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Subjective effects from the first cigarette of the day vary with
pre-cigarette affect in premenopausal female daily smokers
Raina D. Pang, Ph.D.1, Casey R. Guillot, Ph.D.2, Madalyn M. Liautaud, B.A.1, Mariel S. Bello,
M.A.3, Matthew G. Kirkpatrick, Ph.D.1, Jimi Huh, Ph.D.1, Adam M. Leventhal, Ph.D.1,3
1Department of Preventive Medicine, Keck School of Medicine, University of Southern California,
Los Angeles, CA, USA
2Department of Psychology, University of North Texas, Denton, TX, USA
3Department of Psychology, University of Southern California, Los Angeles, CA, USA
Abstract
The first cigarette of the day is strongly tied to tobacco dependence. However, prior research has
not investigated whether within-person day-to-day fluctuations in pre-first-cigarette affect are
associated with the subjective effects from the first cigarette of the day, or if these associations
differ by smokers’ average pre-first-cigarette affect. In the current study, 85 premenopausal female
daily smokers completed baseline measures and 35 days of ecological momentary assessment
(EMA). Pre-first-cigarette positive affect (PA) and negative affect (NA) were assessed prior to the
first cigarette of the day and were partitioned into between-subjects (BS) and within-subject (WS)
variables. Pleasurable and NA relief effects were assessed following the first cigarette of the day.
On days where females reported higher than their usual pre-first-cigarette PA (WS-PA), they
reported more pleasurable effects. On days where females reported higher than their usual pre-
first-cigarette WS-NA, they reported greater pleasurable effects and NA relief effects. Females
with higher average pre-first-cigarette NA relative to others (BS-NA), reported greater NA relief
effects. Females with higher average pre-first-cigarette PA relative to others (BS-PA) reported
greater pleasurable and NA relief effects from smoking. The association of within-person affect
(i.e., that day’s level of NA or PA) with NA relief effects is attenuated in female smokers with
higher average pre-first-cigarette NA (i.e., pre-first-cigarette WS-affect × pre-first-cigarette BS-
NA interaction). Results suggest that pre-first-cigarette affect may impact the subjective effects
from the first cigarette of the day, and that the association between pre-first-cigarette affect and
NA relief effects may be dampened in females with greater average pre-cigarette NA.
Keywords
Cigarette effects; affect; female smokers; first cigarette of the day
Correspondence concerning this article should be addressed to Raina D. Pang, Keck School of Medicine of the University of Southern
California, Department of Preventive Medicine, 2001 N. Soto Street, Room 312E, Los Angeles, CA 90032; Tel: 1-323-442-7251; Fax:
1-323-442-2359; rpang@usc.edu.
All authors contributed in a significant way to the manuscript and all authors have read and approved the final manuscript.
Disclosures
None of the authors report a conflict of interest related to submission of this manuscript.
HHS Public Access
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Affective models of drug addiction posit that affective states act as important motivators in
drug use behavior through affect regulatory processes and negative reinforcing effects
(Baker, Piper, McCarthy, Majeskie, & Fiore, 2004), which may be particularly relevant to
female cigarette smokers. Prior studies have found that females compared to males
experience greater increases in negative affect (NA) during acute tobacco abstinence
(Faulkner et al., 2018; Leventhal et al., 2007; Pang & Leventhal, 2013; Perkins, Karelitz,
Giedgowd, & Conklin, 2013; Weinberger, Platt, Shuter, & Goodwin, 2016; Xu et al., 2008)
and greater withdrawal relief from smoking (Xu et al., 2008) and may be more likely to
smoke in response to increased NA (Weinberger & McKee, 2012). As such, understanding
how affect relates to smoking outcomes may be of particular importance in female smokers.
In relation to affective models of cigarette effects, the first cigarette of the day may be
especially relevant to consider given that it is strongly tied to tobacco dependence (Baker et
al., 2007; Fagerström, 2003; Heatherton, Kozlowski, Frecker, & Fagerström, 1991), which is
probably largely due to the first cigarette of the day coming after the longest period of
tobacco abstinence regularly experienced by most moderate-to-heavy daily smokers—
overnight sleep. To more specifically link the first cigarette of the day with affect regulation,
one prior study found that greater positive affect (PA) enhancement following administration
of the first cigarette of the day predicted relapse during a smoking cessation attempt (Strong
et al., 2011). Thus, examining the relations between the first cigarette of the day, affect, and
cigarette effects among female smokers may provide insight into etiological mechanisms
underlying sex differences in smoking-related affect regulation.
Consistent with affect regulatory theories of smoking, prior laboratory-based studies have
found that smoking reduces NA during both positive and negative mood inductions (Perkins
et al., 2008; Perkins, Karelitz, Conklin, Sayette, & Giedgowd, 2010). Laboratory-based
studies have also found that smoking maintains PA during positive mood induction (Perkins
et al., 2008), which may suggest that higher PA prior to smoking increases PA regulatory
processes of smoking. Though such experimental evidence indicates that affective states
experienced prior to smoking a cigarette can influence affect-related cigarette effects, there
is a relative dearth of evidence about whether these findings generalize to naturalistic
affective situations, which is essential for understanding how these processes operate in the
natural ecology.
In addition to generalizing results to the natural ecology, it is important to understand
whether associations of
within
-subject pre-first-cigarette affective states (that is, day-to-day
fluctuations in pre-first-cigarette affect) with post-first-cigarette effects may vary as a
function of pre-first cigarette affective states
across
people (i.e.,
between
-subjects; individual
differences in “usual” or average pre-first-cigarette affect). Such evidence could inform
personalized treatment approaches for targeting affect in smoking cessation for emotionally
vulnerable populations (i.e., smokers characterized by low average PA and/or high average
NA relative to other smokers) as well as advance models of affective mechanisms of tobacco
addiction. A prior study found that smokers with a history of depression (i.e., smokers prone
to experiencing states of high NA and low PA) compared to smokers without a history of
depression reported greater expectations that smoking would acutely be pleasurable and
relieve NA (Weinberger, George, & McKee, 2011). Another study found that depressed
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smokers compared to psychiatrically healthy smokers placed a higher reward value on
smoking (Spring, Pingitore, & McChargue, 2003). Taken together, these findings suggest
that smokers with relatively low PA and/or high NA may expect more positive cigarette
effects (i.e., pleasurable effects, NA relief effects).
In this study, premenopausal female daily smokers smoking as usual completed 35 days of
ecological momentary assessment (EMA), which includes real-time assessment of behavior
in the natural ecology. This methodology is particularly well-suited for studying episodic
behavior such as smoking (Shiffman, 2009) and is able to assess naturalistic affect prior to
smoking the first cigarette of the day. We hypothesized that, on days when pre-first-cigarette
WS-PA and pre-first-cigarette WS-NA were higher, that cigarette effects would be greater.
Based on research showing increased expectations for pleasurable and NA relief effects of
smoking among individuals with emotional vulnerability, we further hypothesized that those
with high pre-first-cigarette BS-NA and/or low pre-first-cigarette BS-PA would also report
greater cigarette effects. Given the limited literature on interactions of WS and BS affect
with cigarette effects, we did not propose any specific hypotheses in regard to these
interactions.
Method
Participants
The current report is a secondary analysis of EMA data from non-treatment seeking daily
smokers recruited from the greater Los Angeles area via advertisements for a paid
smartphone-based study of premenopausal female smokers. The University of Southern
California Internal Review Board approved all procedures, and all participants provided
informed consent. Inclusion criteria required participants to (a) be 18–40 years of age, (b) be
a female with self-reported regular menstrual cycles lasting 24–35 days in the past 3 months,
(c) be a regular smoker (≥8 cigarettes/day) for at least the past year, (d) have normal
eyesight, (e) be fluent in English, and (f) own a smartphone. Exclusion criteria included (a)
baseline breath carbon monoxide (CO) level of <9 ppm, (b) current use of nicotine
replacement therapy, psychiatric medication implicated in smoking cessation, or regular use
of any other non-cigarette tobacco products, (c) past 3-month use of hormonal medication
including birth control or intent to start hormonal medication in the next 35 days, (d) history
of hysterectomy or intent to obtain hysterectomy in the next 35 days, (e) a desire to quit or to
substantially reduce smoking in the next 35 days, (f) pregnancy or breastfeeding in the past 6
months or intent to get pregnant in the next 35 days, and (g) having a condition that might
affect menstrual cycle function.
One hundred and one participants were deemed eligible at Study Visit 1 and proceeded to
the EMA study. Of these, 16 participants were removed from analyses due to: 1) self-
disclosure at the debriefing of a potential psychotic episode during EMA data collection
(
n
=1), 2) becoming pregnant during EMA data collection (
n
=1), and 3) non-compliant pre-
first-cigarette and post-first cigarette surveys (
n
=14; see Data Analysis). This left a final
analytic sample of 85 participants.
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Design & Procedure
Participants came to the laboratory for two study visits and completed 35 days of EMA. Day
1 was used to allow participants to practice responding to prompts and was excluded from
analyses, leaving up to 34 days of data for each participant. Study Visit 1 was used to obtain
informed consent, confirm study eligibility, administer baseline questionnaires, program
participants’ smartphones with EMA survey application, and provide instructions for EMA
and in-home salivary hormone collection procedures. Participants returned for a second
study visit at the end of EMA to return saliva samples.
EMA data was collected via the commercially available LifeData system
(www.lifedatacorp.com). Participants were instructed to record when they were about to
smoke a cigarette. After reporting their intention to initiate smoking, participants then
indicated whether it was “my first cigarette of the day” or “another cigarette today”.
Immediately after making an entry indicating intention to smoke the first cigarette of a given
day, but prior to lighting the cigarette, participants were instructed to complete questions
assessing pre-first-cigarette affect (described below). Upon completion of smoking the first
cigarette of a given day, participants were instructed to immediately answer post-first-
cigarette questions assessing the subjective effects of smoking (described below). Adherence
to the study protocol and continued eligibility for the study were continuously assessed by
study staff, who sent participants phone calls or texts to review study compliance and answer
participant questions approximately twice a week during the 35 days of EMA. Participants
who maintained an average survey compliance of less than 65% for over a week and a half
were dropped from further participation. Participants were paid at the end of every week
they were enrolled (payment based on survey compliance level: 85% and greater, 65% to
84%, and below 65% with a bonus for weeks with 100% compliance) and were paid for
salivary hormone samples when they were returned during Study Visit 2. In total,
participants could earn up to $515 for completing the study.
Measures
Baseline measures.—Baseline measures collected at Study Visit 1 were collected and
managed using REDCap electronic data capture tools hosted at University of Southern
California (Harris et al., 2009). Race was assessed using an author-constructed questionnaire
that assessed demographic information and was dichotomized as non-Hispanic White vs.
Other. We included race as a covariate due to findings from a prior study that sex differences
in tobacco withdrawal occurred in non-Hispanic Whites but not non-Hispanic African
Americans (Pang, Bello, Liautaud, Weinberger, & Leventhal, 2018). The Fagerström Test for
Cigarette Dependence (FTCD; Fagerström, 2003; Fagerström, 2012) is a 6-item self-report
measure of cigarette dependence severity. Scores range from 0 to 10, with higher scores
reflecting greater cigarette dependence. We included FTCD as a covariate given the
importance of time to first cigarette of the day to tobacco dependence (Fagerström, 2003).
The Center for Epidemiologic Studies Depression Scale (CES-D; Radloff, 1977) is a 20-
item self-report scale designed to assess the frequency “during the past week” of various
feelings and behaviors that capture symptoms of depression (i.e., depressed mood, feelings
of guilt and worthlessness, psychomotor retardation, loss of appetite, and sleep disturbance)
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on 4-point Likert scales ranging from 0 (
Rarely or none of the time, 0–1 days
) to 3 (
Most or
all of the time, 5–7 days
). For this study, a cutoff score of 20 was utilized to dichotomize
CES-D scores into those with probable clinical depression (1) or subclinical depression (0),
which was found to have the best trade-off between specificity and sensitivity in a meta-
analysis (Vilagut, Forero, Barbaglia, & Alonso, 2016). We included CES-D as a covariate to
control for baseline frequency of depressive symptoms because history of major depressive
disorder has been found to associate with cigarette reinforcement (Weinberger et al., 2011).
Ecological Momentary Assessment (EMA) Measures.
Pre-first-cigarette affect.—Pre-first-cigarette affect was assessed with items asking
participants to rate the extent to which they experienced PA (4 items: happy, content,
relaxed, cheerful) and NA (4 items: tense or anxious, sad or blue, irritable or easily angered,
unable to cope or overwhelmed by ordinary demands) during the past 30 minutes. Responses
were recorded on a slider scale ranging from
not at all
(1) to
extremely
(6), with higher
scores indicating greater pre-first-cigarette PA and NA.
Post-first-cigarette effects.—Following completion of the first cigarette of the day,
participants responded to single item measures of pleasurable effects (i.e., “Was the last
cigarette pleasurable?”) and NA relief effects (i.e., “Did the last cigarette relieve unwanted
feelings or symptoms?”). Responses were recorded on a slider scale ranging from
not at all
(1) to
extremely
(6), with higher scores indicating greater pleasurable and NA relief effects.
Data Analysis
We validated the temporal sequence of the pre- and post-first-cigarette measures by limiting
the analyses to days where: 1) both pre- and post-first-cigarette measures were completed, 2)
pre-first-cigarette measures were started at least 3 minutes prior to the post-first-cigarette
measures (based on prior studies showing that some individuals smoke cigarettes within 3
minutes; Kelly, Foltin, Rose, Fischman, & Brady, 1990), and 3) the post-first-cigarette
measures were started within 60 minutes of the pre-first-cigarette measures (to remove those
completing the post-first-cigarette measures after too much time had passed since smoking
the first cigarette of the day). In total, 1556 data points from 85 unique participants were
included in the analyses.
Sample characteristics and average post-first-cigarette pleasurable and NA relief effects are
reported in Table 1. Primary aims were evaluated using multilevel linear models in which
repeated assessments (i.e., days) were nested within participants to test the associations
between pre-first-cigarette PA/NA and post-first-cigarette effects controlling for the
following covariates: time involved in the study (weeks), cigarette dependence severity,
depression (probable clinical depression vs. subclinical depression), and race (Non-Hispanic
White vs. Other). Cigarette dependence severity was grand mean centered. Pre-first-cigarette
PA/NA were partitioned into between-subjects (BS; Level-2) and within-subject (WS;
Level-1) variables. BS variables were operationalized as the participant’s mean across all
completed pre-first-cigarette affect prompts and were grand mean centered. WS variables
reflected whether that day’s pre-first-cigarette affect level was higher or lower than that
person’s usual (or average) pre-first-cigarette affect.
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Model 1 tested the main effects of pre-first-cigarette WS-PA/NA and pre-first-cigarette BS-
PA/NA on post-first-cigarette pleasurable and NA relief effects, controlling for covariates.
Model 2 included the interaction of WS and BS effects of NA and PA variables. Model 3
included the interactions between WS-PA × BS-NA and WS-NA × BS-PA, to investigate
potential cross affect interactions between PA and NA. Significant interactions were plotted
using estimated marginal means at 1
SD
above and 1
SD
below the mean for WS and BS
variables. Analyses were conducted in SPSS v. 24.
Results
Sample Characteristics.
Table 1 summarizes the participant characteristics and the average post-first-cigarette effects
for the overall sample. Across the sample, 8.2% of reported first cigarettes of the day were
smoked within the first 5 minutes of waking up, and there was an average time of 14.67
(
SD=
11.73) minutes between the start of the pre-first-cigarette surveys and the start of the
post-first-cigarette surveys. Participants completed an average of 25 (
Range:
1–34) pairs of
pre-first-cigarette and post-first-cigarette surveys.
Pre-first-cigarette NA.
On days where participants reported higher than their usual pre-first-cigarette NA, they also
tended to report greater pleasurable and NA relief effects (WS-NA:
estimates
=0.09 to 0.13,
p
<.05; Table 2). There was a significant effect for overall pre-first-cigarette NA on post-first-
cigarette NA relief effects, such that participants with higher average levels of pre-first-
cigarette NA reported greater post-first-cigarette NA relief effects (BS-NA:
estimate
=0.50,
p
= .002; Table 2). There was also a significant pre-first-cigarette WS-NA × pre-first-
cigarette BS-NA interaction for post-first-cigarette NA relief effects (WS-NA × BS-NA:
estimate
=−0.13,
p
=.002 ; Table 2), such that the association of that day’s level of pre-first-
cigarette NA (i.e., WS-NA) with that day’s post-first-cigarette NA relief effects was stronger
among women with lower (vs. higher) average levels of pre-first-cigarette NA (Figure 1a).
Pre-first-cigarette PA.
On days where participants reported higher pre-first-cigarette PA than their usual level, they
also tended to report greater post-first-cigarette pleasurable effects (WS-PA:
estimate
=0.09,
p
=.002; Table 2). Participants who reported, on average, higher pre-first-cigarette PA also
tended to report greater post-first-cigarette pleasurable and NA relief effects (BS-PA:
estimate
=0.27 to 0.31,
p
s<.05; Table 2). There were no significant interactions between WS-
PA × BS-PA (Table 2).
Cross affect interactions.
There was a significant pre-first-cigarette WS-NA × BS-PA interaction on post-first-cigarette
NA relief effects (WS-NA× BS-PA:
estimate
=0.08,
p
=.02; Table 2). This interaction shows
that higher than usual pre-first-cigarette NA (WS-NA) was associated with increased post-
first-cigarette NA relief effects among participants with on average greater pre-first-cigarette
PA (BS-PA; Figure 1b). There was also a significant pre-first-cigarette WS-PA × BS-NA
interaction on post-first-cigarette NA relief effects (WS-PA× BS-NA:
estimate
=0.08,
p
=.03;
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Table 2). This interaction shows that higher than usual pre-first-cigarette PA (WS-PA) was
associated with decreased post-first-cigarette NA relief effects only among participants with
on average low pre-first-cigarette NA (BS-NA; Figure 1c). There were no significant cross
affect interactions for post-first-cigarette pleasurable effects (Table 2).
Discussion
This study of premenopausal female smokers found that on days when pre-first-cigarette
WS-NA was higher than usual, females reported greater pleasurable effects and NA relief
effects. This finding extends prior laboratory-based research showing that inducing NA prior
to smoking increases the NA relieving effects of smoking (Perkins et al., 2008; Perkins et
al., 2010). Interestingly, one prior laboratory-based study found that the impact of pre-
cigarette NA on post-cigarette NA varied depending on the source of NA (i.e., NA-related
tobacco withdrawal vs. negative mood induction), with the tobacco withdrawal condition
showing the most robust effect on changes in NA pre-to-post-cigarette administration
(Perkins et al., 2010). As the current study only investigated the first cigarette of the day,
which follows a period of overnight tobacco abstinence, it is unclear whether past and
present findings generalize to pre-cigarette NA that is not related to tobacco abstinence.
Additionally, it is possible that relief of withdrawal symptoms may also be interpreted by
smokers as being pleasurable, which may underlie associations between WS-NA and
pleasurable effects found in this study.
We also found that females with on average higher pre-first-cigarette NA reported greater
post-first-cigarette NA relief effects. This finding is consistent with prior studies showing
that smokers with greater emotional vulnerability (e.g., emotion dysregulation, history of
depression) report greater expectations that smoking relieves NA (Johnson et al., 2008;
Weinberger et al., 2011). Interaction analyses showed that associations between that day’s
affect (i.e., WS-affect) on post-first-cigarette NA relief effects varied depending on the
person’s average pre-first-cigarette NA (i.e., BS-NA; see Table 2, Models 2 & 3).
Specifically, female smokers with higher average pre-first-cigarette NA reported greater NA
relief effects from the first cigarette of the day and the level of NA relief on any given day
was less associated with that days level of pre-first-cigarette affect (see Figures 1a & 1b).
Female smokers with lower average pre-first-cigarette NA reported greater post-first-
cigarette NA relief effects on days when they experience higher than usual pre-first-cigarette
NA (Figure 1a) and lower post-first-cigarette NA relief effects on days they experience
higher than usual pre-first-cigarette PA (Figure 1b).
Pre-first-cigarette PA also associated with post-first-cigarette effects. On days when pre-
first-cigarette WS-PA was higher than their usual, female smokers reported greater post-
first-cigarette pleasurable effects. One prior laboratory study found that smoking maintained
PA only during a positive mood induction (Perkins et al., 2008). Thus, it is possible that
cigarettes may be more pleasurable when an individual is experiencing higher than usual PA.
We also found that female smokers with on average higher pre-first-cigarette BS-PA
reported greater pleasurable effects and NA relief effects. There was an interaction between
BS-PA and WS-NA on NA relief effects (see Table 2, Model 3) such that those with on
average higher pre-first-cigarette PA than other female smokers (BS-PA) reported greater
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NA relief effects, which was stronger on days marked by increased pre-first cigarette NA
(WS-NA, Figure 1c). This finding contradicts our hypotheses that those with low PA would
report greater cigarette effects, which is based on literature related to smoking in individuals
with emotional vulnerability (Johnson et al., 2008; Weinberger et al., 2011). However,
studies have found that tobacco abstinence-related reduction in reward responsivity (Hughes
et al., 2017; Pergadia et al., 2014) may be particularly robust in anhedonic smokers (i.e.,
smokers characterized by clinically low levels of PA; Leventhal et al., 2012). Thus, it is
possible that those with on average low PA are less responsive to the affect-regulating effects
of smoking in the context of the first cigarette of the day, given that it follows a period of
brief overnight abstinence.
This study needs to be interpreted in the context of its limitations. First, this study was
conducted in naturally-cycling premenopausal female smokers that were not intending to
quit smoking. While this limits our ability to generalize to male or treatment-seeking
samples of smokers, evidence suggests that females may have an especially hard time
quitting smoking (McKee, Smith, Kaufman, Mazure, & Weinberger, 2015; Smith, Bessette,
Weinberger, Sheffer, & McKee, 2016; Smith et al., 2015) and that sex differences exist in
potentially important mechanisms that serve to maintain smoking and drive smoking
reinstatement. In particular, sex differences in affective mechanisms of smoking have been
found in laboratory and smoking cessation studies (Messer, Siegel, Bertin, & Erblich, 2018;
Pang, Zvolensky, Schmidt, & Leventhal, 2015; Perkins et al., 2010; Perkins et al., 2013;
Pulvers et al., 2004; Weinberger et al., 2016). Thus, there is value in investigating the impact
of affect in female only samples as an important first step in developing smoking cessation
treatments tailored to female smokers. Second, this study only measured pre-cigarette affect
and post-cigarette effects immediately preceding and following the first cigarette of the day,
respectively. Given that the first cigarette of the day follows a period of overnight tobacco
abstinence, it is possible that these findings are specific to tobacco withdrawal. It will be
important for future studies to compare the current findings involving the first cigarette of
the day to other cigarettes smoked throughout the day. Similarly, this study assessed
subjectively experienced post-first-cigarette effects but did not measure post-first-cigarette
affect. Thus, it is unclear the extent to which smoking changed NA and PA.
Despite these limitations, these findings extend the current literature in several ways. This
study demonstrates that naturalistic variation in affect prior to smoking the first cigarette of
the day impacts the subjective effects from smoking. In particular, we found that female
smokers with on average high NA relative to others reported greater NA relief effects from
smoking, and female smokers with on average low PA relative to others reported less
pleasurable and NA relief effects from smoking. These findings may suggest that closer
investigation of emotional vulnerability may need to separate individuals with low PA and
high NA. We also found that among female smokers higher than usual PA was associated
with greater pleasurable cigarette effects, and higher than usual NA was associated with
greater pleasurable and NA relief effects from smoking. These findings extend laboratory
studies to suggest naturalistic variation in pre-cigarette affect may impact smoking-related
pleasurable and NA relieving effects. Lastly, this study demonstrated that among female
smokers day-level pre-cigarette NA may interact with the average level of NA on the NA
relief effects from smoking. Specifically, this study found that the association of within-
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person NA (i.e., that day’s level of NA) with NA relief effects is attenuated in female
smokers with higher average pre-first-cigarette NA. This is important as it suggests that
individuals with on average greater NA may exhibit a more stable sensitivity to NA relief
effects from smoking, such that it may render it more difficult to modify NA relieving
cigarette effects in these individuals by altering state affect. As such, these findings
contribute to a growing body of literature suggestive of a distinct role of PA and NA in
relation to smoking-related outcomes.
Acknowledgements
This research was supported by funds from NIDA grant K01-DA040043 and NSF Graduate Research Fellowship
Grant DGE-1418060. Preliminary results of this manuscript were presented at the 2019 Society for Research on
Nicotine and Tobacco Conference.
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Public Health Significance:
Within-person day-to-day fluctuations in positive and negative affect and between-person
variations in average positive and negative affect jointly influenced the level of pleasure
and relief from unwanted feelings that female smokers reported in response to smoking
the first cigarette of the day. This study provides initial evidence that both within-person
daily changes in affect and individual differences in typical affect may contribute to
motivation to smoke cigarettes in females.
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Figure 1. Interaction of WS and BS pre-first-cigarette affect on post-first-cigarette effects.
Note:
Estimated marginal means ± standard error at 1
SD
below and 1
SD
above the mean
for WS and BS variables of a) WS-NA × BS-NA associations with NA relief effects; b) WS-
PA × BS-NA associations with NA relief effects; and c) WS-NA × BS-PA associations with
NA relief effects. PA = positive affect; NA= negative affect; WS = within-subject; BS =
between-subjects.
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Table 1.
Sample descriptives and average cigarette effects in the sample (N=85)
M (SD) or N (%)
Demographics
Age 31.65 (5.69)
Race
Non-Hispanic White 27 (31.8%)
Non-Hispanic Black 22 (25.9%)
Hispanic (any race) 14 (16.5%)
Other 22 (25.8%)
Depressed (CESD >19) 27 (31.8%)
Smoking Characteristics
Years Regular Smoker 12.39 (6.45)
FTCD 4.59 (1.97)
Baseline CO 19.09 (7.86)
Average Cigarettes/Day 10.01 (3.65)
Cigarette Effects
Pleasurable effects 4.24 (0.94)
NA relief effects 3.36 (1.16)
Note.
CES-D = Center for Epidemiological Study of Depression; FTCD = Fagerström Test for Cigarette Dependence; CO = carbon monoxide.
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Table 2.
Associations of Pre-Cigarette Affect with Post Cigarette Effects
Pleasurable effects NA relief effects
Model 1
Estimate (SE)Model 2
Estimate (SE)Model 3
Estimate (SE)Model 1
Estimate (SE)Model 2
Estimate (SE)Model 3
Estimate (SE)
Intercept 4.30 (0.20)*** 4.30 (0.20)*** 4.31 (0.20)*** 3.39 (0.22)*** 3.37 (0.22)*** 3.38 (0.22)***
Within-Subject (WS)
Time in study (weeks) −0.04 (0.02)* −0.04 (0.02)* −0.04 (0.02)* 0.00 (0.02) 0.00 (0.02) 0.00 (0.02)
Pre-cigarette PA 0.09 (0.03)** 0.09 (0.03)** 0.09 (0.03)** −0.03 (0.03) −0.02 (0.03) −0.02 (0.03)
Pre-cigarette NA 0.13 (0.03)*** 0.13 (0.03)*** 0.12 (0.03)*** 0.09 (0.04)* 0.13 (0.04)** 0.11 (0.04)**
Between-Subject (BS)
FTND 0.07 (0.05) 0.07 (0.05) 0.07 (0.05) 0.18 (0.06)** 0.18 (0.06)** 0.18 (0.06)**
CESD 0.14 (0.23) 0.14 (0.23) 0.14 (0.23) 0.20 (0.26) 0.20 (0.26) 0.20 (0.26)
White −0.05 (0.22) −0.05 (0.22) −0.05 (0.22) −0.19 (0.24) −0.19 (0.24) −0.19 (0.24)
Pre-cigarette PA 0.27 (0.12)* 0.27 (0.12)* 0.27 (0.12)* 0.31 (0.13)* 0.31 (0.13)* 0.31 (0.13)*
Pre-cigarette NA 0.17 (0.14) 0.17 (0.14) 0.17 (0.14) 0.50 (0.16)** 0.50 (0.16)** 0.50 (0.16)**
Interaction Terms
WS-PA × BS-PA 0.00 (0.03) −0.04 (0.03)
WS-NA × BS-NA 0.00 (0.04) −0.13 (0.04)**
WS-NA × BS-PA −0.02 (0.03) 0.08 (0.03)*
WS-PA × BS-NA −0.05 (0.03) 0.08 (0.04)*
Note.
PA = positive affect; NA = negative affect; FTCD = Fagerström Test for Cigarette Dependence; CES-D = Center for Epidemiological Study
of Depression. CES-D coded 0 = subclinical depression, 1 = probable clinical depression. White coded 0 = Non-Hispanic White, 1 = Other.
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