Modeling naturalistic craving, withdrawal, and affect during early nicotine abstinence: A pilot ecological momentary assessment study.
- Authors
- Bujarski, Spencer; Roche, Daniel J O; Sheets, Erin S; Krull, Jennifer L; Guzman, Iris; Ray, Lara A
- Year
- 2015
- Journal
- Experimental and clinical psychopharmacology
- PMID
- 25844632
- DOI
- 10.1037/a0038861
- PMCID
- PMC4388058
Despite the critical role of withdrawal, craving, and positive affect (PA) and negative affect (NA) in smoking relapse, relatively little is known about the temporal and predictive relationship between these constructs within the first day of abstinence. This pilot study aims to characterize dynamic changes in withdrawal, craving, and affect over the course of early abstinence using ecological momentary assessment. Beginning immediately after smoking, moderate and heavy smoking participants (n = 15 per group) responded to hourly surveys assessing craving, withdrawal, NA, and PA. Univariate and multivariate multilevel random coefficient modeling was used to describe the progression of craving, withdrawal/NA, and PA and to test correlations between these constructs at the subject level over the course of early abstinence. Heavy smokers reported greater craving from 1-4 hr of abstinence and greater withdrawal/NA after 3 or more hours as compared with moderate smokers. Level of withdrawal/NA was strongly positively associated with craving, and PA was negatively correlated with craving; however, the temporal dynamics of these correlations differed substantially. The association between withdrawal/NA and craving decreased over early abstinence, whereas the reverse was observed for PA. These findings can inform experimental studies of nicotine abstinence as well as their clinical applications to smoking cessation efforts. In particular, these results help to elucidate the role of PA in nicotine abstinence by demonstrating its independent association with nicotine craving over and above withdrawal/NA. If supported by future studies, these findings can refine experimental methods and clinical approaches for smoking cessation.
Time course of craving, withdrawal/negative affect and positive affect during initial abstinence. Predicted values from the best fitting multilevel model are presented based on hours since last cigarette and smoking group. Significant smoking group differences are represented by solid lines. N = 15 per smoking group.
Magnitude of between-subject intercept correlations for craving, withdrawal/negative affect and positive affect. Correlation coefficients are plotted hourly relative to the last cigarette of the day. N = 30. * p < 0.05, ** p < 0.01, ***p < 0.001Note: The correlations between withdrawal/NA and PA and between PA and craving are negative but the absolute magnitude of these correlations has been presented to aid interpretability.
Magnitude of between-subject slope correlations for craving, withdrawal/negative affect and positive affect. Correlation coefficients are plotted hourly relative to the last cigarette of the day. N = 30. * p < 0.05, ** p < 0.01, ***p < 0.001Note: The correlations between withdrawal/NA and PA and between PA and craving are negative but the absolute magnitude of correlations has been presented to aid interpretability.
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