The current study examined associations between temperament dimensions assessed by Cloninger's TCI and tobacco abstinence effects. The main finding was that, of the three TCI temperaments, NS demonstrated modest associations with tobacco abstinence effects across a number of domains. This was true even after adjusting for demographic characteristics and nicotine dependence severity ().
Smokers high in NS (and its subscales) reported significantly greater abstinence-induced increases in various withdrawal symptoms (anxiety, anger, concentration difficulties), negative affect, and craving. These findings are in concordance with our hypotheses and results from a previous study showing that smokers with attention deficit hyperactivity disorder (which is generally associated with impulsivity and other aspects of NS; Downey et al., 1996
) are more likely to report irritability, anxiety, difficulty concentrating, and restlessness during tobacco withdrawal (Pomerleau, Downey et al., 2003
). Because NS has been previously linked with positive reinforcement smoking (Pomerleau, Fagerström et al., 2003
), we hypothesized that NS would be associated with abstinence-induced reductions in positive affect and abstinence-induced increases in desire to smoke for pleasure. However, abstinence effects in high-NS smokers were not significantly exaggerated in these domains. It is possible that psychological characteristics that are more representative of the hedonic capacity construct, such as anhedonia, may be more closely associated with abstinence-induced changes in positive affect and desire to smoke for pleasure (Cook, Spring, McChargue, & Hedeker, 2004
Associations with abstinence effects differed somewhat across NS subscales (). NS2-Impulsiveness and NS3-Extravagance subscales were most strongly associated with abstinence effects and may have been driving the effects shown by the NS total scale. Interestingly, a previous study reported that, of all the TCI subscales, NS-3 demonstrated the most robust associations with tobacco dependence (Etter et al., 2003
). Accordingly, the NS2 and NS3 subscales may be useful for identifying smokers who would likely experience excessive unpleasant withdrawal symptoms when trying to abstain.
HA was not associated with abstinence-induced increases in withdrawal assessed by the HHWQ and the WSWS. However, HA was modestly associated with abstinence-induced increases in generalized negative affect (assessed by the PANAS) and desire to smoke to relieve distress, even after adjusting for demographics and nicotine dependence severity (). The current results parallel data demonstrating that smokers with depression and anxiety, which are generally associated with high HA (Peirson & Heuchert, 2001
; Pomerleau et al., 1992
), experience greater abstinence-induced increases in depressed mood, irritability, anxiety, and restlessness (Pomerleau et al., 2000
). Furthermore, these findings also correspond with previous reports that smokers with high HA scores are more likely to smoke for negative reinforcement purposes (Pomerleau, Fagerström et al., 2003
). At the subscale level, HA1-Anticipatory Worry and HA4-Fatigability and Asthenia exhibited the pattern demonstrated by the HA scale (i.e., associations with abstinence-induced increases in PANAS-NA and QSU-Factor 2), which suggests that these two subscales might have accounted for associations produced by the HA total scale.
In contrast with HA and NS, RD was not associated with abstinence effects. This is not surprising given that evidence regarding the relation between RD and smoking behavior is mixed (Etter et al., 2003
; Heath et al., 1995
; Pomerleau et al., 1992
; Van Ammers et al., 1997
; Wills & Cleary, 1999
; Wills et al., 1994
), with some studies actually showing a negative association between RD and nicotine dependence (e.g., Etter et al., 2003
There are several possible explanations of the pattern of associations between the temperament dimensions and abstinence effects. One account of the current findings is that they are reflective of response biases, such that smokers high in NS or HA are more likely to report distress irrespective of actual withdrawal effects. However, the use of a non-abstinent session and abstinence-induced change scores counteracts the influence of any baseline reporting biases. In addition, if response biases systematically impacted abstinence-associated changes, temperament-withdrawal associations would be expected on all measures of distress. Results showed that this was not the case, as associations between NS and HA and abstinence effects were stronger for particular subscales (e.g., QSU-factor 2; PANAS-negative affect) and weaker for others (e.g., WSWS-Hunger, PANAS-Positive Affect). Thus, it is likely that the effects are real and are driven by altered biopsychological processes that influence withdrawal responses in high-NS and high-HA smokers rather than response biases.
There are several potential mechanisms that could explain the pattern of findings. One is that high NS and HA smokers may be vulnerable to particular nicotine-induced neuroadaptations and may therefore experience greater psychological changes during abstinence (withdrawal effect). Alternatively, high NS and HA smokers may have pre-existing psychological symptoms that are masked while smoking but become manifest again during abstinence (offset effect) (Pomerleau, 1997
). Finally, smokers with particular temperaments may exhibit exaggerated responses to stressful circumstances or situations involving the restriction of reward (Ravaja, Keltikangas-Järvinen, & Kettunen, 2006
), which could lead to greater distress and frustration during abstinence. Given that effects were most pronounced for measures related to distress and desire to smoke to relieve distress, this explanation may be the most plausible account of the present findings.
The present findings should be considered in the context of the study's limitations. First, the investigation used an abridged version of the TCI. Although previous studies have shown that this format is psychometrically comparable to the standard version (Chakroun-Vinciguerra et al., 2005
; Cloninger, 1992
), different results might be found using the original TCI questionnaire. Second, the associations between TCI dimensions and abstinence effects were of modest magnitude, though comparable to those observed between the FTND and abstinence effects and generally consistent across multiple measures. Given that associations were of small (but significant) effect size, subjective effects of overnight abstinence may only partially be determined by temperament. Other factors such as gender, ethnicity, age, level of dependence, experience with prior periods of abstinence, and expectations of nicotine withdrawal are important factors that may also play a role in the overall tobacco abstinence response. Third, we do not know whether the associations between TCI dimensions and abstinence effects reflect withdrawal effects, offset effects, effects of frustrative non-reward, or effects of general stressful circumstances. It is therefore only possible to speculate on the mechanisms that underlie the associations between TCI dimensions and abstinence effects. Longitudinal studies, or experimental studies of responses to non-drug related stressors, would shed further light on these mechanisms. Fourth, we only used a single measure of personality. Given that other studies have shown associations between personality traits and abstinence effects using other measures of personality [e.g., Gilbert et al. (1998)
used the NEO-five factor inventory], it would be useful to compare findings with the TCI to other personality inventories. Finally, the study was limited to individuals who abstained for 12 hours, and who were not attempting to quit. Therefore, it is unclear whether these findings will generalize to smokers abstaining for longer periods, or smokers attempting to quit.
To the best of our knowledge, the current study is the first to document associations between TCI temperament dimensions and tobacco abstinence effects. We showed that, of the three temperament dimensions, NS was associated with acute withdrawal across a number of domains, even after controlling for other TCI dimensions and nicotine dependence. Because the effects of NS and HA were independent of each other, smokers who score high in both NS and HA may be at particular risk for experiencing negative affect and urges to smoke in abstinence. Thus, high-NS, high-HA smokers may particularly benefit from nicotine replacement therapy (Shiffman, Ferguson, Gwaltney, Balabanis, & Shadel, 2006
) or mood management interventions (Hall et al., 1996
) to counteract the unpleasant effect of tobacco withdrawal.