Anhedonia: Its dynamic relations with craving, negative affect, and treatment during a quit smoking attempt

Jessica W. Cook, Stephanie T. Lanza, Wanghuan Chu, Timothy B. Baker, Megan E. Piper

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Introduction: Research shows that abstinence from tobacco leads to a withdrawal-related decrement in responsivity to nondrug rewards (ie, anhedonia). However, it remains unclear how anhedonia relates to other key withdrawal symptoms and withdrawal-related constructs over time. We analyzed ecological momentary assessment data to examine whether a decrement in response to rewards during a 10-day period following quitting shows a pattern of associations with other variables (ie, treatment, tobacco dependence, negative affect, and craving) that is consistent with anhedonia being a tobacco withdrawal symptom. Methods: As part of a randomized controlled trial of smoking cessation therapies, 1122 adults (58% female) were assigned to: placebo (n = 131), bupropion (alone or with nicotine lozenge, n = 401) or nicotine replacement therapy (NRT; lozenge, patch, both; n = 590). Participants completed 4 ecological momentary assessments per day for 10 days postquit, resulting in 22 575 assessments. Results: Time-varying effect modeling showed that anhedonia was significantly greater among those high in dependence relative to lower dependent smokers out to day 9 postquit. The placebo group showed elevated anhedonia immediately postquit, which fell to levels similar to the treatment groups by day 7. NRT effectively reduced anhedonia and its time-varying association with craving early in the quit attempt. The positive association between negative affect and anhedonia was moderate and stable over time for both active treatment groups. Conclusions: These results provide additional support that anhedonia following quitting smoking is a manifestation of the tobacco withdrawal syndrome. Implications: This study supported the hypothesis that diminished responsivity to nondrug rewards (ie, anhedonia) is a symptom of the tobacco withdrawal syndrome. Results showed that anhedonia: (1) was significantly associated with dependence, especially during the early postquit period when withdrawal was at its peak intensity; (2) showed significant time-varying associations with other withdrawal symptoms, especially craving; and (3) was significantly suppressed by agonist administration as was its association with craving over time.

Original languageEnglish (US)
Pages (from-to)703-709
Number of pages7
JournalNicotine and Tobacco Research
Volume19
Issue number6
DOIs
StatePublished - Jun 1 2017

Fingerprint

Anhedonia
Smoking
Substance Withdrawal Syndrome
Tobacco
Reward
Therapeutics
Placebos
Craving
Tobacco Use Cessation Products
Bupropion
Tobacco Use Disorder
Smoking Cessation
Nicotine
Randomized Controlled Trials

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health

Cite this

Cook, Jessica W. ; Lanza, Stephanie T. ; Chu, Wanghuan ; Baker, Timothy B. ; Piper, Megan E. / Anhedonia : Its dynamic relations with craving, negative affect, and treatment during a quit smoking attempt. In: Nicotine and Tobacco Research. 2017 ; Vol. 19, No. 6. pp. 703-709.
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abstract = "Introduction: Research shows that abstinence from tobacco leads to a withdrawal-related decrement in responsivity to nondrug rewards (ie, anhedonia). However, it remains unclear how anhedonia relates to other key withdrawal symptoms and withdrawal-related constructs over time. We analyzed ecological momentary assessment data to examine whether a decrement in response to rewards during a 10-day period following quitting shows a pattern of associations with other variables (ie, treatment, tobacco dependence, negative affect, and craving) that is consistent with anhedonia being a tobacco withdrawal symptom. Methods: As part of a randomized controlled trial of smoking cessation therapies, 1122 adults (58{\%} female) were assigned to: placebo (n = 131), bupropion (alone or with nicotine lozenge, n = 401) or nicotine replacement therapy (NRT; lozenge, patch, both; n = 590). Participants completed 4 ecological momentary assessments per day for 10 days postquit, resulting in 22 575 assessments. Results: Time-varying effect modeling showed that anhedonia was significantly greater among those high in dependence relative to lower dependent smokers out to day 9 postquit. The placebo group showed elevated anhedonia immediately postquit, which fell to levels similar to the treatment groups by day 7. NRT effectively reduced anhedonia and its time-varying association with craving early in the quit attempt. The positive association between negative affect and anhedonia was moderate and stable over time for both active treatment groups. Conclusions: These results provide additional support that anhedonia following quitting smoking is a manifestation of the tobacco withdrawal syndrome. Implications: This study supported the hypothesis that diminished responsivity to nondrug rewards (ie, anhedonia) is a symptom of the tobacco withdrawal syndrome. Results showed that anhedonia: (1) was significantly associated with dependence, especially during the early postquit period when withdrawal was at its peak intensity; (2) showed significant time-varying associations with other withdrawal symptoms, especially craving; and (3) was significantly suppressed by agonist administration as was its association with craving over time.",
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Anhedonia : Its dynamic relations with craving, negative affect, and treatment during a quit smoking attempt. / Cook, Jessica W.; Lanza, Stephanie T.; Chu, Wanghuan; Baker, Timothy B.; Piper, Megan E.

In: Nicotine and Tobacco Research, Vol. 19, No. 6, 01.06.2017, p. 703-709.

Research output: Contribution to journalArticle

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T2 - Its dynamic relations with craving, negative affect, and treatment during a quit smoking attempt

AU - Cook, Jessica W.

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AU - Piper, Megan E.

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