DEPRESSION MODERATES THE PROSPECTIVE RELATIONSHIP BETWEEN MOOD AND SMOKING: AN ECOLOGICAL MOMENTARY ASSESSMENT INVESTIGATION

There is a significant association between cigarette smoking and depression. Smokers consistently report that they smoke more when they are experiencing negative mood states (e.g., stress, anger, sadness, anxiety). Affect is a salient trigger for smoking and many theories of tobacco use highlight the role of affect in the maintenance of smoking behaviors. Prior research suggests that the affective features of depression are uniquely involved in the depression-smoking relationship compared to non-affective depressive symptoms. It follows that smokers with depression are likely to use cigarettes to alleviate negative affect. However, the existing literature employing ecological momentary assessment (EMA) methodology, a type of intensive longitudinal study design focused on data collection in “real-time” and in the “real-world”, provides incongruous results with most studies demonstrating no relationship between mood and smoking. Conversely, a small number of experimental studies suggest that there is an association between mood and smoking and that the relationship is dependent on levels of depression. Despite the utility of EMA in studying substance use behaviors researchers have yet to examine the impact of depression on the relationship between mood and smoking using such methods. Accordingly, the aim of the current study is to explore the relationship between depression, mood, and ad lib smoking among adults with EMA data. Participants included 96 adult daily smokers (53% female, 67% non-Hispanic Black, age M(SD) = 40.76 (12.42)) who completed baseline ratings of depressive symptoms and seven consecutive days of data collection focused on cigarette smoking and associated mood and craving ratings. Results indicated that depression moderates the prospective relationship between between mood and smoking (even when controlling for craving), such that participants with high levels of depression smoke more cigarettes in response to an improvement in mood, whereas participants with low levels of depression smoke more in response to worsening mood states. Attempting to increase low positive affect may be a motivating factor for smoking among depressed individuals who are likely using cigarettes to augment their ability to experience pleasurable mood states. These findings may be helpful in tailoring smoking cessation treatment programs among individuals exhibiting depressive symptoms.