Smoking‐related correlates of psychomotor restlessness and agitation in a community sample of daily cigarette smokers

Abstract

Background and Objectives Psychomotor restlessness and agitation (PMA) is a putatively important, yet understudied, psychopathologic correlate of smoking. The scant smoking research on PMA previously conducted has been narrow in scope and conducted among psychiatric patients. To examine the generalizability and relevance of PMA to smoking, this cross-sectional study investigated associations between PMA and a variety of smoking processes in a community sample. Methods Participants in this study were non-treatment-seeking smokers (N = 254, ≥10 cig/day, M age = 44 years) from the community without an active mood disorder. At baseline, they completed a PMA symptom checklist, a composite depressive symptom index, and a battery of smoking questionnaires. Results Linear regression models adjusting for depressive symptoms and demographics indicated that PMA level was positively associated with severity of nicotine withdrawal symptoms during prior quit attempts (β = .18, p < .05), anticipated likelihood of withdrawal in a future quit attempt (β = .19, p < .05), motivation to smoke for negative reinforcement (β = .14, p < .05), and smoking expectancies for negative reinforcement (β = .17, p < .05), negative consequences (β = .22, p < .01), and positive reinforcement (β = .14, p < .05). PMA was not significantly associated with smoking chronicity, frequency, or dependence severity. Conclusion and Scientific Significance Smokers with elevated PMA appear to experience greater smoking-induced affect modulation and nicotine withdrawal than the average smoker, regardless of other depressive symptoms. Given that PMA differentiates a qualitatively unique profile of smoking characteristics, PMA warrants consideration in tobacco addiction research and practice.

Revision of the Wisconsin Smoking Withdrawal Scale: Development of brief and long forms.

“…In the 6-factor model, items for Sad/Depressed, Anxious/Stressed, and Anger loaded on one factor (similar to the 5-factor model) but Concentration and Restlessness items loaded on separate factors. Given the importance of Restlessness as a withdrawal construct that reflects incentive salience, arousal or agitation, smoking motivation, and cessation (Bold et al, 2016; Chandra et al, 2011; Leventhal & Zimmerman, 2010; Wong & Leventhal, 2015), the 6-factor model was preferred. In addition, the factor loadings for the Concentration and Restlessness items were higher in the 6-factor model.…”