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Signs and Symptoms of Tobacco Withdrawal

Signs and Symptoms of Tobacco Withdrawal Abstract • To test the validity, magnitude, and clinical significance of the signs and symptoms of tobacco withdrawal defined by DSM-III, both observed and reported signs and symptoms were measured in 50 smokers during two days of ad lib smoking and then during the first four days of abstinence. Observer and subject ratings of the DSM-III symptoms of craving for tobacco, irritability, anxiety, difficulty concentrating, and restlessness increased after cessation. In addition, bradycardia, impatience, somatic complaints, insomnia, increased hunger, and increased eating occurred after cessation. The frequency and intensity of these symptoms varied across subjects; however, the average distress from tobacco withdrawal was similar to that observed in psychiatric outpatients. Subjects who had more withdrawal discomfort were more tolerant to the cardiovascular effects of nicotine. Subjects who had more withdrawal discomfort did not have a lower rate of smoking cessation. References 1. Hatsukami D, Hughes JR, Pickens RW: Characterization of tobacco abstinence: Physiological and subjective effects , in Grabowski J, Hall S (eds): Pharmacological Adjuncts in the Treatment of Tobacco Dependence . Bethesda, Md, NIDA Research Monograph 53, 1985, pp 56-67. 2. Shiffman SM: The tobacco withdrawal syndrome , in Krasnegor NA (ed): Cigarette Smoking as a Dependence Process . Bethesda, Md, NIDA Research Monograph 23, 1979, pp 158-185. 3. American Psychiatric Association Committee on Nomenclature and Statistics: Diagnostic and Statistical Manual of Mental Disorders , ed 3. Washington, DC, American Psychiatric Association, 1980, pp 159-160, 176-178. 4. Hatsukami DK, Hughes JR, Pickens RW, Svikis D: Tobacco withdrawal symptoms: An experimental analysis . Psychopharmacology 1984;84:231-236.Crossref 5. Gilbert RM, Pope MA: Early effects of quitting smoking . Psychopharmacology 1982;78:121-127.Crossref 6. Hughes JR, Hatsukami DK, Pickens RW, Krahn D, Malin S, Luknic A: Effect of nicotine on the tobacco withdrawal syndrome . Psychopharmacology 1984;83:82-87.Crossref 7. Fagerstrom K-O: Measuring degree of physical dependence to tobacco smoking with reference to individualization of treatment . Addict Behav 1978;3:235-241.Crossref 8. MacAndrews C: On the possibility of the psychometric detection of persons who are prone to the abuse of alcohol and other substances . Addict Behav 1979;4:11-20.Crossref 9. Ikard FF, Green DE, Horn D: A scale to differentiate between types of smoking as related to the management of affect . Int J Addict 1969;4:649-659. 10. Langone J, Gjika HB, van Vunakis H: Nicotine and its metabolites: Radioimmunoassay for nicotine and cotinine . Biochemistry 1973;12:5025-5030.Crossref 11. Hughes JR, Frederiksen LW, Frazier M: A carbon monoxide analyzer for measurement of smoking behavior . Behav Ther 1978;9:293-296.Crossref 12. Carskadon MA, Dement WC, Mitler MM, Guilleminault MD, Zarcone VD, Spiegel R: Self-report vs sleep lab findings in 122 drug free subjects with complaints of chronic insomnia . Am J Psychiatry 1976;133:82-88. 13. McNair DM, Lorr M, Droppleman LF: Manual for the Profile of Mood States . San Diego, Educational and Industrial Testing Service, 1971. 14. Adult Use of Tobacco—1975. US Dept of Health, Education, and Welfare, 1976. 15. Health Consequences of Smoking—The Changing Cigarette. US Dept of Health and Human Services, 1981. 16. Smoking and Health—A Report of the Surgeon General. US Dept of Health and Human Services, 1979, Appendix A1-A29. 17. Siegel S: Nonparametric Statistics for the Behavioral Sciences . New York, McGraw-Hill Book Co, 1956. 18. Nie NH, Hall CH, Jenkins JG, Steinbrenner K, Brent DH: Statistical Packages for the Social Sciences . New York, McGraw-Hill Book Co, 1975. 19. Soldatos CR, Kales JD, Scharf MB, Bixler MB, Kales A: Cigarette smoking associated with changes in sleep difficulty . Science 1980;207:551-553.Crossref 20. Gaudet FJ, Hugli WC: Concomitant habit changes associated with changes in smoking habits: A pilot study . Med Times 1969;97:195-205. 21. Hughes JR, Hatsukami DK, Pickens RW, Svikis D: Consistency of the tobacco withdrawal syndrome . Addict Behav 1984;9:409-412.Crossref 22. Wynder EL, Kaufman PL, Lesser RL: A short term follow-up study on ex-cigarette smokers . Am Rev Respir Dis 1967;96:645-655. 23. Shiffman SM, Jarvik ME: Smoking withdrawal symptoms in two weeks of abstinence . Psychopharmacology 1976;50:35-39.Crossref 24. Hughes JR: Defining the dependent smoker: Validity and clinical utility . Behav Med Abst 1985;5:202-204. 25. Herning RI, Jones RT, Benowitz NL, Mines AH: How a cigarette is smoked determines blood nicotine levels . Clin Pharmacol Ther 1983;33:84-90.Crossref 26. Pomerleau O, Fertig J, Shanahans S: Nicotine dependence in cigarette smoking: An empirically based multivariate model . Pharmacol Biochem Behav 1983;19:291-299.Crossref 27. Gritz ER: Smoking behavior and tobacco abuse , in Mello NK (ed): Advances in Substance Abuse . Greenwich, Conn, JAI Press Inc, 1980, vol 1, pp 91-158. 28. Hall SM: The abstinence phobia , in Krasnegor N (ed): Behavioral Treatment and Analyses of Substance Abuse . Bethesda, Md, NIDA Research Monograph 25, 1979, pp 55-67. 29. Kalant H, LeBlanc AE, Gibbins RJ: Tolerance to, and dependence on, some nonopiate psychotropic drugs . Pharmacol Rev 1971;23:135-191. 30. Hughes JR, Hatsukami DK: Short-term effects of nicotine gum , in Grabowski J, Hall S (eds): Pharmacological Adjuncts in the Treatment of Tobacco Dependence . Bethesda, Md, NIDA Research Monograph 53, 1985, pp 68-82. 31. Falk JL: The origins and functions of adjunctive behavior . Anim Learn Behav 1977;5:325-335.Crossref 32. Fagerstrom K-O, Storm HG: The effects of instructions on smoking cessation for individuals with different degrees of dependence . Behav Psychother 1981;9:310-315.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

Signs and Symptoms of Tobacco Withdrawal

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Publisher
American Medical Association
Copyright
Copyright © 1986 American Medical Association. All Rights Reserved.
ISSN
0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1986.01800030107013
Publisher site
See Article on Publisher Site

Abstract

Abstract • To test the validity, magnitude, and clinical significance of the signs and symptoms of tobacco withdrawal defined by DSM-III, both observed and reported signs and symptoms were measured in 50 smokers during two days of ad lib smoking and then during the first four days of abstinence. Observer and subject ratings of the DSM-III symptoms of craving for tobacco, irritability, anxiety, difficulty concentrating, and restlessness increased after cessation. In addition, bradycardia, impatience, somatic complaints, insomnia, increased hunger, and increased eating occurred after cessation. The frequency and intensity of these symptoms varied across subjects; however, the average distress from tobacco withdrawal was similar to that observed in psychiatric outpatients. Subjects who had more withdrawal discomfort were more tolerant to the cardiovascular effects of nicotine. Subjects who had more withdrawal discomfort did not have a lower rate of smoking cessation. References 1. Hatsukami D, Hughes JR, Pickens RW: Characterization of tobacco abstinence: Physiological and subjective effects , in Grabowski J, Hall S (eds): Pharmacological Adjuncts in the Treatment of Tobacco Dependence . Bethesda, Md, NIDA Research Monograph 53, 1985, pp 56-67. 2. Shiffman SM: The tobacco withdrawal syndrome , in Krasnegor NA (ed): Cigarette Smoking as a Dependence Process . Bethesda, Md, NIDA Research Monograph 23, 1979, pp 158-185. 3. American Psychiatric Association Committee on Nomenclature and Statistics: Diagnostic and Statistical Manual of Mental Disorders , ed 3. Washington, DC, American Psychiatric Association, 1980, pp 159-160, 176-178. 4. Hatsukami DK, Hughes JR, Pickens RW, Svikis D: Tobacco withdrawal symptoms: An experimental analysis . Psychopharmacology 1984;84:231-236.Crossref 5. Gilbert RM, Pope MA: Early effects of quitting smoking . Psychopharmacology 1982;78:121-127.Crossref 6. Hughes JR, Hatsukami DK, Pickens RW, Krahn D, Malin S, Luknic A: Effect of nicotine on the tobacco withdrawal syndrome . Psychopharmacology 1984;83:82-87.Crossref 7. Fagerstrom K-O: Measuring degree of physical dependence to tobacco smoking with reference to individualization of treatment . Addict Behav 1978;3:235-241.Crossref 8. MacAndrews C: On the possibility of the psychometric detection of persons who are prone to the abuse of alcohol and other substances . Addict Behav 1979;4:11-20.Crossref 9. Ikard FF, Green DE, Horn D: A scale to differentiate between types of smoking as related to the management of affect . Int J Addict 1969;4:649-659. 10. Langone J, Gjika HB, van Vunakis H: Nicotine and its metabolites: Radioimmunoassay for nicotine and cotinine . Biochemistry 1973;12:5025-5030.Crossref 11. Hughes JR, Frederiksen LW, Frazier M: A carbon monoxide analyzer for measurement of smoking behavior . Behav Ther 1978;9:293-296.Crossref 12. Carskadon MA, Dement WC, Mitler MM, Guilleminault MD, Zarcone VD, Spiegel R: Self-report vs sleep lab findings in 122 drug free subjects with complaints of chronic insomnia . Am J Psychiatry 1976;133:82-88. 13. McNair DM, Lorr M, Droppleman LF: Manual for the Profile of Mood States . San Diego, Educational and Industrial Testing Service, 1971. 14. Adult Use of Tobacco—1975. US Dept of Health, Education, and Welfare, 1976. 15. Health Consequences of Smoking—The Changing Cigarette. US Dept of Health and Human Services, 1981. 16. Smoking and Health—A Report of the Surgeon General. US Dept of Health and Human Services, 1979, Appendix A1-A29. 17. Siegel S: Nonparametric Statistics for the Behavioral Sciences . New York, McGraw-Hill Book Co, 1956. 18. Nie NH, Hall CH, Jenkins JG, Steinbrenner K, Brent DH: Statistical Packages for the Social Sciences . New York, McGraw-Hill Book Co, 1975. 19. Soldatos CR, Kales JD, Scharf MB, Bixler MB, Kales A: Cigarette smoking associated with changes in sleep difficulty . Science 1980;207:551-553.Crossref 20. Gaudet FJ, Hugli WC: Concomitant habit changes associated with changes in smoking habits: A pilot study . Med Times 1969;97:195-205. 21. Hughes JR, Hatsukami DK, Pickens RW, Svikis D: Consistency of the tobacco withdrawal syndrome . Addict Behav 1984;9:409-412.Crossref 22. Wynder EL, Kaufman PL, Lesser RL: A short term follow-up study on ex-cigarette smokers . Am Rev Respir Dis 1967;96:645-655. 23. Shiffman SM, Jarvik ME: Smoking withdrawal symptoms in two weeks of abstinence . Psychopharmacology 1976;50:35-39.Crossref 24. Hughes JR: Defining the dependent smoker: Validity and clinical utility . Behav Med Abst 1985;5:202-204. 25. Herning RI, Jones RT, Benowitz NL, Mines AH: How a cigarette is smoked determines blood nicotine levels . Clin Pharmacol Ther 1983;33:84-90.Crossref 26. Pomerleau O, Fertig J, Shanahans S: Nicotine dependence in cigarette smoking: An empirically based multivariate model . Pharmacol Biochem Behav 1983;19:291-299.Crossref 27. Gritz ER: Smoking behavior and tobacco abuse , in Mello NK (ed): Advances in Substance Abuse . Greenwich, Conn, JAI Press Inc, 1980, vol 1, pp 91-158. 28. Hall SM: The abstinence phobia , in Krasnegor N (ed): Behavioral Treatment and Analyses of Substance Abuse . Bethesda, Md, NIDA Research Monograph 25, 1979, pp 55-67. 29. Kalant H, LeBlanc AE, Gibbins RJ: Tolerance to, and dependence on, some nonopiate psychotropic drugs . Pharmacol Rev 1971;23:135-191. 30. Hughes JR, Hatsukami DK: Short-term effects of nicotine gum , in Grabowski J, Hall S (eds): Pharmacological Adjuncts in the Treatment of Tobacco Dependence . Bethesda, Md, NIDA Research Monograph 53, 1985, pp 68-82. 31. Falk JL: The origins and functions of adjunctive behavior . Anim Learn Behav 1977;5:325-335.Crossref 32. Fagerstrom K-O, Storm HG: The effects of instructions on smoking cessation for individuals with different degrees of dependence . Behav Psychother 1981;9:310-315.Crossref

Journal

Archives of General PsychiatryAmerican Medical Association

Published: Mar 1, 1986

References