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What a difference a day makes: differences in initial abstinence response during a smoking cessation attempt.

Megan E Piper1,2, Sara A Vasilenko3, Jessica W Cook1,2,4

  • 1Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.

Addiction (Abingdon, England)
|September 17, 2016
PubMed
Summary

Distinct smoking withdrawal patterns emerge on quit day, with some smokers experiencing intense craving, negative affect, or hunger. These patterns correlate with individual characteristics, treatment choices, and ultimately, smoking cessation success.

Keywords:
Anhedoniacravinglatent class analysisperson-centered analysisrelapsesmoking cessationwithdrawal

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Area of Science:

  • Behavioral Science
  • Addiction Medicine
  • Clinical Psychology

Background:

  • Smoking cessation is a critical public health goal.
  • Understanding nicotine withdrawal symptoms is key to developing effective interventions.
  • Previous research has not fully characterized distinct patterns of quit-day withdrawal.

Purpose of the Study:

  • To identify distinct classes of smokers based on their quit-day withdrawal symptoms.
  • To explore the relationships between these withdrawal classes and demographic factors, tobacco dependence, treatment received, and smoking cessation outcomes.

Main Methods:

  • Secondary data analysis of 1504 participants from a randomized controlled smoking cessation trial.
  • Ecological momentary assessment (EMA) using palmtop computers to record withdrawal symptoms (craving, negative affect, difficulty concentrating, hunger, anhedonia) on the quit day.
  • Latent class analysis to identify distinct withdrawal symptom profiles.

Main Results:

  • Four distinct withdrawal classes were identified: Moderate withdrawal (64%), high craving-anhedonia (8%), affective withdrawal (13%), and hunger (15%).
  • The high craving-anhedonia class showed higher tobacco dependence, received less combination nicotine replacement therapy, and had lower abstinence rates at 8 weeks.
  • The affective withdrawal class reported higher baseline negative affect and lifetime psychopathology, and relapsed more quickly.

Conclusions:

  • While most smokers experience moderate withdrawal, over a third report severe symptoms like intense craving, negative affect, or hunger.
  • These distinct quit-day withdrawal symptom patterns are associated with baseline characteristics, treatment received, and subsequent smoking cessation success.
  • Tailoring cessation strategies based on identified withdrawal profiles may improve outcomes.