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Prior analyses of the Wisconsin Inventory of Smoking Dependence Motives (Piper et al., 2004) implicated 4 subscales as primary dependence motives (PDM) indexing the core features of tobacco dependence, with the remaining subscales reflecting secondary dependence motives (SDM; Piper et al., 2008). The current study extended this work by examining the correlates of PDM, SDM, their subscales, and other indicators of dependence in an operant self-administration paradigm. Smokers (N = 58) worked for cigarette puffs under differing fixed ratio schedules. Analyses focused on predicting self-administration under conditions of minimal constraint on tobacco access and on withdrawal and craving under conditions of severe constraint. Results support a 2-factor model of dependence, with the PDM factor showing relatively stronger relations with tobacco self-administration and the SDM factor showing relatively stronger relations with withdrawal symptomatology and distress-related craving. The PDM appears to index core features of tobacco dependence, but susceptibility to deprivation-contingent distress and craving may be better indexed by SDM. Keywords: smoking, tobacco dependence, motives, self-administration, craving DOI: 10.1037/a0020235

The construct of tobacco dependence is important from both scientific and public health perspectives, but it is poorly understood. The current research integrates person-centered analyses (e.g., latent profile analysis) and variable-centered analyses (e.g., exploratory factor analysis) to clarify the latent structure of nicotine dependence and to guide distillation of the phenotype. Using data from 4 samples of smokers, latent profiles were derived using the Wisconsin Inventory of Smoking Dependence Motives subscale scores. Across all 4 samples, results revealed a unique latent profile that had relative elevations on 4 subscales (Automaticity, Craving, Loss of Control, and Tolerance). Variable-centered analyses supported the uniqueness of these 4 subscales as they constituted a distinct common factor and were the strongest predictors of relapse and other dependence criteria. Conversely, the remaining 9 motives carried little unique predictive validity regarding dependence. Applications of a factor mixture model further supported the presence of a unique class of smokers in relation to a common factor underlying the 4 subscales. The results suggest that a pattern of smoking that is heavy, pervasive, automatic, and relatively unresponive to instrumental contingencies is a necessary and sufficient condition for severe nicotine dependence. Keywords: nicotine dependence, latent profile, latent class, phenotype, relapse

Various theories have proposed mechanisms for drug motivation and relapse. For instance, negative reinforcement theories focus on the alleviation of withdrawal. However, other theories and some data cast doubt on the importance of withdrawal as a motivator of addictive drug use. Using data from a randomized double-blind placebo-controlled smoking cessation treatment study (N = 608), this research examined the impact of withdrawal on drug motivation and the ability to maintain abstinence. Withdrawal was experimentally manipulated by randomly assigning participants to receive active bupropion versus placebo. Mediation analyses revealed that active bupropion reduced the amount of withdrawal and craving that individuals reported in the 1st week post quit; modest support was also found for smaller declines in positive affect. These effects, in turn, were all positively associated with posttreatment abstinence. These results implicate withdrawal as an important factor in motivating persistent tobacco use. Keywords: withdrawal, smoking cessation, mediation, bupropion

This article describes a multidimensional, multivariate, and multilevel approach to the assessment of nicotine withdrawal. In this prospective study, 70 adult smokers assigned to an active or placebo nicotine patch condition completed multiple daily assessments using an electronic diary. Average and individual growth curves were estimated for affective and nonaffective withdrawal symptoms. All symptoms but hunger increased significantly on the quit day and remained elevated for three weeks. Variability in symptom experiences across individuals increased from pre- to post-quit. Relations between symptom reports (e.g., negative affect or craving) and episodic events (e.g., stressful events or seeing someone smoke) changed from pre-quit to post-quit. Pre-quit increases in negative affect and quit-day increases in craving were inversely related to abstinence three months after the quit day, suggesting that anticipatory and immediate reactions to quitting influence success. Keywords: ecological momentary assessment system, electronic diary, smoking cessation, withdrawal

In this article, the authors assessed whether continuously scaled symptom parameters derived from growth models (T. M. Piasecki et al., 2003) are linked to smoking at long-term follow-up by using data from a large-scale clinical trial (N = 893). Results revealed that higher withdrawal intercepts, positive linear slopes, and greater volatility were all positively associated with relapse, and cigarette coefficients (indicating smoking-induced withdrawal reduction) were negatively related to relapse. In models keyed around the first lapse to smoking, those destined to lapse reported more severe withdrawal during abstinence, and withdrawal patterns discriminated groups defined according to lapse duration. The findings complement earlier heterogeneity studies in implicating the pattern of changing withdrawal symptoms over time as a factor strongly associated with smoking relapse.

Smoking withdrawal reports from a clinical trial (n = 893) were submitted to hierarchical linear modeling as a cross-method replication of a heterogeneity approach to withdrawal measurement and to clarify the influence of postcessation smoking on symptom reports. Five individual difference parameters tapping distinct facets of withdrawal were derived: intercepts (mean severity), linear slope (direction and rate of change), quadratic trend (curvature), volatility (scatter) and, among lapsers, a cigarette coefficient (smoking-related deflections of symptoms). All parameters were highly variable across persons. Lapsers had more aversive symptom patterns than abstainers, and symptoms tended to be higher than otherwise predicted on lapse days. These results reinforce the conclusion that withdrawal symptoms are highly variable and argue against discarding withdrawal data from participants who lapse.

Research has suggested that the time course of the smoking withdrawal syndrome is fairly invariant across smokers and that smoking withdrawal symptoms are weakly related to relapse. Withdrawal data from 2 clinical trials of the nicotine patch were analyzed to evaluate these characterizations. In both studies, patients were clustered according to the shapes of their withdrawal profiles across 8 weeks of treatment. In each study, 3 clusters with distinct temporal patterns of withdrawal symptomatology emerged. Clusters included both abstinent and lapsing patients, and patch dose was unrelated to cluster membership. Patients with 'atypical' patterns of smoking withdrawal (e.g., late symptomatic elevations) were more likely to relapse than patients who showed a gradual elimination of withdrawal. Withdrawal shape, duration, and severity all contributed significantly to the prediction of relapse. Measures of negative affect closely tracked withdrawal symptoms over time within clusters. Topics for future smoking withdrawal research are discussed.

Use of the Smoking Consequences Questionnaire of Brandon and Baker in a confirmatory factor analysis of smoking outcome expectancies among 632 smokers showed that the best fit was obtained with four factors interpreted as negative consequences, positive reinforcement, negative reinforcement and appetite-weight control. The study collected data from smokers participating in trials of the effectiveness of a nicotine skin patch in aiding stoppage. Smokers who had negative consequences and reinforcement expectations were more likely to quit, and those with positive expectancies displayed greater withdrawal effects.

In 2 experiments we investigated the effects of withdrawal and stress on the affective correlates of urges to smoke. In both, habitual cigarette smokers were divided into continuing and withdrawing smoker groups. In the 1st study, 44 adults reported current mood, urge, and expectations over a 24-hr period. In the 2nd, a controlled laboratory study, urge, affect, and physiological data were obtained from continuing and withdrawing groups (N = 64) exposed to high- or low-stress conditions. Urges among withdrawing smokers were positively associated with negative affect and negatively associated with positive affect; continuing smokers reported urges that were directly associated with positive affect and unrelated to negative affect. Stress and withdrawal produced urge self-reports that were related to negative affect. Moreover, subjects who smoked after exposure to withdrawal and stress reported greater pleasure and arousal than did other subjects., A study exploring the relation between the urge to smoke and self-reported affect in continuing and withdrawing smokers was conducted. Two experiments were conducted for this study. The first had 44 adult smokers and the second had 64 female smokers. The results indicate that withdrawing smokers experienced desire to smoke to avoid withdrawal symptoms. Continuing smokers experienced a desire to smoke due to the pleasure involved in smoking.