Exploring Relationships Among Experience of Regret, Delay Discounting, and Worries About Future Effects of Smoking Among Current Smokers

ABSTRACT

Background: Smoking regret differs by smoker characteristics (dependence) and may be linked to delay discounting (DD), where smaller immediate rewards are preferred to larger delayed rewards. It is hypothesized that those who exhibit stronger tendencies to delay rewards also express fewer future health concerns and possibly less regret about smoking. Objectives: The objective is to determine the interrelationships of regret, dependence, and delay discounting among current smokers. Methods: In July 2010, 1062 smokers completed a 45-minute at-home web based survey and answered questions including regret, dependence (Fagerstrom Test for Cigarette Dependence), and delay discounting (Monetary Choice Questionnaire). Relationships among these variables and perceived future health effects were analyzed using correlations, repeated measures analysis of variance, and generalized linear models. Results: Most smokers (85%) regretted smoking. FTCD and log-k (DD) scores were positively associated (rs = 0.15, p < .001). Though a strong decline in log-k was shown as reward increased (p's < .001), there were no differences in discounting by regret. Regret was positively associated with worries concerning health effects, quality of life, and finances (p's < .001). Little association was found between DD and future health concerns. Conclusions/Importance: Though this study confirms that regret for smoking is associated with perceived future risks as well as supports previous findings between FTCD and DD, it shows little association between DD and perceived future risks.

KEYWORDS:

• Regret
• dependence
• behavioral economics
• delay discounting (DD)
• Fagerstrom Test for Cigarette Dependence (FTCD)

Glossary

• Behavioral economics: The study of the effects of psychological, social, cognitive, and emotional factors on economic decisions, in this case related to cigarette purchase

• Delay discounting (DD): A phenomenon demonstrated when a participant chooses smaller immediate rewards over larger delayed rewards

  Dependence: Level of substance use disorder; in this case to cigarettes

• Fagerstrom Test for Cigarette Dependence (FTCD): A questionnaire-style evaluation by which level of nicotine dependence in cigarette smokers is assessed and quantified

• Regret: Negative conscious and emotional reaction to personal past behaviors; here, related to perceptions of future harms and financial burden.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Funding

This work was supported by the National Institutes of Health [Grant no. R01CA141609].

Additional information

Notes on contributors

Richard J. O'Connor

Dr. Richard J. O'Connor is a Professor of Oncology at Roswell Park Cancer Institute. His program of research focuses on building the evidence base for tobacco regulatory science, with a particular focus on product-user interactions. Current work includes evaluation of state-of-the art methods for assessing tobacco product abuse liability, consumer perceptions, and toxicity. Other work foci include: impact of tobacco policy on product use; assessment of consumer interest in novel tobacco products as substitutes for cigarettes; development of unobtrusive methods for assessing smoke exposure; physical, chemical, and design features of international tobacco products.

James F. Thrasher

James F. Thrasher, PhD, is an Associate Professor in the Department of Health Promotion, Education & Behavior in the Arnold School of Public Health at the University of South Carolina His research generally focuses on assessing the effects of media and policy interventions on nutrition- and smoking-related perceptions and behavior. A particular emphasis of this work involves assessing the consistency of media and policy effects across populations that differ in terms of risk profiles and of sociocultural context.

Maansi Bansal-Travers

Maansi Bansal-Travers, PhD, currently works as a Research Scientist in the Department of Health Behavior at the Roswell Park Cancer Institute. She currently directs the Health Communications Testing Lab, in the Department of Health Behavior, which focuses on testing materials, including cigarette pack design variations, print messages, and television ads, using Web surveys, focus groups, and eye-tracking methodology, to help produce the most salient and effective health communications campaigns. Her research interests include exploring areas of misperceptions held by smokers about cigarette package design, health warning labels, product characteristics, point-of-sale displays, and the health effects of smoking. She also works to design and evaluate materials to correct these misperceptions and promote behavior change.