The dynamics of the urge-to-smoke following smoking cessation via pharmacotherapy
Article first published online: 18 AUG 2011
Published 2011. This article is a U.S. Government work and is in the public domain in the USA
Volume 106, Issue 10, pages 1835–1845, October 2011
How to Cite
Javitz, H. S., Swan, G. E. and Lerman, C. (2011), The dynamics of the urge-to-smoke following smoking cessation via pharmacotherapy. Addiction, 106: 1835–1845. doi: 10.1111/j.1360-0443.2011.03495.x
- Issue published online: 14 SEP 2011
- Article first published online: 18 AUG 2011
- Accepted manuscript online: 11 MAY 2011 09:58AM EST
- Submitted 20 December 2010; initial review completed 21 January 2011; final version accepted 5 May 2011
- hierarchical linear modeling;
- nicotine replacement therapy;
- smoking cessation;
- smoking withdrawal dynamics;
- smoking withdrawal symptom variability;
- withdrawal symptoms;
- withdrawal symptom trajectories
Aims To examine person-specific urge-to-smoke trajectories during the first 7 days of abstinence and the relationship of trajectory parameters to continuous abstinence, demographics, medication and smoking history.
Design Hierarchical linear modeling was used to model person-specific trajectories for urge-to-smoke.
Setting Two university-based smoking cessation trials.
Participants Treatment-seeking smokers in a clinical trial of transdermal nicotine (n = 275) versus nicotine spray (n = 239) and of bupropion (n = 223) versus placebo (n = 198).
Measurements Self-reported urge-to-smoke for 7 days after the planned quit date, and 7-day point prevalence and continuous abstinence at end of treatment (EOT) and 6 months.
Findings Urge-to-smoke trajectory parameters (average level, slope, curvature and volatility) varied substantially among individuals, had modest intercorrelations and predicted continuous and point prevalence abstinence at EOT and at 6 months. Higher trajectory level, slope and volatility were all significantly (P ≤ 0.001) associated with a reduced likelihood of abstinence at EOT (odds ratios 0.44–0.75) and at 6-month follow-up (odds ratios from 0.63 to 0.78), controlling for demographic, medication and smoking use variables.
Conclusion Higher urge-to-smoke trajectory parameters of level, slope and volatility (measured over 7 days) predict continuous and 7-day point prevalence at EOT and 6 months. Although there were some associations of trajectory parameters with demographics and smoking history, the associations of trajectory parameters with relapse were relatively uninfluenced by demographics and smoking history.