A day at a time: predicting smoking lapse from daily urge.

Smokers who recently quit (N = 214) monitored smoking urges for up to 26 days after quitting. Computers administered 4-5 assessments daily at random times; participants rated urges on waking and when they experienced temptation episodes. Urge intensity after cessation did not generally exceed urges reported during baseline ad lib smoking. Urge intensity and temptation frequency consistently declined over the quit period. Controlling for urge intensity at baseline, all daily urge intensity measures predicted lapse the following day in proportional hazards survival analyses. Average duration of temptation episodes also predicted lapses; frequency of temptation did not. To isolate the effect of day-to-day variations in urges, participants' nicotine dependence and urge intensity on quit day were controlled for. Only urge intensity at waking still predicted lapse risk; this was not because of this measured being closer in time to the day's lapses. Among lapsers, urge intensity at waking and in temptations rose preceding a lapse.

[1]  S. Shiffman,et al.  Ecological Momentary Assessment (Ema) in Behavioral Medicine , 1994 .

[2]  P. Davidson,et al.  Behavioral medicine : changing health lifestyles , 1980 .

[3]  Kathleen A. O'Connell,et al.  Highly tempting situations associated with abstinence, temporary lapse, and relapse among participants in smoking cessation programs. , 1987 .

[4]  Saul Shiffman,et al.  What can hunger teach us about drug craving? A comparative analysis of the two constructs , 1992 .

[5]  R. West,et al.  Craving for cigarettes. , 1987, British journal of addiction.

[6]  G. Marlatt,et al.  Alcoholism: New Directions in Behavioural Research and Treatment , 1981 .

[7]  S. Shiffman,et al.  Coping and Substance Use , 1985 .

[8]  J J Heckman,et al.  Econometric mixture models and more general models for unobservables in duration analysis , 1994, Statistical methods in medical research.

[9]  Dc Washington.  Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. , 1994 .

[10]  M. Hufford,et al.  Urge and affect: A facial coding analysis of smokers. , 1995 .

[11]  N. Benowitz,et al.  Apparent tolerance to the acute effect of nicotine results in part from distribution kinetics. , 1987, The Journal of clinical investigation.

[12]  B. Walsh,et al.  Cigarette craving, smoking withdrawal, and clonidine. , 1984, Science.

[13]  G. Marlatt.  Craving for Alcohol, Loss of Control, and Relapse: A Cognitive-Behavioral Analysis , 1978 .

[14]  S. Shiffman,et al.  Progression from a smoking lapse to relapse: prediction from abstinence violation effects, nicotine dependence, and lapse characteristics. , 1996, Journal of consulting and clinical psychology.

[15]  D. Collett.  Modelling Binary Data , 1991 .

[16]  Norman A. Krasnegor,et al.  Cigarette smoking as a dependence process. , 1979, NIDA research monograph.

[17]  S Shiffman.  Relapse following smoking cessation: a situational analysis. , 1982, Journal of consulting and clinical psychology.

[18]  A. Wikler,et al.  The First Drink: Psychobiological Aspects of Craving , 1974 .

[19]  P. Albert,et al.  Models for longitudinal data: a generalized estimating equation approach. , 1988, Biometrics.

[20]  C. Johanson,et al.  Craving: consensus of status and agenda for future research. , 1992, Drug and alcohol dependence.

[21]  E. O. O. Smoking.  "The Health Consequences of Smoking: Nicotine Addiction: A Report of the Surgeon General" (Title Page through Table of Contents) , 1988 .

[22]  S S Smith,et al.  Predicting smoking cessation. Who will quit with and without the nicotine patch. , 1994, JAMA.

[23]  B. Rosner,et al.  Predictors of smoking relapse among self-quitters: a report from the Normative Aging Study. , 1992, Addictive behaviors.

[24]  P Hajek,et al.  Severity of withdrawal symptoms as a predictor of outcome of an attempt to quit smoking , 1989, Psychological Medicine.

[25]  S. Shiffman.  Cognitive Antecedents and Sequelae of Smoking Relapse Crises1 , 1984 .

[26]  S. Siegel.  Classical Conditioning, Drug Tolerance, and Drug Dependence , 1983 .

[27]  H. de Wit,et al.  Role of unconditioned and conditioned drug effects in the self-administration of opiates and stimulants. , 1984, Psychological review.

[28]  S Shiffman,et al.  Temptations to smoke after quitting: a comparison of lapsers and maintainers. , 1996, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[29]  H. Kraemer,et al.  Who will relapse? Symptoms of nicotine dependence predict long-term relapse after smoking cessation. , 1992, Journal of consulting and clinical psychology.

[30]  S. Tiffany,et al.  A cognitive model of drug urges and drug-use behavior: role of automatic and nonautomatic processes. , 1990, Psychological review.

[31]  R. Hammersley,et al.  A digest of memory phenomena for addiction research. , 1994, Addiction.

[32]  S. Shiffman,et al.  The tobacco withdrawal syndrome. , 1979, NIDA research monograph.

[33]  N. E. Breslow.  Statistical Methods in Cancer Research , 1986 .

[34]  M. Csíkszentmihályi,et al.  Validity and Reliability of the Experience‐Sampling Method , 1987, The Journal of nervous and mental disease.

[35]  L. Kozlowski,et al.  The Fagerström Test for Nicotine Dependence: a revision of the Fagerström Tolerance Questionnaire. , 1991, British journal of addiction.

[36]  R. Fildes.  Journal of the Royal Statistical Society (B): Gary K. Grunwald, Adrian E. Raftery and Peter Guttorp, 1993, “Time series of continuous proportions”, 55, 103–116.☆ , 1993 .

[37]  S. Shiffman,et al.  First lapses to smoking: within-subjects analysis of real-time reports. , 1996, Journal of consulting and clinical psychology.

[38]  J. Vejnoska,et al.  ALCOHOL HEALTH AND RESEARCH WORLD , 1983 .

[39]  R. Herning,et al.  Changes in mood, craving, and sleep during short-term abstinence reported by male cocaine addicts. A controlled, residential study. , 1990, Archives of general psychiatry.

[40]  A. Marcus,et al.  The tobacco withdrawal syndrome in unaided quitters. , 1991, British journal of addiction.

[41]  S. Tiffany,et al.  The development and initial validation of a questionnaire on smoking urges. , 1991, British journal of addiction.

[42]  C. Fuchs,et al.  The EM algorithm for maximum likelihood estimation in the mover-stayer model. , 1988, Biometrics.

[43]  Robert West,et al.  Use and Misuse of Craving , 1987 .

[44]  J. E. Sherman,et al.  The motivation to use drugs: a psychobiological analysis of urges. , 1986, Nebraska Symposium on Motivation. Nebraska Symposium on Motivation.

[45]  L. Kozlowski,et al.  Tobacco dependence, restraint and time to the first cigarette of the day , 1981 .

[46]  D. Cox.  Regression Models and Life-Tables , 1972 .

[47]  D J Rohsenow,et al.  Relevance of cue reactivity to understanding alcohol and smoking relapse. , 1988, Journal of abnormal psychology.

[48]  K. Fagerström,et al.  Measuring degree of physical dependence to tobacco smoking with reference to individualization of treatment. , 1978, Addictive behaviors.

[49]  M. Gossop.  Relapse and addictive behaviour. , 1989 .

[50]  L. Kozlowski,et al.  Use and misuse of the concept of craving by alcohol, tobacco, and drug researchers. , 1987, British journal of addiction.

[51]  J. Heckman,et al.  Econometric duration analysis , 1984 .

[52]  P. O. Smith,et al.  Assessing nicotine dependence: a comparison of the Fagerström Tolerance Questionnaire (FTQ) with the Fagerström Test for Nicotine Dependence (FTND) in a clinical sample. , 1994, Addictive behaviors.