The relationship between level of cigarette consumption and latency to the onset of retrospectively reported withdrawal symptoms
Subthreshold smokers (who smoke ≤5 cigarettes/day) experience withdrawal symptoms, yet they smoke less than is required to maintain serum nicotine levels.
For study 1, our aim was to determine (1) if adult subthreshold smokers report withdrawal symptoms; (2) how they rate symptom severity; (3) the length of their latency to withdrawal symptoms; (4) and the relationship between level of cigarette consumption and latency to withdrawal. The aim of study 2 was to attempt to replicate the results of study 1 in a nationally representative sample and to compare subthreshold and threshold (≥6 cigarettes/day) smokers.
Study 1 was conducted through telephone interviews. Study 2 was conducted through secondary analysis of data from the National Youth Tobacco Survey (self-administered in schools).
In study 1, all subjects experienced withdrawal symptoms. The mean number of symptoms was 4.3; mean intensity of each symptom was >6 (1–10 scale). A quarter of the subjects could go for ≥2 days before experiencing withdrawal. More frequent smokers had a shorter latency to withdrawal (r=−0.43, p<0.001, n=36). In study 2, 63% of subthreshold smokers reported feeling at least one withdrawal symptom. Median latency to withdrawal was 168 h for subthreshold and 2 h for threshold smokers. A negative correlation between level of cigarette consumption and latency to withdrawal was observed for both groups.
Although subthreshold smokers experience significant withdrawal symptoms, they can smoke infrequently because symptoms may not appear for one to several days. Consistent with the sensitization–homeostasis theory, low doses of nicotine can suppress withdrawal symptoms over long periods.
KeywordsAddiction Tobacco Smoking Withdrawal
Funding provided by National Institutes on Drug Abuse grant # 5 RO1 DA14666-01 (JR DiFranza, PI). The ideas expressed are not necessarily those of the funding agency.
- American Psychiatric Association (2000) Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision: DSM-IV-TR. American Psychiatric Association, Washington, DC, pp 192, 265Google Scholar
- An L, Lein E, Bliss R, Pallonen U, Hennrikus D, Farley D, Hertel A, Perry C, Lando H (2004) Loss of autonomy over nicotine use among college social smokers. In: Proceedings of the 10th annual meeting of the Society for Research on Nicotine and Tobacco, Scottsdale, Arizona, p 71 (POS2-035 abstract)Google Scholar
- Barker D (1994) Reasons for tobacco use and symptoms of nicotine withdrawal among adolescent and young adult tobacco users—United States, 1993. MMWR Morb Mortal Wkly Rep 43:745–750Google Scholar
- Goddard E (1990) Why children start smoking. Office of Population Censuses and Surveys, HMSO, London, UKGoogle Scholar
- OCR Macro (2005) 2004 NYTS methodology report. Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia. Available at http://www.cdc.gov/tobacco/NYTS/nyts2004.htm
- Presson CC (2006) Stability of light and intermittent smoking (LITS) patterns and transitions to and from LITS: how smokers become LITS and how often and why LITS smoking patterns change. In: Proceedings of the 12th annual meeting of the Society for Research on Nicotine and Tobacco, Orlando, FL, p 9 (SYM7B abstract)Google Scholar
- Wellman RJ, McMillen RC, DiFranza JR (2006a) Assessing college students’ autonomy over tobacco with the hooked on nicotine checklist. In: Proceedings of the 12th annual meeting of the Society for Research on Nicotine and Tobacco, Orlando, FL, p 81 (POS 1-107 abstract)Google Scholar