title: Depressive symptoms affect changes in nicotine withdrawal and smoking urges throughout smoking cessation treatment: Preliminary results.
abstract: BACKGROUND
  Individuals who report more depressive symptoms consistently demonstrate higher rates of nicotine dependence and less successful smoking cessation than do individuals who report fewer depressive symptoms. Nicotine withdrawal and smoking urges are two potential factors that may account for the differences observed between these two groups. This study assessed whether elevated depression symptoms among nicotine dependent smokers are associated with changes in withdrawal and urges to smoke when undergoing smoking cessation treatment.
  
  
  METHODS
  Data on 81 nicotine dependent smokers were collected as part of a smoking cessation randomized trial that compared standard and contingency management treatment across one baseline week and four treatment weeks. Linear mixed model analyses were conducted with high and low depression scores predicting changes in withdrawal and urge ratings from a baseline week and four treatment weeks.
  
  
  RESULTS
  Participants with elevated depression symptoms reported more intense nicotine withdrawal and smoking urges throughout treatment. Further, participants with greater depressive symptoms exhibited an increase in smoking urges at the start of treatment, compared with a gradual decline in urges among participants with fewer depressive symptoms.
  
  
  CONCLUSIONS
  Smokers with elevated depressive symptoms experience significantly elevated discomfort during smoking cessation efforts in the form of increased withdrawal and craving. This discomfort has the potential to make quitting smoking more difficult.Clinical Trial Identifier: NCT00865254.
authors.affiliation: Department of Psychology, Wayne State University, Detroit, MI, USA; Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA.
authors.forename: Holly H
authors.initials: HH
authors.lastname: Reid
authors.affiliation: Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Ledgerwood
keywords: affective disorders; cravings; nicotine dependence; smoking cessation; treatment and intervention; withdrawal symptoms