Featured Article: Nicotine Dependence Diminishes the Effect of Smoking on Mood

November 11, 2015:
women smokerResearch has shown that some adolescents experience nicotine dependence at low levels of smoking (DiFranza et al., 2000; O’Loughlin et al., 2003). Other results indicate that early nicotine dependence strongly predicts future smoking (Dierker & Mermelstein, 2010; DiFranza et al., 2002). A recent paper in the journal Addictive Behavior, “Nicotine-dependence-varying effects of smoking events on momentary mood changes among adolescents,” provides insight into the mechanisms that encourage and maintain nicotine dependence. In this paper, the authors apply time-varying effect modeling (TVEM) and other methods to examine the association between nicotine dependence and the impact of smoking on mood. Authors include Methodology Center investigators, affiliates, and collaborators Arielle Selya, Nicole Updegrove, Jennifer Rose, Lisa Dierker, Xianming Tan, Donald Hedeker, Runze Li, and Robin Mermelstein.

The authors recruited a subsample from the Social and Emotional Contexts of Adolescent Smoking Patterns Study who were classified as former experimental smokers, current experimental smokers, or regular smokers. Participants were followed for 24 months using several waves of questionnaires and week-long ecological momentary assessments (EMA). Some of their findings validated current theory: adolescents with low nicotine dependence experienced improved mood when smoking, but this same improvement in mood was not observed in adolescents with higher levels of nicotine dependence. In other words, smoking more only improved mood among individuals with low levels of nicotine dependence.

Interestingly, the findings did not support other aspects of current theories, which postulate that nicotine withdrawal generates negative reinforcement that is responsible for maintaining dependence (Tiffany et al., 2004). In the current study the correlation between negative affect and amount smoked was NOT significant at higher levels of nicotine dependence.

Lead author Arielle Selya, assistant professor of family and community medicine at The University of North Dakota, is excited about the prospect of untangling the factors that lead to and maintain nicotine dependence. “These findings support theories that positive reinforcement is important at early stages in the addiction process, but we were surprised to see no support for the role of negative reinforcement in maintaining more severe levels of addiction. Perhaps smokers are pre-emptively smoking before they experience withdrawal symptoms. Perhaps social and situational factors are stronger drivers of the average individual smoking event than are nicotine dependence symptoms. Future research can tease apart these different factors and help us to better understand why smokers keep smoking.

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Selya, A. S., Updegrove, N., Rose, J. S., Dierker, L., Tan, X., Hedeker, D., … & Mermelstein, R. J. (2015). Nicotine-dependence-varying effects of smoking events on momentary mood changes among adolescents. Addictive Behaviors, 41, 65-71. doi: 10.1016/j.addbeh.2014.09.028

Dierker, L., & Mermelstein, R. J. (2010). Early emerging nicotine-dependence symptoms: A signal of propensity for chronic smoking behavior in adolescents. The Journal of Pediatrics, 156(5), 818–822. doi: 10.1016/j.jpeds.2009.11.044

DiFranza, J. R., Rigotti, N. A., McNeill, A.D., Ockene, J. K., Savageau, J. A., St Cyr, D., & Coleman, M. (2000). Initial symptoms of nicotine dependence in adolescents.Tobacco Control, 9(3), 313–319. doi: 10.1136/tc.9.3.313

DiFranza, J. R., Savageau, J. A., Rigotti, N. A., Fletcher, K., Ockene, J. K., McNeill, A.D., … & Wood, C. (2002). Development of symptoms of tobacco dependence in youths: 30 month follow up data from the DANDY study. Tobacco Control, 11(3), 228–235. doi: 10.1136/tc.11.3.228

O’Loughlin, J., DiFranza, J., Tyndale, R. F., Meshefedjian, G., McMillan-Davey, E., Clarke, P. B., … & Paradis, G. (2003). Nicotine-dependence symptoms are associated with smoking frequency in adolescents. American Journal of Preventive Medicine, 25(3), 219–225. doi: 10.1016/S0749379703001983

Tiffany, S. T., Conklin, C. A., Shiffman, S., & Clayton, R. R. (2004). What can dependence theories tell us about assessing the emergence of tobacco dependence?Addiction, 99(Suppl. 1), 78–86. doi: 10.1111/j.1360-0443.2004.00734.x

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