Published October 1, 2020 | Version v1
Poster Open

Time-Varying Mediation of Negative Affect on Smoking Status: An Exploratory Analysis

Authors/Creators

  • 1. ROR icon University of Pennsylvania

Contributors

Supervisor:

  • 1. EDMO icon University of South Carolina

Description

Abstract:

The pharmacokinetic mechanism of action of tobacco makes smoking cessation an extremely challenging process. With prolonged exposure, tobacco smoking transforms from being a positive reinforcement to a negative one1. Withdrawal symptoms peak in the first week of quitting, usually resolving over a month2. Studying the variations in withdrawal symptoms is useful in improving cessation aids for future3. Time-varying mediation model is effective in studying such altering withdrawal symptoms acting as mediators in the causal pathway of treatment and cessation.

Our case study includes EMA data from the first 4 weeks post quit day of a smoking cessation study4. Negative affect namely `negative mood`, `cessation fatigue` and `craving` are the mediators. We assess whether negative affect regulate the pathway between treatment and (un)successful smoking cessation. Two time varying mediation models one for outcome smoking status (Yes/No) and one for daily smoking count show that the effect of exposure on outcome is mediated significantly by `cessation fatigue`. Identifying time points with peak `cessation fatigue` may be helpful for including mood boosting/coping techniques.

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Additional details

Related works

Is published in
Journal article: 10.1093/ntr/ntac068 (DOI)

Funding

National Institutes of Health
Developing Methodology to examine causal mediation of Time-Varying Effects in Smoking Cessation Treatments 1R01CA229542-01

References

  • 1. Centers for Disease Control and Prevention. How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: a report of the surgeon general, https://www.ncbi.nlm.nih.gov/books/NBK53017/ (2010, accessed 20 March 2020). [PubMed]
  • 2. Hughes JR. Effects of abstinence from tobacco: valid symptoms and time course. Nicotine Tob Res 2007; 9: 315–327. [PubMed] [Google Scholar]
  • 3. Shiffman, S. (1986). A cluster-analytic classification of smoking relapse episodes. Addictive Behaviors, 11(3), 295–307. doi: 10.1016/0306-4603(86)90057-2
  • 4. Baker, T. B., Piper, M. E., Stein, J. H., Smith, S. S., Bolt, D. M., Fraser, D. L., & Fiore, M. C. (2016). Effects of Nicotine Patch vs Varenicline vs Combination Nicotine Replacement Therapy on Smoking Cessation at 26 Weeks. Jama, 315(4), 371. doi: 10.1001/jama.2015.19284