title: Natural history of nicotine withdrawal.
abstract: 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.
authors.affiliation: University of Pittsburgh, Pennsylvania, USA.
authors.forename: Saul
authors.initials: S
authors.lastname: Shiffman
authors.forename: Christi
authors.initials: C
authors.lastname: Patten
authors.forename: Chad
authors.initials: C
authors.lastname: Gwaltney
authors.forename: Jean
authors.initials: J
authors.lastname: Paty
authors.forename: Maryann
authors.initials: M
authors.lastname: Gnys
authors.forename: Jon
authors.initials: J
authors.lastname: Kassel
authors.forename: Mary
authors.initials: M
authors.lastname: Hickcox
authors.forename: Andrew
authors.initials: A
authors.lastname: Waters
authors.forename: Mark
authors.initials: M
authors.lastname: Balabanis
mesh_terms: 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