Difficulties with emotion regulation amplify perimenstrual emotional distress and cigarette craving.

Abstract

Objective: The female menstrual cycle and associated fluctuations in ovarian hormones are an important biological context that likely influences emotion-focused smoking. The present study evaluated the role of emotion regulation difficulties on daily emotional distress and cigarette craving in the context of the perimenstrum (i.e., days before and during menses).

Method: Naturalistic daily data were collected from non-treatment-seeking naturally cycling females (N = 50, M_age = 32.3, SD = 5.3) who reported daily cigarette smoking. Ecological momentary assessment of anxiety, mood, and cigarette craving was collected while also tracking the menstrual cycle. Days were coded as either occurring during perimenstrum (i.e., 7 days prior to and first 3 days during menses) or reference (i.e., all other days). Trait difficulties with emotion regulation were assessed at baseline.

Results: Multilevel models indicated a significant effect of emotion regulation difficulties on daily emotional distress (i.e., anxiety, negative mood), specifically on perimenstrual days. A second set of multilevel models was conducted to model the influence of daily emotional distress on cigarette craving specifically during perimenstrual days. Significantly higher daily craving was reported on perimenstrum days characterized by higher negative mood relative to lower negative mood, but this effect was only statistically significant in the context of greater emotion regulation difficulties.

Discussion: The menstrual cycle, its associated ovarian hormone fluctuations, as well as individual differences in the response to emotion should be considered as important female-specific determinants of emotion-focused smoking. (PsycInfo Database Record (c) 2025 APA, all rights reserved).