Studying stimuli and smoking behaviors among self-identified gifted smokers and strategies for customizing cessation support.

Introduction: The aim of the study was to examine smoking habits and triggers among self-identified gifted (inner experiences and awareness qualitatively different from the norm in terms of asynchronous development, advanced cognitive abilities, and heightened intensity) adults in order to customize smoking cessation support.

Methods: A total of 123 participants were enrolled through Facility-Based and Snowball Sampling. Quantitative analysis focused on the relationship between overexcitabilities, nicotine dependence, motivation to quit, and smoking triggers, using the following questionnaires: the Overexcitability Questionnaire (OEQ-II) an indicator of areas of overexcitability, a heightened response and lowered threshold to stimuli; the Fagerström Test for Nicotine Dependence; a Cessation Motivation Questionnaire; and a Smoking Triggers Questionnaire. Qualitative analysis drew on six semi-structured interviews. Participant experiences of the relationship between smoking behaviors and experiences of multiple areas of overexcitability were analyzed using process coding.

Results: The quantitative data indicate that self-identified gifted smokers who rate themselves as having 3-5 'High' or 'High Average' overexcitabilities (OEs), are less likely to smoke in response to pattern, social, and addiction focused triggers than those self-reporting as having 0-2 OEs (Fisher's exact test, p<0.1). In the interviews, we observed a high level of complexity in stimulation and smoking behavior, with all interviewees explicitly connecting their smoking habits with experiences of overexcitability. Two interviewees had given up smoking prior to the research and of the four who still smoked, three quit within a few days of the interview.

Conclusions: We found that psychometric testing and interviews designed to increase self-knowledge about the relationship between overexcitabilities and triggers for smoking have the potential to improve outcomes for smoking cessation among the gifted.