title: Tobacco withdrawal components and their relations with cessation success.
abstract: BACKGROUND
  Tobacco withdrawal is a key factor in smoking relapse, but important questions about the withdrawal phenomenon remain.
  
  
  OBJECTIVE
  This research was intended to provide information about two core components of withdrawal (negative affect and craving): (1) how various withdrawal symptom profile dimensions (e.g., mean level, volatility, extreme values) differ between negative affect and craving; and (2) how these dimensions relate to cessation outcome.
  
  
  METHODS
  Adult smokers (N = 1,504) in a double-blind randomized placebo-controlled smoking cessation trial provided real-time withdrawal symptom data four times per day for 4 weeks (2 weeks pre-quit and 2 weeks post-quit) via palmtop computers. Cessation outcome was biochemically confirmed 8-week point-prevalence abstinence.
  
  
  RESULTS
  Examination of craving and negative affect dimensions following a cessation attempt revealed that craving symptoms differed from negative affect symptoms, with higher means, greater variability, and a greater incidence of extreme peaks. Regression analyses revealed that abstinence was associated with lower mean levels of both craving and negative affect and fewer incidences of extreme craving peaks. In a multivariate model, the increase in mean craving and negative affect scores each uniquely predicted relapse.
  
  
  CONCLUSIONS
  Real-time reports revealed different patterns of abstinence-related negative affect and craving and that dimensions of both predict cessation outcome, suggesting that negative affect and craving dimensions each has motivational significance. This underscores the complexity of withdrawal as a determinant of relapse and the need to measure its distinct components and dimensions.
authors.affiliation: Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, WI 53711, USA. mep@ctri.medicine.wisc.edu
authors.forename: Megan E
authors.initials: ME
authors.lastname: Piper
authors.forename: Tanya R
authors.initials: TR
authors.lastname: Schlam
authors.forename: Jessica W
authors.initials: JW
authors.lastname: Cook
authors.forename: Megan A
authors.initials: MA
authors.lastname: Sheffer
authors.forename: Stevens S
authors.initials: SS
authors.lastname: Smith
authors.forename: Wei-Yin
authors.initials: WY
authors.lastname: Loh
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Bolt
authors.forename: Su-Young
authors.initials: SY
authors.lastname: Kim
authors.forename: Jesse T
authors.initials: JT
authors.lastname: Kaye
authors.forename: Kathryn R
authors.initials: KR
authors.lastname: Hefner
authors.forename: Timothy B
authors.initials: TB
authors.lastname: Baker
mesh_terms: D000328:Adult; D000339:Affect; D016642:Bupropion / Q000008:administration & dosage / Q000627:therapeutic use; D004311:Double-Blind Method; D006801:Humans; D015999:Multivariate Analysis; D009538:Nicotine / Q000008:administration & dosage / Q000627:therapeutic use; D018722:Nicotinic Agonists / Q000008:administration & dosage / Q000627:therapeutic use; D012008:Recurrence; D012044:Regression Analysis; D016540:Smoking Cessation / Q000379:methods*; D013375:Substance Withdrawal Syndrome; D014029:Tobacco Use Disorder / Q000534:rehabilitation*; D016896:Treatment Outcome
chemical_list: D018722:Nicotinic Agonists; D016642:Bupropion; D009538:Nicotine