Real-time craving and mood assessments before and after smoking

Abstract

This study explored some quandaries concerning craving and mood as motivators to smoke. Craving and negative mood have long been associated with day-to-day smoking as two of the primary motivational forces behind the maintenance of the behavior, as well as significant barriers in smokers' attempts to quit. Craving remains a clinically relevant phenomenon, with most smokers describing craving as a troublesome problem when quitting. Smokers' self-reports of negative mood, as an antecedent for smoking, are so robustly reported that many models of nicotine dependence have incorporated a critical role for negative mood in maintaining smoking behavior. However, several naturalistic studies that collected mood ratings with hand held computers from smokers in real time, just before smoking a cigarette, have provided scant evidence that negative mood plays a major role in motivation to smoke. No study to date has examined craving and mood data as a consequence of smoking, that is, collecting the same data immediately after smoking. This study used personal digital assistants (PDAs) to collect craving and mood data immediately before smoking, immediately after smoking, and at random times of day. Nontreatment seeking smokers (N = 72) carried a PDA for an average of 10 days while they recorded their smoking behavior. Results showed that craving and negative mood ratings were lowest immediately after smoking compared with immediately before smoking and at random times of day. These findings suggest that smokers may be at least partially motivated to smoke to lower their craving and improve their mood states.

Figure 1

Mean craving scores by assessment type. Note: Standard error bars were omitted because the size of the standard errors (~.021) lacks visual utility. Means and standard deviations were Before=3.89 (SD=.44), After 2.97, (SD=.67), and Random 3.21 (SD=.78). All means were significantly different from each other at the p<.0001 level using Bonferroni adjustment.

Figure 2

Mean negative mood scores by assessment type. Note: Standard error bars were omitted because the size of the standard errors (~.015) lacks visual utility. Also note that the y-axis has been truncated to illustrate the effect. Means and standard deviations were Before=2.22 (SD=.54), After 2.15, (SD=.54), and Random 2.23, (SD=.55). Before and Random means were not significantly different, but both were significant from After at the p<.05 level using Bonferroni adjustment.