SMOKING BEHAVIOR AND THE STRESS/ILLNESS MODEL

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The stress/smoking literature is pretty much a jumble of titillating but disjointed findings. Stress is operationalized variously, as is smoking. It is difficult to discern a pattern of results that would clearly suggest what the next step in research should be and how the critical outcomes of health and illness might tie in. Some comprehensive conceptual framework is now sorely needed to help organize extant stress/smoking results and guide future research efforts. This project employs such a conceptual model. Four constructs occasionally referred to as stress, have been found to be associated with aspects of smoking behavior. They are: psychophysiological distress, major life events, daily irritations and personality trait anxiety. The model predicts that psychophysiological distress directly influences variations in smoking behavior and minor illness and is itself influenced directly by daily irritations and trait anxiety and indirectly by major life events. Protective psychosocial factors are also introduced and predicted to buffer the translation of stress into smoking and illness. Two hundred smoking and 100 nonsmoking college students will be recruited and paid to complete the questionnaire for the assorted stress and psychological measures, to participate in health interviews and focused physical examinations and, for smokers only, to have smoking characterization by a human smoking machine and cotinine analyses done. Subjects will be seen twice with one month between visits. The University of Kentucky Survey Research Center will manage subject recruitment and data collection. Multiple regression will be used to analyze the data. The two major strengths of the study are the use of a conceptual framework to organize extant results and guide further research and the use of objective in addition to self-report measures of smoking and physical status. Other strengths include the examination of the effects of protective factors for the first time in the smoking area and use of a longitudinal research design.