Smokers’ thoughts and worries: A study using ecological momentary assessment

Objective The purpose of this study was to investigate smokers' thoughts and worries about their smoking behavior. Researchers have sometimes asked smokers to make such self-assessments but typically using retrospective summary judgments. Design Using ecological momentary assessment, community and student smokers reported five times daily during two separate 1-week intervals. Main outcome measures Smokers reported their thoughts about smoking, worries about smoking, and level of contemplation to quit smoking. Results Smokers reported thinking negatively about their smoking 26.8% of the time they had a cigarette. The most frequent thoughts reported by smokers related to immediate reinforcement of smoking (e.g., "How I smell like cigarettes"). However, smokers reported more intense worry about thoughts related to health concerns (e.g., "Symptoms I'm having because of smoking"). The occurrence of negative thoughts was significantly and positively related to contemplation about quitting, worry about smoking, and risk perceptions. Finally, self-reported worry intensity was more strongly related to contemplation of quitting than negative thought occurrence. Conclusion Our results show that thoughts about smoking (i.e., cognitions) and feelings about smoking (i.e., worry) are loosely connected and it is feelings rather than cognitions that are most related to contemplation to quit.