Abstract
Rationale
Nicotine nasal spray (NS) is recommended as one of five first-line smoking cessation products. A clinically convenient tool to identify smokers most likely to benefit from NS could assist healthcare practitioners in selecting the optimal treatment for individual patients.
Objectives
To evaluate whether the subjective effects of an initial pre-treatment dose of NS predict 6 month abstinence rates following NS treatment for tobacco dependence.
Methods
One hundred and seventy-five smokers received an initial 1 mg pre-treatment dose of NS and completed a new measure of NS subjective effects (initial spray experience, ISE). This measure, together with demographic and smoking history variables, was examined as a predictor of 6-month point-prevalence (biochemically verified) abstinence rates.
Results
Factor analysis revealed positive and negative effects subscales of the ISE. Smokers with higher ratings of positive effects from the pre-treatment NS dose were significantly more likely to be abstinent at 6-month follow-up. These effects were partially mediated by reduction in urge to smoke.
Conclusions
Pending additional validation in human laboratory and clinical studies, assessment of the acute positive subjective effects of initial NS delivery may be an efficient way to predict who will be successful with NS treatment for tobacco dependence.
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References
Baron RM, Kenny DA (1986) The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Person Soc Psychol 51:1173–1182
Brown RA, Burgess ES, Sales SD, Whiteley JA, Evans DM, Miller IW (1998) Reliability and validity of a smoking timeline follow-back interview. Psychol Addict Behav 12:101–112
Heatherton TF, Kozlowski LT, Frecker RC, Fagerstrom KO (1991) The Fagerstrom test for nicotine dependence: a revision of the Fagerstrom tolerance questionnaire. Br J Addict 86:1119–1127
Henningfield JE, Keenan RM (1993) Nicotine delivery kinetics and abuse liability. J Consult Clin Psychol 61:743–750
Hjalmarson A, Franzon M, Westin A, Wiklund O (1994) Effect of nicotine nasal spray on smoking cessation. A randomized, placebo-controlled, double-blind study. Arch Int Med 154:2567–2572
Hurt RD, Dale LC, Croghan GA, Croghan IT, Gomez-Dahl LC, Offord KP (1998) Nicotine nasal spray for smoking cessation: pattern of use, side effects, relief of withdrawal symptoms, and cotinine levels. Mayo Clin Proc 73:118–125
Killen JD, Fortmann SP (1997) Craving is associated with smoking relapse: findings from three prospective studies. Exp Clin Psychopharmacol 5:137–142
Lerman C, Roth D, Kaufmann V, Audrain J, Hawk L, Liu A, Niaura R, Epstein L (2002) Mediating mechanisms for the impact of bupropion in smoking cessation treatment. Drug Alcohol Depend 67:219–223
McNeil-PPC I (1996) (March) Nicotrol NS product labelling. Fort Washington, Pa.
Perkins KA, Grobe JE, Weiss D, Fonte C, Caggiula A (1996) Nicotine preference in smokers as a function of smoking abstinence. Pharmacol Biochem Behav 55:257–263
Perkins KA, Grobe JE, Caggiula A, Wilson AS, Stiller RL (1997a) Acute reinforcing effects of low-dose nicotine nasal spray in humans. Pharmacol Biochem Behav 56:235–241
Perkins KA, Sanders M, D’Amico D, Wilson A (1997b) Nicotine discrimination and self-administration in humans as a function of smoking status. Psychopharmacology 131:361–370
Perkins KA, Gerlach D, Broge M, Grobe JE, Wilson A (2000) Greater sensitivity to subjective effects of nicotine in nonsmokers high in sensation seeking. Exp Clin Psychopharmacol 8:462–471
Perkins KA, Broge M, Gerlach D, Sanders M, Grobe JE, Cherry C, Wilson AS (2002) Acute nicotine reinforcement, but not chronic tolerance, predicts withdrawal and relapse after quitting smoking. Health Psychol 21:332–339
Pomerleau OF, Pomerleau CS, Namenek RJ (1998) Early experiences with tobacco among women smokers, ex-smokers, and never-smokers. Addiction 93:595–599
Pomerleau CS, Pomerleau OF, Namenek RJ, Marks JL (1999) Initial exposure to nicotine in college-age women smokers and never-smokers: a replication and extension. J Addict Dis 18:13–19
Rose JE, Levin ED (1991) Inter-relationships between conditioned and primary reinforcement in the maintenance of cigarette smoking. Br J Addict 86:605–609
Schneider NG, Lunell E, Olmstead RE, Fagerstrom KO (1996) Clinical pharmacokinetics of nasal nicotine delivery. A review and comparison to other nicotine systems. Clin Pharmacokinet 31:65–80
Sutherland G, Stapleton JA, Russel MA, Jarvis MJ, Hajek P, Belcher M, Feyerabend C (1992) Randomised controlled trial of nasal nicotine spray in smoking cessation. Lancet 340:324–329
USDHHS (2000) Reducing tobacco use: a report of the Surgeon General. USDHHS, Washington D.C.
Acknowledgments
We thank Sean Fleming, Greg Fratteroli, Paul Sanborn, and Kia Wilson for their assistance with data collection. This work was supported by a Transdisciplinary Tobacco Use Research Center Grant from the National Cancer Institute and the National Institute on Drug Abuse P5084718, and support from the Abramson Cancer Center and Annenberg Public Policy Center (C.L.) and a Public Health Services Research Grant M01-RR0040 from the National Institutes of Health.
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Kaufmann, V., Jepson, C., Rukstalis, M. et al. Subjective effects of an initial dose of nicotine nasal spray predict treatment outcome. Psychopharmacology 172, 271–276 (2004). https://doi.org/10.1007/s00213-003-1659-8
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DOI: https://doi.org/10.1007/s00213-003-1659-8