Efficacy of a nicotine (4 mg)-containing lozenge on the cognitive impairment of nicotine withdrawal.
OBJECTIVE
Controversy exists over the effect of tobacco deprivation in nicotine-dependent individuals and the efficacy of nicotine in reversing performance decrements. This study's aim was to assess the efficacy of nicotine (4-mg lozenge) versus placebo on aspects of cognitive and psychomotor performance, mood, and withdrawal symptoms in male and female established smokers.


METHODS
Male and female smokers (N = 22; mean age, 28.8 years), with a smoking history of more than 1 year and time to first cigarette of less than 30 minutes upon waking, were enrolled. Baseline measures were obtained at 17 hours of abstinence. At 18-hour abstinence, nicotine or placebo was administered every 2 hours over an 8-hour period. Cognitive and psychomotor performance measurements were taken 30 minutes after dose. Cognitive test battery included Rapid Visual Information Processing, Continuous Tracking Task, Critical Flicker Fusion, Choice Reaction Time, Stroop Test, and Sternberg's Short-term Memory Scanning Task. Withdrawal (Modified Minnesota Withdrawal Scale) and mood (Positive and Negative Affect Schedule) were also assessed. A mixed-models analysis of covariance was performed.


RESULTS
Compared with placebo nicotine (4 mg) significantly improved vigilance, divided attention, executive functioning, working memory, and sensorimotor performance in abstinent volunteers (P < or = 0.05). Withdrawal symptoms including craving, difficulty concentrating, irritability, and restlessness were also attenuated, and affective state was improved after nicotine 4 mg administration.


CONCLUSIONS
Compared with placebo, nicotine (4 mg) improved measures of vigilance, memory, and attention; improved mood; and reduced withdrawal symptoms. These findings suggest that repeated nicotine replacement therapy over a period of 8 hours can improve cognitive deficits associated with nicotine withdrawal.
Atzori
Giuseppe
G
CRC, Faculty of Medical & Health Sciences, University of Surrey, Guildford, Surrey, UK. G.Atzori@surrey.ac.uk
Lemmonds
Charlotte A
CA
Kotler
Mitchell L
ML
Durcan
Michael J
MJ
Boyle
Julia
J
D000284:Administration, Oral; D000328:Adult; D000339:Affect / Q000187:drug effects; D001288:Attention / Q000187:drug effects; D003071:Cognition / Q000187:drug effects*; D018592:Cross-Over Studies; D004304:Dosage Forms; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory / Q000187:drug effects; D008875:Middle Aged; D009538:Nicotine / Q000008:administration & dosage*; D018722:Nicotinic Agonists / Q000008:administration & dosage*; D011597:Psychomotor Performance / Q000187:drug effects; D012907:Smoking / Q000523:psychology; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D013375:Substance Withdrawal Syndrome / Q000517:prevention & control* / Q000523:psychology; D013997:Time Factors; D014029:Tobacco Use Disorder / Q000188:drug therapy* / Q000523:psychology; D016896:Treatment Outcome; D055815:Young Adult
D004304:Dosage Forms; D018722:Nicotinic Agonists; D009538:Nicotine