Smoking Antecedents: Separating Between- and Within-Person Effects of Tobacco Dependence in a Multiwave Ecological Momentary Assessment Investigation of Adolescent Smoking

Attempts to characterize the momentary antecedents of smoking are among the earliest and most prominent uses of ecological momentary assessment (EMA) methodology in tobacco research. In this work, the frequencies of various contextual attributes recorded in user-logged smoking events are contrasted with the base rates at which each is observed during time-sampled diary entries (Paty, Kassel, & Shiffman, 1992). Features that are found more commonly during smoking than background states may represent triggers for cigarette use. Theoretically, the salient triggers for smoking might change across the early smoking career as tobacco dependence progresses. The nature of such changes might help to refine our theoretical understanding of tobacco dependence and inform tobacco prevention and intervention efforts. Investigators have attempted to investigate this issue by collecting EMA data from samples representing a range of tobacco involvement, then testing whether dependence level or daily smoking moderates associations between measured antecedent conditions and smoking events (e.g., Cronk & Piasecki, 2010; Krukowski, Solomon, & Naud, 2005; Otsuki, 2009; Otsuki, Tinsley, Chao, & Unger, 2008; Shiffman & Paty, 2006; Shiffman & Rathbun, 2011). Findings from these studies vary, but they frequently indicate that cigarette use among smokers higher in dependence is more weakly related to specific contextual setting events. Conversely, smoking among less dependent individuals occurs under more circumscribed conditions, especially “indulgent” conditions such as relaxing, socializing, eating, or drinking alcohol (Shiffman & Paty, 2006). Such results have been interpreted as suggesting that the progression of tobacco dependence is accompanied by an erosion of stimulus control over smoking (Piasecki, Richardson, & Smith, 2007; Shiffman & Paty, 2006). With increasing smoking exposure, cigarette use is thought to be increasingly driven by habit and withdrawal avoidance. Although the existing EMA findings provide valuable clues about the trajectory of smoking patterns, they rely on comparing data from individuals who differ in dependence level at a single point in time. Thus, these designs cannot rigorously resolve the developmental question of whether the triggers for smoking evolve as a given individual’s dependence grows. An alternate explanation might be that individuals who eventually develop dependence have always used cigarettes in distinctive conditions compared to persons destined to be long-term chippers, intermittent smokers, or those who “mature out” of smoking experimentation (Shiffman & Paty, 2006; Shiffman et al., 2012). Longitudinal studies incorporating multiple waves of EMA data collection are needed to more directly address this developmental question. In this article, we investigate this question using data from a study of adolescents recruited in 9th and 10th grade and followed for 2 years. During this span, participants completed up to four 1-week bouts of EMA recording using electronic diaries, answering randomly timed prompts, and logging smoking events. At each wave, participants also completed a youth-specific version of the Nicotine Dependence Syndrome Scale (NDSS; Sterling et al., 2009). This design permits a separation of the NDSS data variation within a multilevel model into between-person and intraindividual components, allowing direct tests of whether each aspect moderates associations between contextual antecedents and smoking behavior.