Anger and psychobiological changes during smoking abstinence and in response to acute stress: Prediction of smoking relapse

Abstract

Nicotine may be used to manage negative emotions, and recent research suggests that smokers with high levels of hostility may use cigarettes to cope with anger provoking situations. This study evaluated the extent to which a high level of trait anger is associated with risk for relapse among smokers interested in cessation. Chronic smokers with different levels of trait anger provided reports of withdrawal symptoms, craving, and state anger, and collected saliva samples for cortisol during 24-hour ad libitum smoking and the first 24-hour abstinence period of a quit attempt. They also attended a laboratory session conducted after the 24-hour abstinence during which they performed brief mental and social stress challenges and provided blood samples for adrenocorticotropin (ACTH) and cortisol assays. High trait anger was associated with greater increases in state anger, withdrawal symptoms, and craving during the first 24 hour of abstinence. It was also associated with greater ACTH concentrations during the laboratory session. High trait anger was also associated with increased risk for early relapse. The findings support the hypothesis that smokers high in anger trait may have greater mood difficulties during abstinence and may be more vulnerable to early relapse than smokers with low anger trait.

Tobacco Smoking, Quitting, and Relapsing Among Adult Males in Mainland China: The China Seven Cities Study

“…These strategies have been shown to increase the likelihood that smokers will quit and remain abstinent once they do ( al ' Absi, Carr, & Bongard, 2007 ;Tsourtos et al, 2011 ) and may be applicable to Chinese adult male smokers. Despite extensive studies in western countries, we still lack evidence for any specifi c behavioral intervention to prevent relapse among smokers who have quit ( Hajek, Stead, West, Jarvis, & Lancaster, 2009 ).…”

Treatment for Tobacco Dependence: Effect on Brain Nicotinic Acetylcholine Receptor Density

“…Greater severity of dependence has been associated with poorer outcome for group psychotherapy (Kozlowski et al, 1994), bupropion HCl (Dale et al, 2001;Paluck et al, 2006), and nicotine patch (Batra et al, 2008;Westman et al, 1997), as well as in naturalistic settings with no specific treatment (Hymowitz et al, 1997). Other factors, such as self-efficacy/ self-confidence (Gwaltney et al, 2005;Haaga and Stewart, 1992;Li and Froelicher, 2008;Schnoll et al, 2003;Shiffman et al, 2000), desire to quit (Wiggers et al, 2005), low negative affect (Shiffman et al, 2007), absence of depression (Japuntich et al, 2007), little craving response to cues (Waters et al, 2004), low anger (Al'Absi et al, 2007), slow nicotine metabolism (Schnoll et al, 2009), and absence of lapses during early treatment (Kenford et al, 1994) have also been found to predict quit status. Thus, clinical factors have been extensively studied for their value in predicting treatment response, with greater severity of specific symptoms being linked to less likelihood of quitting.…”

Psychometric Examination of an Arabic Version of the State-Trait Anger Expression Inventory

“…3 Another study showed that smokers with high trait anger suffered from increased withdrawal symptoms during acute nicotine withdrawal and had a greater risk of relapse within a week of cessation. 28 Due to the tobacco epidemic causing serious concern in many Arab countries, including Yemen and Tunisia, investigating the role of trait anger in emotion regulation and drug consumption behaviour may have important clinical implications within these populations. 29,30 The current study had several limitations; as such, these results should be considered preliminary.…”