorative coping were less likely to progress to another lapse on the same day. Those whose lapses were triggered by stress progressed more quickly, whereas those triggered by eating and drinking or accompanied by alcohol consumption progressed more slowly. More nicotine-dependent participants progressed more rapidly toward relapse, but neither the amount smoked in the first lapse nor its subjective reinforcement predicted progression.

Adult attachment security and symptoms of depression: the mediating roles of dysfunctional attitudes and low self-esteem.

Three studies investigated the relation between adult attachment security and symptoms of depression. Study l examined the overall magnitude of the association between adult attachment and depression, and Studies 2 and 3 tested whether this relation was mediated by dysfunctional attitudes and low self-esteem. Results from the three studies were consistent with a mediation model. This model suggests that insecure adult attachment styles are associated with dysfunctional attitudes, which in turn predispose to lower levels of self-esteem. Such depletions in self-esteem are directly associated with increases in depressive symptoms over time. Insecure attachment appears to lead to depressive symptoms in adulthood through its impact on self-worth contingencies and self-esteem.

Nicotine withdrawal in chippers and regular smokers: subjective and cognitive effects.

From previous studies, chippers (very light, long-time cigarette smokers) seem not to be nicotine dependent, despite decades of smoking. The effect of tobacco deprivation on chippers' withdrawal reactions was examined. Matched groups of 26 chippers and 25 regular smokers were studied while abstaining or smoking for 2-day blocks, with assessments administered 5 times daily by palm-top computers. As hypothesized, chippers showed no changes as a result of nicotine deprivation. In contrast, regular smokers demonstrated distinct changes in craving, mood, arousal, and sleep disturbance. The computers also tested participants' cognitive performance. Unlike chippers, regular smokers' performance on complex tasks was slower under deprivation; the effect could not be explained by changes in motor performance or simple reaction time. Results suggest performance may have been improved by nicotine rather than by worsened by withdrawal.

Psychosocial and personality differences in chippers and regular smokers.

Tobacco chippers are an anomalous group of smokers who, while having smoked regularly for years, have avoided the clutches of nicotine dependence. In an attempt to better understand the factors associated with nondependent cigarette smoking, this paper describes a study in which matched groups of regular smokers, chippers, and nonsmokers were compared on a number of personality and psychosocial variables believed relevant to drug-seeking behavior. The strongest finding indicated that sensation seeking best discriminates among the three groups, with nonsmokers clearly viewing themselves as more socially inhibited and less interested in pursuing sensations relative to both regular smokers and chippers, both of whom evidenced comparable scores. Regular smokers evidenced less self-control, or restraint, and appeared more impulsive and unable to resist temptation, compared to chippers and nonsmokers. Surprisingly, none of the groups could be differentiated on the basis of perceived stress, coping, or social support. Even among the personality variables, however, the effect sizes were relatively small, indicating that these differences in personality cannot fully account for chipper's resistance to dependence.

Smoking typology profiles of chippers and regular smokers.

This study examined smoking patterns among chippers--light, nondependent cigarette smokers--by contrasting their smoking motives (Russell's Reasons for Smoking) and patterns (McKennell's Smoking Occasions) with those of a matched group of regular smokers. Differences between group profiles were initially confounded by differences in overall level of item endorsement, which obscured meaningful interpretation of group differences in smoking patterns. Group differences were clarified by correcting for profile elevation and scatter, as suggested by Cronbach and Gleser (1953). As expected, chippers' subscale profiles deemphasized pharmacological and addiction-related motives such as craving and habit, while emphasizing appetitive and sensory motives such as handling and pleasurable smoking. Social motives for smoking were also more prominent in chippers' smoking profiles.