The Role of Intrusive Thoughts during the First Weeks of Smoking Cessation

Intrusive thoughts could impair smoking cessation or cause relapse to the extent that the thoughts are stimuli for smoking. This is a secondary analysis of data provided by 61 participants attempting to quit smoking. Participants used a hand-held computer to capture, in real time, the experience of quitting smoking. Intrusive thoughts related to smoking were assessed and participants completed assessments when they had an urge to smoke or after they slipped. The outcomes included were proximal measures of smoking cessation: number of slips, number of resisted temptations to smoke, and urge levels of during cessation. Independent variables were smoking stimuli, intrusive thoughts and depressive symptoms. Data were analyzed using multilevel modeling. Intrusive thoughts were significantly and positively related to each cessation outcome (slips, resists, urge levels). Smoking stimuli were differentially related to outcomes; cigarette availability was related to slips; being in usual smoking situations was associated with more resisted temptations, while cigarette availability and others smoking were associated with fewer resisted temptations. Higher urge levels were related to being in usual smoking situations. Depressive symptoms were not found to be related to the cessation outcomes. Intrusive thoughts about smoking were significantly related to the number of slips, the number of resisted temptations and the average urge level experienced by smokers attempting cessation even when other important explanatory variables, including exposure to smoking stimuli and depression symptoms were controlled. Methods for helping clients cope with intrusive thoughts during smoking cessation may be useful in helping them succeed.