An Ecological Momentary Assessment analysis of relations among coping, affect and smoking during a quit attempt

Abstract

Aims-This study used Ecological Momentary Assessment (EMA) data from smokers trying to quit to assess relations among coping, positive affect, negative affect, and smoking. The effects of stress coping on affect and smoking were examined.Design-Data from a randomized clinical trial of smoking cessation treatments were submitted to multilevel modeling to test the effects of coping with stressful events on subsequent affect and smoking.Participants-372 adult, daily smokers who reported at least one stressful event and coping episode and provided post-quit data.Measurements-Participants' smoking, coping, and affect were assessed in near real time with multiple EMA reports using electronic diaries pre-and post-quit.Findings-Multilevel models indicated that a single coping episode did not predict a change in smoking risk over the next 4 or 48 hours, but coping in men was associated with concurrent reports of increased smoking. Coping predicted improved positive and negative affect reported within 4 hours of coping, but these affective gains did not predict reduced likelihood of later smoking. Pre-quit coping frequency and gender moderated post-quit stress coping relations with later positive affect. Men and those with greater pre-quit coping frequency reported greater gains in positive affect following post-quit coping.Conclusions-Coping responses early in a quit attempt may help smokers trying to quit feel better but may not help them stay smoke-free.

Conceptualizing Analyses of Ecological Momentary Assessment Data

“…Accordingly, it is not surprising that EMA methods are being widely applied to studies of tobacco use, particularly smoking. EMA methods have been used to study antecedents and consequences of smoking in adolescents (Mermelstein, Hedeker, & Wesintein, 2010) and adults (Carter et al, 2010;Warthen & Tiffany, 2009), in smokers with posttraumatic stress disorder and other disorders (Beckham et al, 2008;Epstein, Marrone, Heishman, Schmittner, & Preston, 2010;Piper, Cook, Schlam, Jorenby, & Baker, 2011), during ad libitum smoking (Shapiro, Jamner, Davydov, & James, 2002) and smoking cessation (Bolt, Piper, Theobald, & Baker, 2012;Cooney et al, 2007;Minami, McCarthy, Jorenby, & Baker, 2011), and in relation to a range of variables ranging from alcohol use (Holt, Litt, & Cooney, 2012;Piasecki, Wood, Shiffman, Sher, & Heath, 2012;Witkiewitz et al, 2012) to worried thoughts about smoking (Magnan, Köblitz, McCaul, & Dillard, 2013), and exposure to media messages (Shadel, Martino, Setodji, & Scharf, 2012) or proximity to tobacco sales outlets (Kirchner, Cantrell, et al, 2013). EMA methods have also been fruitfully applied to study the effects of treatment, both to define treatment outcome (Shiffman et al, 2000;Shiffman et al, 2006) and to examine the processes that mediate treatment effects (Ferguson, Shiffman, & Gwaltney, 2006;McCarthy et al, 2008;Piper et al, 2008).…”

Assessing the availability of users to engage in just-in-time intervention in the natural environment

“…We note that EMAs are widely used in scientific studies on addictive behavior [33, 45, 46], pain [49], and mental health [2, 30, 38, 50]. While EMAs have obvious benefits, prompting EMAs at inopportune moments can be very disruptive for the recipients’ current task [44] or social situation [5, 44].…”

Emotion differentiation and intensity during acute tobacco abstinence: A comparison of heavy and light smokers

“…Frequent smokers also exhibit greater emotional lability (Dvorak & Simons, 2008). Real-time, ecological momentary assessment (EMA) of smoking behavior shows that those who smoke to regulate negative affect have a heightened risk for lapse and relapse during quit attempts (Minami, McCarthy, Jorenby, & Baker, 2011; Shiffman, Paty, Gnys, Kassel, & Hickcox, 1996; Shiffman et al, 2007). Identifying factors that inhibit effective regulation of negative affect is critical to understanding the dynamic associations of affect, smoking behavior, and successful cessation.…”