Cravings are triggered by emotions in a variety of ways

Negative emotions have been linked to the usage of addictive substances in studies. According to new research, it's not simply terrible sentiments that drive people to seek out addictive substances. Instead, sadness appears to fuel the desire to feed an addiction.

Although the study focused on smoking, experts in the disciplines of emotion and addiction believe it may be applied to other substances. According to Dacher Keltner, PhD, a psychologist at the University of California, Berkeley who studies emotion but was not involved in the new study, the findings are particularly relevant in light of the pandemic of opioid addiction among communities confronting a sense of loss.

"To me," Keltner says, "it's just one of those revelatory articles."

Four distinct studies investigated the relationship between emotions and smoking habit, ranging from an analysis of a nationally representative, longitudinal survey to a lab experiment analyzing actual smoking behavior (Proceedings of the National Academy of Sciences, Vol. 117, No. 2, 2020).

"We found convergent evidence from very various datasets with all these different intensities, all pointing to the same message," says Charlie Dorison, a Harvard University PhD candidate in psychology. "All of the investigations backed up the same underlying hypothesis: sorrow, but not all bad emotions, causes people to smoke."

According to a meta-analysis performed by Bryan Heckman, PhD, a psychologist at the Medical University of South Carolina, negative affect has long been thought to increase cigarette cravings (Addiction, Vol. 108, No. 12, 2013). Dorison and his coworkers, on the other hand, wondered if they could be more particular. They'd discovered that sadness, more than other bad emotions, triggers spending and unhealthy eating, and they wondered if the same could be said for substance abuse.

The researchers used data from the Midlife in the United States survey (an ongoing initiative supported by the National Institute on Aging) in their first analysis, which included responses from 10,685 adults between 1995 and 2014. Participants who reported being sadder were more likely to be smokers at any given timepoint, according to the findings. The researchers were unable to analyze smoking initiation since almost all of the smokers in the sample began before reaching maturity. However, they discovered a link between unhappiness and smoking relapse after quitting: people who were sadder in 1995 and 2005 were more likely to smoke again in 2014. There were no links between smoking and fear, rage, or humiliation.

The researchers then recruited 425 smokers to take part in an online study in which they were asked about their cigarette cravings and then shown one of three film clips designed to elicit sadness (from the Pixar film "Up"), disgust (from the 1996 film "Trainspotting"), or neutral emotions (from the film "Trainspotting") (a documentary on furniture-making). Following the films, the participants completed a brief writing exercise to reinforce the elicited feeling, as well as another set of questions about their cigarette desires. Those who had watched the sorrowful clip had more desires than those who had watched the neutral or disgusting clips.

Dorison and his colleagues used a behavioral economics method in a third experiment, asking participants in an online sample whether they would prefer to smoke sooner but take fewer puffs or later but take more puffs. The participants were randomly randomized to either the sorrow or neutral video manipulations from the prior study (398 in the first experiment and 362 in the replication trial).

Sadness appeared to elicit the want to smoke once more. Smokers in the neutral situation said that for every minute they had to wait for a cigarette, they wanted 6.9% more puffs. Smokers who were depressed needed 8.1 percent more puffs per minute, indicating an 18 percent increase in impatience.

That was an intriguing discovery, but it was based only on speculation. Dorison and his colleagues measured actual smoking behavior in the final trial. The researchers gathered 158 smokers in the lab, exposed them to the same emotional manipulations, and then assessed their actual smoking behavior, including puff volume, velocity, and duration. Smokers were asked to refrain from cigarettes for eight hours before to the experiment, so they were all eager to smoke; melancholy had just a minor impact on this desire.

The researchers did discover, however, that sad smokers breathed 30% more volume per puff than smokers in the neutral condition, which they attribute to them taking longer drags on their cigarettes. Smokers in the melancholy condition were also more self-centered, negative overall, and reported more sentiments of loss than those in the neutral condition. Only self-focus was linked to a desire to smoke. According to Dorison, this discovery fits into a larger body of research that shows that melancholy motivates people to seek quick gratification.

According to Heckman of the Medical University of South Carolina, who was not involved in the study, the result that smokers who were depressed inhaled more hazardous material warrants additional investigation. "The discovery that puff volume changed in response to grief has pretty significant implications for potential damage exposure," Heckman says.

According to Heckman, future research should focus on examining different negative emotional states and how they interact. Sadness may not be the only unpleasant emotion that triggers cravings, but it is one of the most powerful, according to Dorison. The team has received money from the National Cancer Institute to investigate how the findings on emotion and decision-making might be used to public health.

"We're looking at the emotions used in anti-smoking public service advertisements produced by the Centers for Disease Control and Prevention," Dorison adds. "They could accidentally develop a need if they harness sadness."

Addictive substance usage is exacerbated by sadness, but not other unpleasant emotions.