Edited by Susan T. Fiske, Princeton University, Princeton, NJ, and approved November 13, 2019 (received for review June 9, 2019)
The epidemic of deaths attributable to addictive substances, including tobacco, highlights the need to better understand ways in which emotions drive substance craving and consumption. In a test of alternative theories of emotion and decision making, we found that sadness, specifically, rather than negative mood, generally, increased addictive substance use. In a nationally representative, longitudinal sample, sadness—but not other negative emotions—reliably predicted current smoking and relapse 20 y later. In laboratory experiments with real smokers, sadness increased both impatience for cigarette puffs and actual volume of puffs taken. Results provide not only theoretical implications but also policy implications for the design of antismoking public service announcements, which could unintentionally increase cigarette cravings among smokers if they trigger sadness.
Do negative feelings in general trigger addictive behavior, or do specific emotions play a stronger role? Testing these alternative accounts of emotion and decision making, we drew on the Appraisal Tendency Framework to predict that sadness, specifically, rather than negative mood, generally, would 1) increase craving, impatience, and actual addictive substance use and 2) do so through mechanisms selectively heightened by sadness. Using a nationally representative, longitudinal survey, study 1 (n = 10,685) revealed that sadness, but not other negative emotions (i.e., fear, anger, shame), reliably predicted current smoking as well as relapsing 20 years later. Study 2 (n = 425) used an experimental design, and found further support for emotion specificity: Sadness, but not disgust, increased self-reported craving relative to a neutral state. Studies 3 and 4 (n = 918) introduced choice behavior as outcome variables, revealing that sadness causally increased impatience for cigarette puffs. Moreover, study 4 revealed that the effect of sadness on impatience was more fully explained by concomitant appraisals of self-focus, which are specific to sadness, than by concomitant appraisals of negative valence, which are general to all negative emotions. Importantly, study 4 also examined the topography of actual smoking behavior, finding that experimentally induced sadness (as compared to neutral emotion) causally increased the volume and duration of cigarette puffs inhaled. Together, the present studies provide support for a more nuanced model regarding the effects of emotion on tobacco use, in particular, as well as on addictive behavior, in general.
Author contributions: C.A.D., K.W., V.W.R., I.K., K.M.M.E., and J.S.L. designed research; C.A.D., K.W., and J.S.L. performed research; C.A.D., K.W., V.W.R., I.K., K.M.M.E., and J.S.L. analyzed data; and C.A.D., K.W., V.W.R., I.K., K.M.M.E., and J.S.L. wrote the paper.
The authors declare no competing interest.
This article is a PNAS Direct Submission.
This article contains supporting information online at https://www.pnas.org/lookup/suppl/doi:10.1073/pnas.1909888116/-/DCSupplemental.
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