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The restorative effects of smoking upon self-control resources

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Title:
The restorative effects of smoking upon self-control resources
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English
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Heckman, Bryan
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University of South Florida
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Subjects / Keywords:
Self-regulation
Addiction
Tobacco
Negative reinforcement
Task persistence
Dissertations, Academic -- Psychology -- Masters -- USF   ( lcsh )
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non-fiction   ( marcgt )

Notes

Abstract:
ABSTRACT: Based on a model that considers self-control (SC) to be a limited resource, research suggests that diminished SC resources increase the likelihood of smoking. Yet, no study has evaluated how smoking affects SC resources. This study used a randomized, 2 x 2 crossed factorial (SC depletion manipulation X smoking manipulation), between-subjects design to test the hypothesis that smoking restores depleted SC resources. To manipulate SC depletion, half of the 132 dependent smokers were instructed to suppress their emotional reaction to a brief video depicting environmental damage (i.e., Depletion), whereas the other half were instructed to "act natural" (i.e., No Depletion) during viewing. Half of the participants in each condition then smoked a cigarette, whereas the other half sat patiently, without smoking (i.e., Smoke vs. No Smoke). All participants then completed two behavioral measures of SC (Mirror Tracing Performance Task: MTPT; and breath-holding). As hypothesized, an interaction occurred between the Depletion and Smoking manipulations for duration of time spent on the MTPT. That is, participants in the depletion condition showed less persistence on the MTPT, unless they were permitted to smoke. There was no evidence for mediation of this effect from the influence of smoking on affect and/or urge. Thus, smoking appeared to restore depleted SC resources, independent of its effects on self-reported affect and urge. Findings suggest that restoration of SC resources may represent another form of negative reinforcement from smoking that may play a role in nicotine dependence, and could inform treatment development.
Thesis:
Thesis (MA)--University of South Florida, 2010.
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Includes bibliographical references.
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by Bryan Heckman.
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ABSTRACT: Based on a model that considers self-control (SC) to be a limited resource, research suggests that diminished SC resources increase the likelihood of smoking. Yet, no study has evaluated how smoking affects SC resources. This study used a randomized, 2 x 2 crossed factorial (SC depletion manipulation X smoking manipulation), between-subjects design to test the hypothesis that smoking restores depleted SC resources. To manipulate SC depletion, half of the 132 dependent smokers were instructed to suppress their emotional reaction to a brief video depicting environmental damage (i.e., Depletion), whereas the other half were instructed to "act natural" (i.e., No Depletion) during viewing. Half of the participants in each condition then smoked a cigarette, whereas the other half sat patiently, without smoking (i.e., Smoke vs. No Smoke). All participants then completed two behavioral measures of SC (Mirror Tracing Performance Task: MTPT; and breath-holding). As hypothesized, an interaction occurred between the Depletion and Smoking manipulations for duration of time spent on the MTPT. That is, participants in the depletion condition showed less persistence on the MTPT, unless they were permitted to smoke. There was no evidence for mediation of this effect from the influence of smoking on affect and/or urge. Thus, smoking appeared to restore depleted SC resources, independent of its effects on self-reported affect and urge. Findings suggest that restoration of SC resources may represent another form of negative reinforcement from smoking that may play a role in nicotine dependence, and could inform treatment development.
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The Restorative Effects of Smoking upon Self-Control Resources by Bryan W. Heckman A thesis submitted in partial fulfillment of the requirements for the degree of Master of Arts Department of Psychology College of Arts and Science University of South Florida Major Professor: Thomas H. Brandon, Ph.D. David D. Drobes, Ph.D. Jonathan Rottenberg, Ph.D. Kristen Salomon, Ph.D. Date of Approval: September 9, 2010 Keywords: self-regulation, addiction, tobacco, negative reinforcement, task persistence Copyright 2010, Bryan W. Heckman

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i Table of Contents List of Tables ..................................................................................................................... iii List of Figures .................................................................................................................... iv Abstract ................................................................................................................................v Introduction ..........................................................................................................................1 Self-Regulation and Self-Control Theory ................................................................4 Self-Regulation Failure ................................................................................5 Distress Tolerance: Another Form of Self-Control? ....................................7 Effects of Urge on Self-Control Resources .................................................9 Effects of Self-Control Resources on Addictive Behaviors ......................10 Can Smoking Restore SC...........................................................................10 Specific Aims .........................................................................................................12 Specific aim 1: To test if smoking can counteract the effects of self-control depletion .................................................................12 Specific aim 2: To test the effects of smoking on affect ............................13 Secondary aim 1: To test the effects of self-control depletion on motivation to smoke ..................................................................14 Secondary aim 2: To test the effects of self-control depletion on smoking satisfaction..................................................................14 Secondary aim 3: To explore potential mediating and moderating variables for the restorative effects of smoking ..........14 Method ...............................................................................................................................15 Experimental Design ..............................................................................................15 Participants .............................................................................................................16 Measures ................................................................................................................17 Baseline characteristics ..............................................................................17 Demographic questionnaire ...........................................................17 Smoking status questionnaire ........................................................17 Exhaled carbon monoxide ..............................................................17 Balanced Inventory of Desirable Responding-Impression Management .......................................................................17 Depression, Anxiety, and Stress Scale ...........................................18

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ii Manipulation checks ..................................................................................18 Emotional suppression check .........................................................18 Task appraisal-1 .............................................................................19 Specific aim 1: SC measures......................................................................19 Mirror-Tracing Persistence Task ...................................................19 Breath-holding ...............................................................................20 Specific aim 2: Affect measures ................................................................20 Mood Form ....................................................................................20 Deactivated pleasant affect ............................................................20 Secondary aim 1: Motivation to smoke .....................................................21 Urge to smoke ................................................................................21 Smoking topography ......................................................................21 Secondary aim 2: Smoking satisfaction .....................................................22 Modified Cigarette Evaluation Questionnaire ...............................22 Exploratory analyses ..................................................................................22 Distress Tolerance Scale ................................................................22 Emotion Regulation Questionnaire ................................................22 Self-Control Scale-Brief ................................................................22 Smoking Consequences Questionnaire-Adult ...............................23 Task Persistence Self-Report .........................................................23 Task appraisal-2 .............................................................................23 Manipulations ........................................................................................................24 SC depletion ...............................................................................................24 Smoking .....................................................................................................25 Procedure ...............................................................................................................25 Results ................................................................................................................................27 Preliminary Analyses .............................................................................................27 Baseline characteristics ..............................................................................27 Impression management ............................................................................27 Affect .........................................................................................................28 Depletion manipulation checks ..................................................................28 Smoking manipulation check .....................................................................29 Primary Analyses ...................................................................................................29 Specific aim 1: SC restoration ...................................................................29 Specific aim 2: Affect ................................................................................30 Secondary aim 1: Urge to smoke ...............................................................32 Secondary aim 1: Smoking topography .....................................................33 Secondary aim 2: Smoking satisfaction .....................................................33 Secondary aim 2: Mediation ......................................................................33 Additional Analyses ...............................................................................................34 TA-2 ...........................................................................................................34

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iii Discussion ..........................................................................................................................35 Effects of Smoking on Self-Control Resources .....................................................35 Effects of Smoking on Affect ................................................................................37 Possible Mediators of Self-Control Restoration from Smoking ............................38 Effects of Self-Control Depletion on Motivation to Smoke and Reward from Smoking .....................................................................................................40 Theoretical Implications ........................................................................................41 Treatment Implications ..........................................................................................43 Conclusion .............................................................................................................44 References ..........................................................................................................................45

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iv List of Tables Table 1: Means (Standard Errors) for Post-Smoking Manipulation Measures..................31

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v List of Figures Figure 1: Hypothesized results...........................................................................................12 Figure 2: Study design .......................................................................................................14 Figure 3: Schematic timeline of study procedures (with approximate durati on, in minutes) .............................................................................................................24 Figure 4: Mean duration of MTPT (and Standard Errors) as a function of the Depletion manipulation x Smoke manipulation interaction ..................................29 Figure 5: Covariate-adjusted (controlling for post-depletion and BIDR-IM scores) mean affect ratings (and standard errors) as a function of the Smoking manipulation main effects (Post-Smoke). ..............................................30

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vi The Restorative Effects of Smoking upon Self-Control Resources Bryan W. Heckman Abstract Based on a model that considers self-control (SC) to be a limited resource, r esearch suggests that diminished SC resources increase the likelihood of smoking. Yet, no stu dy has evaluated how smoking affects SC resources. This study used a randomize d, 2 x 2 crossed factorial (SC depletion manipulation X smoking manipulation), between-s ubjects design to test the hypothesis that smoking restores depleted SC resources. To manipulate SC depletion, half of the 132 dependent smokers were instructed to suppress their emotional reaction to a brief video depicting environmental damage (i.e., Deple tion), whereas the other half were instructed to “act natural” (i.e., No Depleti on) during viewing. Half of the participants in each condition then smoked a cigarette, where as the other half sat patiently, without smoking (i.e., Smoke vs. No Smoke). All participants then completed two behavioral measures of SC (Mirror Tracing Performanc e Task: MTPT; and breath-holding). As hypothesized, a disordinal interaction occurred be tween the Depletion and Smoking manipulations for duration of time spent on the MTPT. That is, participants in the depletion condition showed less persistence on the MTPT, un less they were permitted to smoke. There was no evidence for mediation of this effec t from the influence of smoking on affect and/or urge. Thus, smoking appeared to restore depleted SC resources, independent of its effects on self-reported affect and urge

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vii Findings suggest that restoration of SC resources may represent another for m of negative reinforcement from smoking that may play a role in nicotine dependence, and could inform treatment development.

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1 Introduction Tobacco use is the leading preventable cause of mortality worldwide (World Health Organization, 2008), and is responsible for approximately $193 billion in annua l medical expenses and lost productivity, nationally (CDC, 2008a). Despite these nega tive consequences, the adult smoking rate in the United States stands at 19.8% (CDC, 2008b). Although about 40% of these smokers attempt to quit each year (CDC, 2008b), only 4-7% succeed (Fiore et al., 2008). In addition to high relapse rates, there is evidenc e suggesting that the population of smokers is growing progressively more difficult to t reat (Hughes & Brandon, 2003; Irvin & Brandon, 2000; Irvin, Hendricks, & Brandon, 2003). These findings exemplify the need to better understand the reinforcing propert ies of smoking (Perkins, Donny, & Caggiula, 1999). As these properties emerge, our conceptualization of nicotine dependence will become more refined, ultimately leading to more effective interventions. Numerous models have been proffered to elucidate the mechanisms underlying nicotine dependence, including models informed by negative reinforcement (see Eissenberg, 2004), positive reinforcement (see Glautier, 2004), social learning, and cognitive theory (see Brandon, Herzog, Irvin, & Gwaltney, 2004). These theories may diverge on proposed mechanisms maintaining substance use, but they all view smoking as a learned behavior, and they need not to be viewed as mutually exclusive (Tiff any, Conklin, Shiffman, & Clayton, 2004). This study takes these models into account, with

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2 particular emphasis on the role of negative reinforcement on the facilitati on of smoking behavior. Specifically, we focus on the interrelationships of affect, self-contr ol (SC), and addictive behaviors. How affect is operationalized and measured can have profound impact on study design and interpretation of results (Kassel, Veilleux et al., 2007). Affect can be conceptualized broadly as a term superordinate to mood, emotion, stress, and impulses (see Gross & Thompson, 2007; Scherer, 1984). Affect regulation then, can be considered to include mood regulation, emotion regulation, coping, and defenses. Although affect is broad, affective state can be described in terms of two bipolar dimensions (se e Barrett & Russell, 1998). That is, a subjective experience can fall within one of four quadrants, delineated by a valence (positive or negative) and activation (activated or deac tivated). Kassel and colleagues highlight the importance of considering differential ( and possibly orthogonal) roles of negative and positive affect (NA and PA). In fact, there is evidence to suggest that each of these have been found to have different neural underpinnings (Cacioppo & Gardner, 1999; Davidson, 1992), psychological correlates (Clark & Watson, 1988; Watson, Clark, & Carey, 1988; Watson, Clark, & Tellegen, 1988), and effects from nicotine (Cook, Spring, & McChargue, 2004; Cook, Spring, & McChargue, 2007). We contend that PA and NA can be independent, but they can also covary, depending on the level of activation and valence of each (Barrett & Russell, 1998). Early accounts of negative reinforcement focused on the ability of substance use to ameliorate aversive withdrawal sympomatology, which then increased the li kelihood of subsequent use (Jellinek, 1960, Wikler, 1948; Wikler, 1980). More recently, the influence of substance use on affective processing has been propagated as the prepotent

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3 motive maintaining drug dependence (Baker, Piper, McCarthy, Majeskie, & Fi ore, 2004). Baker and colleagues propose that through repeated drug use, initially aimed to al leviate the aversive withdrawal syndrome, an individual acquires NA as an interocepti ve cue. Eventually, NA at levels outside of awareness may motivate consumption, in order to prevent it from reaching consciousness. Many other models of substance use also vi ew affective regulation as central to continued use, again emphasizing the role of ne gative reinforcement (e.g., Khantzian, 1997; Wills & Shiffman, 1985). In concordance with these models, a large proportion of dependent smokers endorse affect regulation as a primary motive for smoking (Copeland, Brandon, & Q uinn, 1995; Ikard, Green, & Horn, 1969; Shiffman, 1993). Smokers hold strong outcome expectancies concerning the effects of smoking on NA (Brandon, Juliano, & Copela nd, 1999), and in particular, the anxiolytic properties of smoking are reported as a contributing factor for maintenance (Frith, 1971; Spielberger, 1986). Additionally, desi re to smoke, (Payne, Schare, Levis, & Colletti, 1991; Perkins & Grobe, 1992), smoking intensity (Cherek, 1985; C. S. Pomerleau & O. F. Pomerleau, 1987), and amount of consumption (Conklin & Perkins, 2005; Epstein & Collins, 1977; Rose, Ananda, & Jarvik, 1983; Schachter, Silverstein, & Perlick, 1977) have all been found to increase as a result of negative mood induction. These findings support the notion that NA may serve as an antecedent to smoking, and this is likely driven by the belief that smoking w ill alleviate NA.

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4 Although NA appears to promote smoking behavior, and smokers believe consumption will attenuate NA, results have been less convergent as to whether sm oking actually reduces NA that is unrelated to withdrawal (see Kassel, Stroud, & Paronis, 2003). It has been suggested that smoking may only ameliorate withdrawal-induced NA and that smokers have generalized this, leading to expectancies of relief fr om NA produced by external stressors (Baker et al., 2004; Parrott, 1999). These expectanc ies have an impact though, as past research shows that smokers’ expectancies moderat e the effect of smoking on NA reduction from external stressors (Juliano & Brandon, 2002). Nonetheless, why smokers have these strong expectancies remains largely unanswered, and the failure to find a robust effect of smoking on NA may in part be due to disparity i n research methodology (Baker, Brandon, & Chassin, 2004), the influence of moderators (Kassel et al, 2003), and situation-specificity (Perkins, Karelitz, Conklin, S ayette, & Giedgowd, 2010). Self-Regulation and Self-Control Theory The self-regulation literature may be useful for elucidating the rel ationship between NA and smoking. Self-regulation, as defined by Baumeister (2002), i s a broad term referring to any effort by an organism to alter its own responses and encompasses both conscious and unconscious processes. Self-control (SC) is a term often used interchangeably with self-regulation, but those who make a distinction consider SC to be a subset of self-regulation, referring only to the conscious, deliberate, and ef fortful ability to manipulate one’s own responses (Baumeister, Vohs, & Tice, 2007).

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5 Self-Regulation Failure. Numerous behavioral and impulse-control problems have been linked to self-regulation failure, including: overeating, alcohol and drug a buse, crime and violence, overspending, sexually impulsive behavior, and smoking (Baumeister, Heatherton, & Tice, 1994). Self-regulation has been purported to fa il as a result of underregulation or misregulation (Baumeister et al., 1994). The former conc erns the failure to exert control over oneself, where as misregulation refers t o employing a SC strategy, that has detrimental long term consequences. Both forms of failure appear to be exacerbated by NA (Tice & Bratslavsky, 2000). In terms of misregulation, the priority hypothesis assumes that affect reg ulation takes priority over other forms of SC when someone is experiencing NA, even if t his leads to behaviors that may be damaging to one’s health (Tice, Baumeiste r, Zhang, Philippot, & Feldman, 2004). Experimentally manipulating emotional distress has be en found to increase impulse behaviors (Tice, Bratslavsky, & Baumeister, 2001) Furthermore, when told that these behaviors would not modify their mood, participant s no longer exhibited the increase of impulse behaviors. These findings suggest that emotional distress shifted priorities away from distal goals and toward the immediate present, thereby engaging in behaviors that may alleviate NA acutely (i.e., misregulation), and this can be altered by challenging expectancies c oncerning the capability of the behavior to alter affect. The impact of NA on smoking behavior, t he influence of smoking outcome expectancies as a motive to smoke, and the ability to manipulate these expectancies (Copeland & Brandon, 2000), are all congruent wi th this account.

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6 Efforts to cope with NA may also decrease limited resources, leaving one susceptible to underregulation. Muraven and Baumeister (2000) applied a muscle a nalogy to better clarify the concept of SC, and the occurrence of underregulation in part icular. They suggested that SC resources are limited and can become fatigued, much in t he same way that a muscle becomes fatigued following physical exertion. Further evaluation of this phenomenon led to the development of a SC energy model, which interprets SC as a limited psychological resource that is susceptible to depletion (Baumeister 2002; Baumeister, Bratslavsky, Muraven, & Tice, 1998; Baumeister, Vohs, & Tice, 2007; Muraven & Baumeister, 2000; Muraven, Tice, & Baumeister, 1998). A recent meta-analysis (Hagger, Wood, Stiff, & Chatzisarantis, 2010), incorporating the findings from 83 studies, provide support for the Self-Control Strength Model (also known as the Ego Depletion Model). There was medium-to-large effect size ( d + = .62; Cohen, 1988), with those that completed tasks requiring SC resources having reduced performanc e on subsequent SC tasks. The dual task experimental paradigm employed to examine the SC Strength Model involves the comparison of two groups on a frustrating or discomforting task (e .g. impossible tracing task, unsolvable anagrams, cold pressor, or handgrip). The se tasks are considered to require SC because participants must persist, despite the inclina tion to quit and escape the aversiveness of the task. Prior to completing this SC task, one group f irst completes an initial task thought to require SC (e.g. emotion suppression, resisting a tempting food, or thought suppression), whereas the other completes a comparable but benign task (e.g. acting naturally, resisting a non-tempting food, or completi ng math problems). Those who complete the initial SC task consistently perform worse on the

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7 second task of SC (both performance and duration based); leading to the conclusion that SC has been depleted. Although participants in the SC condition may rate their task to be more effortful and tiring than those in the comparison condition, both report comparable affect and arousal ratings, indicating that SC performance differences ca n occur independent of emotional state or arousal (e.g., Muraven et al., 1998). Distress Tolerance: Another Form of Self-Control? A line of research that coincides with the role of underregulation and smoking relapse, albeit stemming from an alternative conceptualization, concerns individual differences in the degree of tolerance to discomfort and distress (Brown, Lejuez, Kahler, Strong, & Zvolensky 2005). Durin g a cessation attempt, individuals must concurrently deal with the physical and psyc hological discomfort of withdrawal (Hughes, Higgins, & Hatsukami, 1990). Utilizing breath-holding duration as an analogue to persevering through withdrawal (based on the rationale that both depend on the capacity to withstand discomfort) the earliest st udies of this kind found that this biobehavioral index of persistence predicted smoking cessati on outcome (Hajek, 1991; Hajek, Belcher, & Stapleton, 1987). Behavioral persistence towards a goal, in the face of affective discomfort has since been operationaliz ed as distress tolerance (Brown et al., 2005). A similar construct, task persistence deriving from a learning-based “learned industriousness theory” (Eisenberger, 1992), em phasizes the role of reinforcement history for effort and its impact on persisting on fu ture effortful tasks. Both programs of research measure their respective constructs by persistence on psychological or physical challenge tasks (e.g. difficult mirror trac ing task, nearly impossible anagrams, paced auditory serial addition test (PASAT), CO 2 challenge, and breath-holding), all of which are similar to those used within the SC Strength pa radigm

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8 because they require continued persistence in the face of frustration and discomf ort. Collectively, these constructs have been found to differentiate smokers from nonsm okers (Quinn, Brandon, & Copeland, 1996) and to predict: duration of previous smoking and substance cessation attempts (Brown, Lejuez, Kahler, Strong, 2002); resident ial substance abuse treatment dropout rates (Daughters et al., 2005); and future smoking cessation outcome (Brandon et al., 2003). Also consistent with SC theory, distress tolerance has been found to be context-dependent, with 12-hour smoking deprivation leading to decreased breath-holding capacity (Bernstein, Trafton, Ilgen, & Zvolensky, 2008).

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9 Effects of Urge on Self-Control Resources. Substance use as a type of underregulation, rather than misregulation, has received far more attention wit hin the field of addiction (see Sayette, 2004). The emphasis on underregulation is likely a result of trying to understand the phenomenon of relapse. In the context of those trying to quit self-regulation may be required to overcome desires to smoke, which may impai r the capacity for future SC. Contrary to this notion is evidence from a study utilizing ecological momentary assessment (EMA) suggesting that resistin g temptations to smoke served as a protective factor to lapse (O’Connell, Schwartz, & Shiffman, 2008). T his may be explained by experimental evidence that SC expenditure may enhance SC performance within the same domain, but lead to deleterious effects in others (D ewitte, Bruyneel, & Geyskens, 2009). Consistent with this explanation, resisting the consumption of alcohol during in vivo alcohol cue exposure has been found to reduce performance on a handgrip and self-stopping task (Muraven & Shmueli, 2006), and suppressing the urge to drink has been found to intensify smoking behavior (Palfai, Colby, Monti, & Rohsenow, 1997). Thus, resisting smoking during a cessation attempt may lead to underregulation in other areas of life.

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10 Effects of Self-Control Resources on Addictive Behaviors. In addition to the potential for NA and urge to undermine effective self-regulation, SC res ources may independently influence substance use. For example, an EMA study found social drinker s to be more likely to violate self-imposed drinking limits on days when SC demands w ere high, and this effect remained after controlling for mood and urge (Muraven, Coll ins, Shiffman, & Paty, 2005). The SC Strength Model has been applied directly to evaluate the effect of SC depletion on substance use. A SC depletion task was found to increase alcohol consumption relative to a control task, among a sample of social drinkers who were motivated not to drink (Muraven, Collins, & Neinhaus, 2002). This effect occurred despite no group differences in mood, arousal, or frustration. To date, only one study has employed the typical SC model paradigm to evaluate the effects of SC depleti on on smoking behavior (Shmueli & Prochaska, 2009). Although the SC depletion task had no impact on urge to smoke or withdrawal, it increased the likelihood of smoking. This finding suggests that depletion of SC resources may independently increase the motivation to smoke, possibly at a level that is outside of awareness. Can Smoking Restore SC? Following the principles of reinforcement, depletion may serve as a discriminative stimulus for smoking. If smoking were to re duce the depletion effect, it would then be reinforced, increasing the likelihood of future engagement in the behavior. There is evidence that although SC is expendable, it can a lso be restored (Tice et al., 2004). PA and relaxation induction have been found to fac ilitate this replenishment (Tice, Baumeister, Shmueli, & Muraven, 2007; Smith, 2002; Tyler & Burns, 2008). The usual design for testing this parallels the original deple tion paradigm described above. Participants engaged in an initial act of SC (i.e. depleted) or a

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11 comparison condition (i.e. non-depleted), and then SC was measured on another, seemingly unrelated task. However, when a positive or relaxation mood induction was placed in between the two tasks, those that were depleted performed similar to those that were not. Because non-depleted participants who received PA did not outperform non-depleted participants who did not, it can be concluded that PA does not lead to broad SC improvement, but merely the restoration of depleted SC (Tice et al., 2007). If smoking were to increase PA and/or relaxation it may serve to restore SC resources. Dependent smokers commonly have outcome expectancies that smoki ng will increase PA (Copeland et al., 1995), and relaxation has been reliably reported as a motive for smoking (Dozois, Farrow, & Miser, 1995; Ikard, Green, & Horn, 1969; McNeil, Jarvis, & West, 1987). Although smokers have strong beliefs that smoking will led t o increases in PA, the actual effects of smoking on PA are less clear (Kas sel, Evatt et al., 2007). Many theories do focus on positive reinforcement as the mechanism maintaining drug dependence (Robinson & Berridge, 1993; Stewart, de Wit, & Eikelboom, 1984). Findings concerning the positive hedonic effects from smoking have been equivocal (Gilbert, 1995), but evidence is accumulating that suggests nicotine can increa se PA (Argue, 1973; Perkins et al., 2006; C. S. Pomerleau & O. F. Pomerleau, 1992; Warburton & Mancuso, 1998). However, studies typically focus on high activation PA (e.g., euphoria), leaving deactivated pleasant affect (e.g., relaxation, calmness ) largely unexamined (e.g., Kassel, Evatt, et al., 2007).

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12 Specific Aims We have reviewed evidence that SC is a limited resource and that acts requiri ng SC will impair future SC performance (i.e., depletion). Negative affect appears to facilitate this depletion, commonly serves as an antecedent to smoking, and may be attenuated following consumption. Positive affect appears to restore deplet ed SC resources, and may be augmented by smoking. Additionally, depleted SC resour ces, independent of affect, may lead to increased substance use. Smoking following SC depletion might serve to restore SC resources to baseline levels, allowin g smokers to cope more effectively with subsequent tasks requiring SC. Thus, the main goal of th e proposed study is to test empirically the influence of smoking on SC resources. Using a 2 X 2 experimental design we were able to test this hypothesis, using a common SC depletion manipulation (emotional suppression) followed by a smoking manipulation. Specific aim 1: To test if smoking can counteract the effects of self -control depletion. Given that emotional suppression should deplete SC resources, we hypothesized that participants in the emotional suppression (i.e., Depletion) condit ion would persist less on two SC tasks (nearly impossible mirror tracing and brea th-holding) than those in an “act natural” comparison condition (i.e., No Depletion). However, we hypothesized that participants who were allowed to smoke would not show this depletion effect on the SC tasks, because smoking would restore SC. Our primary dependent variable was duration spent on the mirror tracing task (MTPT). Breath-holding was considered as a secondary dependent variable, as the depletion effect may dissi pate quickly. Figure 1 illustrates the hypothesized results.

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13 No SmokeSmoke Mean Duration on MTPT or BH No Depletion Depletion Figure 1. Hypothesized results. Specific aim 2: To test the effects of smoking on affect Although the effects of smoking on affect appear to have a strong influence on maintaining smoking behavior, the actual effects of smoking on affect have been equivocal. First, we hypothesiz ed that those in the Smoking condition, compared to the No Smoking condition, would experience lower levels of NA, following the smoking manipulation. We also hypothesized that those in the Smoking condition, compared to the No Smoking condition, would experience higher levels of PA, following the smoking manipulation. We expect a similar pattern to emerge for deactivated pleasant affect ( DPA).

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14 Secondary aim 1: To test the effects of self-control depletion on motivati on to smoke. To date, only one study has directly tested the influence of SC depletion on motivation to smoke (Shmueli & Prochaska, 2009). Although SC depletion was found to have no effect on self-reported urge to smoke in that study, we hypothesized that participants in the Depletion condition would report higher craving than those in the N o Depletion condition, prior to the smoking manipulation. We also hypothesized that when given the opportunity to smoke, the Depletion condition would show patterns of smoking topography consistent with increased smoking motivation, as indexed by decre ased latency to smoke and inter-puff interval, and increased # of puffs, puff volume, puff duration, and maximum flow rate (velocity) per puff, when compared to those in the No Depletion condition. Secondary aim 2: To test the effects of self-control depletion on smoki ng satisfaction. Given that SC depletion may lead to more intense smoking topography and that smoking may be more reinforcing because it is paired with SC restoration, s ubjective ratings about the rewarding aspects of smoking may vary. We hypothesized that smoking would be more satisfying and psychologically rewarding, as indicated by selfreport, for those in the Depletion condition compared to those in the No Depletion condition. Secondary aim 3: To explore potential mediating and moderating variables for the restorative effects of smoking. Given that smoking may have effects on selfreported affect and urge to smoke, changes in these variables were tested as pos sible mediators, within the two depletion conditions (i.e. Smoke vs. No smoke), on the hypothesized effects of smoking on the SC tasks. Gender was explored as a potentia l moderator of the specific aims.

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15 Method Experimental Design We employed a 2 X 2, crossed-factorial, between-subjects design to evaluate the interaction between SC depletion (via emotional suppression) and smoking. Participant s were randomly assigned to one of four conditions (No Depletion + No Smoke, Depletion + No Smoke, No Depletion + Smoke, and Depletion + Smoke), stratified by gender (s ee figure 2). Dependent measures included time persisted on a near impossible mirror tracing task, breath-holding duration, self-reported affect and urge to smoke, sm oking topography, and smoking satisfaction. Participants were compensated $25 for approximately 1.5 hours of their time. Figure 2. Study design.

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16 Participants The sample consisted of 132 smokers (50% female) recruited from the Tampa, Florida area, via newspaper and electronic advertisements. Power analyses demonstrated that this sample size provided a power of .81 to detect ‘medium’ sized main and interaction effects (Specific Aim 1), with a two-tailed alpha level of .05 (C ohen, 1988). Prospective participants were screened for the following inclusion criteri a: Englishspeaking, between 18 and 65 years of age ( M = 41.18; SD = 11.86), smoked at least 20 cigarettes per day ( M = 24.06; SD = 6.50), began smoking 20 cigarettes daily at least one year ago, pre-session expired carbon monoxide (CO) concentration of at least 10 ppm ( M = 35.31; SD = 19.58). Prospective participants were also screened for the following exclusion criteria: attempting to quit smoking (e.g. cutting down, enrolled in tre atment, or using pharmacotherapy), pregnant, arthritis or any other condition that would prevent t he full use of hands (e.g., paralysis), and hearing or visual impairment. Individual s who met all of the inclusion criteria and did not endorse any of the exclusion criteria we re enrolled in the study. The sample was moderately to highly dependent on tobacco ( M = 6.27; SD = 2.01), as indexed by the Fagerstrm Test for Nicotine Dependence (FTND; Hea therton, Kozlowski, Frecker, & Fagerstrom, 1991). Of the participants who indicated race a nd ethnicity ( N = 130), the majority were Caucasian (78.5%), with 19.2% identifying as African American, 1.5% as American Indian or Alaskan Native, and .8% Native Hawaiian or other Pacific Islander. Of the sample, 13.8% were Hispanic or La tino.

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17 Measures Baseline characteristics. Demographic questionnaire (DQ). The DQ is designed to assess basic information about participants, including: gender, age, marital status, ethnicity race, educational level, and household income. Smoking status questionnaire (SSQ) This measure assessed smoking history, current smoking status, and other smoking-related variables. Included in this mea sure is the Fagerstrm Test for Nicotine Dependence (FTND), which is a reliable and valid measure of nicotine dependence (Heatherton et al., 1991). Exhaled carbon monoxide (CO). The measurement of exhaled CO level correlates closely with blood carboxyhaemoglobin concentration and provides an immediate, non-invasive method of assessing smoking status. Balanced Inventory of Desirable Responding Impression Management (BIDR-IM; Paulhus, Robinson, Shaver, & Wrightsman, 1991). The 20-item measure ( = .77 ) allowed for investigation of possible associations between impression manag ement and all outcome variables. The dichotomous and continuous scoring methods produced similar results, so all subsequent analyses include continuous scoring of the BID R-IM.

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18 Depression, Anxiety, and Stress Scale (DASS-21; Antony et al., 1998). The DASS-21 is comprised of three subscales (Depression, Anxiety, and Stress), each containing 7 items and showing acceptable Cronbach’s alphas (.94, .87, and .91). This measure has been found to be valid in clinical and non-clinical samples, and was used t o assess trait dimensions of dysphoric mood (Depression), physical arousal (Str ess), and psychological tension (Anxiety). The Depression and Anxiety subscales have shown concurrent validity with the widely used Beck Depression inventory ( r =.79) and the Beck Anxiety Inventory ( r =.85). Manipulation checks. Emotional suppression check (ES) This scale was used to assess the degree to which participants followed the Depletion manipulation instructions (i.e., emotional suppression vs. “act natural”). Participants indicated their agreement wit h 3 statements (“during the film, I tried not to feel anything at all,” “during the film, I felt emotions, but tried to hide them,” and “during the film, I reacted completely spontaneously” ) on a 7point Likert-type scale. The last statement was reverse coded, and averag ed with the other two to create an MC index ( = .84). These statements have previously been used to confirm the degree to which participants followed instructions (Gross, 1998a).

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19 Task appraisal-1 (TA-1) Likert-type items assessed the degree of effort, difficulty, and fatigue experienced as a result of the depletion manipulation. F or example, the effort item ranged from 0 (no effort at all) to 6 (extreme amount of effor t). Scores on these items were average to create a TA-1 index ( = .85) assessing energy expenditure from the emotional suppression instructions. These appraisal items are commonly us ed, and the emotional suppression group should report higher scores than the comparison condition (e.g. Baumeister et al., 1998). Specific aim 1: SC measures. Mirror-Tracing Persistence Task (MTPT; Quinn et al.,1996). This measure served as the primary dependent outcome because it was the first SC task complete d following the experimental manipulations, at which point the depletion effect was mos t likely to be present. This task is also more reliable, and less influenced by hea lth status, in comparison to the secondary SC outcome. Participants were asked to trace geom etric figures while viewing them through a mirror. Participants completed 5 tria ls. The first trial was relatively easy and served as a practice trial, at baseline The second through fifth trials were extremely difficult and never successfully compl eted by participants. Participants were instructed to move on to the next trial when they had given up or af ter working on a figure for 5 minutes. The dependent measure was the mean time spent on all unsuccessfully completed trials. This task demonstrated high internal cons istency ( = .93)

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20 Breath-holding (BH) Due to previous research showing that the depletion effect is time limited (Tyler & Burns, 2008), this measure served as a secondary out come. Participants were instructed to hold their breath for as long as they possibl y could. Duration of breath-holding was timed with a stopwatch and used as a secondary dependent variable, measuring self-control. Specific aim 2: Affect measures. Mood Form (MF: Diener & Emmons, 1984). This measure contains 4 items that assess positive affect ( = .88-.92) and 5 items that assess negative affect ( = .84-.86). This measure was chosen for its brevity and ability to broadly assess each dom ain (as conceptualized by Barrett & Russell, 1998). Participants were asked how much the y were currently experiencing each item using a 7-point scale ranging from “ not at all” to “extremely much.” This measure was administered at baseline, post-deplet ion manipulation, and post-smoking manipulation. Deactivated pleasant affect (DPA). This measure was used to more comprehensively capture the effects of smoking on affect. The scale consists of 5 items that measured low activation pleasant affect (Barrett & Russell, 1998), and w as integrated within the mood form. The scale displayed excellent reliability ( = .89-95).

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21 Secondary aim 1: Motivation to smoke. Urge to smoke (Urge: Kozlowski, Pillitteri, Sweeney, Whitfield, & Graham, 1996). This 3-item self-report measure was used to assess immediate urge or craving to smoke a cigarette ( = .88-.95). Participants were asked to use a 7-point scale ranging from “strongly disagree” to “strongly agree,” for the following items: “I do want to smoke now,” “I crave a cigarette right now,” and “I have a desire for a cigarette right now.” This measure was administered at baseline, post-depletion manipulation, and post smoking manipulation. Smoking topography As behavioral index of smoking motivation, specific smoking behavior was recorded using the Clinical Research Support System (CR eSS; Plowshare Technologies, Baltimore, MD). CReSS captured the number of puffs per cigarette, puff volume, puff duration, inter-puff interval, and maximum puff velocity Participants smoked their usual brand cigarette through the CReSS mouthpiece, whic h has a small tube that connects to a pressure flow transducer. CReSS has been found as a reliable and valid assessment method of smoking topography in dependent smokers (Lee, Malson, Waters, Moolchan, & Pickworth, 2003). Data from the first puff and all puffs with volumes less than 12ml were excluded (all subsequent analyses showed simila r patterns with these data included or excluded). Latency to first puff was coded independently by two trained raters (ICC = .97), from video obtained via a discreet di gital video camera

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22 Secondary aim 2: Smoking satisfaction. Modified Cigarette Evaluation Questionnaire (mCEQ; Cappelleri et al., 2007). The 12-item mCEQ is designed to assess the degree to which participants exper ience the reinforcing effects of smoking, including: Smoking Satisfaction ( = .86), Psychological Reward ( = .88), Aversion ( = .50), Enjoyment of Respiratory Tract Sensations (single item), and Craving Reduction (single item). Exploratory analyses. Distress Tolerance Scale (DTS; Simons & Gaher, 2005). This 14-item measure of general distress tolerance ( = .90) includes four subscales (Tolerance, Appraisal, Absorption, and Regulation). This measure has been found to be associated with alcohol problems and was examined here in relation to nicotine dependence, smoking topography, and persistence on the MTPT and BH tasks. Emotion Regulation Questionnaire (ERQ; Gross & John, 2003). This 10-item measure was used to assess individual differences in the habitual use of expressi ve suppression ( = .62) and cognitive reappraisal ( = .81). Scores were evaluated as possible moderators of the depletion effect. Self-Control Scale-Brief (SCS-B; Tangney, Baumeister, & Boone, 2004). This 13-item measure was used to assess participants’ trait level of self-c ontrol. Previous research has shown this measure to be a valid predictor on behavioral measures of sel fcontrol and it showed adequate internal consistency ( = .80). Analyses were conducted to see if scores on this measure moderated the depletion effect.

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23 Smoking Consequences Questionnaire Adult (SCQ-A; Copeland et al., 1995). Three of the 10 subscales were included in this study. The Negative Affect Reduction ( = .94), Stimulation/State Enhancement ( = .88), and Craving Reduction ( = .81) subscales demonstrated high internal consistency. Participants rated how li kely or unlikely each statement was for them by circling a number on a 10-point scale ranging from 0 (“completely unlikely”) to 9 (“completely likely”). Analyses were conducted to examine possible moderating effects of these scales on smoking topography, and with t he effects of smoking on affect. Task Persistence Self-Report (TPSP; Steinberg et al., 2007). This 2-item selfreport measure of task persistence was used to assess participants’ tend ency to persist in effortful behavior. This measure did not demonstrate adequate reliability ( = .34), although it has in prior research ( = .73). Task appraisal-2 (TA-2) Likert-type items assessed the degree of effort, difficulty, and fatigue experienced as a result of MTPT and BH tasks (sim ilar to TA-1). Along with assessing how stressful and frustrating these tasks were, the m easure allowed for the evaluation of how much participants tried on each of these tasks. This measure also allowed for comparisons to be made between the two SC tasks. These appraisal items are commonly used to evaluate how participants view stressful situations (e.g. Marlowe, 1998; Monroe & Kelley, 1997).

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24 Manipulations SC depletion. Emotional suppression has been defined as inhibition of emotionexpressive behavior while emotionally aroused (Gross & Levenson, 1993). Engagin g in emotional suppression while watching a negatively valenced film is a typica l manipulation used to deplete SC (Muraven et al., 1998; Vohs & Heatherton, 2000; Vohs & Schmeichel, 2003). This response-focused form of emotion regulation is commonly applied in everyday life (Gross et al., 2006), and although it is effective for inhibit ing ongoing emotion-expressive behavior, it provides no relief from subjective effec ts of the emotion, and may come with cognitive and physiological costs (Gross & Levens on, 1993; Gross & Levenson, 1997; Richards & Gross, 2000). All participants watched a 6 minute 11 second video clip from the film Mondo Cane (Jacopetti, 1961), depicting mutations and death of sea life. This was viewed on a laptop computer placed 2 feet in front of them. Prior to viewing, all participants were informed that they were about to watch a short film clip from an old documentary called Mondo Cane showing some of the effects of the atomic bombs released during World War II. Everyone was told that they would be recorded while viewing the clip, and all participants were made aware of the location of the video camera during inf ormed consent. Those in the Depletion condition were then instructed: “remain complete ly neutral on the inside and out. Please try your best not to let any feelings or r esponses you may have show on your face, and to the best of your ability, try to keep all of your internal reactions suppressed.” Participants in the No Depletion condition were instructed: “be as natural as possible, both on the inside and out. If you have any feel ings or reactions to the movie, let them flow naturally.”

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25 Smoking. All participants were told that the experimenter needed a few minutes to set-up for the next part of the study. Those in the Smoking condition were then given one of their usual brand cigarettes and asked to smoke using the CReSS machine. Participants in the No Smoking condition were asked to sit patiently until the experimenter returned. Following instruction delivery, the experimenter ex ited the room. Because of the limited duration of the depletion effect (Tyler & Burns, 2008), only 3 minutes was allocated for this manipulation. Procedure Potential participants were screened by trained operators. Those who qualifi ed were instructed to bring a pack of their own cigarettes and to smoke one cigare tte exactly one hour prior to their appointment and none thereafter. Figure 3 presents a timeline of the procedures. Informed Consent (10) Smoking Standardization (7) Depletion Manipulation (6) Smoking Manipulation (3) MTPT (11) BH (1) Debrief (8) Baseline Post-Depletion Post-Smoking As sessment Assessment A ssessment (38) (4) (2.5) Figure 3 Schematic timeline of study procedures (with approximate duration, in minutes).

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26 Upon arrival, informed consent and HIPAA authorization were obtained. Participa nts were then asked when they smoked their last cigarette and provided an expired ai r breath sample (to determine CO levels). Those reporting 45 minutes or greater since their last cigarette (75 minutes, on average) and meeting CO level eligibility then s moked one of their cigarettes using the CReSS machine. Along with standardizing smoking behavior, this procedure familiarized participants with the CReSS machine. Afte r participants extinguished their cigarette, the experimenter collected their pack of ci garettes (to be returned at the end of the study) and administered baseline measures (DQ, SF TPSR, DTS, SCS, SCQ-A, MTPT-1, ERQ, DASS, BIDR-IM, Urge-1, and MF-1). Upon completion of baseline measures, participants were randomly assigned to one of the four experimental conditions. Next, the Depletion manipulation was administered. Foll owing the completion of the film, participants were asked to complete post-depletion manipulation measures of affect, urge to smoke, and the manipulation check (i.e. MF-2, Urge-2, ES, and TA-1). The smoking manipulation was administered immediately after participants completed the post-depletion manipulation measures (on average, 49 minut es from smoking standardization). Next, participants were asked to complete post-s moking manipulation measures (MF-3 and Urge-3). When participants were done with these measures, they completed the MTPT (began 9.5 minutes from the end of Depletion, on average). Following the MTPT, participants completed BH (approximatel y 26 minutes from the end of Depletion), TA-2, and those in the Smoke condition completed the mCEQ (approximately 30 minutes after smoking completion). Participants we re then debriefed and compensated. To reduce demand effects, the experimenter was not prese nt in the room while participants completed self-report measures.

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27 Results Preliminary Analyses Baseline characteristics Analyses of variances (ANOVAs) were used to verify that randomization led to equivalent group characteristics, and as expected the re were no significant differences (all p s .09) across the four experimental conditions for demographic variables (DQ), nicotine dependence (FTND), urge to smoke (Urge), negative affect (MF-NA), positive affect (MF-PA), deactivated pleasa nt affect (DPA) and impression management (BIDR-IM). Also as expected, no differences were obs erved for number of attempts ( M = 5.73; SE = 0.72) or time spent ( M = 188.74; SE = 8.91) on the pre-manipulation MTPT practice trial (all p s .47). Impression management To test for potential bias due to demand effects, BIDR-IM scores were correlated with all administered measures ( behavioral and selfreport). No significant correlations were found between behavioral measures ( MTPT, BH, and smoking topography) and BIDR-IM (all p s .10). Although no relationships were observed between BIDR-IM and self-report measures of manipulation che ck (ES and TA), and mCEQ (all p s .12), significant positive correlations emerged with PA and DPA (r’s ranging from .23 to .35, all p’s .008), and significant negative correlations occurred with NA and urge to smoke (r’s ranging from -.19 to -.25, all p’s .03). To correct for any potential bias, BIDR-IM was entered as a covariate on all analyses involving self-reported affect or urge to smoke.

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28 Affect To assess the interrelatedness of the self-reported measures of affec t, correlational analyses were conducted between NA, PA, and DPA. NA was inversely correlated with PA and DPA at baseline, r(130) = -.40, p < .001; r(130) = -.39, p < .001, post-depletion, r(130) = -.46, p < .001; r(130) = -.47, p < .001, and post-smoking, r(130) = -.37, p < .001; r(130) = -.38, p < .001, but not to the degree that would suggest they represent a unitary construct. PA and DPA also covaried at baseline, r(130) = .78, p < .001, post-depletion, r(130) = .71, p < .001, and post-smoke r(130) = .80, p < .001. Although these correlations were high, all subsequent analyses were conducted on both scales because they were conceptualized as measuring distinct components of affective experience. Depletion manipulation checks To examine the degree to which Depletion manipulation instruction sets were followed, Analysis of variance (ANOV A) was conducted. As indexed by MC scores (possible score of 0-6), those in the Depletion conditions reported engaging in significantly higher levels of emotional suppr ession ( M = 4.74; SE = .09) compared to those in the No Depletion conditions ( M = 1.48; SE = .11), F (1, 128) = 256.02, p < .001, f = 1.42. Additionally, those asked to suppress their emotions (Depletion: M = 2.31; SE = .15) reported that following the assigned instruction set was significantly more effortful, difficult, and fatiguing compar ed to those asked to act naturally (No Depletion: M = .70; SE = .08), F (1, 128) = 43.30, p < .001, f = .58. To validate that a depletion effect did in fact occur, only those in the No Smoke conditions ( n = 66) were included in an ANOVA that examined the effect of the Depletion manipulation on MTPT. Replicating previous findings, those instructed to suppress their emotional reactions to the video (Depletion: M = 117.06; SE = 7.60)

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29 persisted significantly less on the MTPT than did participants instructed to ac t naturally (No Depletion: M = 181.55; SE = 12.11), F (1, 64) = 10.17, p = .002, f = .40. However, breath-holding durations between the No Depletion (M = 51.73; SE = 4.60) and Depletion conditions ( M = 51.62; SE = 4.60) were not significantly different ( p = .99), thus a depletion effect was not apparent on this outcome variable. Consistent with prior literature on emotional suppression (and depletion manipulations more generally), the Depletion manipulation did not lead to subsequent differences on self-reported affe ct (all p s > .65). Smoking manipulation check Video data corroborated that none of the participants in the No Smoke conditions smoked and all of those in the Smoke condition did. Primary Analyses Specific aim 1: SC restoration The hypothesized disordinal interaction of the manipulations on MTPT was tested via ANOVA. As predicted, neither Depletion ( p = .08) nor Smoking had a main effect ( p = .12), but as can be seen in Figure 4, there was the hypothesized significant Depletion x Smoking interaction [ F (1, 128) = 7.18, p = .008, f = .24]. Post hoc Fisher's LSD tests revealed that MTPT was signific antly lower for participants randomized to the Depletion + No Smoke condition, relative to each of th e other three experimental conditions (all p s < .05). None of the remaining pairwise comparisons reached significance (see Table 1). However, there were no ma in effects or interaction for breath holding duration (all p s > .71). Thus, the Depletion manipulation led to decreased time spent completing the MTPT, but this depletion effect was mitigated by the Smoking manipulation.

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30 No SmokeSmoke MTPT (Mean Duration) 100 120 140 160 180 200 No Depletion Depletion Figure 4. Mean duration on MTPT (and Standard Errors) as a function of the Depletion manipulation x Smoke manipulation interaction. Specific aim 2: Affect. To examine the influence of Smoking on self-reported affect, separate ANCOVAs were conducted for post-smoking manipulation negat ive, positive, and deactivated pleasant affect (controlling for post-depletion and BIDR-IM scores). Consistent with our hypotheses, participants randomized to the Smoke condi tions reported less negative affect [F (1, 126) = 3.94, p < .05, f = .18], more positive affect [F (1, 126) = 13.16, p < .001, f = .32], and higher levels of deactivated pleasant affect [F (1, 126) = 21.69, p < .001, f = .42], than their No Smoke counterparts (depicted in Figure 5 and Table 1).

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31 There was also a main effect for the Depletion manipulation on NA, with No Depl etion conditions ( M = .81; SE = .09) reporting less NA compared to Depletion conditions ( M = 1.07; SE = .09), F (1, 126) = 4.18, p < .05, f = .18. No significant interactions occurred between Smoke and Depletion manipulations (all p s > .54). PANADPA Mean Rating (0-6) 0.0 0.5 1.0 1.5 2.0 2.5 3.0 3.5 Smoke No Smoke Figure 5. Covariate-adjusted (controlling for post-depletion and BIDR-IM scores) mean affect ratings (and standard errors) as a function of the Smoking manipulat ion main effects (Post-Smoke).

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32 Table 1. Means (Standard Errors) for Post-Smoking Manipulation Measures 2 X 2 Condition Breakdown (1) No Depletion + No Smoking (2) Depletion + No Smoking (3) No Depletion + Smoking (4) Depletion + Smoking MTPT 181.55 (14.49) 2 117.06 (14.49) 1,3,4 165.26 (14.49) 2 178.43 (14.49) 2 BH 51.73 (4.60) 51.62 (4.60) 52.20 (4.60) 54.54 (4 .60) NA 0.94 (0.13) 1.19 (0.13) 3 0.67 (0.13) 2 0.95 (0.13) PA 1.91 (0.16) 3 1.54 (0.16) 3,4 2.40 (0.16) 1,2 2.23 (0.16) 2 DPA 2.39 (0.17) 3,4 2.27 (0.17) 3,4 3.19 (0.17) 1,2 3.07 (0.17) 1,2 Urge 3.72 (0.21) 3,4 3.67 (0.21) 3,4 0.40 (0.21) 1,2,4 1.09 (0.22) 1,2,3 Note. MTPT = duration of time (in seconds) until partici pants quit MTPT. BH = duration of time (in seconds) until participants quit holding their breath. NA = covari ate-adjusted negative affect ratings derived from N A-3 mean score (controlling for post-manipulation NA= 1.49 and BID R-IM = 3.72). PA = covariate-adjusted positive affe ct ratings derived from PA-3 mean score (controlling for postmanipulation PA= 1.56 and BIDR-IM = 3.72). DPA = co variateadjusted deactivated positive affect ratings derive d from DPA-3 mean score (controlling for post-manip ulation DPA= 2.33 and BIDR-IM = 3.72). Urge = covariate-adjusted urge ratings derived from Urge-3 mean score (contr olling for post-manipulation urge = 3.19 and BIDR-IM = 3.72). Superscript numbers indicate significant post hoc p airwise comparisons between the subscripted cell and the co ndition indicated by the subscript number (all p s < .05). Secondary aim 1: Urge to smoke. To test the effect of the Depletion manipulation on self-reported urge to smoke, 2 X 2 ANCOVA was utilized (control ling for baseline urge and BIDR-IM scores). Analysis revealed no differences between Depletion conditions ( p > .16), indicating that the Depletion manipulation did not influence post-depletion urge ratings. Unexpectedly, participants in the Smoke condi tions had significantly lower post-depletion urge ratings ( M = 2.80; SE = .15) than those in the No Smoke conditions ( M = 3.58; SE = .15), F (1, 126) = 14.67, p < .001, f = .34, despite the fact that both conditions received identical experiences up to that point. As would be expected, this pattern also emerged for post-smoking urge ratings (Sm oke: M = .75; SE = .15 vs. No Smoke: M = 3.69; SE = .15), F (1, 126) = 187.95, p < .001, f = 1.22.

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33 Secondary aim 1: Smoking topography Due to technical error, CReSS data from three participants were not captured. ANOVA was conducted on the remaining participants to examine the influence of the Depletion manipulation on latency to first puff. The effect of Depletion on the remaining topography variables were tested via ANCOVAs (controlling for baseline topography). Contrary to our hypotheses, no significant differences emerged between conditions (all p s > .20). Thus, the depletion effect manipulation had no impact on smoking topography. Secondary aim 2: Smoking satisfaction ANOVAs were conducted to test the effects of the Depletion manipulation on self-reported satisfaction, psyc hological reward, aversion, respiratory sensation, and craving reduction from the cigarette smoked during the Smoking manipulation ( n = 66). No significant differences were found between conditions (all p s > .14). Thus, emotional suppression (Depletion) had no effect on the perception of pleasure/displeasure derived from smoking. Secondary aim 3: Mediation. Exploratory analyses were conducted to determine whether SC restoration (on MTPT) produced by the smoking manipulation, was mediated by changes in affect and/or urge. Three standard tests of mediation were c onducted: the Sobel (1982) test, the bootstrap approach (Efron & Tibshirani, 1993; Preacher & Hayes, 2004) and procedures as outlined by Baron and Kenny (1986). No evidence for mediation was found.

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34 Additional Analyses TA-2. Although there were no differences between conditions on how effortful, difficult, fatiguing, or frustrating the MTPT was perceived to be (all p s > .23), those in the No Smoke conditions ( M = 4.32; SE = .24) reported the MTPT to be more stressful than those in the Smoke conditions ( M = 3.49; SE = .24) F (1, 128) = 5.92, p < .02, f = .21. Additionally, Depletion conditions ( M = 5.02; SE = .14) indicated that they did not try as hard on the MTPT as participants in the No Depletion conditions ( M = 5.46; SE = .14) F (1, 128) = 5.25, p < .02, f = .20. Paired sample t-tests comparing appraisal rating between the two SC tasks (across conditions), found that MTPT was perceived to be more effortful, difficult, fatiguing, frustrating, and stressful than BH (all p s < .001).

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35 Discussion The main goal of the current study was to determine whether the SC depletion effect could be attenuated by smoking. The evaluation of smoking on SC resourc es was selected because of its potential to integrate findings within the addiction fiel d concerning distress tolerance, learned industriousness, and affect regulation. Furtherm ore, understanding the relationship between SC resources and smoking may help to better inform theories of nicotine dependence and facilitate the development of new interventions for smoking cessation. Effects of Smoking on Self-Control Resources Our findings supported our hypothesis that smoking would have a restorative effect on depleted SC resources. To test this hypothesis it was essential t hat we could experimentally recreate a depletion effect. Participants randomize d to the emotional suppression, compared to the “act natural” condition persisted less on a difficult and frustrating behavioral task (MTPT), thereby confirming that a depleti on effect occurred. Those participants who were randomized to smoke prior to SC task initiation did not show this performance decrement, and they persisted as long as those who had not bee n depleted. Given that withdrawal effects can emerge rapidly (Hendricks, Dit re, Drobes, & Brandon, 2006), it was imperative to rule out withdrawal relief as the cause of sm oking’s apparent SC restorative effects. If withdrawal relief alone produces lon ger task persistence, we would expect to see this pattern within the No Depletion condition s.

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36 However, there were no differences in task persistence between those w ho smoked compared to those who did not, so it appears that withdrawal relief did not account for this effect. It is important to note that smoking did not lead to broad improvements in SC resources-it only restored SC resources to pre-depletion levels. The current findings support the conceptualization that the constructs of distress tolerance and task persistence may be context-sensitive; that is, influenc ed by both SC and smoking. This is consistent with a finding that smoking deprivation, when experimentally manipulated, led to decreased persistence on breath-holding, even af ter accounting for stress (Bernstein et al., 2008). The capacity to tolerate distr ess also appears to be compromised following engagement in tasks requiring SC (e.g., emot ional suppression), and smoking can restore this capacity. As pointed out by Bernstein et al. (2008), research administering pre-quit measures of distress tolerance t o prospectively predict outcome typically do so in a smoking-as-usual context (e.g., Brandon et al., 2003). It was suggested that administration should occur in contexts most similar t o that experienced during a quit attempt, specifically a nicotine deprived state. Predictive power may also be increased by considering SC depletion state, as this is a context that will occur on occasion long after withdrawal symptoms subside. The process of relapse ma y also be better understood by evaluating SC resources during the actual quit att empt (via EMA), as a possible antecedent to lapse/relapse. We were able to test our restoration hypothesis on only one of our behavioral persistence tasks because a depletion effect was only observed for the prima ry SC task (MTPT), and not the secondary SC task (BH).The former has been considered a psychological stressor while the latter has been thought to be more of a physica l stressor.

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37 However, it is unlikely that the domain of the task resulted in the differential eff icacy of the depletion manipulation, as depletion effects have emerged on numerous physical tasks (e.g. cold pressor and handgrip). It may also be that BH was not stressful e nough to evince a depletion effect, and, indeed, participants indicated that MTPT was mor e stressful than BH. The most plausible explanation for the lack of a depletion effe ct for the second behavioral task may be the limited duration of a depletion effect (Tyler & Burns, 2008). BH always occurred after MTPT, so not only was depletion time longer for BH than for MTPT (26 vs. 9.5 minutes, on average) it also differed as a function of MTPT performance. Alternatively, the MTPT task itself may have depleted SC r esources, reducing the group differences in SC by the time of the BH task. Future studies ma y benefit by testing these hypotheses using a range of SC measures, at var ious postdepletion times. Effects of Smoking on Affect This study also aimed to evaluate the effects of smoking on different dimensi ons of affect. As hypothesized, we found that smoking resulted in higher levels of self-reported PA and DPA and lower levels of NA, compared to not smoking. It is apparent that smoking influenced participants’ subjective experience; however, there a re limitations to our findings. The study design compared only nicotine-deprived and nondeprived smokers, therefore we cannot differentiate whether smoking genuinely improved affect or simply reversed withdrawal. We are also unable to make infer ences as to whether the pharmacological properties of nicotine or the behavioral components of smoking led to these differences. Systematically varying cigarett e nicotine content and/or mood induction will likely led to a better understanding of the causal relationshi p

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38 between smoking and affect (e.g., Perkins et al., 2008; Perkins et al., 2010; Conklin & Perkins, 2005). Additionally, Perkins and colleagues found that apparent affect modulation from smoking differs depending on the affect self-report measure used. This highlights the importance of having an a priori conceptualization of affect, i n order to select appropriate study designs and measures most relevant to the resear ch question at hand (Kassel et al., 2007). We chose the Mood Form (Diener & Emmons, 1984) because the descriptors of PA and NA broadly assess pleasant and unpleasant affect, ac ross different levels of activation (see Barrett & Russell, 1998). More specific ally, we aimed to evaluate the influence of smoking on deactivated pleasant descriptors (e.g., re laxed), because smokers hold strong smoking outcome expectancies concerning them and the effects of smoking on such descriptors has rarely been tested (e.g., Kass el, Evatt et al., 2007). In fact, smoking appeared to have the largest impact on deactivated pleasant a ffect ( ES = .42 vs. PA: .32 and NA: .18), suggesting that it is an outcome deserving further research. Possible Mediators of Self-Control Restoration from Smoking Considering the evidence suggesting NA and urge to have deleterious and PA and relaxation to have restorative effects on SC resources, we examined if thes e factors mediated SC restoration from smoking. No evidence for mediation was found, as sel freported affect and urge were not predictive of persistence on the SC task. Thus, the current study suggests that smoking restored SC independent of its influence on aff ect and urge. By choosing brief measures of affect, we were unable to assess all poss ible affective domains (e.g., the PANAS could be used to capture high activation PA, whic h was not assessed here). This may have limited our ability to find a mediation e ffect.

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39 Future studies may benefit from a more comprehensive assessment of self-repor ted affect, along with physiological and behavioral indices. As discussed by Kas sel and colleagues (2007), addiction research may be aided by examining the effect s of smoking on basic emotions (e.g., Ekman, 1984; Johnson-Laird & Oatley, 1992), rather than viewing affective experience in terms of two broad constructs (PA and NA). The mechanism through which smoking restores SC was not delineated through this study, but the effects of smoking on numerous systems lead to a wide array of possibilities for future investigation. Executive control and SC resources have been shown to be highly related (Schmeichel, 2007), and smoking has been found to increase a variety of executive control indices (Evans & Drobes, 2009), so future research m ay benefit from evaluating some of these (e.g., working memory, attentional contr ol, etc.) as potential mediators. A psychophysiological measure that may be informa tive is heart rate variability (HRV). HRV may serve as an index of SC resource strength, wi th increased HRV during tasks requiring high SC, and tonic levels predictive of SC task perf ormance (Segerstrom & Nes, 2007). Increases in HRV have been observed for alcohol-depende nt individuals who were able to resist consumption compared to those who could not, when exposed to alcohol cues (Ingjaldsson, Thayer, & Laberg, 2003). Although the acute a nd long term effects of smoking on HRV have been examined post-smoking (Hayono et al., 1990), no studies have evaluated HRV during smoking behavior, among non-abstinent smokers. Because smoking can alter respiratory rate (Jones, 1987) and fluctuations in respiration directly affects HRV (Bernston et al., 1997), it is likely that smoking would influence HRV.

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40 Additionally, our design did not allow for us to differentiate whether nicotine was the responsible agent for smoking’s restorative effect on SC, but placebo contr olled designs could be used to parse the effects of nicotine and other smoking related f actors. Effects of Self-Control Depletion on Motivation to Smoke and Reward from Smoking Although the primary hypotheses of the study were supported, none of the secondary hypotheses were. Prior to the smoking manipulation, we examined the im pact of the depletion manipulation on self-reported urge. Consistent with the only other investigation of depletion on urge to smoke (Shmeuli & Prochaska, 2009), we found no differences between Depletion conditions. The current study utilized only a brief, 3-item, measure, which may have lacked sensitivity and precluded the multidimensional assessment of urge (Tiffany & Drobes, 1991). Shmeuli and Prochaska (2009) did find that Depletion predicted the likelihood of smoking, indicating that SC is associated wi th smoking motivation, and highlighting the need to measure the construct using verbal and nonverbal methods (see Sayette et al., 2000). To evaluate whether motivation to smoke may be influenced by depleted resources at a level outside of consciousness, and therefore insensitive to se lf-report, we also incorporated behavioral measures of smoking topography. Again no difference s emerged between Depletion conditions. By only allocating three minutes for the smoking manipulation we may have restricted variability in smoking behavior, thereby r educing the possibility of finding a depletion effect. It is also possible that the contri ved smoking context of using the CReSS machine suppressed possible effects. Future resea rch is warranted with participants smoking ad libitum.

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41 In addition to smoking behavior, assessing changes in smoking motivation may better be detected through multidimensional, multi-modal approaches (e.g., psychophysiol ogy, facial coding, neural substrates, etc.). Additionally, we found that both Depletion conditions perceived smoking to be equally rewarding, as indexed by the mCEQ. However, it is difficult to draw a clear inference from this finding because this measure was administered approxi mately 30 minutes after smoking occurred, and therefore its validity may have been compr omised. Administering the mCEQ directly following smoking behavior may lead to differ ential results on the reinforcing aspects of smoking, as a function of SC resource levels Theoretical Implications The ability of smoking to remedy SC depletion strengthens the conceptualiza tion that negative reinforcement is central to understanding nicotine dependence (Bak er et al., 2004), while offering new mechanisms through which this might occur. Specifica lly, smoking may have been reinforced by ameliorating SC resource deficienci es, independent from its ability to modulate affect and urge. Although our study did not indicate that smoking was influenced by the depletion manipulation, other studies have provided evidence that depleted SC resources may serve as a discriminative st imulus, increasing smoking behavior independent of affect and urge (Palfai et al., 1997; Shmue li & Prochaska, 2009). This suggests that smoking may be used to regulate SC resource s, with fluctuations of these resources serving as interoceptive cues indicat ing when to smoke. This could be a conscious decision, or it may be the case that smoking becomes an automatic form of self-regulation that does not require deliberate contr ol (Mauss et al., 2007). Cognitive models of drug use have suggested that smoking can occur in such an

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42 automatized form, with little expenditure of cognitive effort (Tiffany, 1990 ). Smoking may then allow for the allocation of SC resources towards affect regula tion, thereby alleviating NA before it is experienced subjectively (Baker et al., 2004), or allowing for better tolerance for future stressors. The latter explanation views smoking as an antecedent-focused regulation strategy, modifying internal context prior to the occurrence of an emotional r esponse (Gross & Thompson, 2007). Consistent with this account is that participants who smoked found the MTPT to be less stressful than those who did not smoke. Most of the extent literature concerning the relationship between NA and smoking has instead vi ewed smoking as a response-focused strategy, used to regulate emotion following the occurrence of emotional response. This distinction may be critical for underst anding the maintenance of nicotine dependence, as smokers may be attempting to modify future outcomes (Sayette, Loewenstein, Kirchner, & Travis, 2005), rather than react t o the past. Whether smoking is used to alleviate previous SC demands or to enhance the capacity to deal those to come, the capacity for smoking to restore SC can be viewed as a form of misregulation. Various forms of impulse behaviors have been described as misregulation, as they have been shown to increase when SC demands were higher (e. g., NA), resulting in priorities shifting toward proximal and away from distal g oals (Tice et al., 2001). Perhaps SC demands are at the core of determining one’s goal prioritie s, and smoking serves to regulate this relationship. Our findings are consistent with thi s account, because those who were depleted appeared to be focusing more proximally (e.g., escaping the aversiveness of the MTPT), unless permitted to smoke. Thus, the capac ity of smoking to alleviate SC demands may bolster focus on distal priorities in other domains.

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43 Future research may better explicate this hypothesis by examining the int errelationship of smoking and SC resources on decision making processes. Treatment Implications Considering that reinforcement from smoking may be a result of SC restoration that allows smokers to deal with subsequent tasks, cessation treatments may need t o focus on providing them with other antecedent-focused strategies, thereby decreasing t he risk of relapse. As suggested above, PA and relaxation are two promising areas. I nterventions designed specifically to influence mood management have found that PA predicted cessation rates ( Brnstrm, Penilla, Prez-Stable, Muoz, 2010). Although relaxation training is often incorporated within typical cessation treatments, we are unaware of smoking cessation treatments that rely solely on relaxation. When experime ntally manipulated, controlled deep breathing has been found to reduce cravings, NA, and other withdrawal symptoms (McClernon et al., 2004). Glucose has also been found to restore SC resources (Galliot & Bauimester, 2007). Evidence also suggests that glu cose may be a useful aid for smoking cessation (West, 2001), possibly more effective than NRT f or short term abstinence (West & Willis, 1998). This is consistent with the curr ent conceptualization that SC regulation is an underlying mechanism of nicotine depende nce, as increasing levels of SC resources decreases the likelihood of relapse. Research on distress tolerance has already aided in the development of a potenti al psychotherapy for smoking cessation (Brown et al., 2008). Utilizing Acceptance and Commitment and exposure-based techniques as adjuncts to typical cessation tre atment, this new intervention aims to increase the capacity to tolerate discomfort. E vidence from the SC literature may also aid in the development of new treatments. Consistent w ith the

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44 muscle analogy, SC can be strengthened through regular exercise of se lf-regulation (Baumeister et al., 2006). Thus, a behavioral intervention requiring repeated acts of SC in domains other than resisting urges could bolster SC capacity, increasing the li kelihood of a successful quit attempt. This is convergent with learned industriousness theory, which posits that reinforcement for tolerating aversive tasks conditions rewar d value for effort expenditure, thereby reducing the aversiveness of high effort. Eff ort training (see Eisenberger, 1992) has yet to be tested experimentally as a form of smoking ce ssation treatment. Conclusion In summary, this was the first study to evaluate the effects of smoking on SC, a nd it appears that smoking can restore depleted SC resources. The capacity for smoking to restore SC occurred independent of its effects on self-reported affect and ur ge. Thus, the mechanism through which smoking acts on SC resources is yet to be determined, but may help to understand nicotine dependence, as the ability of smoking to restore SC resourc es may be conceptualized as a newly-identified form of negative reinforcement. U ltimately, it is our hope that what is learned through this experimental line of research wi ll prove useful for developing more effective cessation interventions.

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