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Time-Varying Mediation of Negative Affect on Smoking Status: An Exploratory Analysis (309548)
*Yajnaseni Chakraborti, Temple University, Dept. of Epidemiology and BiostatisticsDonna L. Coffman, Temple University, Dept. of Epidemiology and Biostatistics
Keywords: time-varying mediation effect, smoking cessation, EMA data
The pharmacokinetic mechanism of action of tobacco makes smoking cessation an extremely challenging process. With prolonged exposure, tobacco smoking transforms from being a positive reinforcement to a negative one. Withdrawal symptoms peak in the first week of quitting, usually resolving over a month. Studying the variations in withdrawal symptoms is useful in improving cessation aids for future programs. Time-varying mediation model is effective in studying such altering withdrawal symptoms acting as mediators in the causal pathway of treatment and cessation. Our case study includes EMA data from the first 4 weeks post quit day of a smoking cessation study. Negative affect namely `negative mood`, `cessation fatigue`, and `craving` are the mediators. We assess whether negative affect regulates the pathway between treatment and (un)successful smoking cessation. Two time-varying mediation models one for outcome smoking status (Yes/No) and one for daily smoking count shows that the effect of exposure on outcome is mediated significantly by `cessation fatigue`. Identifying time points with peak `cessation fatigue` may be helpful for including mood-boosting/coping techniques.