, Volume 187, Issue 3, pp 385–396 | Cite as

The early time course of smoking withdrawal effects

  • Peter S. HendricksEmail author
  • Joseph W. Ditre
  • David J. Drobes
  • Thomas H. BrandonEmail author
Original Investigation



There has been little study of the very early time course of the smoking withdrawal syndrome, despite its relevance to the maintenance of both smoking and postcessation abstinence. The literature contains a range of estimates about the early appearance of withdrawal symptoms, but without reference to empirical data.


The study aim was to conduct a comprehensive, multimodal assessment of the early time course of the symptoms associated with smoking withdrawal among cigarette smokers.


Participants were 50 smokers randomly assigned to either abstain or smoke at their own pace during 4 h in the laboratory. Dependent measures included resting heart rate, sustained attention (Rapid Visual Information Processing task; RVIP), selective attention to smoking stimuli (an emotional Stroop task), and self-report (Wisconsin Smoking Withdrawal Scale; WSWS). After baseline assessment, participants were assigned to the two conditions and the dependent measures were collected every 30 min.


Generalized estimating equations revealed that abstaining participants displayed greater withdrawal than smoking participants on all measures with the exception of the Stroop task. Statistically significant differences in withdrawal were found within 60 min on heart rate, within 30 min on the RVIP, and between 30 and 180 min postcessation on the various subscales of the WSWS.


These findings provide the first evidence of the early time course of smoking withdrawal symptoms, although further research is needed to distinguish withdrawal from drug offset effects. Implications for understanding the maintenance of daily smoking and for the treatment of tobacco dependence are discussed.


Nicotine Withdrawal Attention Abstinence 



This study was funded by the University of South Florida and the National Cancer Institute (R01 CA94256), and complies with the laws of the United States of America. The authors thank Drs. Mike Brannick, Ji-Hyun Lee, Doug Nelson, and Kevin Thompson for their helpful suggestions, and Amanda Heisserer and Lauren Siliati for their work on the project.


  1. al’Absi M, Amunrud T, Wittmers LE (2002) Psychophysiological effects of nicotine abstinence and behavioral challenges in habitual smokers. Pharmacol Biochem Behav 72:707–716PubMedCrossRefGoogle Scholar
  2. American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington DCGoogle Scholar
  3. Baker TB, Brandon TH, Chassin L (2004a) Motivational influences on cigarette smoking. Annu Rev Psychol 55:463–491PubMedCrossRefGoogle Scholar
  4. Baker TB, Piper ME, McCarthy DE, Majeskie MR, Fiore MC (2004b) Addiction motivation reformulated: an affective processing model of negative reinforcement. Psychol Rev 111:33–51PubMedCrossRefGoogle Scholar
  5. Baldinger B, Hasenfratz M, Bättig K (1995) Comparison of the effects of nicotine on a fixed rate and a subject-paced version of the rapid information processing task. Psychopharmacology 121:396–400PubMedCrossRefGoogle Scholar
  6. Bell SL, Taylor RC, Singleton EG, Henningfield JE, Heishman SJ (1999) Smoking after nicotine deprivation enhances cognitive performance and decreases tobacco craving in drug abusers. Nicotine Tob Res 1:45–52PubMedCrossRefGoogle Scholar
  7. Braver TS, Barch DM, Keys BA, Carter CS, Cohen JD, Kaye JA et al (2001) Cognitive processing in older adults: evidence for a theory relating cognitive control to neurobiology in healthy aging. J Exp Psychol Gen 130:746–763PubMedCrossRefGoogle Scholar
  8. Cook MR, Gerkovich MM, Graham C, Hoffman SJ, Peterson RC (2003) Effects of nicotine patch on performance during the first week of smoking cessation. Nicotine Tob Res 5:169–180PubMedCrossRefGoogle Scholar
  9. Drobes DJ, Tiffany ST (1997) Induction of smoking urge through imaginal and in vivo procedures: physiological and self-report manifestations. J Abnorm Psychol 106:15–25PubMedCrossRefGoogle Scholar
  10. Edwards JA, Wesnes K, Warburton DM, Gale A (1985) Evidence of more rapid stimulus evaluation following cigarette smoking. Addict Behav 10:113–126PubMedCrossRefGoogle Scholar
  11. Etter JF, Hughes JR (2006) A comparison of the psychometric properties of three cigarette withdrawal scales. Addiction 101:362–372PubMedCrossRefGoogle Scholar
  12. Fichtenberg CM, Glantz SA (2002) Effect of smoke-free workplaces on smoking behaviour: systematic review. BMJ 325:188–191PubMedCrossRefGoogle Scholar
  13. Foulds J, Stapleton J, Swettenham J, Bell N, McSorley K, Russell MA (1996) Cognitive performance effects of subcutaneous nicotine in smokers and never-smokers. Psychopharmacology 127:31–38PubMedCrossRefGoogle Scholar
  14. Giannakoulas G, Katramados A, Melas N, Diamantopoulos I, Chimonas E (2003) Acute effects of nicotine withdrawal syndrome in pilots during flight. Aviat Space Environ Med 74:247–251PubMedGoogle Scholar
  15. Gilbert DG, Izetelny A, Radtke R, Hammersley J, Rabinovich NE, Jameson TR, Huggnevik JI (2005) Dopamine receptor (DRD2) genotype-dependent effects of nicotine on attention and distraction during rapid visual information processing. Nicotine Tob Res 7:361–379PubMedCrossRefGoogle Scholar
  16. Goldman MS (1999) Expectancy operation: cognitive-neural models and architectures. In: Kirsch I (ed) How expectancies shape experience. American Psychological Association, Washington DC, pp 41–63CrossRefGoogle Scholar
  17. Gross J, Stitzer ML (1989) Nicotine replacement: ten-week effects on tobacco withdrawal symptoms. Psychopharmacology 98:334–341PubMedCrossRefGoogle Scholar
  18. Gross TM, Jarvik ME, Rosenblatt MR (1993) Nicotine abstinence produces content-specific Stroop interference. Psychopharmacology 110:333–336PubMedCrossRefGoogle Scholar
  19. Gross J, Lee J, Stitzer ML (1997) Nicotine-containing versus de-nicotinized cigarettes: effects on craving and withdrawal. Pharmacol Biochem Behav 57:159–165PubMedCrossRefGoogle Scholar
  20. Hasenfratz M, Bättig K (1993) Psychophysiological interactions between smoking and stress coping? Psychopharmacology 113:37–44PubMedCrossRefGoogle Scholar
  21. Hatsukami DK, Pickens RW, Svikis DS, Hughes JR (1988) Smoking topography and nicotine blood levels. Addict Behav 13:91–95PubMedCrossRefGoogle Scholar
  22. Hatsukami D, Fletcher L, Morgan S, Keenan R, Amble P (1989) The effects of varying cigarette deprivation duration on cognitive and performance tasks. J Subst Abuse 1:407–416PubMedGoogle Scholar
  23. Heatherton TF, Kozlowski LT, Frecker RC, Fagerström KO (1991) The Fagerström Test for Nicotine Dependence: a revision of the Fagerström Tolerance Questionnaire. Br J Addict 86:1119–1127PubMedCrossRefGoogle Scholar
  24. Heishman SJ, Taylor RC, Henningfield JE (1994) Nicotine and smoking: a review of effects on human performance. Exp Clin Psychopharmacol 2:345–395CrossRefGoogle Scholar
  25. Hendricks PS, Brandon TH (2005) Smoking expectancy associates among college smokers. Addict Behav 30:235–245PubMedCrossRefGoogle Scholar
  26. Herbert M, Foulds J, Fife-Schaw C (2001) No effect of cigarette smoking on attention or mood in non-deprived smokers. Addiction 96:1349–1356PubMedCrossRefGoogle Scholar
  27. Hirshman E, Rhodes DK, Zinser M, Merritt P (2004) The effect of tobacco abstinence on recognition memory, digit span recall, and attentional vigilance. Exp Clin Psychopharmacol 12:76–83PubMedCrossRefGoogle Scholar
  28. Hugdahl K (1981) The three-systems-model of fear and emotion: a critical examination. Behav Res Ther 24:587–596Google Scholar
  29. Hughes JR (1992) Tobacco withdrawal in self-quitters. J Consult Clin Psychol 60:689–697PubMedCrossRefGoogle Scholar
  30. Hughes JR, Hatsukami DK (1986) Signs and symptoms of tobacco withdrawal. Arch Gen Psychiatry 43:289–294PubMedGoogle Scholar
  31. Hughes JR, Keenan RM, Yellin A (1989) Effect of tobacco withdrawal on sustained attention. Addict Behav 14:577–580PubMedCrossRefGoogle Scholar
  32. Hughes JR, Higgins ST, Hatsukami DK (1990) Effects of abstinence from tobacco: a critical review. In:Kozlowski LT, Annis H, Cappell HD, Glaser F, Goodstadt M, Israel Y, Kalant H, Sellers EM, Vingillis J (eds) Research advances in alcohol and drug problems, vol 10. Plenum Press, New York, pp 317–398Google Scholar
  33. Hughes JR, Gust SW, Skoog K, Keenan RM, Fenwick JW (1991) Symptoms of tobacco withdrawal. A replication and extension. Arch Gen Psychiatry 48:52–59PubMedGoogle Scholar
  34. Hughes JR, Higgins ST, Bickel WK (1994) Nicotine withdrawal versus other drug withdrawal syndromes: similarities and dissimilarities. Addiction 89:1461–1470PubMedCrossRefGoogle Scholar
  35. Kassel JD (1997) Smoking and attention: a review and reformulation of the stimulus-filter hypothesis. Clin Psychol Rev 17:451–478PubMedCrossRefGoogle Scholar
  36. Killen JD, Ammerman S, Rojas N, Varady J, Haydel F, Robinson TN (2001) Do adolescent smokers experience withdrawal effects when deprived of nicotine? Exp Clin Psychopharmacol 9:176–182PubMedCrossRefGoogle Scholar
  37. Kirsch I (1985) Response expectancy as a determinant of experience and behavior. Am Psychol 40:1189–1202CrossRefGoogle Scholar
  38. Kučera H, Francis WN (1967) Computational analysis of present day American English. Brown University Press, Providence RIGoogle Scholar
  39. Lang PJ (1968) Fear reduction and fear behavior: problems in treating a construct. In: Shlien JM (ed) Research in psychotherapy, vol. 3. American Psychological Association, Washington DC, pp 90–103CrossRefGoogle Scholar
  40. Lawrence NS, Ross TJ, Stein EA (2002) Cognitive mechanisms of nicotine on visual attention. Neuron 36:539–548PubMedCrossRefGoogle Scholar
  41. Liang KY, Zeger SL (1986) Longitudinal data analysis using generalized linear models. Biometrika 73:13–22CrossRefGoogle Scholar
  42. MacLeod CM (1991) Half a century of research on the Stroop effect: an integrative review. Psychol Bull 109:163–203PubMedCrossRefGoogle Scholar
  43. Mancuso G, Andres P, Ansseau M, Tirelli E (1999a) Effects of nicotine administered via a transdermal delivery system on vigilance: a repeated measure study. Psychopharmacology 142:18–23PubMedCrossRefGoogle Scholar
  44. Manusco G, Warburton DM, Mélen M, Sherwood N, Tirelli E (1999b) Selective effects of nicotine on attentional processes. Psychopharmacology 146:199–204CrossRefGoogle Scholar
  45. Mancuso G, Lejeune M, Ansseau M (2001) Cigarette smoking and attention: processing speed or specific effects? Psychopharmacology 155:372–378PubMedCrossRefGoogle Scholar
  46. Mogg K, Bradley BP (2002) Selective processing of smoking-related cues in smokers: manipulation of deprivation level and comparison of three measures of processing bias. J Psychopharmacol 16:385–392CrossRefGoogle Scholar
  47. Munafo M, Mogg K, Roberts S, Bradley BP, Murphy M (2003) Selective processing of smoking-related cues in current smokers, ex-smokers and never-smokers on the modified Stroop task. J Psychopharmacol 17:310–316PubMedCrossRefGoogle Scholar
  48. Nelson DL, McEvoy CL, Schreiber TA (1998) The University of South Florida word association, rhyme, and word fragment norms.
  49. Parrott AC, Winder G (1989) Nicotine chewing gum (2 mg, 4 mg) and cigarette smoking: comparative effects upon vigilance and heart rate. Psychopharmacology 97:257–261PubMedCrossRefGoogle Scholar
  50. Parrott AC, Roberts G (1991) Smoking deprivation and cigarette reinstatement: effects upon visual attention. J Psychopharmacol 5:404–409CrossRefGoogle Scholar
  51. Parrott AC, Craig D (1992) Cigarette smoking and nicotine gum (0, 2, and 4 mg): effects upon four visual attention tasks. Neuropsychobiology 25:34–43PubMedCrossRefGoogle Scholar
  52. Parrott AC, Garnham NJ, Wesnes K, Pincock C (1996) Cigarette smoking and abstinence: comparative effects upon cognitive task performance and mood state over 24 hours. Hum Psychopharmac 11:391–400CrossRefGoogle Scholar
  53. Petrie RXA, Deary IJ (1989) Smoking and human information processing. Psychopharmacology 99:393–396PubMedCrossRefGoogle Scholar
  54. Piasecki TM, Fiore MC, Baker TB (1998) Profiles in discouragement: two studies of variability in the time course of withdrawal symptoms. J Abnorm Psychol 107:238–251PubMedCrossRefGoogle Scholar
  55. Piasecki TM, Niaura R, Shadel WG, Abrams DB, Goldstein MG, Fiore MC, Baker TB (2000) Smoking withdrawal dynamics in unaided quitters. J Abnorm Psychol 109:74–86PubMedCrossRefGoogle Scholar
  56. Piasecki TM, Jorenby DE, Smith SS, Fiore MC, Baker TB (2003a) Smoking withdrawal dynamics: I. Abstinence distress in lapsers and abstainers. J Abnorm Psychol 112:3–13PubMedCrossRefGoogle Scholar
  57. Piasecki, TM, Jorenby DE, Smith SS, Fiore MC, Baker TB (2003b) Smoking withdrawal dynamics: II. Improved tests of withdrawal-relapse relations. J Abnorm Psychol 112:14–27PubMedCrossRefGoogle Scholar
  58. Pomerleau OF, Pomerleau CS, Marks JL (2000) Abstinence effects and reactivity to nicotine during 11 days of smoking deprivation. Nicotine Tob Res 2:149–157Google Scholar
  59. Powell J, Trait S, Lessiter J (2002) Cigarette smoking and attention to signals of reward and threat in the Stroop paradigm. Addiction 97:1163–1170PubMedCrossRefGoogle Scholar
  60. Rachman S, Hodgson R (1974) I. Synchrony and desynchrony in fear and avoidance. Behav Res Ther 12:311–318PubMedCrossRefGoogle Scholar
  61. Revell AD (1988) Smoking and performance-a puff-by-puff analysis. Psychopharmacology 96:563–565PubMedCrossRefGoogle Scholar
  62. Rose JE (2006) Nicotine and nonnicotine factors in cigarette addiction. Psychopharmacology 184:274–285PubMedCrossRefGoogle Scholar
  63. Rose JE, Behm FM, Westman EC, Kukovich P (2006) Precessation treatment with nicotine skin patch facilitates smoking cessation. Nicotine Tob Res 8:89–101PubMedCrossRefGoogle Scholar
  64. Russell MA (1988) Nicotine replacement: the role of blood nicotine levels, their rate of change, and nicotine tolerance. Prog Clin Biol Res 261:63–94PubMedGoogle Scholar
  65. Schneider NG, Jarvik ME, Forsythe AB (1984) Nicotine versus placebo gum in the alleviation of withdrawal during smoking cessation. Addict Behav 9:149–156PubMedCrossRefGoogle Scholar
  66. Schuh KJ, Stitzer ML (1995) Desire to smoke during spaced smoking intervals. Psychopharmacology 120:289–295PubMedCrossRefGoogle Scholar
  67. Shiffman S, Jarvik ME (1976) Smoking withdrawal symptoms in two weeks of abstinence. Psychopharmacology 50:35–39PubMedCrossRefGoogle Scholar
  68. Shiffman S, Paty JA, Gnys M, Kassel JD, Elash C (1995) Nicotine withdrawal in chippers and regular smokers: Subjective and cognitive effects. Health Psychol 14:301–309PubMedCrossRefGoogle Scholar
  69. Shiffman S, Johnston JA, Khayrallah M, Elash CA, Gwaltney CJ, Paty JA, Gnys M, Evoniuk G, DeVaugh-Geiss J (2000) The effect of buproprion on nicotine craving and withdrawal. Psychopharmacology 148:33–40PubMedCrossRefGoogle Scholar
  70. Shiffman S, Gwaltney CJ, Balabanis MH, Liu KS, Paty JA, Kassel JD, Hickcox M, Gnys M (2002) Immediate antecedents of cigarette smoking: an analysis from ecological momentary assessment. J Abnorm Psychol 111:531–545PubMedCrossRefGoogle Scholar
  71. Shiffman S, West RJ, Gilbert DG (2004) Recommendation for the assessment of tobacco craving and withdrawal in smoking cessation trials. Nicotine Tob Res 6:599–614PubMedCrossRefGoogle Scholar
  72. Shirtcliff EA, Marrocco RT (2003) Salivary cotinine levels in human tobacco smokers predict the attentional validity effect size during smoking abstinence. Psychopharmacology 166:11–18PubMedGoogle Scholar
  73. Snyder FR, Henningfield JE (1989) Effects of nicotine administration following 12 h of tobacco deprivation: assessment on computerized performance tasks. Psychopharmacology 97:17–22PubMedCrossRefGoogle Scholar
  74. Stone AA, Shiffman S (1994) Ecological momentary assessment in behavioral medicine. Ann Behav Med 16:199–202Google Scholar
  75. Stroop JR (1935) Studies of interference in serial verbal reactions. J Exp Psychol 18:643–662CrossRefGoogle Scholar
  76. Tiffany ST, Drobes DJ (1991) The development and initial validation of a questionnaire of smoking urges. Br J Addict 86:1467–1476PubMedCrossRefGoogle Scholar
  77. Warburton DM, Arnall C (1994) Improvements in performance without nicotine withdrawal. Psychopharmacology 115:539–542PubMedCrossRefGoogle Scholar
  78. Warburton DM, Mancuso G (1998) Evaluation of the information processing and mood effects of a transdermal nicotine patch. Psychopharmacology 135:305–310PubMedCrossRefGoogle Scholar
  79. Waters AJ, Feyerabend C (2000) Determinants and effects of attentional bias in smokers. Psychol Addict Behav 14:111–120PubMedCrossRefGoogle Scholar
  80. Waters AJ, Sayette MA, Wertz JA (2003a) Carry-over effects can modulate emotional Stroop effects. Cogn Emot 17:501–509CrossRefGoogle Scholar
  81. Waters AJ, Shiffman S, Sayette MA, Paty JA, Gwaltney CJ, Balabanis MH (2003b) Attentional bias predicts outcome in smoking cessation. Health Psychol 22:378–387PubMedCrossRefGoogle Scholar
  82. Welsch SK, Smith SS, Wetter DW, Jorenby DE, Fiore MC, Baker TB (1999) Development and validation of the Wisconsin Smoking Withdrawal Scale. Exp Clin Psychopharmacol 7:354–361PubMedCrossRefGoogle Scholar
  83. Wesnes K, Warburton DM (1983) Effects of smoking on rapid information processing performance. Neuropsychobiology 9:223–229PubMedCrossRefGoogle Scholar
  84. Wesnes K, Warburton DM (1984) The effects of cigarettes of varying yield on rapid information processing performance. Psychopharmacology 82:338–342PubMedCrossRefGoogle Scholar
  85. West R, Ussher M, Evans M, Rashid M (2006) Assessing DSM-IV nicotine withdrawal symptoms: a comparison and evaluation of five different scales. Psychopharmacology 184:619–627PubMedCrossRefGoogle Scholar
  86. Wetter DW, Fiore MC, Baker TB, Young TB (1995) Tobacco withdrawal and nicotine replacement influence objective measures of sleep. J Consult Clin Psychol 63:658–667PubMedCrossRefGoogle Scholar
  87. Wetter DW, Fiore MC, Young TB, McClure JB, de Moor CA, Baker TB (1999) Gender differences in response to nicotine replacement therapy: objective and subjective indexes of tobacco withdrawal. Exp Clin Psychopharmacol 7:135–144PubMedCrossRefGoogle Scholar
  88. Williams JMG, Mathews A, MacLeod C (1996) The emotional Stroop task and psychopathology. Psychol Bull 120:3–24PubMedCrossRefGoogle Scholar
  89. Zack M, Belsito L, Scher R, Eissenberg T, Corrigall WA (2001) Effects of abstinence and smoking on information processing in adolescent smokers. Psychopharmacology 153:249–257PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  1. 1.Department of PsychologyUniversity of South FloridaTampaUSA
  2. 2.Tobacco Research & Intervention ProgramH. Lee Moffitt Cancer Center & Research InstituteTampaUSA

Personalised recommendations