Patterns of change in affect and adrenocortical activity over an extended period of smoking abstinence

This study examined patterns of change in postcessation withdrawal symptoms and basal adrenocortical activity of smokers who were abstinent over a 4-week period (n = 18) and those who relapsed within the first week (n = 35). Participants interested in smoking cessation attended a prequit assessment in which they completed multiple forms associated with smoking withdrawal and provided a saliva sample for cortisol and cotinine measures. Then, the participants were asked to set a quit day and were required to abstain from smoking for at least 24 hours. After that, the participants attended four weekly follow-up support sessions during which self-report measures on withdrawal symptoms and tobacco use and saliva samples were collected. Smoking status was confirmed biochemically. We found that, overall, the abstinent smokers reported lower withdrawal symptoms, craving, and negative affect than relapsed smokers. Further exploratory analysis indicated that prequit withdrawal severity was lower in those who were abstinent than in those who eventually relapsed. Craving and physical symptoms in abstainers decreased as distress in relapsers increased during the follow-up period. Smoking urges diminished in both groups. Reported numbers of cigarettes per day after the failure of a quit attempt were lower than their precessation baseline. Cortisol did not differ by group or by time. Despite using a cross-sectional method, these results may suggest individual differences in negative symptoms while smoking regularly, and abstinence may be associated with reduction of craving and physical symptoms. The findings also suggested that relapsers may not immediately bring back their regular smoking habit after having relapsed.