Text

theses

Research on the proximal influences on smoking relapse has focused primarily on the independent effects of risk factors, yet relapse may also be governed by complex, interactive processes. The current study sought to expand our understanding of relapse mechanisms by identifying the independent and interactive effects of real-time risk factors on temptations and the ability to resist temptations in smokers during a quit attempt. This study was a secondary analysis of ecological momentary assessment data collected from 109 treatment-seeking smokers 4 times a day for 21 days following a quit attempt. All smokers received nicotine replacement therapy and smoking cessation counseling. Multinomial hierarchical linear models were used to evaluate ways momentary impulsiveness, affect, urge, cigarette exposure, alcohol use and their interactions predicted temptations and smoking up to 8 hours later. Level-one data comprised report-level predictors and outcomes nested within individuals at level-two. Results suggested temptations were predicted by higher momentary agitation, distress, and urge; and lower positive affect. The inability to resist temptations was predicted by prior smoking, higher distress, and recent alcohol use. There were significant interactions between level-one predictors that influenced the risk of temptations (positive affect x impulsiveness, urge x agitation, agitation x cigarette exposure, urge x cigarette exposure) and the odds of resisting a temptation (alcohol x impulsiveness). These results suggest studies of complex relationships between proximal risk factors may provide new information about relapse processes and inform smoking cessation interventions.

ETD_6578

Ph.D.

Includes bibliographical references

by Krysten Williams Bold

doi:10.7282/T35B04G1

ETD doctoral

The author owns the copyright to this work.