title: Stress-related increases in risk taking and attentional failures predict earlier relapse to smoking in young adults: A pilot investigation.
abstract: 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.
authors.affiliation: Department of Psychology, Texas State University.
authors.forename: Ty S
authors.identifier: 0000-0003-3655-0496
authors.initials: TS
authors.lastname: Schepis
authors.affiliation: Department of Psychology, University of Rhode Island.
authors.forename: Brian E
authors.initials: BE
authors.lastname: Tapscott
authors.affiliation: Department of Psychiatry, Yale University School of Medicine.
authors.forename: Suchitra
authors.initials: S
authors.lastname: Krishnan-Sarin
mesh_terms: D001288:Attention; D066249:Craving; D005260:Female; D006801:Humans; D007175:Impulsive Behavior; D008297:Male; D010865:Pilot Projects; D011930:Reaction Time; D012008:Recurrence; D012309:Risk-Taking; D012907:Smoking / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology*; D013375:Substance Withdrawal Syndrome / Q000523:psychology; D013997:Time Factors; D055815:Young Adult