Comparative dynamics of four smoking withdrawal symptom scales
Article first published online: 17 APR 2012
Published 2012. This article is a U.S. Government work and is in the public domain in the USA.
Volume 107, Issue 8, pages 1501–1511, August 2012
How to Cite
Javitz, H. S., Lerman, C. and Swan, G. E. (2012), Comparative dynamics of four smoking withdrawal symptom scales. Addiction, 107: 1501–1511. doi: 10.1111/j.1360-0443.2012.03838.x
- Issue published online: 10 JUL 2012
- Article first published online: 17 APR 2012
- Accepted manuscript online: 9 FEB 2012 05:51PM EST
- Submitted 22 October 2011; initial review completed 12 December 2011; final version accepted 2 February 2012
- negative affect;
- nicotine replacement therapy;
- physical symptoms;
- smoking cessation;
- withdrawal symptoms
Aims To examine the association of person-specific trajectories of withdrawal symptoms of urge-to-smoke, negative affect, physical symptoms and hunger during the first 7 days after smoking cessation with abstinence at end of treatment (EOT) and at 6 months.
Design Hierarchical linear modeling (HLM) was used to model person-specific trajectory parameters (level, slope, curvature and volatility) for withdrawal symptoms.
Setting University-based smoking cessation trials.
Participants Treatment-seeking smokers in clinical trials of transdermal nicotine versus nicotine spray (n = 514) and bupropion versus placebo (n = 421).
Measurements Self-reported withdrawal symptoms for 7 days after the planned quit date, and 7-day point prevalence and continuous abstinence at EOT and 6 months.
Findings In regressions that included trajectory parameters for one group of withdrawal symptoms, both urge-to-smoke and negative affect were predictive of abstinence while physical symptoms and hunger were generally not predictive. In stepwise regressions that included the complete set of trajectory parameters across withdrawal symptoms (for urge-to-smoke, negative affect, physical symptoms and hunger), with a single exception only the trajectory parameters for urge-to-smoke were predictive. Area under the receiver operator characteristic curve was 0.594 for covariates alone, and 0.670 for covariates plus urge-to-smoke trajectory parameters.
Conclusions Among a number of different withdrawal symptoms (urge-to-smoke, negative affect, physical symptoms and hunger) urge-to-smoke trajectory parameters (level, slope and volatility) over the first 7 days of smoking cessation show the strongest prediction of both short- and long-term relapse. Other withdrawal symptoms increase the predictive ability by negligible amounts.