Effects of smoking abstinence on mood and craving in men: influences of negative-affect-related personality traits, habitual nicotine intake and repeated measurements

A two-factor model of individual differences in smoking abstinence response was assessed. The two factors were nicotine bioadaptation (nicotine exposure and self-reported tolerance/dependence) and self-medication for negative affect/psychopathology. Bioadaptation was expected to promote transient increases in smoking abstinence-related negative affect, while self-medication was expected to be related to relatively permanent increases in negative affect. Of 56 male smokers starting, 50 completed the study, 30 of whom were randomly assigned to an immediate cessation group and 20 to a continuing-to-smoke control group. Mood and craving were repeatedly measured with the Profile of Mood States (POMS) and the Shiffman Withdrawal Questionnaire, administered twice per week during a three-week pre-quit baseline period and every 48 h during the 30-day abstinence phase. POMS negative moods decreased significantly across the six pre-quit baseline days even though there was no smoking cessation-related intervention during this time, a finding with implications for the question of whether quitters return to pre-quit levels of negative affect. Support for the two-factor model was provided by three of our findings. First, POMS Depression, Tension and Anger increased in the quit group after quitting and never returned to levels corresponding to the continuingto-smoke controls even after 30 days of abstinence. Second, trait depression assessed prior to smoking abstinence correlated with abstinence-related increases in POMS state depressive affect score shortly after quitting and during the last eight days of the study. Third, pre-quit cotinine concentration correlated with increases in negative affect during the first 48 h of abstinence. The findings suggest that previous studies should be interpreted with caution because of their failure to take into account the repeated-measures effect and selective attrition.