An Ecological Momentary Assessment analysis of relations among coping, affect and smoking during a quit attempt.

AIMS This study used Ecological Momentary Assessment (EMA) data from smokers trying to quit to assess relations among coping, positive affect, negative affect and smoking. The effects of stress coping on affect and smoking were examined. DESIGN Data from a randomized clinical trial of smoking cessation treatments were submitted to multi-level modeling to test the effects of coping with stressful events on subsequent affect and smoking. SETTING Center for Tobacco Research and Intervention, Madison, Wisconsin. PARTICIPANTS A total of 372 adult daily smokers who reported at least one stressful event and coping episode and provided post-quit data. MEASUREMENTS Participants' smoking, coping and affect were assessed in near real time with multiple EMA reports using electronic diaries pre- and post-quit. FINDINGS Multi-level models indicated that a single coping episode did not predict a change in smoking risk over the next 4 or 48 hours, but coping in men was associated with concurrent reports of increased smoking. Coping predicted improved positive and negative affect reported within 4 hours of coping, but these affective gains did not predict reduced likelihood of later smoking. Pre-quit coping frequency and gender moderated post-quit stress coping relations with later positive affect. Men and those with greater pre-quit coping frequency reported greater gains in positive affect following post-quit coping. CONCLUSIONS Coping responses early in a quit attempt may help smokers trying to quit feel better, but may not help them stay smoke-free.