title: A quantitative analysis of subjective, cognitive, and physiological manifestations of the acute tobacco abstinence syndrome.
abstract: BACKGROUND
  Previous studies have documented the existence of signs and symptoms of the acute tobacco abstinence syndrome; however, less attention has been paid to quantifying the magnitude of these effects.
  
  
  OBJECTIVE
  The present study quantified the relative magnitude of subjective, cognitive, and physiological manifestations of acute tobacco abstinence.
  
  
  METHODS
  Smokers (N=203, ≥ 15 cig/day) attended two counterbalanced laboratory sessions, one following 12-h of abstinence and the other following ad-lib smoking. At both sessions, they completed an extensive battery of self-report measures (withdrawal, affect, hunger, craving, subjective attentional bias towards smoking cues), physiological assessments (heart rate, blood pressure, brain EEG), and cognitive performance tasks (psychomotor processing, sustained attention, objective attentional bias).
  
  
  RESULTS
  Abstinence effects were largest for craving, subjective attentional bias, negative affect, overall withdrawal severity, concentration difficulty, hunger, and heart rate. Effects were moderate for positive affect and EEG power. Effects were small, but reliable, for psychomotor speed, sustained attention, and somatic symptoms. Effects on performance-based indices of attentional bias towards smoking-related cues were small and reliable for some indices but not others. Effects were small and inconsistent for blood pressure and EEG frequency. Variation in internal consistency accounted for 33% of the variation in abstinence effect sizes across measures.
  
  
  CONCLUSIONS
  There was a wide range of effect sizes both across and within domains, indicating that the acute tobacco abstinence syndrome is not a monotonic phenomenon. These findings may be indicative of the relative magnitudes of signs and symptoms that the average smoker may exhibit during acute abstinence.
authors.affiliation: Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA 90033, USA. adam.leventhal@usc.edu
authors.forename: Adam M
authors.initials: AM
authors.lastname: Leventhal
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Waters
authors.forename: Eric T
authors.initials: ET
authors.lastname: Moolchan
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Heishman
authors.forename: Wallace B
authors.initials: WB
authors.lastname: Pickworth
mesh_terms: D000328:Adult; D015142:Baltimore; D001794:Blood Pressure / Q000187:drug effects; D004569:Electroencephalography / Q000187:drug effects; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011597:Psychomotor Performance / Q000187:drug effects*; D016540:Smoking Cessation / Q000523:psychology*; D013375:Substance Withdrawal Syndrome / Q000503:physiopathology / Q000523:psychology
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