Relationship of Self-Reported and Acute Stress to Smoking in Emerging Adult Smokers

Emerging adults, aged 18 to 25 years (Arnett, 2004; Riggs, Chou, Li, & Pentz, 2007), have the highest rates of tobacco smoking of any age group in the United States (Substance Abuse and Mental Health Services Administration [SAMHSA], 2010), and exhibit steady increases in smoking behavior and nicotine dependence during this developmental period (Chassin, Presson, Rose, & Sherman, 1996; Jackson, Sher, & Wood, 2000). Understanding risk factors for cigarette use and smoking progression during the vulnerable transitional period from initial experimentation to heavier smoking could lead to more effective prevention and early intervention efforts. Young adulthood is also associated with new stressors related to changing life roles and responsibilities that may affect smoking. Chronic smokers smoke more when experiencing negative emotions (Kassel, Paronis, & Stroud, 2003; McKennell, 1970; Shiffman & Waters, 2004) and they report that smoking alleviates negative mood (Brandon & Baker, 1991; Copeland, Brandon, & Quinn, 1995; Kassel et al., 2003). Adolescent experimental smokers report similar motivations for smoking, and in laboratory tests smoking actually reduces negative affect in these individuals (Kassel et al., 2007; Wang, Fitzhugh, Eddy, & Westerfield, 1996). Thus, stress may be a risk factor for initiation and maintenance of smoking during these early stages. Prospective investigations are critical to infer causal conclusions about the relationship between stress and smoking (Kassel et al., 2003). Several studies have examined whether individual differences in stress response predict smoking among occasional smokers, but results have been mixed. Among college-age experimental smokers, Magid and colleagues (Magid, Colder, Stroud, Nichter, & Nichter, 2009) found that self-reported negative affect, but not objective accounts of stressful events, was associated with smoking. In an earlier prospective self-report study of young adult occasional smokers, Wetter and colleagues (Wetter et al., 2004) found that expecting smoking to relieve negative affect predicted the transition from occasional to regular smoking better than actual experience of negative affect or stress. Finally, in a preliminary prospective study in which occasional smokers were exposed to an acute social stress procedure, we found that higher cortisol responses to the stressor predicted increases in smoking over a 6-month follow-up period (de Wit, Vicini, Childs, Sayla, & Terner, 2007). Overall, these studies have used a variety of measures to conceptualize “stress,” making it difficult to integrate the findings. To our knowledge, however, no study has systematically employed both self-report and objective methods to examine the role of stress in a prospective design with emerging adults who are not yet habitual smokers. The goal of the current study was to examine whether responses to a valid laboratory stressor, the Trier Social Stress Test (TSST), or self-reported ratings of daily stress and hassles predicted changes in smoking over 1 year, among occasional smokers. We also examined whether individual differences in stress were associated with levels of smoking at baseline.