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Momentary changes in craving predict smoking lapse behavior: a laboratory study

Abstract

Rationale

Current research on factors that predict smoking lapse behavior is limited in its ability to fully characterize the critical moments leading up to decisions to smoke.

Objectives

We used a validated and widely used experimental analogue for smoking lapse to assess how moment-to-moment dynamics of craving relate to decisions to smoke.

Methods

Heavy smokers (N = 128, M age = 35.9) participated in a 50-min laboratory delay to smoking task on 2 consecutive days, earning money for each 5 min they remained abstinent or ending the task by choosing to smoke. Participants rated craving and negative affect levels immediately prior to each choice. Participants were randomized to smoking as usual (n = 50) or overnight abstinence (n = 50 successfully abstained, n = 22 failed abstaining) prior to session 2. Discrete-time hazard models were used to examine craving and negative affect as time-varying predictors of smoking.

Results

Higher craving levels prior to smoking opportunities predicted increased risk of smoking. When controlling for craving levels, incremental increases in craving predicted increased smoking risk. Increases in negative affect incrementally predicted increased smoking risk at session 2 only. Smokers who failed to abstain were at a higher risk of smoking than those who successfully abstained, whereas abstinent and non-abstinent smokers did not differ in smoking risk.

Conclusions

Findings demonstrate an extension of the smoking lapse paradigm that can be utilized to capture momentary changes in craving that predict smoking behavior. Evaluations of nuanced craving experiences may inform clinical and pharmacological research on preventing smoking lapse and relapse.

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Fig. 1

Notes

  1. The six participants missing from session 2 either did not return for the session (n = 5) or a computer malfunction resulted in missing data for session 2.

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Acknowledgements

The authors would like to acknowledge Dr. Craig Colder for his assistance with data analyses reported in this manuscript.

Funding

This research was supported by the American Psychological Association (Dissertation Research Award), the Bugelski Fellowship (Department of Psychology, University at Buffalo, SUNY), and the Mark Diamond Research Fund (Graduate Student Association, University at Buffalo, SUNY) awarded to co-author LJG.

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Authors and Affiliations

Authors

Corresponding author

Correspondence to Stephen T. Tiffany.

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Conflict of interest

Courtney A. Motschman, Lisa G. Germeroth, and Stephen T. Tiffany declare that they have no conflicts of interest. This research was approved by the Institutional Review Board (IRB) at the University at Buffalo, State University of New York. All participants provided written informed consent prior to their participation.

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Motschman, C.A., Germeroth, L.J. & Tiffany, S.T. Momentary changes in craving predict smoking lapse behavior: a laboratory study. Psychopharmacology 235, 2001–2012 (2018). https://doi.org/10.1007/s00213-018-4898-4

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  • DOI: https://doi.org/10.1007/s00213-018-4898-4

Keywords

  • Smoking
  • Lapse
  • Relapse
  • Craving
  • Cessation