Fatigue and Smoking Relapse

The majority of smokers in the US report a desire to quit and most, who smoke, make a serious quit attempt each year, primarily on their own (i.e., self-guided quit). Smoking prevalence has stabilized as the remaining population becomes increasingly representative of “at-risk smokers” who are unable to quit. The experience of prolonged fatigue may be one underrecognized but highly common problem that may help in understanding smoking maintenance and relapse. Prolonged fatigue is defined as self-reported, persistent fatigue lasting 1 month or longer. Emerging work suggests that prolonged fatigue is common among smokers and that nicotine may be used to combat fatigue. However, there has been no research on prolonged fatigue in relation to actual smoking behavior. Therefore, the purpose of the present study was to better understand whether and how individual differences in severity of fatigue predict smoking behavior during an experimental relapse analogue task. Participants attended two counterbalanced experimental sessions- (1) smoking deprivation (16 hours smoking deprived) and (2) smoking as usual. It was hypothesized that greater fatigue severity would predict greater number of cigarettes smoked, puff velocity, smoking urges, smoking withdrawal, and shorter latency to first cigarette and inter-puff intervals. In addition, it was hypothesized that smoking deprivation would significantly moderate such relations. Participants in the current study included 36 (Mage= 49.25; SD=8.83; 54.1% male) daily cigarette smokers that reported past month fatigue. Results were partially consistent with prediction. Specifically, results suggest that fatigue severity statistically significantly predicted smoking withdrawal (b=0.16, p<.05). Smoking deprivation condition statistically significantly predicted number of cigarettes smoked (b=1.35, p<.05) and puff velocity (b=28.24, p<.05). Lastly, the interaction between fatigue severity and smoking deprivation condition statistically significantly predicted number of cigarettes smoked (b=-0.29, p<.05), such that individuals that were smoking deprived reported lower levels of fatigue and smoked more cigarettes. However, due to sample size limitations, more work is needed to better understand the role of severe fatigue in the context of smoking behavior. Future work would benefit from more directly manipulating fatigue among smokers, such as through behavioral tasks or sleep deprivation, to determine the impact of severe fatigue on smoking behavior.