Comparative dynamics of four smoking withdrawal symptom scales.
OBJECTIVE
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.


METHODS
Hierarchical linear modeling (HLM) was used to model person-specific trajectory parameters (level, slope, curvature and volatility) for withdrawal symptoms.


METHODS
University-based smoking cessation trials.


METHODS
Treatment-seeking smokers in clinical trials of transdermal nicotine versus nicotine spray (n = 514) and bupropion versus placebo (n = 421).


METHODS
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.


RESULTS
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.
Center for Health Sciences, SRI International, 333 Ravenswood Avenue, Menlo Park, CA 94025, USA. harold.javitz@sri.com
Harold S
HS
Javitz
Caryn
C
Lerman
Gary E
GE
Swan
D000280:Administration, Inhalation; D016642:Bupropion / Q000627:therapeutic use; D018765:Dopamine Uptake Inhibitors / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006815:Hunger / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009042:Motivation / Q000502:physiology; D011569:Psychiatric Status Rating Scales; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D057566:Self Report; D016540:Smoking Cessation; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis*; D061485:Tobacco Use Cessation Devices
D018765:Dopamine Uptake Inhibitors; D016642:Bupropion