Reduction of Abstinence-induced Withdrawal and Craving Using High-dose Nicotine Replacement Therapy

Overview

Journal Psychopharmacology (Berl)

Specialty Pharmacology

Date 2005 Nov 2

PMID 16261317

Citations 60

Authors

Saul Shiffman

Stuart G Ferguson

Chad J Gwaltney

Mark H Balabanis

William G Shadel

Affiliations

Soon will be listed here.

Abstract

Rationale: Decreasing withdrawal and craving during smoking cessation is a major aim of cessation medications. Prior studies have shown that Nicotine Replacement Therapy (NRT) decreases withdrawal symptom severity but have relied on retrospective reports and lacked robust measures of baseline symptoms or symptoms during unmedicated abstinence.

Objectives And Methods: We tested the effect of high-dose (35 mg) nicotine patch on withdrawal and craving during abstinence using real-time assessment with electronic diaries during ad libitum smoking, a brief period of experimentally directed trial abstinence, and the first 3 days of cessation. Subjects were 324 smokers randomized to high-dose nicotine patches or placebo.

Results: Treatment with active patches reduced withdrawal and craving during cessation and completely eliminated deprivation-related changes in affect or concentration.

Conclusion: High-dose NRT reduces withdrawal symptoms and craving and can eliminate some symptoms entirely.

Citing Articles

Associations between nicotine product use and craving among stable daily and non-daily users.

Reed B, Doran N, Courtney K Addict Behav. 2023; 146:107803.

PMID: 37423069 PMC: 10827279. DOI: 10.1016/j.addbeh.2023.107803.

Behavioural support and nicotine replacement therapy for smokeless tobacco cessation: protocol for a pilot randomised-controlled multi-country trial.

Siddiqui F, Bauld L, Croucher R, Jackson C, Kellar I, Kanaan M Pilot Feasibility Stud. 2022; 8(1):189.

PMID: 35996179 PMC: 9396808. DOI: 10.1186/s40814-022-01146-5.

Electronic Versus Traditional Data Collection: A Multicenter Randomized Controlled Perioperative Pain Trial.

Khan J, Jibb L, Busse J, Gilron I, Choi S, Paul J Can J Pain. 2022; 3(2):16-25.

PMID: 35005415 PMC: 8730625. DOI: 10.1080/24740527.2019.1587584.

Possible New Symptoms of Tobacco Withdrawal III: Reduced Positive Affect-A Review and Meta-analysis.

Klemperer E, Hughes J, Peasley-Miklus C, Callas P, Cook J, Streck J Nicotine Tob Res. 2020; 23(2):259-266.

PMID: 32188995 PMC: 7822099. DOI: 10.1093/ntr/ntaa044.

Lack of effect of transcranial direct current stimulation (tDCS) on short-term smoking cessation: Results of a randomized, sham-controlled clinical trial.

Falcone M, Bernardo L, Wileyto E, Allenby C, Burke A, Hamilton R Drug Alcohol Depend. 2018; 194:244-251.

PMID: 30497056 PMC: 6312458. DOI: 10.1016/j.drugalcdep.2018.10.016.

References

Cosby R, Howard M, Kaczorowski J, Willan A, Sellors J . Randomizing patients by family practice: sample size estimation, intracluster correlation and data analysis. Fam Pract. 2003; 20(1):77-82. DOI: 10.1093/fampra/20.1.77. View

Sayette M, Wertz J, Martin C, Cohn J, Perrott M, Hobel J . Effects of smoking opportunity on cue-elicited urge: a facial coding analysis. Exp Clin Psychopharmacol. 2003; 11(3):218-227. PMC: 2632972. DOI: 10.1037/1064-1297.11.3.218. View

. Transdermal nicotine for smoking cessation. Six-month results from two multicenter controlled clinical trials. Transdermal Nicotine Study Group. JAMA. 1991; 266(22):3133-8. View

Killen J, Fortmann S . Craving is associated with smoking relapse: findings from three prospective studies. Exp Clin Psychopharmacol. 1997; 5(2):137-42. DOI: 10.1037//1064-1297.5.2.137. View

Shiffman S, Scharf D, Shadel W, Gwaltney C, Dang Q, Paton S . Analyzing milestones in smoking cessation: illustration in a nicotine patch trial in adult smokers. J Consult Clin Psychol. 2006; 74(2):276-85. DOI: 10.1037/0022-006X.74.2.276. View

Shiffman S, Engberg J, Paty J, Perz W, Gnys M, Kassel J . A day at a time: predicting smoking lapse from daily urge. J Abnorm Psychol. 1997; 106(1):104-16. DOI: 10.1037//0021-843x.106.1.104. View

Tiffany S, Cox L, Elash C . Effects of transdermal nicotine patches on abstinence-induced and cue-elicited craving in cigarette smokers. J Consult Clin Psychol. 2000; 68(2):233-40. DOI: 10.1037//0022-006x.68.2.233. View

Dols M, van den Hout M, Kindt M, Willems B . The urge to smoke depends on the expectation of smoking. Addiction. 2002; 97(1):87-93. DOI: 10.1046/j.1360-0443.2002.00010.x. View

Killen J, Fortmann S, Davis L, Strausberg L, VARADY A . Do heavy smokers benefit from higher dose nicotine patch therapy?. Exp Clin Psychopharmacol. 1999; 7(3):226-33. DOI: 10.1037//1064-1297.7.3.226. View

10.

Stone A, Broderick J, Schwartz J, Shiffman S, Litcher-Kelly L, Calvanese P . Intensive momentary reporting of pain with an electronic diary: reactivity, compliance, and patient satisfaction. Pain. 2003; 104(1-2):343-51. DOI: 10.1016/s0304-3959(03)00040-x. View

11.

DALE L, Hurt R, Offord K, Lawson G, Croghan I, Schroeder D . High-dose nicotine patch therapy. Percentage of replacement and smoking cessation. JAMA. 1995; 274(17):1353-8. View

12.

Stone A, Shiffman S, Schwartz J, Broderick J, Hufford M . Patient non-compliance with paper diaries. BMJ. 2002; 324(7347):1193-4. PMC: 111114. DOI: 10.1136/bmj.324.7347.1193. View

13.

Patten C, Martin J . Does nicotine withdrawal affect smoking cessation? Clinical and theoretical issues. Ann Behav Med. 2013; 18(3):190-200. DOI: 10.1007/BF02883397. View

14.

Piasecki T, Niaura R, Shadel W, Abrams D, Goldstein M, Fiore M . Smoking withdrawal dynamics in unaided quitters. J Abnorm Psychol. 2000; 109(1):74-86. DOI: 10.1037//0021-843x.109.1.74. View

15.

West R, Hajek P, Belcher M . Severity of withdrawal symptoms as a predictor of outcome of an attempt to quit smoking. Psychol Med. 1989; 19(4):981-5. DOI: 10.1017/s0033291700005705. View

16.

Hughes J, Hatsukami D . Signs and symptoms of tobacco withdrawal. Arch Gen Psychiatry. 1986; 43(3):289-94. DOI: 10.1001/archpsyc.1986.01800030107013. View

17.

Redelmeier D, Kahneman D . Patients' memories of painful medical treatments: real-time and retrospective evaluations of two minimally invasive procedures. Pain. 1996; 66(1):3-8. DOI: 10.1016/0304-3959(96)02994-6. View

18.

Hufford M, Shields A, Shiffman S, Paty J, Balabanis M . Reactivity to ecological momentary assessment: an example using undergraduate problem drinkers. Psychol Addict Behav. 2002; 16(3):205-11. View

19.

Teneggi V, Tiffany S, Squassante L, Milleri S, Ziviani L, Bye A . Smokers deprived of cigarettes for 72 h: effect of nicotine patches on craving and withdrawal. Psychopharmacology (Berl). 2002; 164(2):177-87. DOI: 10.1007/s00213-002-1176-1. View

20.

Heatherton T, Kozlowski L, Frecker R, Fagerstrom K . The Fagerström Test for Nicotine Dependence: a revision of the Fagerström Tolerance Questionnaire. Br J Addict. 1991; 86(9):1119-27. DOI: 10.1111/j.1360-0443.1991.tb01879.x. View