Want, need and habit as drivers of smoking behaviour: A preliminary analysis

Abstract Background and aims Models of tobacco smoking behaviour propose that anticipated pleasureor satisfaction, the need to alleviate a nicotine-induced drive state and a stimulus-driven impulse potentially play an important role. This study aimed to provide a preliminary assessment of how far urges to smoke are reported by smokers and whether the strength of such urges prior to a quit attempt predicts short-term success at quitting. Methods In a prospective study, 566 smokers attending a treatment programme to help smokers quit completed a written questionnaire covering frequency of different types of urge to smoke (automatic impulse – ‘automatic urges’, anticipated pleasure– ‘ pleasureurges’, and fulfilling a need – ‘need urges’). They were asked to rate this for whichever of these urges was dominant for them. The questionnaire also assessed daily cigarette consumption, time to first cigarette of the day, age and gender. Carbon monoxide verified smoking status was recorded at 1 and 4 weeks after the target quit date. Findings A total of 47.9% (271) of smokers reported that automatic urges were dominant, 21.7% (123) reported pleasureurges to be dominant, and 30.4% (172) reported need urges to be dominant. The strength of automatic urges predicted abstinenceat both 1 week (OR = 0.74, p = 0.005, 95%CI = 0.60–0.92) and 4 weeks (OR = 0.73, p = 0.008, 95%CI = 0.59–0.92). Associations between other urge types and abstinencewere not statistically significant. Conclusions A substantial proportion of smokers attending a clinic for help with quitting report that their dominant urges to smoke occur without any anticipation of pleasureor relief and the strength of the automatic urges predicts failure to sustain abstinencefollowing a quit attempt.