A family history of smoking predicts heightened levels of stress-induced cigarette craving

Aims: Individuals with histories of smoking in first-degree relatives are significantly more likely to be persistent smokers themselves. The mechanisms underlying this relationship are unknown. Considerable research has demonstrated that smokers display heightened levels of cigarette craving after being exposed to stressful situations, and the magnitude of these craving responses is thought to be predictive of later cessation failure. Based on this research, we tested experimentally the hypothesis that smokers with two or more first-degree relatives who smoked (FH+) would exhibit stronger craving reactions following stressful stimuli than smokers without such family histories (FH-). Participants: We recruited 83 smokers by advertisement (mean age = 41.2 years. 57% female, 41% completed some college, 59% African American). Setting: The study was conducted in an interview room in an urban medical center. Design: Participants were exposed to a neutral situation (changing a lightbulb) and a stressful situation (dental work) using script-guided imagery. Measurements: Participants completed background measures of demographics, distress and smoking behavior. In addition, participants completed cigarette craving and anxiety questionnaires immediately before and after each condition. Findings: Supporting the study hypothesis, FH+ smokers (n= 39) selectively displayed stronger craving reactions to dental imagery (P < 0.03) than did FH- smokers (n = 44). Conclusion: The higher levels of stress-induced cigarette craving demonstrated experimentally for individuals with family histories of smoking suggest one mechanism for their poorer cessation success.