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Assessing cigarette smoking withdrawal in unmedicated individuals: Validating the Wisconsin Smoking Withdrawal Scales
Jesse T Kaye1, Daniel M Bolt2, Megan E Piper1
1University of Wisconsin Center for Tobacco Research and Intervention, University of Wisconsin, School of Medicine and Public Health.
Objective:
Assessment of cigarette smoking withdrawal is critical to treatment research and clinical care. This study aimed to develop and evaluate the psychometric properties and construct validity of brief and long versions of the new Wisconsin Smoking Withdrawal Scales Version 3 (WSWS3), which include new items to assess anhedonia. The Minnesota Tobacco Withdrawal Scale-Revised and WSWS3 were compared.
Method:
This study was a single-arm clinical trial of 232 adults attempting to stop smoking without using pharmacotherapy during the first week of their quit attempt. Treatment included 8 weeks of nicotine patch and minilozenge initiated 1 week after the target quit date and four counseling calls. The WSWS3 long version (WSWS3-L) includes 21 items and seven subscales, and the WSWS3 brief version (WSWS3-B) includes seven items, one for each subscale.
Results:
The WSWS3-L and WSWS3-B demonstrated good-to-excellent internal consistency and acceptable confirmatory factor analysis model fit for a seven-factor higher order model (WSWS3-L) and one-factor model (WSWS3-B). The WSWS3 and Minnesota Tobacco Withdrawal Scale-Revised displayed convergent validity with one another. The WSWS3-L subscales demonstrated convergent validity with measures of related constructs (e.g., stress, depression, and urge). The WSWS3-L and WSWS3-B total scale and subscale scores displayed sensitivity to withdrawal during early quitting. In contrast to the MSWS-R, the WSWS3-L and -B scores were predictive of the time-to-first cigarette dependence measure, and withdrawal-related increases in WSWS3-L and -B scores were predictive of 1-week postquit abstinence.
Conclusions:
The WSWS3 brief and long versions display reasonable psychometric properties and construct validity for assessing cigarette smoking withdrawal. The stronger prediction of clinical outcome by the WSWS3 versus the MSWS-R scale may be due to its assessment of craving. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
