Responsiveness to Reward Following Cessation of Smoking

Rationale And Objectives: It has been suggested that stopping smoking may lead to reduced responsiveness to rewarding stimulation. We assessed such changes in dependent smokers who abstained from smoking continuously for 4 weeks.

Methods: Eight hundred seventy-four consecutive smokers treated at a UK Clinic provided ratings of changes in their perception of rewarding events at 1 and 4 weeks after their target quit date. Measurements included the Enjoyment of Life Questionnaire (EOL) and Mood and Physical Symptoms Scale (a measure of withdrawal discomfort). Self-reports of continuous abstinence were verified by expired air carbon monoxide readings.

Results: In 585 participants who were continuously abstinent for the first week and provided EOL ratings, there was an increase in positive reactions to rewarding events compared to reactions while smoking (t = 5.9, p < 0.001). In 192 participants who were continuously abstinent for 4 weeks and provided ratings at both 1 and 4 weeks, there was a further significant increase in positive reactions (F(1,191) = 18.71, p < 0.001). More severe withdrawal discomfort was related to decreased enjoyment of rewarding events.

Conclusions: Responsiveness to reward increases within a week of stopping smoking and it increases further after 4 weeks of abstinence. The finding has implications for reassuring smokers worried about post-quitting mood changes.