Temporal Dynamics of Smoking Urges: Investigating Morning Cravings, Nicotine Dependence, and Smoking Behaviors

Understanding the relationship between different dimensions of nicotine cravings and smoking behavior is crucial for addressing nicotine dependence. This study examined how morning cravings and past-week cravings relate to nicotine intake, as measured by salivary cotinine, and the mediating role of cigarettes per day (CPD) and time to first cigarette (TTFC).

Data were obtained as part of the Pennsylvania Adult Smoking Study (PASS), a community-based study of adult smokers. Participants (N = 353) completed structured questionnaires assessing smoking behaviors, cravings, and nicotine dependence. Salivary cotinine levels were measured to assess nicotine intake. Regression and path analyses were conducted to evaluate associations among craving phenotypes, smoking behaviors, and nicotine intake.

Morning cravings were significantly associated with both TTFC (β = -0.62, p < 0.001) and CPD (β = 0.27, p = 0.001), while past-week cravings were associated only with CPD (β = 0.14, p = 0.01). TTFC and CPD were both predictors of cotinine levels (β = -0.33, p < 0.001 and β = 0.22, p < 0.001, respectively). The total standardized effect of morning cravings on cotinine was 0.27, significantly greater than the effect of past-week cravings (0.05). Path analysis indicated that the influence of morning cravings on cotinine was mediated through both TTFC and CPD, whereas past-week cravings affected cotinine only via CPD.

Morning cravings demonstrate a stronger association with nicotine intake than past-week cravings, primarily through their effect on TTFC and CPD. These findings highlight the importance of targeting morning cravings in smoking cessation interventions. Future research should explore the role of neurobiological mechanisms, such as cortisol dynamics, in shaping nicotine cravings and smoking behavior.