title: Subjective effects of an initial dose of nicotine nasal spray predict treatment outcome.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  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.
authors.affiliation: Department of Psychiatry and Abramson Cancer Center, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA 19104, USA.
authors.forename: Vyga
authors.initials: V
authors.lastname: Kaufmann
authors.forename: Christopher
authors.initials: C
authors.lastname: Jepson
authors.forename: Margaret
authors.initials: M
authors.lastname: Rukstalis
authors.forename: Kenneth
authors.initials: K
authors.lastname: Perkins
authors.forename: Janet
authors.initials: J
authors.lastname: Audrain-McGovern
authors.forename: Caryn
authors.initials: C
authors.lastname: Lerman
mesh_terms: D000281:Administration, Intranasal; D003376:Counseling; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000008:administration & dosage / Q000627:therapeutic use*; D016540:Smoking Cessation; D016896:Treatment Outcome
chemical_list: D009538:Nicotine