The Role of Daily Hassles and Distress Tolerance in Predicting Cigarette Craving During a Quit Attempt

Abstract

Ecological momentary assessment (EMA) has shown that smoking behavior is linked to transient variables in the smoker's immediate context. Such research suggests that daily hassles (e.g., losing one's keys) may be more likely to lead to cigarette craving and eventual lapse than infrequent, large-scale stressors (e.g., death of a loved one) among individuals attempting to quit smoking. However, individual differences in distress tolerance (DT) may moderate the relationship between daily hassles and daily cigarette craving during a quit attempt. A sample of 56 veterans and community members drawn from a larger smoking-cessation study completed structured interviews and paper-and-pencil questionnaires during an initial laboratory visit and, directly following a quit attempt, were monitored via EMA. Multilevel modeling was used to examine the relationship between daily hassles and daily cigarette craving and to determine whether DT moderated this relationship. Daily hassles were positively associated with daily cigarette craving, and this association was moderated by individual differences in DT, such that the lower one's DT, the stronger the relationship between daily hassles and daily cigarette craving. This model explained 13% of the intraindividual variability and 8% of the interindividual variability in daily cigarette craving. Smoking-cessation interventions may be strengthened by targeting smokers' individual responses to contextual factors, such as by helping smokers develop skills to cope more effectively with distress prior to and during the quit phase.