title: Effects of abstinence in adolescent tobacco smokers: withdrawal symptoms, urge, affect, and cue reactivity.
abstract: BACKGROUND
  The aim of this study was to evaluate abstinence effects in adolescent daily smokers by examining the effects of experimentally manipulated acute smoking abstinence on measures including: (a) withdrawal symptoms, (b) reactive irritability, (c) smoking urges, (d) affect, and (e) responses to smoking cues.
  
  
  METHODS
  Participants (ages 13-19, 74 daily smokers, and 22 nonsmokers) completed baseline questionnaires and laboratory assessments (Session 1) and returned 1-4 days later to repeat the laboratory assessments (Session 2); half of the smokers were randomly assigned to overnight tobacco abstinence preceding Session 2.
  
  
  RESULTS
  During Session 2, abstinent smokers reported significantly greater increases in withdrawal symptoms, smoking urges, and negative affect compared with smokers who did not abstain and compared with nonsmokers. Although there was not a significant effect of abstinence on differential reactivity to smoking versus neutral cues, abstinence did result in significantly increased peak provoked urges and negative effect. There was not a significant effect of abstinence on positive affect or reactive irritability,
  
  
  CONCLUSIONS
  Our results suggest that adolescents experience increases in withdrawal symptoms, smoking urges (un-cued and peak provoked), and negative affect (un-cued and peak provoked) after acute smoking abstinence, but do not experience the increases in reactive irritability or decreases in positive affect that have been shown in adult smokers. Overall findings support the withdrawal relief and negative reinforcement models of smoking maintenance in adolescents and point to withdrawal, urge, and negative affect as important targets for treatment.
authors.affiliation: Center for Alcohol and Addiction Studies Brown University, Providence RI 02912, USA. Cinnamon_Bidwell@brown.edu
authors.forename: L Cinnamon
authors.initials: LC
authors.lastname: Bidwell
authors.forename: Adam M
authors.initials: AM
authors.lastname: Leventhal
authors.forename: Jennifer W
authors.initials: JW
authors.lastname: Tidey
authors.forename: Linda
authors.initials: L
authors.lastname: Brazil
authors.forename: Raymond S
authors.initials: RS
authors.lastname: Niaura
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Colby
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D013375:Substance Withdrawal Syndrome / Q000523:psychology*; D055815:Young Adult; D014026:Nicotiana