Date of Award

Summer 8-1-1999

Document Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Psychology

Abstract

Previous research has demonstrated the link between depression and severity of nicotine withdrawal symptoms. This study investigated depression and other psychopathology as predictors of severity of nicotine withdrawal symptoms among incarcerated males forced to quit smoking due to prison policy. Four hundred and ninety current Smokers, Ex-Smokers, and Non-Smokers completed a baseline questionnaire one week prior to smoking cessation. Three hundred and sixty-nine participants completed the second follow-up questionnaire four days after cessation, an attrition rate of 24. 7%. Two hundred and fifty-six participants completed the final follow-up assessment one month after implementation of the smoking ban, an overall attrition rate of 47.8%. The participants completed the Fagerstrom Test for Nicotine Dependence (FTND), the Center for Epidemiological Studies of Depression (CES-D) measure, Hughes-Hatsukami Withdrawal Scale (HHWS), and smoking history questions prior to cessation. At followup, participants completed the HHWS, the CES-D, and the Tiffany Questionnaire of Smoking Urges-Brief Form (QSU). The Minnesota Multiphasic Personality Inventory-2 validity and clinical scales, administered at initial incarceration, was also extracted from the participant's Department of Corrections (DOC) packet and was used in the predictions of severity of withdrawal symptoms related to psychopathology. Results from this study showed that the majority of the smokers continued to smoke at some level after implementation of the smoking ban and were further classified on their level of abstinence. Surprisingly, Smokers who continued to smoke at the highest levels reported the most severe withdrawal symptoms. As expected, those participants who continued to IV smoke at the highest levels were the most addicted to nicotine at baseline. OveraH, results indicated an interaction between depression and abstinence status such that individuaJs who had the highest levels of depression as measured at baseline and who continued to smoke after the ban experienced the most severe withdrawal symptoms. This was true even when accounting for baseline "withdrawal-type" symptoms. Abstinence status was predicted by cravings and depression. Participants who experienced the highest level of cravings were more likely to continue smoking. Unexpectedly, Smokers who experienced higher levels of depression at baseline were the most likely to abstain at follow-up. Motivational and stage of change factors appear to influence ability to abstain during the smoking ban. These findings have important implications for how nicotine withdrawal is conceptualized and measured in future studies.

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