Negative affect subtypes and craving differentially predict long-term cessation success among smokers achieving initial abstinence.

Abstract

This study aimed to examine the associations of individual trajectories of three types of negative affect (NA: anxiety, depression, and anger) and craving during a 44-day period of incentivized smoking abstinence period with cessation outcome at 3months and at 1year. Adult smokers (N=140) completed questionnaire assessments of NA and craving during pre-quit baseline sessions and 15 postquit sessions over the 45days of biochemically verified abstinence while on nicotine or placebo patch treatment. Growth curve and logistic regression analyses were used to examine the associations of trajectory parameters of the individual NA states and craving with the abstinence outcomes at 3months and 1year postquit. Greater declines in anxiety, depression, and anger symptoms over the first 44days of smoking cessation were predictive of higher odds of abstinence at both 3months and 1year. Moreover, the greater declines in anxiety and anger remained as significant predictors of abstinence at both time points, independent of the predictive ability of the trajectory profiles of craving. The findings suggest that slower dissipation of NA, especially anxiety and anger, represents a greater risk for relapse to smoking beyond that predicted by craving during early abstinence. Thus, temporal profiles of the affective symptoms convey unique motivational significance in relapse. Reduction in NA during early abstinence may be a valid target for interventions to increase long-term cessation success rates particularly among individuals with refractory affective symptoms.