Abstract C021: Affective mechanisms of stress-induced cigarette craving: Considerations of sex and ethnicity

Cigarette smoking continues to be the number one modifiable risk factor for the development of cancer. Among the major impediments to successful smoking cessation are strong cravings to smoke, especially during times of heightened stress. Affective responses to stress (e.g., acute anxious and depressed mood) may serve as important mediators of cigarette cravings that are amenable to intervention. Experimental models have been developed to induce cravings reliably during stress under laboratory conditions, permitting a closer examination of possible changes in affect that may be driving cigarette cravings. The possibility that specific types of affect may be responsible for cigarette cravings, however, has not been investigated. Another key limitation of the extant research is its reliance on samples of predominantly male Caucasian smokers. Although several recent studies suggest possible sex- and ethnicity-based differences in affective responses to acute stress, no studies have explored how such differences may contribute to cigarette cravings. To that end, we conducted an experimental study in which an ethnically diverse sample of healthy volunteer female (n=163) and male (n=139) nicotine-dependent smokers were exposed to a mild stressor (guided imagery of painful dental work). We assessed positive affect (happy, relaxed, energized), negative affect (anxious, depressed, emotionally upset), and cigarette craving immediately before and after the imaginal dental stressor. Mean age of the sample was 38.6 (+ 10.2). Participants reported smoking an average of 19.5 (+ 9.8) cigarettes per day for an average of 18.9 (+ 10.0) years. Path analyses revealed that the acute stressor induced significant increases in negative affect and decreases in positive affect (p's < 0.0001). In turn, increases in anxious, but not depressed mood, mediated effects of the stressor on cigarette craving. Bootstrapped confidence intervals indicated that indirect mediated effects were significant at the 0.05 level. Interestingly, effects were particularly pronounced in women (85% of total effect for women vs. 65% of total effect for men). Among Hispanic (n=81) smokers, elevations in depressed mood mediated increases in cigarette craving (p <0.05), unlike among African American (n=138) and Caucasian (n=62) smokers. Results highlight the importance of considering sex and ethnicity when developing interventions to manage stress-induced cigarette cravings among smokers attempting to quit.

Citation Format: Joel Erblich, Guy H. Montgomery, Julie B. Schnur, Camille Ragin. Affective mechanisms of stress-induced cigarette craving: Considerations of sex and ethnicity [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr C021.