Effects of depressive symptoms on antecedents of lapses during a smoking cessation attempt: an ecological momentary assessment study. (23rd May 2014)

• Record Type: Journal Article
• Authors: Brodbeck, Jeannette; Bachmann, Monica S.; Brown, Anna; Znoj, Hans Joerg
• Is Part Of: Addiction. Volume 109:Number 8(2014:Aug.)
• Page Start: 1363
• Page End: 1370
• Publication Date: 2014-05-23
• Subjects: Alcoholism -- Periodicals; Drug addiction -- Periodicals; 616.86
• DOI: 10.1111/add.12563
• Languages: English
• ISSNs: 0965-2140

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="add12563-sec-0001" sec-type="section"> <title>Aims</title> <p>To investigate pathways through which momentary negative affect and depressive symptoms affect risk of lapse during smoking cessation attempts.</p> </sec> <sec id="add12563-sec-0002" sec-type="section"> <title>Design</title> <p>Ecological momentary assessment was carried out during 2 weeks after an unassisted smoking cessation attempt. A 3‐month follow‐up measured smoking frequency.</p> </sec> <sec id="add12563-sec-0003" sec-type="section"> <title>Setting</title> <p>Data were collected via mobile devices in German‐speaking Switzerland.</p> </sec> <sec id="add12563-sec-0004" sec-type="section"> <title>Participants</title> <p>A total of 242 individuals (age 20–40, 67% men) reported 7112 observations.</p> </sec> <sec id="add12563-sec-0005" sec-type="section"> <title>Measurements</title> <p>Online surveys assessed baseline depressive symptoms and nicotine dependence. Real‐time data on negative affect, physical withdrawal symptoms, urge to smoke, abstinence‐related self‐efficacy and lapses.</p> </sec> <sec id="add12563-sec-0006" sec-type="section"> <title>Findings</title> <p>A two‐level structural equation model suggested that on the situational level, negative affect increased the urge to smoke and decreased self‐efficacy (β = 0.20; β = −0.12, respectively), but had no direct effect on lapse risk. A higher urge to smoke (β = 0.09) and lower self‐efficacy (β = −0.11) were confirmed as situational antecedents of lapses. Depressive symptoms at baseline were a strong predictor of a person's average negative affect (β = 0.35, all <italic>P</italic> < 0.001). However, the baseline characteristics influenced smoking frequency 3 months later only indirectly, through influences of average states on the number of lapses during the quit attempt.</p> </sec> <sec id="add12563-sec-0007" sec-type="section"> <title>Conclusions</title> <p>Controlling for nicotine dependence, higher depressive symptoms at baseline were associated strongly with a worse longer‐term outcome. Negative affect experienced during the quit attempt was the only pathway through which the baseline depressive symptoms were associated with a reduced self‐efficacy and increased urges to smoke, all leading to the increased probability of lapses.</p> </sec> </abstract>