Salivary cortisol reactivity to the Trier Social Stress Test-Online in habitual smokers: response blunting and recovery

Abstract

Abstract Background In Japan, alcohol, tobacco, coffee, and tea are categorized as “ Shikohin ” (i.e., non-nutritious items consumed for flavor). Shikohin provides a culturally grounded lens for examining health-related behaviors like smoking. Using it as a framework, I hypothesized that participants with high resilience and strong smoking habits would show blunted cortisol responses to the Trier Social Stress Test-Online (TSST-OL). Based on a previous study showing that individuals with high alcohol consumption and high resilience scores exhibited a specific blunted cortisol response, the purpose is to examine whether a similar relationship can be detected in smoking habits, which are also categorized as Shikohin . Methods Participants ( N = 41) were classified into four groups based on the degree of smoking (≤ 14 or ≥ 15 cigarettes per day) and the median total score on resilience scales (low-resilience low-smoking, low-resilience high-smoking, high-resilience low-smoking, and high-resilience high-smoking). Participants completed the TSST-OL, measuring subjective stress and salivary cortisol, at eight time points. Exploratorily, a two-piece multilevel growth curve model with landmark registration (GCM-LR) examined the effects of smoking habits and resilience scores on cortisol concentrations. Results Both the Analysis of Variance (ANOVA) and the GCM-LR showed blunted cortisol responses and intact cortisol recovery in smokers. Differences in cortisol non-responder prevalence were not detected between the groups. All groups showed similarly elevated subjective stress responses. The likelihood ratio test in the GCM-LR model showed that the random effect of resilience scores was significant. Conclusions The present results suggest that the cortisol response-blunting and recovery to psychosocial stressors exhibit distinct patterns in habitual smokers. Specifically, cortisol recovery might be maintained even in contexts where cortisol response-blunting was observed. Considering cortisol recovery as an aspect of resilience, this suggests that stress responses and resilience are driven by distinct mechanisms. However, it is possible that there are substantial individual differences in the effect of resilience scores on cortisol concentrations. Furthermore, several patterns seemingly specific to smokers were observed: high baseline cortisol levels, blunted cortisol responses, and appropriate recognition of subjective stress. The relationship between smoking habits, cortisol, and resilience should be understood from a perspective that integrates cultural and social factors. Studying smokers may provide insights into the mechanistic distinctness of blunted cortisol response and resilience.

The authors' abstract, as published at the source. Journal of PHYSIOLOGICAL ANTHROPOLOGY, 2026 · DOI ↗