title: Understanding the role of cessation fatigue in the smoking cessation process.
abstract: BACKGROUND
  To understand the dynamic process of cessation fatigue (i.e., the tiredness of trying to quit smoking) with respect to its average trend, effect on relapse, time-varying relations with craving and negative affect, and differences among genders and treatment groups.
  
  
  METHODS
  Randomized placebo-controlled clinical trial. Participants received either placebo, monotherapy (bupropion SR, nicotine patch, nicotine lozenge), or combined pharmacotherapy (bupropion SR+nicotine lozenge, nicotine patch+nicotine lozenge). Data were collected from 1504 daily smokers who were motivated to quit smoking. The participants completed baseline assessments and ecological momentary assessments for 2 weeks post-quit.
  
  
  RESULTS
  Cessation fatigue reduced the likelihood of 6-month post-quit abstinence (OR=0.97, 95% CI (0.95, 0.99)), and was positively associated with craving and negative affect. After controlling for these two factors, average cessation fatigue increased over time. Compared to men, women experienced greater fatigue (t=-10.69, p<0.0001) and a stronger relation between fatigue and craving (t=-8.80, p<0.0001). The relationship between fatigue and negative affect was significantly stronger in men (t=5.73, p<0.0001). Cessation fatigue was significantly reduced by combined pharmacotherapy (t=-13.4, p<0.0001), as well as monotherapy (t=-6.2, p<0.0001).
  
  
  CONCLUSIONS
  Cessation fatigue was closely related to craving, negative affect, and cessation outcomes. Women reported greater cessation fatigue than men. Current treatments appeared to reduce fatigue and weaken its relations with craving and negative affect.
authors: The Methodology Center, The Pennsylvania State University, United States; Department of Statistics, The Pennsylvania State University, United States. Electronic address: xol5086@psu.edu.
authors: Xiaoyu
authors: X
authors: Liu
authors: Runze
authors: R
authors: Li
authors: Stephanie T
authors: ST
authors: Lanza
authors: Sara A
authors: SA
authors: Vasilenko
authors: Megan
authors: M
authors: Piper
mesh_terms: D000328:Adult; D000465:Algorithms; D003131:Combined Modality Therapy; D003627:Data Interpretation, Statistical; D005221:Fatigue / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D012008:Recurrence; D012727:Sex Characteristics; D016540:Smoking Cessation / Q000523:psychology*; D012984:Software; D016896:Treatment Outcome
keywords: Cessation fatigue; Ecological momentary assessments; Smoking cessation; Time-varying effect model
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