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Abstract

Rationale: Little is known about relapse among non-daily, intermittent smokers (ITS), who have difficulty quitting, despite a lackof dependence.Objectives: To analyze situations associated with temptations to smoke and smoking lapses among ITS trying to maintainabstinence.Methods: Participants were 130 initially abstinent ITS in the placebo arm of a smoking cessation study. EMA data capturedparticipants’situations and states in temptations (n = 976), including those that eventuated in lapses (n = 147), for up to 6 weeks.Randomly timed assessments assessed background states (n = 11,446). Participants also reported coping performed to preventlapses. Multilevel analyses compared temptations to background situations, and lapse episodes to resolved temptations.Results: Temptations were marked by exposure to smoking cues, including others smoking, lax smoking restrictions, and alcoholconsumption, as well as more negative affect. Lapses did not differ from resolved temptations in craving intensity, but were moreoften associated with smoking cues and availability of cigarettes, alcohol consumption, and worse affect, and were more oftenattributed to good moods. Both behavioral and cognitive coping responses were associated with avoiding lapsing, but behavioralcoping had much larger effects. The effects of affective distress on lapse risk were mediated by its effects on coping.Conclusions: Smoking cues play a major role in ITS’ temptations and lapses, perhaps indicating a degree of behavioral dependence. Affective distress also played a role in ITS lapses, undermining the idea that the affective distress seen in daily smokers’lapses is due to nicotine withdrawal. The data reinforce the important role of coping in preventing lapses.

Item Type:	Article
Authors/Creators:	Shiffman, S and Scholl, SM and Mao, J and Ferguson, SG and Hedeker, D and Tindle, HA
Keywords:	smoking, relapse, ecological momentary assessment, coping, smoking cessation, non-daily smoking
Journal or Publication Title:	Psychopharmacology
Publisher:	Springer-Verlag
ISSN:	0033-3158
DOI / ID Number:	10.1007/s00213-020-05539-3
Copyright Information:	Copyright 2020 Springer-Verlag GmbH Germany, part of Springer Nature
Related URLs:	Google Scholar: Ferguson, SG UTAS Profile: Ferguson, SG
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