Questionnaire on Smoking Urges—Brief (QSU-Brief)
Questionnaire on Smoking Urges—Brief · Also known as: QSU-Brief, QSU
The QSU-Brief is a 10-item self-report instrument that rapidly assesses the intensity of craving for cigarettes and the intention to smoke. Developed by Cox, Tiffany, and Christen in 1996, it is a brief version of the longer Questionnaire on Smoking Urges (QSU) and is widely used in smoking cessation treatment and research settings to measure one of the strongest predictors of smoking relapse. The QSU-Brief is also applicable, with adaptation, to other addictive substances.
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When to use it
The QSU-Brief is appropriate for use during smoking cessation treatment to monitor craving intensity, predict short-term relapse risk, and guide therapeutic adjustments. It is useful at multiple time points (e.g., daily or weekly during the critical early quit period, or during high-risk situations). The QSU-Brief is less suitable as a pre-treatment screening tool; use it only in individuals who have already decided to quit smoking or are engaged in cessation treatment.
Strengths & limitations
- Brief, validated instrument requiring minimal time to administer while capturing a strong predictor of smoking relapse
- Continuous score provides fine-grained assessment of craving fluctuations across treatment
- Highly predictive of imminent smoking lapse (within 24–48 hours), enabling timely intervention
- Responsive to treatment effects; scores decline during successful cessation treatment
- Applicable across smoking contexts and populations, with translations available in multiple languages
- Measures craving only; does not assess other important relapse predictors (e.g., mood, social support, coping skills)
- Craving is necessary but not sufficient for relapse; some individuals experience high craving without lapsing
- Depends on self-report and may be subject to random response variability or measurement error
- Short-term predictive validity (24–48 hours); longer-term prediction requires integration with other factors
Frequently asked
What craving score should trigger action?
Scores above 30 on the 0–40 Likert scale indicate significant craving and warrant therapeutic response. However, any upward trajectory or rising craving despite treatment may warrant intervention. Work with your clinician to develop coping strategies for managing high-craving situations.
Can high QSU-Brief scores predict whether I will relapse?
QSU-Brief scores are strong predictors of smoking lapse within 24–48 hours, but high craving does not guarantee relapse. Many individuals experience high craving and successfully manage it through coping skills and support. The score indicates risk, not certainty.
How often should I complete the QSU-Brief?
Frequency depends on treatment intensity. During the critical early quit period (first 2–4 weeks), daily or multiple-times-daily assessment provides valuable data. As abstinence stabilizes, weekly or monthly assessment may suffice. Use high-risk periods (stress, social situations) as triggers for assessment.
Can QSU-Brief be used for other drugs besides cigarettes?
Yes, the QSU-Brief has been adapted with minor wording changes ('desire to use [drug]' instead of 'smoke') to assess craving for cannabis, opioids, alcohol, and other substances. The underlying construct (urge intensity and intention) applies broadly across addictive substances.
What if my QSU-Brief scores are low but I'm still smoking?
Low craving does not guarantee abstinence. Smoking may be maintained by habit, context cues, or other factors beyond subjective craving. Conversely, environmental or cognitive cues may trigger smoking despite low reported craving. Work with your clinician to identify triggers and develop comprehensive cessation strategies beyond craving management.
Is there a difference between QSU-Brief and the longer QSU?
The QSU-Brief (10 items) is a shortened version of the full QSU (32 items). Both measure craving, but the brief version is more practical for frequent administration. Psychometric properties are comparable; use QSU-Brief in most clinical settings unless comprehensive measurement is specifically needed.
Sources
- Cox, L. S., Tiffany, S. T., & Christen, A. G. (1996). Evaluation of the brief Questionnaire of Smoking Urges (QSU-brief) in laboratory and clinical settings. Nicotine & Tobacco Research, 2(1), 7–16. link ↗
How to cite this page
ScholarGate. (2026, June 3). Questionnaire on Smoking Urges—Brief. ScholarGate. https://scholargate.app/en/addiction-medicine/craving-questionnaire
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