title: Cigarette craving and withdrawal symptoms during temporary abstinence and the effect of nicotine gum.
abstract: BACKGROUND
  It is widely believed that nicotine withdrawal symptoms appear within a few hours of stopping smoking, but few data exist documenting their emergence in naturalistic settings. In several countries, nicotine replacement products are licensed for relief of withdrawal symptoms during temporary abstinence, but again, there are no data supporting this from naturalistic settings.
  
  
  OBJECTIVE
  To examine the emergence of cigarette craving and withdrawal symptoms during temporary abstinence in a naturalistic setting while using either nicotine or placebo gum.
  
  
  METHODS
  Double-blind, randomised, placebo-controlled study in which 132 dependent smokers abstained for 6 h with the assistance of either nicotine (2 mg, n = 42 or 4 mg, n = 24) or placebo (n = 66) gum while travelling on a non-smoking train. Outcome measures were ratings of craving and mood withdrawal symptoms prior to treatment and at regular intervals during abstinence.
  
  
  RESULTS
  In a multivariate analysis of all symptoms, there was no interaction between treatment and time [F(21,110) = 1.28, p = 0.20, η²(p)= 0.20] nor an effect of treatment [F(7,124) = 0.45, p = 0.87, η²(p)=  0.03]. There was an effect of time [F(21,110) = 11.59, p < 0.001, η²(p)= 0.69) and univariate analyses revealed that the majority of symptoms increased linearly throughout the period of abstinence with detectable onsets typically between the first 60 and 180 min of abstinence.
  
  
  CONCLUSIONS
  Smokers who temporarily abstain in naturalistic settings experience craving and withdrawal symptoms that emerge linearly over the first 6 h of abstinence. Changes in craving and several mood withdrawal symptoms can be detected within the first 3 h. Nicotine gum may not have an acute effect on the development of these symptoms.
authors: Cancer Research UK Health Behaviour Research Centre, University College London, London, UK. jbimrosebrown@gmail.com
authors: Jamie
authors: J
authors: Brown
authors: Peter
authors: P
authors: Hajek
authors: Hayden
authors: H
authors: McRobbie
authors: Jo
authors: J
authors: Locker
authors: Fiona
authors: F
authors: Gillison
authors: Andy
authors: A
authors: McEwen
authors: Emma
authors: E
authors: Beard
authors: Robert
authors: R
authors: West
mesh_terms: D000328:Adult; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000008:administration & dosage; D012907:Smoking / Q000188:drug therapy* / Q000523:psychology*; D016540:Smoking Cessation / Q000379:methods / Q000523:psychology*; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy* / Q000523:psychology*; D013997:Time Factors; D061485:Tobacco Use Cessation Devices; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D009538:Nicotine
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