Smoking is Associated with Worse Mood on Stressful Days: Results from a National Diary Study
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ORIGINAL ARTICLE
Smoking is Associated with Worse Mood on Stressful Days: Results from a National Diary Study Keith R. Aronson, Ph.D. & David M. Almeida, Ph.D. & Robert S. Stawski, Ph.D. & Laura Cousino Klein, Ph.D. & Lynn T. Kozlowski, Ph.D.
Published online: 6 December 2008 # The Society of Behavioral Medicine 2008
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 modeling K. R. Aronson : D. M. Almeida : R. S. Stawski The Pennsylvania State University, University Park, PA 16802, USA L. T. Kozlowski State University of New York, Buffalo, NY, USA K. R. Aronson (*) Social Science Research Institute, The Pennsylvania State University, University Park, PA 16802, USA e-mail: [email protected]
: L. C. Klein
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. Keywords Smoking . Smoker . Negative effect . NSDE . Stress
Introduction Despite the well-documented public health threat and tremendous economic costs associated with cigarette smoking [1], approximately 21% of the US population continues to smoke [2]. Smokers often report that they continue to smoke because it helps them regulate their affective states [3, 4]. In particular, virtually all smokers report that when confronted with stressors and emotional upset, smoking helps reduce
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