Urge to smoke over 52 weeks of abstinence.

RATIONALE: Cigarette cravings are well documented during the first weeks of smoking abstinence. Treatments focus on helping smokers reduce these acute cravings. Cravings experienced later on are less well understood and may be important when considering treatment duration.
OBJECTIVE: We conducted a longitudinal study of cravings over 52 weeks of smoking abstinence.
METHODS: Cravings were operationalised as strength of, and time spent with, urges to smoke. These were assessed among 452 smokers quitting with behavioural support but without pharmacotherapies. Individuals maintaining abstinence were assessed at 1, 2, 3, 4, 26 and 52 weeks after quitting (n = 197, 156, 139, 131, 66 and 38, respectively). Abstinence was validated at each assessment by expired carbon monoxide. Time courses were plotted for those abstinent for 52 weeks and for those abstinent up to earlier time points. Correlations were examined between ratings of urges at consecutive time points.
RESULTS: Ratings of strength of urges to smoke followed an exponential decline over 52 weeks of abstinence, but 6 months after quitting 13 % of ex-smokers still reported strong urges. At 12 months, no ex-smokers reported strong urges, although 34 % reported some urges. Strength of urges to smoke after 1, 2, 3 and 4 weeks of abstinence predicted strength of urges at 6 months.
CONCLUSIONS: Strength of urges to smoke decline exponentially over time following smoking cessation, though some smokers report strong urges after 6 months of abstinence, and urges are still reported by a third of smokers after 12 months. Relapse prevention treatments may need to target prolonged craving.