University of Wisconsin School of Medicine and Public Health, Center for Tobacco Research and Intervention, 1930 Monroe Street, Madison, WI 53711, USA.
J Abnorm Psychol. 2012 Nov;121(4):909-21. doi: 10.1037/a0027889. Epub 2012 May 28.
Measured tobacco dependence is typically only modestly related to tobacco withdrawal severity among regular smokers making a quit attempt. The weak association between dependence and withdrawal is notable because it conflicts with core theories of dependence and because both measures predict cessation outcomes, suggesting they both index a common dependence construct. This study used data from a smoking cessation comparative effectiveness trial (N = 1504) to characterize relations of tobacco dependence with craving and negative affect withdrawal symptoms using multiple dependence measures and analytic methods to detect both additive and interactive effects and to determine whether withdrawal meaningfully mediates the influence of dependence on smoking cessation. We conclude: (a) Although univariate analyses suggest dependence and withdrawal measures are only modestly interrelated, more powerful analytic techniques show they are, in fact, meaningfully related and their shared variance is associated with cessation likelihood; (b) there are clear differences between craving and negative affective withdrawal symptoms, with the former more related to smoking heaviness and the latter related to trait measures of negative affect; moreover, craving more strongly mediates dependence effects on cessation; and (c) both craving and negative affect withdrawal symptoms are strongly related to a pattern of regular smoking that is sensitive to the passage of time and powerfully affected by smoking cues. These findings support models that accord an important role for associative processes and withdrawal symptoms, especially craving, in drug dependence. The findings also support the use of withdrawal variables as criteria for the evaluation of dependence measures.
衡量的烟草依赖通常只有适度相关的烟草戒断严重程度之间的定期吸烟者戒烟尝试。依赖和戒断之间的弱关联是值得注意的，因为它与依赖的核心理论相冲突，因为这两个措施都预测戒烟的结果，这表明它们都索引一个共同的依赖结构。本研究使用从一个戒烟比较效果试验（N = 1504）的特点关系烟草依赖与渴望和消极影响戒断症状使用多种依赖措施和分析方法来检测添加剂和交互作用，并确定戒断是否有意义调解依赖对戒烟的影响。我们得出结论：（一）虽然单变量分析表明依赖和戒断措施只是适度相关，更强大的分析技术表明，事实上，他们是有意义的相关和他们的共同方差与戒烟的可能性；（b）有明显的差异之间的渴望和消极情感戒断症状，前者更相关的吸烟量和后者与特质的消极情绪措施有关；此外，渴望更强烈调解依赖对戒烟的影响；（c）的渴望和消极情感戒断症状都与定期吸烟的模式是敏感的时间推移和有力的影响吸烟线索。这些发现支持模型，给予一个重要的作用，联想过程和戒断症状，特别是渴望，在药物依赖。这些发现也支持使用戒断变量作为评估依赖措施的标准。
