Relapse is the greatest challenge in the treatment of addictions, including cigarette smoking. Research on relapse episodes has relied solely on retrospective recall; furthermore, relapse research has failed to integrate data on proximal antecedents of relapse episodes with data on individual differences and on contextual variables that predispose people to relapse. The proposed study uses an innovative method of computerized self-monitoring to study smoking relapse. A hand-held self-monitoring computer (SMC) will be used to characterize the baseline smoking patterns of 252 subjects recruited for smoking cessation treatment. Subjects carry the SMC for 2 weeks and record the situational and affective antecedents of smoking. The SMC also prompts subjects randomly to record data when they are not smoking, thus measuring the base-rates of relevant behaviors outside of smoking situations, and estimating the association between these stimuli and smoking. The computer also obtains daily measures of stress and withdrawal (both subjective and objective [cognitive performance]). Once subjects quit smoking, they use the SMC for 4 weeks to record the antecedents and sequelae of episodes of smoking (""""""""lapses"""""""") and strong temptations; the SMC continues to randomly sample situations and to assess stress and withdrawal. Statistical methods include logistic regression and survival analysis. We will examine proximal antecedents of lapses and temptations in comparison to base-rates in randomly-sampled situations. Other analyses will consider the role of background stress and withdrawal in promoting relapse, and their interactions with proximal precipitating stimuli. The prospective design will assess whether the after-effects of relapse crises (""""""""Abstinence Violation Effects"""""""") promote progression towards relapse. Finally, using data collected at baseline, we will examine whether (as conditioning theories predict) individual differences in smoking patterns are mirrored in individual differences in relapse patterns. The study includes methodological analyses: The effects of prolonged monitoring will be measured in a comparison group that undergoes self-monitoring but does not quit smoking. The validity of retrospective relapse interviews, widely-used to collect relapse data, will be assessed relative to real-time self-monitoring data. The findings of the study are expected to be highly relevant for the design of more effective interventions to prevent relapse to cigarette smoking and other drug addictions.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA006084-04
Application #
3212698
Study Section
Special Emphasis Panel (SRCD (25))
Project Start
1990-06-01
Project End
1995-05-31
Budget Start
1993-06-01
Budget End
1994-05-31
Support Year
4
Fiscal Year
1993
Total Cost
Indirect Cost
Name
University of Pittsburgh
Department
Type
Schools of Arts and Sciences
DUNS #
053785812
City
Pittsburgh
State
PA
Country
United States
Zip Code
15213
Shiffman, Saul (2014) Conceptualizing analyses of ecological momentary assessment data. Nicotine Tob Res 16 Suppl 2:S76-87
Ferguson, Stuart G; Shiffman, Saul (2014) Effect of high-dose nicotine patch on craving and negative affect leading up to lapse episodes. Psychopharmacology (Berl) 231:2595-602
Rathbun, Stephen L; Song, Xiao; Neustifter, Benjamin et al. (2013) Survival Analysis with Time-Varying Covariates Measured at Random Times by Design. J R Stat Soc Ser C Appl Stat 62:419-434
Kirchner, Thomas R; Shiffman, Saul; Wileyto, E Paul (2012) Relapse dynamics during smoking cessation: recurrent abstinence violation effects and lapse-relapse progression. J Abnorm Psychol 121:187-97
Shiyko, Mariya P; Lanza, Stephanie T; Tan, Xianming et al. (2012) Using the time-varying effect model (TVEM) to examine dynamic associations between negative affect and self confidence on smoking urges: differences between successful quitters and relapsers. Prev Sci 13:288-99
Shiffman, Saul; Rathbun, Stephen L (2011) Point process analyses of variations in smoking rate by setting, mood, gender, and dependence. Psychol Addict Behav 25:501-10
Chandra, Siddharth; Scharf, Deborah; Shiffman, Saul (2011) Within-day temporal patterns of smoking, withdrawal symptoms, and craving. Drug Alcohol Depend 117:118-25
O'Connell, Kathleen A; Shiffman, Saul; Decarlo, Lawrence T (2011) Does extinction of responses to cigarette cues occur during smoking cessation? Addiction 106:410-7
Ferguson, Stuart G; Shiffman, Saul (2010) Effect of high-dose nicotine patch on the characteristics of lapse episodes. Health Psychol 29:358-66
Dunbar, Michael S; Scharf, Deborah; Kirchner, Thomas et al. (2010) Do smokers crave cigarettes in some smoking situations more than others? Situational correlates of craving when smoking. Nicotine Tob Res 12:226-34

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