Predictors of Momentary Smoking Lapse Among Adults Who Smoke Menthol Cigarettes

About This Grant

Adults who smoke, especially those who smoke menthol cigarettes, suffer excess tobacco-caused morbidity and death, including cancer and cardiovascular disease. Compared to adults who smoke non-menthol cigarettes, adults who smoke menthol cigarettes have a greater dependence on nicotine and are less likely to quit smoking. This may be partly due to greater abstinence-induced declines in positive mood/affect and nicotine cravings and high risk situational/contextual factors. However, there are limited data on the underlying mechanisms that explain smoking lapses among adults who smoke menthol cigarettes, whom experience limited success with cessation interventions. Few studies that have used ecological momentary assessment (EMA) to examine how negative affect (i.e., poor mood), nicotine craving (i.e., smoking urge), and contextual factors, like stress, predict cigarette smoking lapse in real-time have considered cigarette flavor. Understanding these momentary precipitants to smoking lapse will help us to inform effective smoking cessation interventions for adults who smoke menthol cigarettes. To fill these critical research gaps, this study will use EMA to 1) define the within-subject associations between momentary negative affect, nicotine craving, and smoking lapse (aim 1); and 2) determine whether momentary perceived stress is a moderator of the momentary affect, nicotine craving, and smoking lapse relationship (aim 2) among adults who smoke menthol cigarettes. Our central hypothesis is that, at the within-subjects level, higher levels of negative affect than usual and exposure to situational/contextual factors (i.e., perceived stress) will be associated with stronger nicotine cravings, and in turn predict momentary smoking lapse (any v. no smoking) during a planned quit attempt among adults who smoke menthol cigarettes. We will recruit up to 150 adults in Arkansas between the ages of 21-75 years who smoke menthol cigarettes and plan to quit smoking in the next 30 days to test our hypothesis on the primary outcome, momentary of smoking lapse (any v no smoking). Secondary outcomes include time to smoking lapse, time to smoking relapse, and cigarette consumption. Participants will complete 7-day pre-quit and 7-day post-quit EMA waves, as well as baseline, 1 month, and 3-month follow-up online surveys. Smoking status will be verified using exhaled carbon monoxide. This study will fill literary gaps on momentary predictors of smoking lapses among adults who smoke menthol cigarettes and provide preliminary data for an R01 application. The PI has assembled an outstanding mentorship team who will guide her rigorous training and career development plans. Through formal coursework, summer institutes, hands-on training, and external trainings the PI will increase her competency in EMA/mHealth, randomized behavioral trials, advanced statistics, and tobacco research. Receipt of this K award will strengthen the PI's likelihood of achieving her career goal to become an independent researcher and conduct technology-supported observational studies and interventions that aim to increase successful smoking cessation among people who smoke.