The dynamics of the urge-to-smoke following smoking cessation via pharmacotherapy

Aims To examine person‐specific urge‐to‐smoke trajectories during the first 7 days of abstinence and the relationship of trajectory parameters to continuous abstinence, demographics, medication and smoking history. Design Hierarchical linear modeling was used to model person‐specific trajectories for urge‐to‐smoke. Setting Two university‐based smoking cessation trials. Participants Treatment‐seeking smokers in a clinical trial of transdermal nicotine (n = 275) versus nicotine spray (n = 239) and of bupropion (n = 223) versus placebo (n = 198). Measurements Self‐reported urge‐to‐smoke for 7 days after the planned quit date, and 7‐day point prevalence and continuous abstinence at end of treatment (EOT) and 6 months. Findings Urge‐to‐smoke trajectory parameters (average level, slope, curvature and volatility) varied substantially among individuals, had modest intercorrelations and predicted continuous and point prevalence abstinence at EOT and at 6 months. Higher trajectory level, slope and volatility were all significantly (P ≤ 0.001) associated with a reduced likelihood of abstinence at EOT (odds ratios 0.44–0.75) and at 6‐month follow‐up (odds ratios from 0.63 to 0.78), controlling for demographic, medication and smoking use variables. Conclusion Higher urge‐to‐smoke trajectory parameters of level, slope and volatility (measured over 7 days) predict continuous and 7‐day point prevalence at EOT and 6 months. Although there were some associations of trajectory parameters with demographics and smoking history, the associations of trajectory parameters with relapse were relatively uninfluenced by demographics and smoking history.