Pitt Researchers Conclude Mood Does Not Usually Influence Smoking Habits of Longtime Smokers Study Gathers Data in Real Time Using Electronic Diary

November 20, 2002

PITTSBURGH—In what is believed to be the first study of its type regarding ongoing smoking, a team of researchers at the University of Pittsburgh has concluded that cigarette smoking might not be as directly related to the smoker's mood as researchers had previously thought.

The study, "Immediate Antecedents of Cigarette Smoking: An Analysis From Ecological Momentary Assessment," can be found in the November 2002 edition of the Journal of Abnormal Psychology. The researchers, led by Saul Shiffman, professor of psychology, recruited 304 heavy smokers who had enrolled in a smoking cessation program. Each participant was trained to use a handheld computer or electronic diary (ED) to record data. Smokers were required to push a button on the ED to keep a record of every time they smoked a cigarette.

In addition, about four or five times a day, the ED would randomly assess the circumstances surrounding a person's smoking, posing questions on the handheld device for the smoker to answer. The smokers were asked to enter information about their mood, their urge to smoke, their location, and their activity at the time.

Participants also were randomly "beeped" by the ED four or five times a day and asked to enter information about times when they were not smoking. Thus, the study used technology and novel methodology to assess smoking in real time, in the smokers' natural environment. At the end of a one-week period, the EDs had calculated equations and contrasted 10,084 instances of smoking with 11,155 nonsmoking situations.

The study found that smoking was strongly related to smoking urges and that people were more likely to smoke when they drank coffee, ate food, were around other smokers, or were engaged in leisure activities. But smoking was not related to positive or negative mood or arousal. At the time participants were moved to smoke, they felt neither better nor worse than they did when they were not smoking.

"We have long believed that smoking was triggered by negative moods, based on smokers' own beliefs," says Shiffman. "However, this more direct and valid research method shows that smoking is not usually related to mood. This should make us reevaluate our basic models of smoking behavior."

Most of the evidence indicating that negative emotions prompt people to smoke comes from information smokers reported on questionnaires, information that can be unreliable. Shiffman and his colleagues believe questionnaire methods give a false picture of smoking situations because smokers form their beliefs about why they smoke as they first take up the habit, when mood might really influence smoking. Shiffman said smokers continue to report this belief even after these associations have disappeared—when smoking is driven primarily by nicotine regulation, triggered by the brain.

Shiffman's team also concluded that:

• While overall mood was not associated with smoking, restlessness showed a modest association, reflecting, the authors believe, the influence of nicotine withdrawal that smokers experience in the interval between cigarettes;

• Social cues influenced smoking, making it more likely the participants would smoke when they were around other people who were smoking;

• Participants were more likely to smoke when they had been eating or drinking; and

• Participants seemed to smoke more often during breaks from their daily routine.

The study was funded by a grant from the National Institute on Drug Abuse. Shiffman's team included Department of Psychology researcher Kenneth Liu and former graduate students Chad Gwaltney, Mark Balabanis, Jean Paty, Jon Kassel, Mary Hickcox, and Maryann Gnys.

"The improved research methods used in this study allowed us to get beyond what smokers believe about their behavior to capture what is really going on," Shiffman says. "They are likely to revolutionize our understanding not only of smoking, but of many behaviors and clinical symptoms."

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11/20/02/tmw