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 years), (2) non-treatment-seekers (n = 30, 17 females, mean age = 35.27 years), (3) people in smoking cessation treatment and currently abstinent (n = 30, 17 females, mean age = 48.93 years) and (4) people in smoking cessation treatment but non-abstinent (n = 30, 21 females, mean age = 33.70 years). 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). 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.