Furthermore, the inclusion of daily laboratory visits provides an opportunity for conducting detailed assessment of the processes and state-based changes occurring within individual participants that may contribute to lapse and relapse. In the present study, higher levels of craving and http://www.selleckchem.com/products/ganetespib-sta-9090.html withdrawal upon initiating abstinence were associated with earlier lapse. However, craving did not appear to explain the association between TTFC and smoking lapse, as TTFC continued to significantly predict abstinence outcomes when both variables were included in the same model. These findings illustrate the potential utility of this model in exploring how state-based changes may explain or add to trait level predictors, thus providing a framework for elucidating mechanisms by which nicotine dependence or other factors may contribute to relapse.

Although the assessment of craving and withdrawal in the present study represents a small initial step, exploration of other state changes in mood, affect, or behavior remains an important future direction. Although FTND and TTFC were significant predictors of abstinence outcomes, no association was found between NDSS or WISDM and time to first lapse. This is surprising, given that both NDSS and WISDM have been shown to predict smoking cessation outcomes in other studies (Courvoisier & Etter, 2010; Piper et al., 2008; Shiffman et al., 2004). However, in one study comparing all three measures of nicotine dependence, the FTND was found to be the single best predictor of smoking cessation outcomes across all time points, from abstinence initiation to 6-month follow-up (Piper et al.

, 2008). By contrast, specific subscales of the WISDM and NDSS improved prediction of outcomes beyond the FTND only at the end of treatment. Thus, it is possible that the lack of association between abstinence and the NDSS and WISDM in the present study is a function of (a) the FTND as a better index of smoking cessation success, (b) the focus on initiation rather than maintenance of abstinence in the present study, and (c) analysis of the global measures rather than evaluation of specific subscales. Furthermore, each of these dependence measures was derived from distinct theoretical backgrounds and may be assessing different aspects of dependence. The FTND was designed to emphasize physical dependence and withdrawal (Fagerstr?m, 1978; Heatherton et al.

, 1991), although it has also been Batimastat argued to primarily assess the motivational impact of abstinence on smoking behavior (Piper, McCarthy, & Baker, 2006). In this regard, it is not surprising that the FTND (and TTFC) was the strongest predictor of lapse within the abstinence incentive test. By contrast, the NDSS and WISDM are both multidimensional scales, attempting to capture underlying processes or motives inherent in nicotine addiction.