Open AccessStress-related increases in risk taking and attentional failures predict earlier relapse to smoking in young adults: A pilot investigation.
Author(s) -
Ty S. Schepis,
Brian E. Tapscott,
Suchitra KrishnanSarin
Publication year - 2016
Publication title -
experimental and clinical psychopharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.066
H-Index - 92
eISSN - 1936-2293
pISSN - 1064-1297
DOI - 10.1037/pha0000066
Subject(s) - craving , impulsivity , smoking cessation , young adult , nicotine , nicotine withdrawal , psychology , repeated measures design , analysis of variance , clinical psychology , medicine , psychiatry , addiction , developmental psychology , statistics , mathematics , pathology
Substantial evidence links greater impulsivity and stress exposure to poorer smoking cessation outcomes. Results from adolescents also indicate that stress-related change in risk taking can impede cessation attempts. We investigated the effects of stress-related change in impulsivity, risk taking, attention and nicotine withdrawal, and craving in young adult smokers on time to smoking relapse in a relapse analogue paradigm. Twenty-six young adult smokers (50% women; mean age: 20.9 ± 1.8) were exposed to a stress imagery session followed by a contingency management-based relapse analogue paradigm. Participants smoked at least 5 cigarettes daily, with a mean baseline carbon monoxide (CO) level of 13.7 (± 5.1) ppm. Repeated measures analysis of variance (ANOVA) and paired t tests examined stress induction validity and Cox regressions of proportional hazards examined the effects of stress-related changes in nicotine withdrawal, nicotine craving, attention, impulsivity, and risk taking on time to relapse. While stress-related change in impulsivity, nicotine craving and withdrawal did not predict time to relapse (all ps > .10), greater stress-related increases in reaction time (RT) variability (p = .02) were predictive of shorter time to relapse, with trend-level findings for inattention and risk taking. Furthermore, changes in stress-related risk taking affected outcome in women more than in men, with a significant relationship between stress-related change in risk taking only in women (p = .026). Smoking cessation attempts in young adults may be adversely impacted by stress-related increases in risk taking and attentional disruption. Clinicians working with young adults attempting cessation may need to target these stress-related impairments by fostering more adaptive coping and resilience.