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Nicotine & Tobacco Research Advance Access originally published online on May 7, 2009
Nicotine & Tobacco Research 2009 11(6):722-729; doi:10.1093/ntr/ntp055
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© The Author 2009. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Nicotine withdrawal symptoms following a quit attempt: An ecological momentary assessment study among adolescents

Rinka M. P. Van Zundert, Emiel A. Boogerd, Ad A. Vermulst and Rutger C. M. E. Engels

Rinka M. P. Van Zundert, M.Sc., Behavioural Science Institute, Radboud University Nijmegen, The Netherlands
Emiel A. Boogerd, M.Sc., Behavioural Science Institute, Radboud University Nijmegen, The Netherlands
Ad A. Vermulst, Ph.D., Behavioural Science Institute, Radboud University Nijmegen, The Netherlands
Rutger C. M. E. Engels, Ph.D., Behavioural Science Institute, Radboud University Nijmegen, The Netherlands

Corresponding Author: Rinka M. P. Van Zundert, M.Sc., Behavioural Science Institute, Radboud University, PO Box 9104, 6500 HE Nijmegen, The Netherlands. Telephone: +31-0031-24-3612816; Fax: +3100-31-24-3612776; E-mail: r.vanzundert{at}pwo.ru.nl


  Abstract

Introduction: The present study describes growth curves of withdrawal symptoms among 138 daily smoking adolescents before, during, and after a quit attempt.

Methods: Participants reported their levels of withdrawal symptoms (craving, negative affect, and hunger) three times a day over a period of 28 days: 1 week prior to and 3 weeks following a quit attempt.

Results: All withdrawal symptoms were quite stable at a relatively low level during the 5 days prior to the quit day. At Day 8, withdrawal symptoms (especially craving) increased substantially. A significant decrease in symptoms was visible during the week following the quit day, and within 2 weeks postquit, both abstinent and relapsed adolescents had reverted to levels comparable to those during the prequit period. The course over time for craving and hunger were best described by a quadratic term, and a linear model best suited negative affect. Individual intercepts and slopes of the growth curves were used to predict abstinence during the last week of the study and at the 2-month follow-up. Analyses revealed that higher levels of craving at the beginning of the prequit week and on the target quit day (intercepts) decreased the odds of being abstinent during the last week of the study. In addition, the quadratic term for hunger predicted abstinence during the last week. Finally, among all three symptoms, none of the growth model characteristics predicted abstinence at follow-up.

Discussion: The findings generally suggest that smoking cessation among daily smoking adolescents does not largely depend on how their withdrawal symptoms evolve over time after achieving abstinence.

Received: July 17, 2008; Accepted: January 28, 2009
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