title: Rate of nicotine onset from nicotine replacement therapy and acute responses in smokers.
abstract: The subjective and reinforcing effects of drugs of abuse may depend partly on their rate of onset, with faster acting formulations typically producing stronger effects than slower ones. In this within-subjects study, we examined the acute effects of nicotine replacement therapy via nicotine nasal spray (fast delivery) vs. transdermal nicotine patch (slow delivery) on craving, withdrawal, cardiovascular responses, subjective ratings, and reinforcing effects of smoking. Smokers (N=30) not seeking treatment participated in three sessions, each after overnight smoking abstinence, involving 14-mg nicotine (Nicoderm) or placebo patch, followed 4 hr later by intermittent administration of nicotine (Nicotrol) or placebo nasal spray. Specifically, the three group comparisons were nicotine patch condition (with placebo spray), nicotine spray condition (with placebo patch), and placebo condition (placebo spray and patch). Nicotine patch and nicotine spray were never administered in the same session. Blood nicotine levels were similar between nicotine patch and nicotine spray conditions, by design. Heart rate and systolic blood pressure were higher following nicotine spray vs. the other conditions, as hypothesized. However, other than reductions in craving related to nicotine spray and patch at some points, no differences between conditions were observed in withdrawal, subjective effects of sprays and smoking, or smoking reinforcement assessed by a computer task. Thus, under these acute conditions, the speed of nicotine delivery from nasal spray vs. patch differentially affected cardiovascular responses and perhaps craving but did not influence withdrawal, subjective ratings, and smoking reinforcement.
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA. perkinska@msx.upmc.edu
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Perkins
authors.forename: Caryn
authors.initials: C
authors.lastname: Lerman
authors.forename: Jason
authors.initials: J
authors.lastname: Keenan
authors.forename: Carolyn
authors.initials: C
authors.lastname: Fonte
authors.forename: Sarah
authors.initials: S
authors.lastname: Coddington
mesh_terms: D000279:Administration, Cutaneous; D000281:Administration, Intranasal; D000328:Adult; D001794:Blood Pressure; D004334:Drug Administration Schedule; D005260:Female; D005731:Ganglionic Stimulants / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006339:Heart Rate; D006801:Humans; D008297:Male; D009538:Nicotine / Q000008:administration & dosage* / Q000493:pharmacokinetics; D010919:Placebos; D012055:Reinforcement Schedule; D016540:Smoking Cessation / Q000379:methods*; D014029:Tobacco Use Disorder / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D005731:Ganglionic Stimulants; D010919:Placebos; D009538:Nicotine