Peer pressure, psychological distress and the urge to smoke

Background: Psychology and addiction research have found that cigarette smokers react with subjective and automatic responses to stimuli associated with smoking. This study examines the association between the number of cigarettes smokers consume per month and their response to cues derived from peer and psychological distress. Methods: We studied 1,220 adult past and current smokers drawn from a national face-to-face interview survey administered in 2004. We defined two types of cues possibly triggering a smoker to have a cigarette: peer cues and psychological cues. We used ordinary least square linear regressions to analyze smoking amount and response to peer and psychological distress cues. Results: We found a positive association between amount smoked and cue response: peer cues (1.06, 95%CI: 0.74-1.38) and psychological cues (0.44, 95%CI = 0.17-0.70). Response to psychological cues was lower among male smokers (-1.62, 95%CI = - 2.26- -0.98), but response to psychological cues were higher among those who had senior high school level educations (0.96, 95%CI = 0.40-1.53) and who began smoking as a response to their moods (1.25, 95%CI = 0.68-1.82). Conclusions: These results suggest that both peer cues and psychological cues increase the possibility of contingent smoking, and should, therefore, be addressed by anti-smoking policies and anti-smoking programs. More specifically, special attention can be paid to help smokers avoid or counter social pressure to smoke and to help smokers resist the use of cigarettes to relieve distress.