The Perils of Positive Puffing

TOBACCO RESEARCH | A positive attitude is good for many things, but apparently not for people who are about to light up. Scientists at Penn’s Tobacco Use Research Center found that smokers who reported happier moods had higher levels of nicotine boost—the measure of the increase in blood-nicotine level—after smoking a single cigarette than did their less cheerful counterparts.

Though bearing further study, these findings could have implications for smoking-cessation programs, according to Dr. Caryn Lerman, who directs the Center [“Cutting Through the Smoke,” Jan/Feb] and was principal investigator on the study, as well as associate director for population studies at Penn’s Abramson Cancer Center.

Earlier studies have related nicotine boost to different demographics, including sex and race, Lerman explains. For instance, men inhale more deeply and smoke more of a cigarette than women do.

“As psychologists we were interested in seeing if there were differences among people related to mood. We thought that when people were in their worst moods they might take in more nicotine from cigarettes, but found that when they are in better moods they take in more nicotine. We found no relationship between negative mood and nicotine boost, so that was a surprise.”

The study, conducted jointly with Georgetown University, looked at 190 smokers enrolled in a smoking-cessation program. They were given questionnaires to evaluate positive and negative moods during the seven days prior to assessment. Based on blood samples drawn before and after smoking one cigarette, nicotine boost was significantly higher among smokers who reported more “positive affect.”

“People smoke when they’re feeling low but they also smoke when they’re excited,” Lerman says. “And nicotine can have paradoxical effects. If their mood is low, nicotine can make people feel they have more energy. If they’re excited, people also smoke to relax.”

More research is needed to determine if smokers with higher levels of nicotine boost are more prone to relapse, Lerman says. Such people might benefit from “treatment that gives more rapid nicotine delivery, like a nicotine spray,” instead of a patch, which delivers nicotine more slowly.”

In addition, “people should be alerted to a pattern they might have [in which] they smoke more when they’re happy, ” Lerman says. Smoking-cessation programs might include teaching people alternative behaviors to engage in, such as sharing good news with a friend or going out for a walk. —S.F.