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Wisconsin Smoking Withdrawal Scale
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About Wisconsin Smoking Withdrawal Scale
Scale Name
Wisconsin Smoking Withdrawal Scale
Author Details
Susan K. Welsch, Stevens S. Smith, David W. Wetter, Douglas E. Jorenby, Michael C. Fiore, and Timothy B. Baker
Translation Availability
English
Background/Description
The Wisconsin Smoking Withdrawal Scale (WSWS), developed by Welsch et al. (1999), is a 28-item self-report scale designed to measure nicotine withdrawal symptoms in adult cigarette smokers attempting cessation. Published in Experimental and Clinical Psychopharmacology, the WSWS assesses seven domains: Anger (4 items, e.g., irritability), Anxiety (4 items, e.g., nervousness), Concentration (3 items, e.g., difficulty focusing), Craving (4 items, e.g., urge to smoke), Hunger (5 items, e.g., increased appetite), Sadness (4 items, e.g., depressed mood), and Sleep (4 items, e.g., insomnia). It is grounded in DSM-IV nicotine withdrawal criteria and designed to capture the multidimensional nature of withdrawal during smoking cessation.
Participants rate symptom severity over the past 24 hours on a 5-point Likert scale (0 = “Strongly disagree” to 4 = “Strongly agree”). Subscale scores vary by item count, with total scores ranging from 0–112, where higher scores indicate greater withdrawal severity. The WSWS was validated with 304 smokers (mean age ≈ 40 years, ~50% female, U.S.-based) in a placebo-controlled cessation trial, showing peak withdrawal at 1–2 weeks post-cessation for 70–80% of participants. It correlates with the Fagerström Test for Nicotine Dependence (r ≈ 0.30–0.50) and negative affect measures (r ≈ 0.40–0.60). The scale is used in clinical psychology, addiction research, and smoking cessation programs to assess withdrawal severity, predict relapse risk, and monitor treatment outcomes.
Administration, Scoring and Interpretation
- Obtain the scale from Welsch et al. (1999) or authorized sources (e.g., Experimental and Clinical Psychopharmacology, University of Wisconsin Center for Tobacco Research), ensuring ethical permissions.
- Explain to participants (adult smokers attempting cessation) that the questionnaire assesses withdrawal symptoms, emphasizing confidentiality and voluntary participation.
- Administer the 28-item scale in a clinical, research, or cessation program setting, using paper or digital formats, with instructions to rate symptoms over the past 24 hours.
- Estimated completion time is 5–8 minutes.
- Ensure a private, supportive environment; provide support resources (e.g., smoking cessation helplines) and adapt for accessibility (e.g., oral administration) if needed.
Reliability and Validity
The WSWS demonstrates strong psychometric properties (Welsch et al., 1999; Etter & Hughes, 2006). Internal consistency is high for subscales: Anger (Cronbach’s alpha = 0.86), Anxiety (0.87), Concentration (0.75), Craving (0.86), Hunger (0.86), Sadness (0.85), and Sleep (0.75), based on a sample of 304 smokers. Test-retest reliability is moderate to high (r ≈ 0.60–0.80 over 1–2 days). Confirmatory factor analysis supports a seven-factor structure, explaining 60–70% of variance.
Convergent validity is evidenced by correlations with the Minnesota Nicotine Withdrawal Scale (r ≈ 0.50–0.70) and mood measures (r ≈ 0.40–0.60). Criterion validity is shown by its sensitivity to withdrawal intensity changes post-cessation and prediction of relapse risk. Discriminant validity is supported by weak correlations with unrelated constructs like general life satisfaction (r < 0.20). Pairing with the Brief Questionnaire of Smoking Urges (QSU-Brief) or Fagerström Test enhances comprehensive assessment.
Available Versions
28-Items
Reference
Welsch, S. K., Smith, S. S., Wetter, D. W., Jorenby, D. E., Fiore, M. C., & Baker, T. B. (1999). Development and validation of the Wisconsin Smoking Withdrawal Scale. Experimental and clinical psychopharmacology, 7(4), 354.
Important Link
Scale File:
Frequently Asked Questions
What does the Wisconsin Smoking Withdrawal Scale measure?
It measures nicotine withdrawal symptoms, including anger, anxiety, concentration, craving, hunger, sadness, and sleep issues.
Who is the target population?
Adult cigarette smokers attempting cessation.
How long does it take to administer?
Approximately 5–8 minutes.
Can it inform interventions?
Yes, it assesses withdrawal severity to guide cessation support and predict relapse risk.
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