SOCIAL PROBLEM-SOLVING, NEGATIVE AFFECT, AND SMOKING URGE REACTIVITY DURING BASELINE CUE EXPOSURE

Abstract

Introduction: Despite advances in smoking cessation interventions, the majority of smokers who seek treatment will relapse. To better understand nicotine dependence, and relapse risk factors this study tested for potential relationships between social problem-solving, negative affect, and smoking urges during a baseline smoking cue exposure trial. Methods: aA part of a larger cessation study. 51 male and 50 female physically inactive, sedentary smokers with the intention to quit smoking, and bioverified smoking abstinence (CO < 11ppm) completed demographic questionnaires, the Social Problem-Solving Inventory-Revised: Short-Form, and questionnaires related to smoking history and demographic characteristics. In addition, participants completed a baseline 5-minute relaxation session followed by a 5-minute imaginal and in vivo smoking cue exposure trial. Participants completed pre and post cue exposure measures of urge and affect. Analysis: t-tests were used to validate the effect of cue exposure procedures on urge and negative affect. Multivariate linear regression models assessed the strength of possible relationships between social problem-solving, gender, negative affect, and urge to smoke. Results: Smoking urge and negative affect significantly increased from pre to post exposure. Women and men did not differ on any measure of social problem-solving, affect, or smoking urge. In regression models, the social problem-solving composite score was not statistically associated with post-cue exposure urge strength (as measured by the Questionnaire for Smoking Urges-Brief) when controlling for cigarettes per day or level of nicotine dependence. Greater pre-test negative problem orientation was significantly correlated with pre-post increases in negative affect (a predictor of relapse). In models with a gender and negative problem orientation interaction, negative problem orientation became a stronger predictor of negative affect, although the interaction term was non-significant. Impulsive-careless problem-solving styles and negative affect were also found to be significantly associated with post-exposure urge strength. Conclusions: A 5-minute smoking cue exposure trial produced a reliable increase in smoking urge and negative affect among treatment-seeking smokers who were abstinent for at least three hours. Future research of social problem-solving, stress and coping and negative affect within cue reactivity paradigms may provide insights for integrating cue exposure treatments and counseling-based smoking cessation interventions.