Effects of depressive symptoms on antecedents of lapses during a smoking cessation attempt: an ecological momentary assessment study

Brodbeck, Jeannette; Bachmann, Monica S.; Brown, Anna; Znoj, Hans Jörg (2014). Effects of depressive symptoms on antecedents of lapses during a smoking cessation attempt: an ecological momentary assessment study. Addiction, 109(8), pp. 1363-1370. Wiley-Blackwell 10.1111/add.12563

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AIMS: To investigate pathways through which momentary negative affect and depressive symptoms affect risk of lapse during smoking cessation attempts. DESIGN: Ecological momentary assessment was carried out during 2 weeks after an unassisted smoking cessation attempt. A 3-month follow-up measured smoking frequency. SETTING: Data were collected via mobile devices in German-speaking Switzerland. PARTICIPANTS: A total of 242 individuals (age 20-40, 67% men) reported 7112 observations. MEASUREMENTS: Online surveys assessed baseline depressive symptoms and nicotine dependence. Real-time data on negative affect, physical withdrawal symptoms, urge to smoke, abstinence-related self-efficacy and lapses. FINDINGS: A two-level structural equation model suggested that on the situational level, negative affect increased the urge to smoke and decreased self-efficacy (β = 0.20; β = -0.12, respectively), but had no direct effect on lapse risk. A higher urge to smoke (β = 0.09) and lower self-efficacy (β = -0.11) were confirmed as situational antecedents of lapses. Depressive symptoms at baseline were a strong predictor of a person's average negative affect (β = 0.35, all P < 0.001). However, the baseline characteristics influenced smoking frequency 3 months later only indirectly, through influences of average states on the number of lapses during the quit attempt. CONCLUSIONS: Controlling for nicotine dependence, higher depressive symptoms at baseline were associated strongly with a worse longer-term outcome. Negative affect experienced during the quit attempt was the only pathway through which the baseline depressive symptoms were associated with a reduced self-efficacy and increased urges to smoke, all leading to the increased probability of lapses.

Item Type:

Journal Article (Original Article)


07 Faculty of Human Sciences > Institute of Psychology > Clinical Psychology and Psychotherapy
07 Faculty of Human Sciences > Institute of Psychology

UniBE Contributor:

Brodbeck, Jeannette and Znoj, Hans Jörg


100 Philosophy > 150 Psychology








Adriana Biaggi

Date Deposited:

14 Apr 2015 14:49

Last Modified:

20 Oct 2015 09:57

Publisher DOI:


Uncontrolled Keywords:

Depression, ecological momentary assessment, lapse, negative affect, relapse, self-efficacy, smoking, urge, withdrawal





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