Pre-abstinence smoke intake and smoking motivation as predictors of severity of cigarette withdrawal symptoms.

Twenty-nine cigarette smokers completed a smoking motivation questionnaire and had expired-air carbon monoxide (CO) and plasma nicotine concentrations measured prior to abstaining from smoking for 24 h. Before and after the abstinence period, the subjects rated mood and physical symptoms known to be affected by cigarette abstinence (e.g. irritability, restlessness). Scores on the "dependent smoking" subscale of the smoking motivation questionnaire correlated significantly with overall withdrawal severity, craving, and increased irritability. "Indulgent smoking" scores correlated positively with increased hunger. Pre-abstinence plasma nicotine concentration significantly predicted craving, hunger, restlessness, inability to concentrate and overall withdrawal severity, while expired-air CO predicted craving and restlessness only. Usual daily cigarette consumption did not significantly predict any withdrawal effects. The data indicate that pre-abstinence measures of smoking motivation and smoke intake may provide a guide to withdrawal severity on smoking cessation and that smokers with a high pre-abstinence nicotine intake experience the greatest discomfort.