Applying Lessons Learned from Obsessions: Metacognitive Processes in Smoking Cessation

Cognitive theories of obsessions propose that unwanted thoughts become frequent, intense and persistent when people interpret them in personally meaningful ways and attempt to control them through thought suppression. The present study examined the generalizability of this model to another form of unwanted, actively resisted intrusion--nicotine cravings. In this investigation, 180 individuals attempting to quit smoking completed several online questionnaires. In line with cognitive theories, individuals who appraised their cravings as more catastrophic and personally significant experienced more severe craving-related thoughts and were more likely to be smoking one month later; these effects remained after accounting for several established predictors of cessation difficulty. Contrary to expectation, tendency to suppress unwanted thoughts was not a significant factor. Overall, findings complement existing work on the role of anxiety sensitivity in smoking behaviour and implicate personally meaningful appraisals of smoking-related thoughts, images and impulses in cessation difficulty.