title: Effects of cumulative stress and impulsivity on smoking status.
abstract: OBJECTIVE
  The stress-vulnerability model of addiction predicts that environmental factors, such as cumulative stress, will result in individual adaptations that decrease self-control, increase impulsivity, and increase risk for addiction. Impulsivity and cumulative stress are risk factors for tobacco smoking that are rarely examined simultaneously in research.
  
  
  METHODS
  We examined the indirect and direct effects of cumulative adversity in a community sample consisting of 291 men and women who participated in an assessment of cumulative stress, self-reported impulsivity, and smoking history. Data were analyzed using bootstrapping techniques to estimate indirect effects of stress on smoking via impulsivity.
  
  
  RESULTS
  Cumulative adversity is associated with smoking status via direct effects and indirect effects through impulsivity scores. Additional models examining specific types of stress indicate contributions of traumatic stress and recent life events as well as chronic relationship stressors.
  
  
  CONCLUSIONS
  Overall, cumulative stress is associated with increased risk of smoking via increased impulsivity and via pathways independent of impulsivity. These findings support the stress-vulnerability model and highlight the utility of mediation models in assessing how, and for whom, cumulative stress increases risk of current cigarette smoking. Increasing self-control is a target for interventions with individuals who have experienced cumulative adversity.
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, Connecticut, USA. Emily.Ansell@yale.edu
authors.forename: Emily B
authors.initials: EB
authors.lastname: Ansell
authors.forename: Peihua
authors.initials: P
authors.lastname: Gu
authors.forename: Keri
authors.initials: K
authors.lastname: Tuit
authors.forename: Rajita
authors.initials: R
authors.lastname: Sinha
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007175:Impulsive Behavior / Q000453:epidemiology*; D008016:Life Change Events; D008297:Male; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D013315:Stress, Psychological / Q000453:epidemiology*; D013997:Time Factors; D055815:Young Adult