Cigarette smoking is the leading preventable cause of death in the United States, and data suggest that it is responsible for over 438,000 deaths per year (Centers for Disease Control and Prevention, 2002, Centers for Disease Control and Prevention, 2005 and National Institute on Drug Abuse, 2001). Recent statistics indicate that approximately 19.8% of the general United States population currently smokes cigarettes, but prevalence estimates rise to 22.2% for college-aged adults ages 18 to 24 years (Centers for Disease Control and Prevention, 2007 and Centers for Disease Control and Prevention, 2008). Furthermore, studies have shown that 11% of smokers report that they first tried cigarettes after the age of 19, that between 11.5% and 22% of college students who have never smoked progress to occasional or daily smoking during the college years, and that the period of risk for smoking initiation may continue until age 20 (Costa et al., 2007, DeWit et al., 1997, Everett et al., 1999, Stockdale et al., 2005 and Wetter et al., 2004). Therefore, it is important to understand the factors that influence smoking behavior among college students.
Research suggests that smoking among college students may be influenced by the presence of clinical depression or depressive symptomatology (Brown, et al., 2001). As many as 31.9% of undergraduate smokers report that they smoke to manage depression (DeBernardo, et al., 1999). Higher levels of depression are associated with lower self-efficacy to resist smoking, which in turn is associated with higher levels of self-reported smoking behavior (Kear, 2002). In addition, higher scores on specific subscales of the Multiscore Depression Inventory (Instrumental Helplessness, Social Isolation/Withdrawal) are associated with an increased likelihood and intention to smoke among high school and college students (Vogel, Hurford, Smith, & Cole, 2003). What is more, college students are more likely to use tobacco if they have a history of depression, which may represent proneness or vulnerability to depression (Lenz, 2004, McChargue & Cook, 2007 and Schleicher et al., 2009). For example, college students are five to seven times more likely to use tobacco within the past month or year if they have a lifetime diagnosis of depression or have been treated for depression (McChargue, Spring, Cook, & Neumann, 2004).
If vulnerability to depression is linked to smoking behavior in college students, then it is important to understand the moderators and mediators of this relationship so that researchers and clinicians can develop more effective targeted smoking prevention and cessation interventions for this population. Gender may be one such important moderator, given that women are two times more likely than men to experience depression and that depressed female college students exhibit greater levels of nicotine dependence compared to their male counterparts (American Psychiatric Association, 2000 and McChargue et al., 2004).
Expectations that smoking will reduce negative affect may mediate the relationship between depression and smoking, such that college students may be more likely to smoke because they expect it will relieve negative mood (i.e., they hold negative reinforcement expectancies). There is evidence to suggest that heavier, more dependent smokers hold more positive expectations about the consequences of smoking compared to lighter smokers or non-smokers ( Brandon & Baker, 1991). In addition, expectancies for positive outcomes (e.g., social facilitation, relaxation, mood enhancement) appear to be more strongly related to cigarette consumption than expectancies for negative outcomes (e.g., negative health consequences) ( Brandon et al., 1999 and Copeland & Carney, 2003).
Although research has demonstrated that affect and smoking expectancies are linked and may predict smoking behavior, only three studies to our knowledge have examined the role of smoking expectancies as a mediating variable between negative affect and smoking behavior in young adults (Brandon et al., 1996, McKee, et al., 2003 and Schleicher et al., 2009). One study found that positive smoking expectancies, or expectations of positive reinforcement from smoking, partially mediated the relationship between negative affect and self-reported smoking behavior among young adults (Cohen, McCarthy, Brown, & Myers, 2002). In a similar study among college students, positive smoking expectancies mediated the relationship between history of depression and smoking status, such that students with a history of depression were more likely to smoke when they held positive expectations about the consequences of smoking (McChargue, Spring, et al., 2004). A more recent study showed that negative reinforcement expectancies, in the form of negative affect reduction expectancies, mediated the relationship between a history of depression and the number of cigarettes smoked in the past month (Schleicher, et al., 2009). While these studies are informative, the first two did not evaluate negative reinforcement expectancies as a mediator of the relationship between depression and smoking status, and none of the three studies addressed whether smoking expectancies operate differently for males and females.
The present study was designed to examine the relationship between vulnerability to depression and smoking behavior among college students, while evaluating gender and negative reinforcement expectancies (specifically, expectations of negative affect reduction) as potential moderators or mediators of this relationship. It was hypothesized that depression vulnerability would predict self-reported smoking behavior. It was also hypothesized that gender would moderate the relationship between depression vulnerability and self-reported smoking behavior, such that this predictive relationship would exist for females, but not males. Finally, it was hypothesized that the relationship between depression vulnerability and self-reported smoking behavior would be mediated by negative reinforcement expectancies, but only among female participants.
