Abstract
Objective Environmental factors, such as household smoking restrictions (HSR), may impact a range of smoking-related outcomes. The current study examined the effects of various levels of HSR on smoking behaviors, including the number of cigarettes smoked per day and levels of nicotine dependence in a population of adult smokers. (1) Having specific HSR reduces the urges to smoke (path A); (2) having specific HSR reduces CPD (path B); (3) having specific HSR results in lower overall nicotine addiction (path C), and later, TTFC will be associated with (4) lower urges to smoke in the morning (path A'), (5) fewer CPD (path B'), and (6) lower levels of nicotine addiction (path C'). Method Regression models using self-reported data from the Pennsylvania Adult Smoking Study (N = 353) were used. TTFC was measured minutes between waking and the first cigarette of the day. Household smoking restrictions were measured as follows: (1) full ban on smoking in the home, (2) partial ban, or (3) no ban. Results Subjects with no household smoking restrictions had lower incomes and education than those with at least some household smoking restrictions; those with full bans smoked less and had an earlier TTFC than those with at least some household smoking restrictions. Smokers with a full ban had a later TTFC, mediated by fewer cigarettes per day and lower cravings. Among those with partial bans, there is no reduction in cigarettes per day and an increase in urges to smoke. Conclusions Partial household smoking restrictions are no better than no household smoking restrictions with regard to cigarettes per day and TTFC, and may cause an increase in urges to smoke in the morning.
Highlights
The time from waking in the morning until the first cigarette of the day is strongly associated with nicotine use behaviors and has increasingly been used as a single-item measure of dependence in a range of smoking studies, including clinical trials, laboratory studies, and other investigations of cigarette use [1,2,3,4]
We found that a full smoking ban was more likely to be categorized in the 31-60minute and more than 60-minute categories of TTFC than those with partial or no bans, and less likely to be in the 05-minute category
Having a full smoking ban and having no smoking ban were both directly related to TTFC, even when considering smoking-related behaviors such as cigarettes per day and other social and demographic factors such as education, income, and age; there was no direct effect of having only a partial ban on TTFC
Summary
The time from waking in the morning until the first cigarette of the day is strongly associated with nicotine use behaviors and has increasingly been used as a single-item measure of dependence in a range of smoking studies, including clinical trials, laboratory studies, and other investigations of cigarette use [1,2,3,4]. The most commonly used time to first cigarette of the day (TTFC) item, “how soon after you wake up do you smoke your first cigarette?,” is derived from the Fagerstrom Test for Nicotine Dependence (FTND; [5]). This single item has been shown to be a robust predictor of smoking cessation outcomes, tobacco smoke toxicant exposure, risk of lung and head and neck cancers, and sleep outcomes, even when controlling for the number of cigarettes per day (CPD; [6,7,8]b; Mercincavage et al, In Press; [9]). Environmental and social controls of smoking behaviors, including self-imposed household restrictions or rules (HSR) on when or where smoking can take place within the home [12], may influence patterns of tobacco use
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