Psychopharmacology

, Volume 229, Issue 1, pp 209–218

Cigarette craving and withdrawal symptoms during temporary abstinence and the effect of nicotine gum

  • Jamie Brown
  • Peter Hajek
  • Hayden McRobbie
  • Jo Locker
  • Fiona Gillison
  • Andy McEwen
  • Emma Beard
  • Robert West
Original Investigation

DOI: 10.1007/s00213-013-3100-2

Cite this article as:
Brown, J., Hajek, P., McRobbie, H. et al. Psychopharmacology (2013) 229: 209. doi:10.1007/s00213-013-3100-2

Abstract

Rationale

It is widely believed that nicotine withdrawal symptoms appear within a few hours of stopping smoking, but few data exist documenting their emergence in naturalistic settings. In several countries, nicotine replacement products are licensed for relief of withdrawal symptoms during temporary abstinence, but again, there are no data supporting this from naturalistic settings.

Objectives

To examine the emergence of cigarette craving and withdrawal symptoms during temporary abstinence in a naturalistic setting while using either nicotine or placebo gum.

Methods

Double-blind, randomised, placebo-controlled study in which 132 dependent smokers abstained for 6 h with the assistance of either nicotine (2 mg, n = 42 or 4 mg, n = 24) or placebo (n = 66) gum while travelling on a non-smoking train. Outcome measures were ratings of craving and mood withdrawal symptoms prior to treatment and at regular intervals during abstinence.

Results

In a multivariate analysis of all symptoms, there was no interaction between treatment and time [F(21,110) = 1.28, p = 0.20, \( \eta_{\mathrm{p}}^2 \) = 0.20] nor an effect of treatment [F(7,124) = 0.45, p = 0.87, \( \eta_{\mathrm{p}}^2 \) = 0.03]. There was an effect of time [F(21,110) = 11.59, p < 0.001, \( \eta_{\mathrm{p}}^2 \) = 0.69) and univariate analyses revealed that the majority of symptoms increased linearly throughout the period of abstinence with detectable onsets typically between the first 60 and 180 min of abstinence.

Conclusions

Smokers who temporarily abstain in naturalistic settings experience craving and withdrawal symptoms that emerge linearly over the first 6 h of abstinence. Changes in craving and several mood withdrawal symptoms can be detected within the first 3 h. Nicotine gum may not have an acute effect on the development of these symptoms.

Keywords

Temporary abstinenceCravingWithdrawal symptomsNicotine gumSmoking

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Jamie Brown
    • 1
    • 5
  • Peter Hajek
    • 2
  • Hayden McRobbie
    • 2
  • Jo Locker
    • 3
  • Fiona Gillison
    • 4
  • Andy McEwen
    • 1
    • 3
  • Emma Beard
    • 1
  • Robert West
    • 1
    • 3
  1. 1.Cancer Research UK Health Behaviour Research CentreUniversity College LondonLondonUK
  2. 2.Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen MaryUniversity of LondonLondonUK
  3. 3.National Centre for Smoking Cessation and TrainingLondonUK
  4. 4.Department for HealthUniversity of BathBathUK
  5. 5.Health Behaviour Research Centre, Department of Epidemiology and Public HealthUniversity College LondonLondonUK