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Reduction of abstinence-induced withdrawal and craving using high-dose nicotine replacement therapy

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Psychopharmacology Aims and scope Submit manuscript

Abstract

Rationale

Decreasing withdrawal and craving during smoking cessation is a major aim of cessation medications. Prior studies have shown that Nicotine Replacement Therapy (NRT) decreases withdrawal symptom severity but have relied on retrospective reports and lacked robust measures of baseline symptoms or symptoms during unmedicated abstinence.

Objectives and methods

We tested the effect of high-dose (35 mg) nicotine patch on withdrawal and craving during abstinence using real-time assessment with electronic diaries during ad libitum smoking, a brief period of experimentally directed trial abstinence, and the first 3 days of cessation. Subjects were 324 smokers randomized to high-dose nicotine patches or placebo.

Results

Treatment with active patches reduced withdrawal and craving during cessation and completely eliminated deprivation-related changes in affect or concentration.

Conclusion

High-dose NRT reduces withdrawal symptoms and craving and can eliminate some symptoms entirely.

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Acknowledgements

This research was supported by Grant DA 06084 from the National Institute on Drug Abuse to Saul Shiffman. We are grateful to GlaxoSmithKline Consumer Healthcare (GSKCH) for providing nicotine and placebo patches for the study; GSKCH did not otherwise participate in the study or the paper. The authors acknowledge the assistance of Stephanie Paton and Celeste Elash in conducting this study; and Yolanda DiBucci and Qianyu Dang in manuscript preparation

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Authors and Affiliations

  1. University of Pittsburgh, Pittsburgh, PA, 15213, USA

    Saul Shiffman, Stuart G. Ferguson & William G. Shadel

  2. Pinney Associates, Pittsburgh, PA, 15213, USA

    Saul Shiffman & Stuart G. Ferguson

  3. Smoking Research Group, 130 N. Bellefield Avenue, Suite 510, Pittsburgh, PA, 15260, USA

    Saul Shiffman

  4. Brown University, Providence, RI, 02912, USA

    Chad J. Gwaltney

  5. San Francisco Bay Area Center for Cognitive Therapy, Oakland, CA, 94618, USA

    Mark H. Balabanis

Authors
  1. Saul Shiffman
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  2. Stuart G. Ferguson
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  3. Chad J. Gwaltney
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  4. Mark H. Balabanis
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  5. William G. Shadel
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Corresponding author

Correspondence to Saul Shiffman.

Additional information

Saul Shiffman and Stuart Ferguson consult exclusively for GlaxoSmithKline Consumer Healthcare on matters relating to existing smoking cessation products. Dr. Shiffman also has an interest in a new smoking cessation product, and is a founder of invivodata, inc., which provides electronic diaries for clinical trials.

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Shiffman, S., Ferguson, S.G., Gwaltney, C.J. et al. Reduction of abstinence-induced withdrawal and craving using high-dose nicotine replacement therapy. Psychopharmacology 184, 637–644 (2006). https://doi.org/10.1007/s00213-005-0184-3

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  • DOI: https://doi.org/10.1007/s00213-005-0184-3

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