How everyday stress impacts cigarette smoking

According to the Centers for Disease Control and Prevention, around 28.3 million U.S. adults currently smoke cigarettes, in spite of the clear and deadly links between cigarette smoking and cancer, and between smoking and damage to nearly every organ in the body. The majority of smokers want to stop, but fewer than 10% successfully quit each year.

Over the summer, in the Addiction, Health, & Adolescence (AHA!) Lab in the Annenberg School for Communication, Gabriella Jean, a second-year economics major in the College of Arts & Sciences, worked with principal investigator David Lydon-Staley on a research project studying the association between everyday life stressors-such as financial stress or an unpleasant social interaction-and cigarette smoking. Jean applied for and received the research opportunity through the Penn Undergraduate Research Mentoring Program, offered through the Center for Undergraduate Research and Fellowships.

The goal of the AHA! Lab is to study everyday behaviors and experiences as they unfold over relatively short time scales, such as day to day or hour to hour, in the context of everyday life. The Lab's research on everyday stressors and smoking, part of a larger study funded by the National Institute on Drug Abuse, investigates the emotions of daily cigarette smokers and their impact on smoking behavior.

"What David and I are mostly interested in is the relationship between everyday stressors and smoking, as well as everyday stressors and both craving and negative emotion, such as sadness, anxiety, and anger," Jean says. "We are trying to understand whether or not, when you experience a stressor, it increases your negative affect, craving, and likelihood of smoking when you're trying to quit."

Jean and Lydon-Staley's project, which utilizes the ecological momentary assessment method, included a sample size of 156 daily cigarette smokers from Philadelphia. Participants were recruited through advertisements on SEPTA, radio, and TV, and collaboration with Penn's Center for Interdisciplinary Research on Nicotine Addiction and the Perelman School of Medicine. Enrollees visited the AHA! Lab and had an app installed on their phone that pinged them 10 times a day for 10 days during a smoking cessation attempt, asking them questions about their cravings, their smoking behavior, and their stress exposure as they went about their daily lives.

"I think the nice thing about this study is that because so much of it is happening out in the world, and because there are so few demands on asking people to come to the University, we ended up with a pretty good representation of Philadelphia and its diversity," says Lydon-Staley, who is also an assistant professor of communication at Annenberg.

After analyzing the data, Jean and Lydon-Staley identified a strong relationship between everyday stressors, negative affect, and cigarette craving. They found that in moments when study participants reported experiencing a stressor, their craving was higher, their negative affect was heightened, and they were more likely to have smoked, using cigarettes as sort of a coping mechanism.

Jean says everyday stressors in general can trigger the urge to smoke, but she noticed an assortment of individual differences.

"Me personally, my stressor could be school, and that would affect my craving, but as for another individual, their stressor might be finances," she says. "The stressors are different for each individual and they can change from day to day, but what remains consistent is that those stressors really affect your smoking, negative emotions, and cravings."

Potential solutions, says Jean, could be developing new ways to help individuals cope with their daily stressors and providing them with available resources.

"I think if they become more resilient or they're just more able to cope with their day-to-day lives and issues, they will be able to fight against it," she says. "And from my readings, there is indeed a strong relationship between interventions that decrease cravings and a decrease in smoking."

Lydon-Staley says Jean was a great addition to the research project and is a "really smart, really motivated, and very curious student."

"She really just jumped into the project with lots of energy," he says. "She started by reading very widely and deeply in the literature. When it was time to move to data analysis, she was able to approach the data analysis with a good sense of what we were looking for, which helped her then interpret the results."

Jean, who is from Haiti, was pitched a couple of projects by Lydon-Staley at the start of her research opportunity. She says she was interested in studying smoking behaviors because her great uncle and one of her mom's closest friends were both smokers who died from cancer. When she noticed some of her friends begin to smoke as teenagers, she became even more curious about smoking behaviors in general. The summer research project, she says, was a great opportunity for her to study something she has been curious about for a long time.

"Also, it was my way to be able to help because, most importantly, the goal of our research is to be able to improve the interventions that are meant to help people quit smoking," Jean says.

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