Development and initial validation of a cessation fatigue scale

- Cessation fatigue is a potentially key but understudied component of relapse risk.
- We examined the reliability and validity of a new Cessation Fatigue Scale (CFS).
- The CFS was associated with several important, theory-based smoking variables.
- The CFS has demonstrated promising initial validity and warrants further study.

BackgroundSmoking cessation fatigue, or tiredness of attempting to quit smoking, has been posited as a latent construct encompassing loss of motivation, loss of hope in cessation success, decreased self-efficacy, and exhaustion of self-control resources. Despite the potential clinical impact of characterizing cessation fatigue, there is currently no validated measure to assess it. Using a rational scale development approach, we developed a cessation fatigue measure and examined its reliability and construct validity in relation to a) smokers' experience of a recently failed quit attempt (QA) and b) readiness to engage in a subsequent QA.MethodsData were drawn from an online cross-sectional survey of 484 smokers who relapsed from a QA within the past 30 days.ResultsExploratory factor analysis identified three factors within the 17-item Cessation Fatigue Scale (CFS), which we labeled: emotional exhaustion, pessimism, and devaluation. High internal consistency was observed for each factor and across the full scale. As expected, CFS overall was positively associated with withdrawal severity and difficulty quitting. CFS was negatively associated with previously validated measures of intention to quit, self-efficacy, and abstinence-related motivational engagement, even after adjusting for nicotine dependence.ConclusionsFindings provide initial validation for a new tool to assess cessation fatigue and contribute needed information on a theory-driven component of cessation-related motivation and relapse risk.