Reliability and validity of measures of impulsive choice and impulsive action in smokers trying to quit

Abstract

Cross-sectional research suggests that smokers are more impulsive than are nonsmokers, but few studies have examined relations between impulsiveness and later success in quitting smoking. The purpose of this study was to investigate the reliability and predictive validity of facets of impulsiveness in adult smokers trying to quit. Baseline behavioral measures of impulsive choice (assessed with a delay discounting task) and impulsive action (assessed with a measure of behavioral disinhibition) were used as predictors of smoking cessation success over 12 weeks. The sample included 116 adult (18 years old or older) daily smokers from central New Jersey. Impulsive choice, impulsive action, and self-reported impulsiveness were not significantly related to one another at baseline. Impulsive choice had high test-retest reliability from pre- to postquit, whereas impulsive action was less stable. Test-retest reliability from prequit to 3 weeks' postquit was moderated by achievement of 7-day abstinence. Baseline impulsive action was significantly negatively related to quitting for at least 1 day in the first 2 weeks of a quit attempt and of prolonged abstinence (no relapse over the next 10 weeks). Baseline impulsive choice was robustly associated with biochemically verified 7-day point-prevalence abstinence 12 weeks' postquit, such that those with lower delay discounting were more likely to achieve abstinence. Facets of impulsiveness appear to function largely independently in adult smokers, as indicated by their lack of intercorrelation, differential stability, and differential relations with abstinence. Impulsive action may impede initial quitting, whereas impulsive choice may be an obstacle to maintaining lasting abstinence.

Figure 1

Participant flow diagram.