Smoking remains the leading preventable cause of morbidity and mortality in the United States and its prevalence is elevated in disparate groups (e.g., mental health problems, low education, low SES) characterizedby chronic stress. Integrated physiological and psychological processes related to stress and cigarette smokingmay elucidate these relations. For example, nicotine consumption and stress repeatedly activate thehypothalamic-pituitary-adrenal (HPA) axis and sympathetic nervous system (SNS) system, leading todysregulation that has been empirically linked to craving, reward, and lapse, following cessation. Emergingresearch suggests cognitive vulnerabilities related to how one appraises stress also may play a role in stress-precipitated smoking. However, one notable gap in the existing body of work is that it has not adequatelybridged the relations between psychological states, physiology, and smoking behavior, thereby limiting theutility of translating findings to intervention. The Biopsychosocial model of challenge and threat identifies twodistinct responses to stress, integrating psychological and physiological processes. Specifically, a challengeappraisal, in the context of stress, occurs when one perceives coping resources to exceed environmentaldemands, and is accompanied by less negative affect. Alternatively, a threat appraisal occurs when oneperceives limited resources to cope with a taxing environmental demand and is accompanied by high negativeaffect and inability to respond in an adaptive manner. These responses are also associated with uniquecardiovascular responses whereby both responses are associated with increased sympathetic nervous systemactivation but challenge is characterized by an increase in cardiac output (CO) and decrease in total peripheralresistance (TPR), and threat is prototypically characterized by little change in CO and an increase in TPR.Informed by this model, the current proposal seeks to fill an existing gap in the investigation of stress-precipitated smoking by simultaneously examining cognitive appraisal and cardiovascular reactivity asmechanisms explaining stress-precipitated smoking. Using a modified version of the Trier Social Stress Test,participants will be randomly assigned to receive either supportive (i.e., positive) or unsupportive (i.e.,negative) non-verbal feedback from confederates. We expect two significant outcomes from the proposedresearch: (1) determine whether challenge and threat manipulations are differentially related to smokingmotivation and smoking behavior; and (2) identify cognitive appraisal and CV reactivity as mechanismsexplaining stress-precipitated smoking, thereby providing preliminary support for the development andapplication of interventions. Via this novel exploration of stress-precipitated smoking, and multi-methodexamination of cognitive and physiological explanatory mechanisms, this proposal is expected to have directtranslational impact on smoking intervention.
|Effective start/end date||4/1/17 → 3/31/18|
- National Institutes of Health (NIH)
Sympathetic Nervous System