Temporal analysis of the relationship of smoking behavior and urges to mood states in men versus women.

Epidemiological investigations of mood and smoking have relied largely on retrospective self-reports, with little research on real-time associations. We examined the relationship of mood states to contemporaneous smoking urges and to subsequent smoking and also assessed the effects of smoking on subsequent mood. For 2 days, 25 female and 35 male smokers aged 18-42 made three prompted diary entries per hour plus pre- and post-smoking entries (6882 entries). Data were analyzed with generalized estimating equations. We found significant positive associations between smoking urge and anger, anxiety, and alertness in women and men; fatigue in men only; sadness more strongly in men than women; and happiness in women only. Decreased alertness and increased anxiety predicted subsequent smoking in men only. Smoking was followed by decreased anger levels in men and women and decreased sadness in men only. In men with lower overall anger episodes, increased anger was associated with subsequent increased smoking. These findings suggest that smoking is related to negative affect and energy level, more clearly in men, and has palliative effects on sadness in men and on anger in men and women. These data demonstrate that ambulatory research can reveal targets for early intervention and smoking cessation.