Visceral sensitivity,anxiety, and smoking among treatment-seeking smokers

It is widely recognized that smoking is related to abdominal pain and discomfort, as well as gastrointestinal disorders. Research has shown that visceral sensitivity, experiencing anxiety around gastrointestinal sensations, is associated with poorer gastrointestinal health and related health outcomes. Visceral sensitivity also increases anxiety symptoms and mediates the relation with other risk factors, including gastrointestinal distress. No work to date, however, has evaluated visceral sensitivity in the context of smoking despite the strong association between smoking and poor physical and mental health. The current study sought to examine visceral sensitivity as a unique predictor of cigarette dependence, threat-related smoking abstinence expectancies (somatic symptoms and harmful consequences), and perceived barriers for cessation via anxiety symptoms. Eighty-four treatment seeking adult daily smokers (M_age = 45.1 years [SD = 10.4]; 71.6% male) participated in this study. There was a statistically significant indirect effect of visceral sensitivity via general anxiety symptoms on cigarette dependence (b = 0.02, SE = 0.01, Bootstrapped 95% CI [0.006, 0.05]), smoking abstinence somatic expectancies (b = 0.10, SE = 0.03, Bootstrapped 95% CI [0.03, 0.19]), smoking abstinence harmful experiences (b = 0.13, SE = 0.05, Bootstrapped 95% CI [0.03, 0.25]), and barriers to cessation (b = 0.05, SE = 0.06, Bootstrapped 95% CI [0.01, 0.13]). Overall, the present study serves as an initial investigation into the nature of the associations between visceral sensitivity, anxiety symptoms, and clinically significant smoking processes among treatment-seeking smokers. Future work is needed to explore the extent to which anxiety accounts for relations between visceral sensitivity and other smoking processes (e.g., withdrawal, cessation outcome).     

The relationship of waterpipe use with cigarette smoking susceptibility and nicotine dependence: A cross-sectional study among Hong Kong adolescents

IntroductionWaterpipe smoking has become increasingly popular in adolescents. We examined the association of waterpipe smoking with cigarette smoking susceptibility and nicotine dependence among adolescents in Hong Kong.MethodsWe analyzed the data of School-based Survey on Smoking among Students 2012/13 from a representative sample of 45,857 secondary school students (US grades 7–12) in Hong Kong. Among never cigarette smokers (n = 37,740), we conducted chi-square test to compare cigarette smoking susceptibility by current (past 30-day) waterpipe smoking status, and used multivariate logistic regression to examine the association between current waterpipe smoking and cigarette smoking susceptibility controlling for age, sex, peer cigarette smoking, and living with a cigarette smoker. Then we conducted chi-square test and multivariate logistic regression among current cigarette smokers (n = 1694) to examine the relationship of current waterpipe smoking with two nicotine dependence outcomes, including heavier smoking (≥ 5 cigarettes/day) and first cigarette within 30 min of waking, controlling for demographics and the number of smoking days in the past 30 days.ResultsAmong never cigarette smokers, current waterpipe use was associated with cigarette smoking susceptibility (adjusted odds ratio [AOR] = 3.58, 95% confidence interval [CI]: 1.61–7.97). Of current cigarette smokers, waterpipe use was associated with heavier smoking (AOR = 1.56, 95% CI: 1.00–2.43) and first cigarette within 30 min of waking (AOR = 2.08, 95% CI: 1.35–3.19).ConclusionsSurveillance, prevention, and intervention programs should address waterpipe use in addition to cigarette smoking. Educational programs need to inform youth about the harmful and addictive effects of waterpipe smoking. Public health campaigns deglamourizing waterpipe use may help reduce waterpipe smoking among youth.     

Emotion dysregulation and smoking among treatment-seeking smokers

IntroductionThere has been increased scholarly interest in advancing the study of emotion dysregulation and substance use. However, there is limited study of emotion dysregulation in the context of smoking. The current study examined the emotion dysregulation global construct and sub facets in relation to negative affect reduction expectancies, coping motives, perceived barriers for quitting, and the severity of problems experienced during quit attempts.MethodTreatment seeking smokers (n = 469; 48.2% female, M_age = 36.59, SD = 13.58) enrolled in a smoking cessation trial and completed baseline measures of smoking cognitions and emotion dysregulation.ResultsResults indicated that the emotion dysregulation global score was significantly associated with each of the smoking dependent variables. Additionally, difficulty accessing emotion regulation strategies and difficulty engaging in goal-directed behavior were significantly associated with the dependent variables.ConclusionOverall, this is the first study to evaluate relations between multidimensional facets of emotion dysregulation and clinically relevant smoking variables. Emotion dysregulation may be an important treatment target for changing smoking.     

E-cigarette advertisements,and associations with the use of e-cigarettes and disapproval or quitting of smoking: Findings from the International Tobacco Control (ITC) Netherlands Survey

BackgroundMuch attention has been directed towards the possible effects of e-cigarette advertisements on adolescent never smokers. However, e-cigarette advertising may also influence perceptions and behaviours of adult smokers. The aim of our study was to examine whether noticing e-cigarette advertisements is associated with current use of e-cigarettes, disapproval of smoking, quit smoking attempts, and quit smoking success.MethodsWe used longitudinal data from two survey waves of the ITC Netherlands Survey among smokers aged 16 years and older (n = 1198). Respondents were asked whether they noticed e-cigarettes being advertised on television, on the radio, and in newspapers or magazines in the previous 6 months.ResultsThere was a significant increase in noticing e-cigarette advertisements between 2013 (13.3%) and 2014 (36.0%), across all media. The largest increase was for television advertisements. There was also a substantial increase in current use of e-cigarettes (from 3.1% to 13.3%), but this was not related to noticing advertisements in traditional media (OR = 0.99, p = 0.937). Noticing advertisements was bivariately associated with more disapproval of smoking (Beta = 0.05, p = 0.019) and with a higher likelihood of attempting to quit smoking (OR = 1.37, p = 0.038), but these associations did not reach significance in multivariate analyses. There was no significant association between noticing advertisements and quit smoking success in either the bivariate or multivariate regression analysis (OR = 0.92, p = 0.807).ConclusionNoticing e-cigarette advertisements increased sharply in the Netherlands between 2013 and 2014 along with increased e-cigarette use, but the two appear unrelated. The advertisements did not seem to have adverse effects on disapproval of smoking and smoking cessation.     

Multidimensional assessment of nicotine dependence in adolescents

Despite the critical importance of adolescent smoking, the assessment of nicotine dependence during this developmental period has been the subject of relatively little research. In this study, 301 adolescents (ages 12 through 18 years) reporting daily smoking were recruited for a project on alcohol use disorders (AUDs). The sample included 140 females and 161 males, 251 subjects from clinical and 50 from community sources, and 176 subjects with AUDs at the baseline assessment. Subjects were evaluated with the Nicotine Dependence Syndrome Scale (NDSS), the Fagerstrom Test for Nicotine Dependence (FTND) and a determination of average number of cigarettes per day (cigarettes/day). A varimax factor analysis of 27 NDSS items revealed four factors: (1) Drive/Tolerance (13 items; Cronbach alpha = 0.91); (2) Continuity (five items; Cronbach alpha = 0.67); (3) Priority (three items; Cronbach alpha = 0.64); (4) Stereotypy (five items; Cronbach alpha = 0.66). The NDSS total score, refined by the removal of four items, was also examined (23 items; Cronbach alpha = 0.90). Predicting cigarettes/day at follow-up, initial smoking rate was the best predictor, with the FTND and NDSS Total score showing significant and similar predictive validity. The NDSS Total showed incremental validity in the prediction of smoking progression in a model including demographic characteristics, initial smoking rate and FTND. The findings suggest that the NDSS has acceptable psychometric properties when applied to adolescents, complementing smoking rate and FTND in a multidimensional smoking assessment.     

Development and initial testing of the brief adolescent smoking curiosity scale (ASCOS)

BackgroundAlthough the reasons behind tobacco smoking at young age are complex, research has identified curiosity as a potent driver of smoking among adolescents.ObjectiveThe objective of the current study is to develop and provide initial evidence of reliability and validity of a short scale assessing smoking curiosity among adolescents (first measure of its kind). In particular, we developed and tested the adolescent smoking curiosity scale (ASCOS).MethodsAfter scale development, 101 adolescents completed a survey on smoking-related measures, including ASCOS (June to August 2014). We conducted exploratory factor analysis and Cronbach's alpha calculation to inspect factor-structure and reliability. We conducted multiple linear regression models to examine the scale's capacity to predict antecedents of smoking initiation.ResultsFactor analysis supported a single-factor structure of smoking curiosity. ASCOS was internally reliable (Cronbach's alpha = 0.83). Controlling for demographics, the measure correlated significantly with temptation to try smoking (β = 0.41, p < 0.01), number of friends who smoke (β = 0.27, p < 0.01), agreeing with the pros of smoking (β = 0.41, p < 0.001), sensation seeking (β = 0.21, p < 0.05), and depression (β = 0.23, p < 0.01). When controlling for a single-item measure for smoking curiosity, ASCOS significantly predicted susceptibility to smoke cigarettes (OR = 3.40, p < 0.05) and cigars (OR = 6.66, p < 0.01).ConclusionsASCOS presented good psychometric properties and passed initial validity-testing through associations with antecedents of smoking. ASCOS was a better predictor of susceptibility to smoke than did a traditional single-item measure used by previous research. As an implication, ASCOS can be crucial to the development of tailored interventions for smoking prevention that can reduce smoking curiosity.     

Respiratory problems and anxiety sensitivity in smoking lapse among treatment seeking smokers

PurposeThe current study examined whether the interaction of lower respiratory symptoms and anxiety sensitivity is related to smoking lapse in the context of smoking cessation.MethodParticipants were adult daily smokers (N = 60) exposed to the World Trade Center (WTC) disaster who were in a smoking cessation treatment program (75.0% male, 50.6 years old [SD = 9.2], and current smoking rate was 17.6 cigarettes per day (SD = 10.6).ResultsResults indicated that the interaction between lower respiratory symptoms and anxiety sensitivity was a significant predictor of greater risk for lapse (i.e., lower survival time; B = 0.005, OR = 1.01, p = 0.039). Follow-up analysis showed that greater respiratory symptoms were a significant predictor of lapse risk among those with high (B = 0.116, OR = 1.12, p = 0.025), but not those with low (B = − 0.048, OR = 0.95, p = 0.322), levels of anxiety sensitivity.DiscussionThe findings from the current study suggest that smokers with greater respiratory symptoms and higher levels of anxiety sensitivity may be associated with early lapse to smoking following smoking cessation treatment. Future work has the potential to inform the development of tailored cessation interventions for smokers who experience varying levels of lower respiratory symptoms and anxiety sensitivity.     

Prevalence and correlates of a lifetime cannabis use disorder among pregnant former tobacco smokers

BackgroundFollowing tobacco and alcohol, cannabis is the most commonly used substance during pregnancy. Given the high prevalence of concurrent cannabis and tobacco use as well as the health consequences associated with prenatal substance use, we sought to document the relative contributions of psychosocial and psychiatric factors commonly associated with cannabis use in predicting a lifetime cannabis use disorder (CUD) among women who had quit smoking tobacco as a result of pregnancy.MethodsPregnant former tobacco smokers (n = 273) enrolled in a larger randomized controlled trial for postpartum tobacco relapse prevention completed semi-structured psychiatric interviews and self-reported demographic, pregnancy, health, psychosocial, and tobacco use factors during their third trimester of pregnancy.ResultsIn total, 14% (n = 38) of women met criteria for a lifetime CUD. The strongest predictors of a lifetime CUD were a history of having multiple psychiatric disorders (OR = 36.44; 95% CI = 5.03–264.27; p < 0.001) followed by a lifetime alcohol use disorder (OR = 3.54; 95% CI = 1.27–9.87; p < 0.05). In addition, more frequent attempts to quit smoking tobacco (OR = 1.12; 95% CI = 1.01–1.25; p < 0.05) and lower self-efficacy about weight management after quitting smoking tobacco (OR = 0.78; 95% CI = 0.62–0.97; p < 0.05) also were significantly associated with a lifetime CUD.ConclusionsWomen with a history of both cannabis and tobacco dependence may represent a subset of women who need more specialized treatment during the perinatal period to improve substance use outcomes.     

Reducing alcohol consumption to minimize weight gain and facilitate smoking cessation among military beneficiaries

IntroductionSmoking cessation-related weight gain can have significant negative health and career consequences for military personnel. Alcohol reduction combined with smoking cessation may decrease weight gain and relapse.MethodA randomized clinical trial of military beneficiaries compared a standard smoking cessation (i.e., brief informational) intervention (N = 159), with a brief motivational smoking cessation intervention that emphasized reduced drinking to lessen caloric intake and minimize weight gain (N = 158).ResultsParticipants who received the motivational intervention were significantly more likely to quit smoking at the 3-month follow-up (p = 0.02), but the differences were not maintained at 6 (p = 0.18) or 12 months (p = 0.16). Neither weight change nor alcohol reduction distinguished the 2 groups. Smoking cessation rates at 12 months (motivational group = 32.91%, informational group = 25.79%) were comparable to previous studies, but successful cessation was not mediated by reduced drinking.ConclusionsAlcohol reduction combined with smoking cessation did not result in decreased weight gain or improved outcomes.     

Treatment non-response: Associations with smoking expectancies among treatment-seeking smokers

Despite the high rate of smoking cessation treatment non-response, relatively little empirical work has examined predictors of treatment non-response. The present study sought to explore the effect of smoking outcome expectancies on treatment response in a sample of treatment-seeking adult daily smokers (N = 182; 53.3% female; M_age = 40.67; SD = 13.63). Results indicated that expectancies for smoking to reduce negative affect were related to an increased likelihood of treatment non-response (OR = 0.73, CI: 0.54, 0.98). These findings remained significant after controlling for sex, presence of Axis I disorder, tobacco-related health problems, tobacco dependence, anxiety sensitivity, and condition assignment as well as other smoking expectancy dimensions. Post hoc analyses revealed that this relation was stronger for smokers in the integrated care condition vs. the standard care condition (Interaction: OR = 1.69, CI: 1.05, 2.73). Additionally, expectancies for smoking to enhance positive affect and provide sensory satisfaction were associated with an increased likelihood of treatment response in the standard care condition. The current findings suggest expectancies that smoking will alleviate negative affect may be a risk factor of smoking cessation treatment non-response. Additionally, findings provide evidence that the relation between smoking expectancies and treatment non-response may differ by smoking cessation treatment.     

Get with the program: Adherence to a smartphone app for smoking cessation

IntroductionAlthough engagement is generally predictive of positive outcomes in technology-based behavioral change interventions, engagement measures remain largely atheoretical and lack treatment-specificity. This study examines the extent to which adherence measures based on the underlying behavioral change theory of an Acceptance and Commitment Therapy (ACT) app for smoking cessation predict smoking outcomes, and user characteristics associated with adherence.MethodsStudy sample was adult daily smokers in a single arm pilot study (n = 84). Using the app's log file data, we examined measures of adherence to four key components of the ACT behavior change model as predictors of smoking cessation and reduction. We also examined baseline user characteristics associated with adherence measures that predict smoking cessation.ResultsFully adherent users (24%) were over four times more likely to quit smoking (OR = 4.45; 95% CI = 1.13, 17.45; p = 0.032). Both an increase in tracking the number of urges passed (OR = 1.02; 95% CI = 1.00, 1.03; p = 0.043) and ACT modules completed (OR = 1.27; 95% CI = 1.01, 1.60; p = 0.042) predicted cessation. Lower baseline acceptance of cravings was associated with over four times higher odds of full adherence (OR = 4.59; 95% CI = 1.35, 15.54; p = 0.014).ConclusionsFull adherence and use of specific ACT theory-based components of the app predicted quitting. Consistent with ACT theory, users with low acceptance were most likely to adhere to the app. Further research is needed on ways to promote app engagement.     

Tobacco consumption and spontaneous quitting at the first trimester of pregnancy

IntroductionThe purpose of this study was to examine the association between pregnant women's socio-demographic characteristics, smoking-related variables and psychological symptoms (anxiety and depression) and both tobacco consumption and spontaneous quitting at the first trimester of pregnancy. In particular, we wished to examine the contribution of depressive symptoms to tobacco consumption and spontaneous quitting, while controlling for anxiety symptoms, socio-demographic and smoking-related variables.MethodsThe sample was comprised of 901 Spanish pregnant women. Assessment included an ad hoc questionnaire with socio-demographic and tobacco consumption information, the Edinburg Postnatal Depression Scale (EPDS), and The State-Anxiety Inventory (STAI-S). Two multiple logistic regression analyses were performed, respectively to predict tobacco consumption and to predict spontaneous quitting.ResultsHaving a partner who smokes (OR = 5.578), not having a college education (OR = 2.803), higher scores on the EPDS (OR = 1.073) and higher scores on the STAI-S (OR = 1.027) increase the probability of continuing smoking. Being primiparous (OR = 2.463), having a college education (OR = 2.141), smoking fewer cigarettes before pregnancy (OR = 1.175), and lower scores on the STAI-S (OR = 1.045) increase the probability of spontaneously quitting smoking at the first trimester of pregnancy.ConclusionsDepressive symptoms were a predictor of tobacco consumption but not of spontaneous quitting; spontaneous quitting was better predicted by anxiety symptoms. These findings support recommendations that women with depressive symptoms are at risk for smoking during pregnancy and highlight that anxious symptoms should be targeted in interventions for smoking cessation during pregnancy.     

Breakdowns of eye movement control toward smoking cues in young adult light smokers

BackgroundMany studies suggest that dependent smokers have a preference or attentional bias toward smoking cues. The purpose of this study was to test the ability of infrequent non-dependent light smokers to control their eye movements by look away from smoking cues. Poor control in the lightest of smokers would suggest nicotine cue-elicited behavior occurring even prior to nicotine dependency as measured by daily smoking.Methods17 infrequent non-dependent light smokers and 17 lifetime non-smokers performed an antisaccade task (look away from suddenly appearing cue) on smoking, alcohol, neutral, and dot cues.ResultsThe light smokers, who were confirmed light smokers and non-dependent (M_{Faegerström Dependency Score} = 0.35), were significantly worse at controlling their eye movements to smoking cues relative to both neutral cues (p < .04) and alcohol cues (p < .02). Light smokers made significantly more errors to smoking cues than non-smokers (p < .004).ConclusionsThese data suggest that prior to developing clinical symptoms of severe dependence or progressing to heavier smoking (e.g., daily smoking), the lightest of smokers are showing a specific deficit in control of nicotine cue-elicited behavior.     

The relationship of dysthymia,minor depression,and gender to changes in smoking for current and former smokers: Longitudinal evaluation in the U.S. population

BackgroundAlthough data clearly link major depression and smoking, little is known about the association between dysthymia and minor depression and smoking behavior. The current study examined changes in smoking over 3 years for current and former smokers with and without dysthymia and minor depression.MethodsParticipants who were current or former daily cigarette smokers at Wave 1 of the National Epidemiologic Survey on Alcohol and Related Conditions and completed the Wave 2 assessment were included in these analyses (n = 11,973; 46% female). Analyses examined the main and gender-specific effects of current dysthymia, lifetime dysthymia, and minor depression (a single diagnostic category that denoted current and/or lifetime prevalence) on continued smoking for Wave 1 current daily smokers and continued abstinence for Wave 1 former daily smokers.ResultsWave 1 current daily smokers with current dysthymia (OR = 2.13, 95% CI = 1.23, 3.70) or minor depression (OR = 1.53, 95% CI = 1.07, 2.18) were more likely than smokers without the respective diagnosis to report continued smoking at Wave 2. Wave 1 former daily smokers with current dysthymia (OR = 0.44, 95% CI = 0.20, 0.96) and lifetime dysthymia (OR = 0.37, 95% CI = 0.15, 0.91) were less likely than those without the diagnosis to remain abstinent from smoking at Wave 2. The gender-by-diagnosis interactions were not significant, suggesting that the impact of dysthymia and minor depression on smoking behavior is similar among men and women.ConclusionsCurrent dysthymia and minor depression are associated with a greater likelihood of continued smoking; current and lifetime dysthymia are associated with a decreased likelihood of continued smoking abstinence.     

Panic attacks and smoking cessation among cancer patients receiving smoking cessation treatment

ObjectiveLittle is known about factors associated with smoking cessation in cancer patients. This study examined the impact of panic attacks on smoking abstinence likelihood among cancer patients receiving tobacco cessation treatment.MethodThe relationship of panic attacks to 7-day point-prevalence abstinence at mid-treatment, end of treatment, and 6-month post-end of treatment were examined among cancer patients (N = 2255 patients; 50.1% female; M_age = 54.9, SD = 11.0) who received counseling and pharmacotherapy for smoking cessation. Panic attack history indexed by two questions from the Patient Health Questionnaire (PHQ). Point-prevalence abstinence was assessed via the Timeline Follow-Back.ResultsCancer patients with a history of panic attacks, (n = 493, 21.9%) relative to those without, were less likely to be abstinent at mid-treatment (OR = 0.79, CI_95% = 0.64–0.98) and end of treatment (OR = 0.72, CI_95% = 0.58–0.89). After adjusting for significant covariates, panic attack history remained predictive of decreased abstinence likelihood at end of treatment (OR = 0.78, CI_95% = 0.62–0.99).ConclusionsPanic attacks may be related to poorer cessation outcome during smoking treatment among cancer patients, and may be usefully assessed and targeted for intervention.     

Impact of the Spanish smoking laws on tobacco consumption and secondhand smoke exposure: A longitudinal population study

BackgroundIn Spain, two smoke-free laws have been passed after the approval of the WHO-FCTC. This study assesses the impact of these Spanish smoking legislations on the active and passive smoking through a population cohort in Barcelona (Spain).MethodsThis is a longitudinal study before and after the implementation of two national smoking bans in Spain in a representative sample (n = 1245) of adults (≥ 16 years old) from Barcelona (Spain) surveyed in 2004–2005 and followed-up in 2013–2014. The final sample analyzed was 736 individuals. Both questionnaires (before and after the two laws) included the same variables about active and passive smoking. We calculated the prevalence and the prevalence ratio (PR, with their 95% confidence intervals, 95% CI) of smoking cigarettes and hand-rolled tobacco and also the prevalence of exposure to secondhand smoke (SHS) at home, work, public transport, leisure time and at any setting after vs. before Spanish legislations.ResultsAfter the implementation of the two Spanish smoke-free bans, a significant decrease was observed in the smoking prevalence (from 34.5% to 26.1%, PR = 0.76, p < 0.001), in the average cigarettes per day (median from 15.2 to 10.0, p < 0.001), and in the percentage of conventional tobacco consumption (from 92.6% to 74.4%, PR = 0.80, p < 0.001). Furthermore, a significant increase in the use of hand-rolled tobacco (from 6.1% to 30.9%, PR = 5.07, p < 0.001) and other tobacco products (from 17.1% to 32.8%, PR = 1.92, p < 0.001) was observed. In addition, a significant decrease in the self-reported SHS exposure was observed in all the assessed settings (home, work, transport, and leisure time).ConclusionsThe implementation of the two smoke-free legislations in Spain is related to a reduction in smoking prevalence and SHS exposure. However, the smoking of other tobacco products, particularly hand-rolled tobacco, has increased among young population.     

Pilot toxicokinetic study and absolute oral bioavailability of the Fusarium mycotoxin enniatin B1 in pigs

The aim of present study was to reveal the toxicokinetic properties and absolute oral bioavailability of enniatin B1 in pigs. Five pigs were administered this Fusarium mycotoxin per os and intravenously in a two-way cross-over design. The toxicokinetic profile fitted a two-compartmental model. Enniatin B1 is rapidly absorbed after oral administration (T_1/2a = 0.15 h, T_max = 0.24 h) and rapidly distributed and eliminated as well (T_1/2elα = 0.15 h; T_1/2elβ = 1.57 h). The absolute oral bioavailability is high (90.9%), indicating a clear systemic exposure. After intravenous administration, the mycotoxin is distributed and eliminated rapidly (T_1/2elα = 0.15 h; T_1/2elβ = 1.13 h), in accordance with oral administration.     

Transitioning from adequate to inadequate sleep duration associated with higher smoking rate and greater nicotine dependence in a population sample

IntroductionInadequate sleep (≤ 6 and ≥ 9 h) is more prevalent in smokers than non-smokers but the extent to which sleep duration in smokers relates to smoking behaviors and cessation outcomes, is not yet clear. To begin to address this knowledge gap, we investigated the extent to which sleep duration predicted smoking behaviors and quitting intention in a population sample.MethodsData from current smokers who completed the baseline (N = 635) and 5-year follow-up (N = 477) assessment in the United Kingdom Biobank cohort study were analyzed. Multivariable regression models using smoking behavior outcomes (cigarettes per day, time to first cigarette, difficulty not smoking for a day, quitting intention) and sleep duration (adequate (7–8 h) versus inadequate (≤ 6 and ≥ 9 h) as the predictor were generated. All models adjusted for age, sex, race, and education.ResultsWorsening sleep duration (adequate to inadequate) predicted a more than three-fold higher odds in increased cigarettes per day (OR = 3.18; 95% CI = 1.25–8.06), a more than three-fold increased odds of not smoking for the day remaining difficult (OR = 3.90; 95% CI = 1.27–12.01), and a > 8-fold increased odds of higher nicotine dependence (OR = 8.98; 95% CI = 2.81–28.66). Improving sleep duration (i.e., inadequate to adequate sleep) did not predict reduced cigarette consumption or nicotine dependence in this population sample.ConclusionTransitioning from adequate to inadequate sleep duration may be a risk factor for developing a more “hard-core” smoking profile. The extent to which achieving healthy sleep may promote, or optimize smoking cessation treatment response, warrants investigation.