title: Timing of nicotine lozenge administration to minimize trigger induced craving and withdrawal symptoms.
abstract: Smokers are often advised to use nicotine lozenge when craving or withdrawal symptoms occur. This may be too late to prevent lapses. This study assessed if nicotine lozenge use prior to a common smoking trigger can minimize trigger induced increases in craving and withdrawal symptoms.
  
  
  
  Eighty-four smokers completed two laboratory sessions in random order. At one session, nicotine lozenge was given immediately after a stressor (to approximate current recommended use - i.e., after craving and withdrawal symptoms occur); at the other session subjects were randomized to receive nicotine lozenge at time points ranging from immediately to 30min prior to the stressor. Withdrawal symptoms and urge to smoke were measured using the Minnesota Nicotine Withdrawal Scale and the Questionnaire of Smoking Urges (QSU).
  
  
  
  Relative to receiving lozenge after the stressor, a smaller increase in pre-stressor to post-stressor withdrawal symptom scores occurred when lozenge was used immediately (p=0.03) and 10min prior (p=0.044) to the stressor. Results were similar for factors 1 and 2 of the QSU when lozenge was used immediately prior to the stressor (p<0.03) and for factor 1 of the QSU when lozenge was used 10min prior to the stressor (p=0.028). Absolute levels of post-stressor withdrawal symptom and urge to smoke severity were lower when lozenge was given prior to versus after a stressor.
  
  
  
  Administering the nicotine lozenge prior to a smoking trigger can decrease trigger induced craving and withdrawal symptoms. Future studies are needed to determine if such use would increase cessation rates. Clinicaltrials.gov # NCT01522963.
authors.affiliation: Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, 7-153 Weaver Densford Hall, 308 Harvard St SE, Minneapolis, MN 55455, United States; Department of Psychiatry, University of Minnesota, 2450 Riverside Ave, Minneapolis, MN 55454, United States. Electronic address: kotly001@umn.edu.
authors.forename: Michael
authors.initials: M
authors.lastname: Kotlyar
authors.affiliation: Masonic Cancer Center, University of Minnesota, Mayo Mail Code 806 420 Delaware Street SE, Minneapolis, MN 55455, United States.
authors.forename: Bruce R
authors.initials: BR
authors.lastname: Lindgren
authors.affiliation: Department of Psychiatry, University of Minnesota, 2450 Riverside Ave, Minneapolis, MN 55454, United States.
authors.forename: John P
authors.initials: JP
authors.lastname: Vuchetich
authors.affiliation: Masonic Cancer Center, University of Minnesota, Mayo Mail Code 806 420 Delaware Street SE, Minneapolis, MN 55455, United States.
authors.forename: Chap
authors.initials: C
authors.lastname: Le
authors.affiliation: Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, 7-153 Weaver Densford Hall, 308 Harvard St SE, Minneapolis, MN 55455, United States.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Mills
authors.affiliation: Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, 7-153 Weaver Densford Hall, 308 Harvard St SE, Minneapolis, MN 55455, United States.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Amiot
authors.affiliation: Department of Psychiatry, University of Minnesota, 2450 Riverside Ave, Minneapolis, MN 55454, United States; Tobacco Research Programs, University of Minnesota, 717 Delaware Street SE, Minnneapolis, MN 55414, United States.
authors.forename: Dorothy K
authors.initials: DK
authors.lastname: Hatsukami
mesh_terms: D066249:Craving / Q000187:drug effects*; D018592:Cross-Over Studies; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000008:administration & dosage*; D018722:Nicotinic Agonists / Q000008:administration & dosage*; D016540:Smoking Cessation / Q000379:methods*; D013375:Substance Withdrawal Syndrome / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D013607:Tablets; D061485:Tobacco Use Cessation Devices; D014029:Tobacco Use Disorder / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D018722:Nicotinic Agonists; D013607:Tablets; D009538:Nicotine
keywords: Craving; Nicotine Lozenge; Smoking; Withdrawal symptoms