Tobacco withdrawal system recovery time predicts smoking behavior change among individuals who smoke cigarettes daily

Introduction. A network theory of tobacco withdrawal posits between-person differences in how withdrawal symptoms causally influence one another across time. Individuals with densely connected symptom networks that facilitate the perpetuation of withdrawal symptom activity across time are theorized to have more difficulty quitting due to intense withdrawal experiences that persist even after the events instigating initial increases in withdrawal intensity are no longer present. Method. Here, we test this theory by constructing withdrawal symptom networks using ecological momentary assessment data in 123 individuals who smoke cigarettes daily from a period during which they were smoking as usual and test the extent to which between-person differences in these networks predict change in smoking behavior during a 10-day smoking abstinence period. Results. Individuals with symptom networks facilitating sustained withdrawal symptom intensity after symptom perturbation exhibited a less pronounced decrease in smoking between the smoking as usual and smoking abstinence period. Conclusions. Results support a network theory of tobacco withdrawal and highlight the significance of inter-symptom interplay in smoking cessation outcomes.