Updated tool empowers researchers to assess withdrawal

UW-CTRI researchers have revised a questionnaire that researchers and clinicians can use to assess tobacco withdrawal. It’s called the Wisconsin Smoking Withdrawal Scale version 3 (WSWS 3) and it was published in the journal Psychology of Addictive Behaviors.

Based on the Withdraw From Tobacco study, led by UW-CTRI Co-founder and Associate Director Dr. Tim Baker and UW-CTRI Assistant Professor Dr. Jesse Kaye, the scale will help professionals to better understand withdrawal from tobacco so that they can better help people quit smoking.

This study recruited more than 200 people. All participants tried to quit ‘cold turkey’ at first and then got eight weeks of combination nicotine-replacement medication (nicotine patch and mini lozenge).

“One of the unique aspects of this study was that participants who wanted to quit smoking were willing to try to quit without using any medications during the first week of their attempt,” Kaye said. “Most prior studies that evaluated withdrawal studied participants who were using medications like varenicline or nicotine-replacement medication. The Withdraw From Tobacco Study allowed us to examine the nature of withdrawal symptoms without medication on board, which we know can suppress the full expression of withdrawal.”

Study staff provided coaching to help participants quit smoking and confirm their smoking status two months after their quit date.

WSWS 3 builds on the original scales and a later revision led by Dr. Stevens Smith, then a UW-CTRI researcher and now an emeritus researcher assisting UW-CTRI with data analysis. The main difference between WSWS 2 and 3 is that the latest revision assesses anhedonia – or the diminished desire to pursue or enjoy experiences that would normally be rewarding.

It also builds on groundbreaking research on anhedonia and tobacco addiction by UW-CTRI colleagues Dr. Jess Cook, Dr. Jen Betts and others.

“Work by Jess Cook and colleagues has contributed strong evidence that anhedonia is a symptom of the tobacco withdrawal syndrome,” Kaye said. “The WSWS 3 will now provide researchers with a new tool to continue to examine the nature and importance of anhedonia in the context of quitting smoking.”

Tobacco withdrawal measures are widely used in clinical research and less so in real-world clinical settings. However, Kaye said that symptom tracking is incredibly common in most other areas of healthcare – for example, checking your blood pressure at every primary care appointment or assessing depression symptoms using self-report measures at therapy appointments.

“Using self-report assessments of withdrawal, like the WSWS 3, could provide clinicians and patients a better understanding of the patient’s progress in quitting smoking and the challenges that they encounter in their quit attempts,” he said. “This symptom awareness and understanding could help inform treatment approaches to support people to successfully quit and stay quit.”

Kaye JT, Bolt DM, Piper ME, Cook JW, Williams BS, Piasecki TM,Baker TB. Assessing Cigarette Smoking Withdrawal in Unmedicated Individuals: Validating the Wisconsin Smoking Withdrawal Scales Version 3 (WSWS3). Psychology of Addictive Behaviors. Online August 17, 2026.