TOPLINE:

Among adults seeking treatment to quit smoking, those with a history of sleep problems were more likely to continue smoking. However, current sleep issues and insomnia related to withdrawal showed no association with quitting success.

METHODOLOGY:

• Researchers investigated factors related to sleep difficulties and the effect of sleep difficulties on smoking abstinence in 3295 adults (average age, 50.9 years; 52.3% men; 61.3% White individuals) seeking tobacco cessation treatment at 11 New Jersey Department of Health-funded Quit Centers (November 2019-July 2022).
• Clinicians conducted baseline interviews that captured information on sociodemographic characteristics, medical history, health behaviors, and tobacco-related factors.
• Participants completed baseline assessments of three sleep difficulty measures: past sleep difficulties, present sleep difficulties, and insomnia as a withdrawal symptom in the past.
• Tobacco-related metrics assessed were the Heaviness of Smoking Index, waking at night to smoke, and product used.
• Smoking status was self-reported as 7-day abstinence at 1 and 7 months.

TAKEAWAY:

• At baseline, female sex and never married status were associated with lower odds of preexisting sleep difficulties.
• Depression, anxiety, excessive alcohol and caffeine use, waking at night to smoke, dual use of cigarettes and e-cigarettes , and a higher Heaviness of Smoking Index were associated with higher odds of preexisting sleep difficulties.
• Past sleep difficulties were associated with nonabstinence at both 1 month (adjusted odds ratio [aOR], 2.95; 95% CI, 1.28-6.79) and 7 months (aOR, 4.64; 95% CI, 1.06-20.23).
• Among sleep difficulty measures, only past sleep difficulties were related to abstinence status at the 7-month follow-up assessment (P = .006). No significant association was found between current sleep difficulties or insomnia as a withdrawal symptom and cessation outcomes.

IN PRACTICE:

"Addressing preexisting sleep difficulties in smoking cessation treatment could help reduce relapse risk and enhance cessation success," the authors wrote.

SOURCE:

The study was led by Chaelin K. Ra, PhD, MPH, of the Robert Wood Johnson Medical School at Rutgers University in New Brunswick, New Jersey. It was published online on March 17, 2026, as a research brief in the American Journal of Preventive Medicine.

LIMITATIONS: 

The study relied on self-reported information to check if people had quit smoking. Only a few participants reported having past sleep difficulties, and participants were recruited from a single state. 

DISCLOSURES:

The research was supported by the National Institute on Drug Abuse, with additional support from Cancer Center Support Grant. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.