John R Hughes1, Saul Shiffman2, Shelly Naud3, Erica N Peters4. 1. Vermont Center on Health and Behavior, Department of Psychiatry, University of Vermont, Burlington, VT. 2. Department of Psychology, University of Pittsburgh, Pittsburgh, PA. 3. Department of Medical Biostatistics, University of Vermont, Burlington, VT. 4. Battelle Public Health Center for Tobacco Research, Battelle Memorial Institute, Baltimore, MD.
Abstract
BACKGROUND AND AIMS: Nicotine addiction theory predicts small day-to-day variability in cigarettes/day (CPD) whereas social learning theory predicts large variability. A description of the variability in CPD over multiple days is not available. METHODS: We conducted secondary analyses of two natural history studies with daily smokers-one of smokers not intending to quit, and one of smokers intending to quit sometime in the next 3 months. In the former, smokers recorded their smoking during the day by Ecological Momentary Assessment, using a palm-top computer. In the latter, participants reported CPD nightly via a phone Interactive Voice Response system. Analyses were based on smokers who reported averaging ≥10 CPD, and on days in which there was no attempt to stop or reduce smoking. RESULTS: Across the two studies, on average, smokers had small changes in day-to-day CPD (mean changes were 2.2 and 2.9 CPD). However a minority averaged changing by ≥5 CPD from one day to the next (7% and 11%), and many changed by ≥5 CPD on at least 10 of the 90 days (8% and 31%). Neither smoking restrictions, dependence, stereotypy ratings, nor interest in quitting predicted variability. CONCLUSION: Although on average, smokers have little change day-to-day CPD, a substantial minority of smokers often change by 5 CPD from day-to-day. We did not find potential causes of this variability. IMPLICATIONS: Across day variability in CPD is larger than implied in prior studies. Determining causes of day-to-day variability should increase our understanding of the determinants of smoking.
BACKGROUND AND AIMS: Nicotine addiction theory predicts small day-to-day variability in cigarettes/day (CPD) whereas social learning theory predicts large variability. A description of the variability in CPD over multiple days is not available. METHODS: We conducted secondary analyses of two natural history studies with daily smokers-one of smokers not intending to quit, and one of smokers intending to quit sometime in the next 3 months. In the former, smokers recorded their smoking during the day by Ecological Momentary Assessment, using a palm-top computer. In the latter, participants reported CPD nightly via a phone Interactive Voice Response system. Analyses were based on smokers who reported averaging ≥10 CPD, and on days in which there was no attempt to stop or reduce smoking. RESULTS: Across the two studies, on average, smokers had small changes in day-to-day CPD (mean changes were 2.2 and 2.9 CPD). However a minority averaged changing by ≥5 CPD from one day to the next (7% and 11%), and many changed by ≥5 CPD on at least 10 of the 90 days (8% and 31%). Neither smoking restrictions, dependence, stereotypy ratings, nor interest in quitting predicted variability. CONCLUSION: Although on average, smokers have little change day-to-day CPD, a substantial minority of smokers often change by 5 CPD from day-to-day. We did not find potential causes of this variability. IMPLICATIONS: Across day variability in CPD is larger than implied in prior studies. Determining causes of day-to-day variability should increase our understanding of the determinants of smoking.
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