Negative Urgency and Emotion Regulation Predict Positive Smoking Expectancies in Youth

Introduction: It is estimated that 42.1 million adults in the Unites States are current cigarette users, with most adult smokers becoming addicted to tobacco before age 18. Although rates of tobacco use among youth are decreasing, recent findings show that close to one-fourth of high school students are current tobacco users. This is of significant concern given estimates that among smokers under the age of 18, more than 6 million will likely die prematurely from a smoking related disease. Research suggests that a critical period exists in young children, during which they establish beliefs, or expectancies, about the reinforcing and punishing effects of substances. Positive expectancies related to cigarette use have been shown to predict smoking initiation among youth who have never smoked. These findings suggest that preventative efforts should target expectancies in young children prior to smoking onset to best deter tobacco use. The current study examines the relationship that two risk factors strongly associated with smoking behavior, namely, negative urgency (i.e., the tendency to engage in risky behaviors due to intense negative mood) and emotion regulation, have on the development of positive smoking expectancies among cigarette naïve youth.

Methods: Participants were 61 children aged 10-14 (mean=12.03) with a negative history of nicotine use. Most participants were female (62%) and Caucasian (41%) or African American (43%). Each participant completed measures of negative urgency, emotion regulation and positive smoking expectancies.

Results: Both emotion dysregulation (b = .66, p = .06) and negative urgency (b = .53, p =.05) were significantly and independently associated with smoking expectancies. The interaction between emotion dysregulation and negative urgency was significant (b = .14, p = .05), such that emotion dysregulation was not significantly related to smoking expectancies at low levels of negative urgency (b = .21, p = .65), but was significantly related to smoking expectancies at mean (b = -.61, p = .03) and high (b = -1.42, p = .004) levels of negative urgency.

Conclusion: The findings provide evidence that both emotion regulation and negative urgency are related to positive smoking expectancies in naïve-smoking youth. Further, these findings suggest that children who are both emotionally dysregulated and who act rashly in response to negative emotions are more likely to endorse positive smoking expectancies, suggesting that they are at greater risk for smoking onset. Given these findings, engaging impulsive, emotionally labile youth using expectancy challenge strategies, among others, may yield promising preventative outcomes.