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. 2009 May;104(5):850-8.
doi: 10.1111/j.1360-0443.2009.02522.x. Epub 2009 Mar 13.

Patterns of change in withdrawal symptoms, desire to smoke, reward motivation and response inhibition across 3 months of smoking abstinence

Lynne Dawkins  1 , Jane H Powell, Alan Pickering, John Powell, Robert West
Affiliations

Patterns of change in withdrawal symptoms, desire to smoke, reward motivation and response inhibition across 3 months of smoking abstinence

Lynne Dawkins et al. Addiction. 2009 May.

Abstract

Aims: We have demonstrated previously that acute smoking abstinence is associated with lowered reward motivation and impaired response inhibition. This prospective study explores whether these impairments, along with withdrawal-related symptoms, recover over 3 months of sustained abstinence.

Design: Participants completed a 12-hour abstinent baseline assessment and were then allocated randomly to quit unaided or continue smoking. All were re-tested after 7 days, 1 month and 3 months. Successful quitters' scores were compared with those of continuing smokers, who were tested after ad libitum smoking.

Setting: Goldsmiths, University of London.

Participants: A total of 33 smokers who maintained abstinence to 3 months, and 31 continuing smokers.

Measurements: Indices demonstrated previously in this cohort of smokers to be sensitive to the effect of nicotine versus acute abstinence: reward motivation [Snaith-Hamilton pleasure scale (SHAPS), Card Arranging Reward Responsivity Objective Test (CARROT), Stroop], tasks of response inhibition [anti-saccade task; Continuous Performance Task (CPT)], clinical indices of mood [Hospital Anxiety and Depression Scale (HADS)], withdrawal symptoms [Mood and Physical Symptoms Scale (MPSS)] and desire to smoke.

Findings: SHAPS anhedonia and reward responsivity (CARROT) showed significant improvement and plateaued after a month of abstinence, not differing from the scores of continuing smokers tested in a satiated state. Mood, other withdrawal symptoms and desire to smoke all declined from acute abstinence to 1 month of cessation and were equivalent to, or lower than, the levels reported by continuing, satiated smokers. Neither group showed a change in CPT errors over time while continuing smokers, but not abstainers, showed improved accuracy on the anti-saccade task at 3 months.

Conclusion: Appetitive processes and related affective states appear to improve in smokers who remain nicotine-free for 3 months, whereas response inhibition does not. Although in need of replication, the results suggest tentatively that poor inhibitory control may constitute a long-term risk factor for relapse and could be a target for intervention.

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Figures

Figure 1
Figure 1
Withdrawal symptoms scores (MPSS) on each assessment occasion for quitters and continuing smokers. Error bars are +/− 1SE
Figure 2
Figure 2
Ratings of desire to smoke on each assessment occasion for quitters and continuing smokers. Error bars are +/− 1SE
Figure 3
Figure 3
HADS Anxiety scores on each assessment occasion for quitters and continuing smokers. Error bars are +/− 1SE
Figure 4
Figure 4
HADS depression scores on each assessment occasion for quitters and continuing smokers. Error bars are +/− 1SE
Figure 5
Figure 5
SHAPS anhedonia scores on each assessment occasion for quitters and continuing smokers (high score = greater anhedonia). Error bars are +/− 1SE
Figure 6
Figure 6
Reward Responsivity scores on the CARROT on each assessment occasion for quitters and continuing smokers. Error bars are +/− 1SE
Figure 7
Figure 7
Antisaccade percentage correct on each assessment occasion for quitters and continuing smokers. Error bars are +/− 1SE
See this image and copyright information in PMC

References

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