Our study found that never-quitters, a little-studied subgroup of smokers who were unable to achieve initial abstinence, exhibited a pattern of affective reactivity as assessed by startle responses that was significantly different from those exhibited by smokers who were instructed to continue to smoke (controls), smokers who were able to abstain for ≥24 hours (abstainers), and smokers who achieved initial abstinence but relapsed (relapsers). Our results showed that, starting at approximately three days after their scheduled quit date, never-quitters exhibited an atypical response pattern in which emotional pictures no longer modulated the startle response. In particular, the never-quitters exhibited, relative to ITI, blunted startle potentiation to unpleasant stimuli. These findings indicate that as never-quitters struggle to stop smoking, their affective reactions to unpleasant, neutral, pleasant, and cigarette stimuli become less distinct and eventually become a relatively flat, undifferentiated reactivity. Results from analyses that regressed startle response on smoking status and stimulus valence further suggested that this lack of startle modulation was unique to never-quitters and could not simply be explained by the effect of smoking status alone. Although female participants
