Suicidality prospectively predicts greater urges to smoke following a cessation attempt: Mediation through perceived barriers to cessation

- We examine the effect of pre-cessation suicidality on quit week barriers to cessation and month 1 urges to smoke.
- Greater suicidality predicted greater urges to smoke through greater perceived internal barriers to cessation.
- Results highlight the importance of assessing for suicidality prior to smoking cessation attempt.

Growing interest in developing more effective smoking cessation treatments has facilitated the need to further investigate cognitive-affective factors that inhibit successful smoking cessation, such as urges to smoke. Research has strongly supported an association between suicidality and smoking, yet no work has investigated whether suicidality may increase urges to smoke. The current study sought to evaluate the impact of suicidality on smoking-related cognitive-affective factors predictive of smoking relapse among a community sample of 209 daily smokers engaged in a smoking cessation program. Structural equation modeling (SEM) was used to test the effects of self-reported pre-cessation suicidality on urges to smoke 1 month post-cessation as well as whether this effect was mediated by greater barriers to cessation. Results indicated that internal barriers to cessation significantly mediated the effect of pre-cessation suicidality on greater urges to smoke 1 month following smoking cessation attempt. These findings suggest that elevated suicidality may affect perceived internal barriers to cessation and subsequently urges to smoke 1 month following a quit attempt.