Further research in this project will contrast risk profiles of dual use and single smokers using different definitions of dual use and eventually estimate health effects on the selleck MEK162 societal level in simulation models. FUNDING The work was supported by the Norwegian Institute for Alcohol and Drug Research, the Norwegian Directorate of Health, and the Norwegian Research Council project no. 190443, Tobacco and the Social Inequality Gap. DECLARATION OF Interests None declared.
Cigarette smoking is the leading cause of preventable mortality in the United States, and smoking has additional consequences for women, including increased risk for cervical cancer, reproductive complications, and hormone irregularities (Centers for Disease Control and Prevention, 2002).

Female smokers often report heightened levels of body dissatisfaction (Kendzor, Adams, Stewart, Baillie, & Copeland, 2009; King, Matacin, Marcus, Bock, & Tripolone, 2000), which can prompt smoking initiation and interfere with quit attempts (King, Matacin, White, & Marcus, 2005; Stice & Shaw, 2003). Lopez, Drobes, Thompson, & Brandon (2008) investigated the effect of a manipulation designed to prime body dissatisfaction on smoking urges among female smokers. Participants viewed either thin models (body image challenge) or neutral cues in the presence or absence of smoking cues. Consistent with past research (Groesz, Levine, & Murnen, 2002), viewing thin models increased body dissatisfaction compared with neutral images.

Furthermore, pictures of thin models and smoking cues each independently increased urges to smoke, indicating that priming body dissatisfaction increased smoking urges even in absence of smoking cues. Lopez Khoury, Litvin, and Brandon (2009) investigated the effects of another body image manipulation (trying on a bathing suit) among female smokers. Participants either tried on a bathing suit in front of a mirror or looked at a purse, in the presence or absence of smoking cues. Compared with the purse condition, the body image manipulation increased body dissatisfaction and triggered urges to smoke for negative affect reduction. Negative affect mediated the relationship between body image challenge and smoking urges, suggesting that priming body dissatisfaction increases negative affect, which in turn increases smoking urges. Smoking may represent an attempt to relieve distress associated with body dissatisfaction.

Additional research suggests that priming body dissatisfaction induces negative Batimastat affect (Pinhas, Toner, Ali, Garfinkel, & Stuckless, 1999), and negative affect is a common trigger for smoking urges (Baker, Piper, McCarthy, Majeskie, & Fiore, 2004; Brandon, 1994; Brandon, Wetter, & Baker, 1996; Payne, Schare, Levis, & Colletti, 1991). Negative affect has also been linked to difficulties in smoking cessation and relapse (Brandon, 1994).