Ecological momentary assessment in the investigation of craving and substance use in daily life: a systematic review

Drug Alcohol Depend. 2015 Mar 1;148:1-20. doi: 10.1016/j.drugalcdep.2014.12.024. Epub 2015 Jan 3.


Background: Craving is viewed as a major determinant of relapse in persons with substance addiction, but this association remains poorly understood due to its time-limited nature and the biases associated with retrospective reporting. Ecological momentary assessment (EMA) offers new opportunities to examine both craving and substance use with strong ecological validity by collecting real-time data in daily life. This review examined all published studies using EMA to: (1) assess the link between craving and substance use; and (2) identify relevant moderators of craving among substance users.

Methods: We searched PubMed and PsycInfo databases up to October 31, 2013.

Results: Ninety-one studies were selected, involving mostly tobacco smokers (73%). A majority of studies (92%) reported a positive relationship between craving and substance use, concurrently and prospectively, and among users with different levels of use for both legal and illegal substances. Results suggest that craving is a stronger predictor of relapse episodes when assessed in close temporal proximity to substance use. EMA data also confirmed the influence of diverse within-person and between-person sources of variation in daily life craving reports.

Conclusions: This review provides strong support for the link between craving and substance use, and underscores the importance of the timing of assessments.

Keywords: Craving; Ecological momentary assessment; Experience sampling methodology; Relapse; Systematic review.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Craving*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Monitoring, Ambulatory / methods*
  • Prospective Studies
  • Retrospective Studies
  • Substance-Related Disorders / diagnosis*
  • Substance-Related Disorders / epidemiology*