Measuring coping with smoking urges better predicts smoking cessation outcome than measuring smoking urges alone

Abstract

Background: Despite the ubiquity of this nicotine withdrawal symptom, the urge to smoke is poorly associated with smoking behavior. Measuring success at coping with smoking urges may be more informative. Here, we developed the Coping with the Urge to Smoke Inventory (CUSI) and validated it on smoking and withdrawal behavior. Methods: We collected CUSI, smoking behavior, and withdrawal data from adult smokers (n=1016) enrolled in smoking cessation randomized clinical trials. We used factor analytic techniques to construct the CUSI, and validated it on measures of smoking behavior and withdrawal collected out to 1 year after quitting. Findings: Psychometric analysis of the CUSI indicated a 2-factor model, which we named the Resolve and Resign scales. The CUSI scales demonstrated construct validity when compared with measures of smoking urge, nicotine dependence, and affect. In terms of predictive validity, the CUSI Resign scale better predicted relapse than did a measure of smoking urges. Discussion: The CUSI is a valid and reliable measure of coping with smoking urges that better predicts smoking cessation outcome than simply measuring smoking urges.