Effects of acute tobacco abstinence in adolescent smokers compared with nonsmokers.
OBJECTIVE
Abstinence effects such as nicotine withdrawal and mood changes contribute to the maintenance of cigarette smoking in adult smokers, and emerging reports on adolescent smokers suggest they may experience similar subjective effects when deprived. This study aimed to prospectively document tobacco abstinence-induced changes during the first 48 hours of abstinence in adolescent smokers compared with nonsmokers, to distinguish effects distinct from typical adolescent lability.


METHODS
Fifty-seven adolescent smokers and 44 adolescent nonsmokers were assessed during a 48-hour inpatient session. Characteristic nicotine withdrawal symptoms, cravings for cigarettes, and mood symptoms were measured at 13 time points following initiation of abstinence.


RESULTS
The only abstinence-related effects observed were changes in craving for tobacco and feelings of anger. Tobacco craving increased and peaked quickly following initiation of abstinence and displayed a slight decrease toward the end of the 48-hour abstinence period, while anger symptoms peaked after a more prolonged abstinence. Overall, smokers' symptoms and cravings were positively associated with amount of daily smoking but not with reports of dependence or biological measures of extent of use.


CONCLUSIONS
We observed that among adolescent smokers, the primary effects associated with abstinence from cigarettes are relatively minimal, and include a heightened and persistent craving to smoke and increases in anger. Although smokers had greater negative mood symptoms compared with nonsmokers, the presence and severity of most of these symptoms appear to be minimally altered by abstinence and not associated with dependency or biological indicators of amount of tobacco use.
Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut 06519, USA.
Anne E
AE
Smith
Dana A
DA
Cavallo
Tricia
T
Dahl
Ran
R
Wu
Tony P
TP
George
Suchitra
S
Krishnan-Sarin
D000293:Adolescent; D003237:Connecticut / Q000453:epidemiology; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D011446:Prospective Studies; D012720:Severity of Illness Index; D012907:Smoking / Q000453:epidemiology*; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D011795:Surveys and Questionnaires