Responsiveness to reward following cessation of smoking
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Rationale and objectives
It has been suggested that stopping smoking may lead to reduced responsiveness to rewarding stimulation. We assessed such changes in dependent smokers who abstained from smoking continuously for 4 weeks.
Eight hundred seventy-four consecutive smokers treated at a UK Clinic provided ratings of changes in their perception of rewarding events at 1 and 4 weeks after their target quit date. Measurements included the Enjoyment of Life Questionnaire (EOL) and Mood and Physical Symptoms Scale (a measure of withdrawal discomfort). Self-reports of continuous abstinence were verified by expired air carbon monoxide readings.
In 585 participants who were continuously abstinent for the first week and provided EOL ratings, there was an increase in positive reactions to rewarding events compared to reactions while smoking (t = 5.9, p < 0.001). In 192 participants who were continuously abstinent for 4 weeks and provided ratings at both 1 and 4 weeks, there was a further significant increase in positive reactions (F(1,191) = 18.71, p < 0.001). More severe withdrawal discomfort was related to decreased enjoyment of rewarding events.
Responsiveness to reward increases within a week of stopping smoking and it increases further after 4 weeks of abstinence. The finding has implications for reassuring smokers worried about post-quitting mood changes.
KeywordsSmoking cessation Reward responsivity Anhedonia Nicotine withdrawal
We are grateful to John Stapleton for statistical advice.
Conflict of interest
There were no competing interests and the study required no external funding.