Self-changing behaviour in smoking cessation linked to trait and cognitive impulsivity

Background and aims To compare impulsivity, measured using self-report and cognitive tasks in people who ceased smoking without treatment (self-changers) with each of the following groups: (i) smoking non-treatment seekers, (ii) people in smoking cessation treatment and currently abstinent, and (iii) people in smoking cessation treatment but non-abstinent. Design Cross-sectional, observational study. Setting The smoking cessation unit of a public general hospital, Hospital de Santa Maria, in Lleida, Spain. All participants were from the hospital's catchment area. Participants One hundred and twenty participants, classified in four groups: (1) self-changers (n=30, 21 females, mean age=41.50), (2) non-treatment seekers (n=30, 17 females, mean age=35.27), (3) people in smoking cessation treatment and currently abstinent (n=30, 17 females, mean age=48.93), and (4) people in smoking cessation treatment but non-abstinent (n=30, 21 females, mean age=33.70). Measurements The Barratt Impulsiveness Scale, including measures of non-planning, attentional and motor impulsivity, and two behavioural tasks measuring cognitive inhibition (Stroop test) and choice impulsivity (Delay-discounting task). Confounders included sex, age, education, employment, smoking severity, depression and trait and state anxiety. Findings Although not on the other three measures, we found significant group differences on trait non-planning impulsivity and Stroop performance. Self-changers compared with non-treatment seekers had lower non-planning impulsivity (p = 0.018, Cohen's d = 0.62) and better Stroop performance (p = 0.001, Cohen's d = 0.66). Self-changers also had better Stroop performance than participants in treatment and currently abstinent (p = 0.002, Cohen's d = 0.85). Although not on the other three measures, we found significant group differences on trait non-planning impulsivity and Stroop performance. Self-changers compared with non-treatment seekers had lower non-planning impulsivity (p = 0.018, Cohen's d = 0.62) and better Stroop performance (p = 0.001, Cohen's d = 0.66). Self-changers also had better Stroop performance than participants in treatment and currently abstinent (p = 0.002, Cohen's d = 0.85). Conclusions People who have stopped smoking without treatment appear to have lower non-planning impulsivity and more effective cognitive inhibition compared with smoking non-treatment seekers, and better cognitive inhibition than people who cease smoking with treatment aid.