Intermittent and daily smokers' subjective responses to smoking.

Abstract

One third of US smokers are intermittent smokers (ITS) who do not smoke daily. Unlike daily smokers (DS), whose smoking is negatively reinforced by withdrawal relief, ITS may be motivated by immediate positive reinforcement. In contrast, incentive salience theory posits hypothesis that "liking" of drug effects fades in established users, such as DS. This study aims to compare ITS' and DS' hedonic responses to smoking. Participants were 109 ITS (smoking 4-27days/month) and 52 DS (smoking daily 5-25 cigarettes/day), aged ≥21, smoking ≥3years, and not quitting smoking. For 3weeks, participants engaged in ecological momentary assessment, carrying an electronic diary that asked them to rate their most recent smoking experience on 0-100 visual analog scales (satisfaction, enjoyment [averaged as "pleasure"], feeling sick, feeling a "rush," enjoying upper respiratory sensations, and immediate craving relief). Hierarchical random effect regression analyzed 4476 ratings. ITS found smoking pleasurable (mean=69.7±1.7 [SE]) but significantly less so than DS did (77.6±2.3; p<0.006). ITS also reported more aversive response (ITS 18.2±1.4, DS 11.6±2.0; p<0.007). Even though ITS are more likely to smoke at bars/restaurants, when drinking alcohol, or when others were present, they did not report more pleasure in these settings (compared to DS). More extensive smoking experience was unrelated to craving or smoking effects among DS, but predicted greater craving, greater pleasure, and less aversion among ITS. The findings were largely inconsistent with incentive-salience models of drug use.