Natural history of nicotine withdrawal.
OBJECTIVE
To examine the natural history of nicotine withdrawal and individual differences associated with withdrawal duration and severity.


METHODS
Prospective study of withdrawal symptoms among smokers who quit for at least 24 hours. Participants used Ecological Momentary Assessment to monitor symptoms in their natural environment using an Electronic Diary (ED).


METHODS
A total of 214 cigarette smokers (59% female, 92% Caucasian).


METHODS
All participants received a clinic-based, behavioral, group cessation intervention. Severity and duration of withdrawal was not addressed explicitly in treatment.


METHODS
Participants were 'beeped' by the ED approximately five times/day to complete affect assessments (negative affect, arousal, attention disturbance, restlessness), and daily assessments of sleep disturbance (at waking) and of cognitive performance (each evening) for a week prior to quitting and for up to 21 days after quitting. Withdrawal was considered resolved when withdrawal scores returned to baseline levels for at least 2 consecutive days.


RESULTS
All symptoms returned to baseline levels within 10 days of quitting. All variables except arousal and sleep disturbance showed change over time. No robust predictors of individual differences in withdrawal responses emerged.


CONCLUSIONS
The time-course of withdrawal may be shorter than previously reported. The natural history of nicotine withdrawal may have implications for theories of withdrawal and smoking relapse and for smoking cessation treatment.
Shiffman
Saul
S
University of Pittsburgh, Pennsylvania, USA.
Patten
Christi
C
Gwaltney
Chad
C
Paty
Jean
J
Gnys
Maryann
M
Kassel
Jon
J
Hickcox
Mary
M
Waters
Andrew
A
Balabanis
Mark
M
D000328:Adult; D001521:Behavior Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011597:Psychomotor Performance; D012893:Sleep Wake Disorders / Q000175:diagnosis; D016540:Smoking Cessation / Q000379:methods / Q000523:psychology; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis* / Q000523:psychology; D011795:Surveys and Questionnaires