Effects of expectancies and coping on pain-induced motivation to smoke

Joseph W. Ditre, Bryan W. Heckman, Emily A. Butts, Thomas H. Brandon

Research output: Contribution to journalArticlepeer-review

83 Scopus citations


The prevalence of tobacco smoking among persons with recurrent pain is approximately twice that observed in the general population. Smoking has been associated with the development and exacerbation of several chronically painful conditions. Conversely, there is both experimental and cross-sectional evidence that pain is a potent motivator of smoking. A recent study provided the first evidence that laboratory-induced pain could elicit increased craving and produce shorter latencies to smoke (Ditre & Brandon, 2008). To further elucidate interrelations between pain and smoking, and to identify potential targets for intervention, in the current study, we tested whether several constructs derived from social-cognitive theory influence the causal pathway between pain and increased motivation to smoke. Smokers (N = 132) were randomly assigned to 1 of 4 conditions in this 2 × 2 between-subjects experimental design. Results indicated that manipulations designed to (a) challenge smoking-related outcome expectancies for pain reduction and (b) enhance pain-related coping produced decreased urge ratings and increased latencies to smoke, relative to controls. An unexpected interaction effect revealed that although each manipulation was sufficient to reduce smoking urges, the combination was neither additive nor synergistic. These findings were integrated with those of the extant literature to conceptualize and depict a causal pathway between pain and motivation to smoke as moderated by smoking-related outcome expectancies and mediated by the use of pain coping behaviors.

Original languageEnglish (US)
Pages (from-to)524-533
Number of pages10
JournalJournal of abnormal psychology
Issue number3
StatePublished - Aug 2010
Externally publishedYes


  • Cold pressor
  • Pain
  • Smoking
  • Social cognitive theory
  • Tobacco

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry


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