title: Increases in hyperactive-impulsive symptoms predict relapse among smokers in nicotine replacement therapy.
abstract: Inattention and hyperactive-impulsive symptoms have been associated with nicotine dependence. In an open-label randomized trial (N = 454) of transdermal nicotine versus nicotine nasal spray, we examined whether increases in inattention and hyperactive-impulsive symptoms measured by self-report in the first quit week predicted relapse at the end of 8 weeks of treatment (EOT). During the first quit week, 166 (37%) participants reported an increase whereas 288 (63%) reported no change/decrease in total symptoms; changes were not influenced by treatment type. In a logistic regression model of abstinence, an increase in total symptoms in the first quit week significantly reduced odds of abstinence at EOT (continuous change score: OR = 0.94, 95% CI = 0.91-0.98, p = .002; dichotomized change score: OR = 0.57, 95% CI = 0.37-0.87, p = .009). Early increases in inattention and hyperactive-impulsive symptoms following quit date during nicotine replacement therapy predicted relapse to smoking, suggesting that treatments targeting these symptoms in the first quit week may facilitate abstinence.
authors.affiliation: Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA.
authors.forename: Margaret
authors.initials: M
authors.lastname: Rukstalis
authors.forename: Christopher
authors.initials: C
authors.lastname: Jepson
authors.forename: Freda
authors.initials: F
authors.lastname: Patterson
authors.forename: Caryn
authors.initials: C
authors.lastname: Lerman
mesh_terms: D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D007175:Impulsive Behavior / Q000453:epidemiology*; D008297:Male; D009538:Nicotine / Q000627:therapeutic use*; D018722:Nicotinic Agonists / Q000627:therapeutic use*; D011237:Predictive Value of Tests; D012008:Recurrence; D012907:Smoking / Q000188:drug therapy* / Q000453:epidemiology*
chemical_list: D018722:Nicotinic Agonists; D009538:Nicotine