This study will test whether abstinent smokers who experience intense withdrawal are more likely to relapse to smoking than abstinent smokers who experience little withdrawal. Most smokers who quit on their own relapse in the first two weeks. Whether this is due to aversive withdrawal symptoms (e.g. irritability) is unknown because prior studies have had several major flaws; e.g., retrospective designs, nongeneralizable samples and unvalidated, self-report measures of withdrawal. We have experimentally documented several physiological signs and observable behaviors that reliably occur upon cessation of smoking and have the characteristics of classical withdrawal syndromes. We now propose to prospectively test the ability of these withdrawal variables to predict relapse in self-quitters. 1000 smokers who are about to quit on their own will name a reliable observer to rate their withdrawal behavior. These observer ratings plus weight, heart rate, and self-reported symptoms will be recorded prior to and 2, 14 and 30 days after subject quit. One year later, salivary cotinine will verify whether smokers have relapsed. We will test the hypothesis that among smokers who quit for 2 days, those with more intense withdrawal are more likely to relapse by one year follow-up. The results of this study will be a crucial, direct test of the nicotine dependence theory of smoking. The results will also encourage or discourage the development of smoking treatments designed to combat withdrawal symptoms.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL039220-02
Application #
3355910
Study Section
(SRC)
Project Start
1987-06-01
Project End
1990-05-31
Budget Start
1988-06-01
Budget End
1989-05-31
Support Year
2
Fiscal Year
1988
Total Cost
Indirect Cost
Name
University of Vermont & St Agric College
Department
Type
Schools of Medicine
DUNS #
066811191
City
Burlington
State
VT
Country
United States
Zip Code
05405
Hughes, J R; Oliveto, A H (1993) Coffee and alcohol intake as predictors of smoking cessation and tobacco withdrawal. J Subst Abuse 5:305-10
Hughes, J R (1993) Treatment of smoking cessation in smokers with past alcohol/drug problems. J Subst Abuse Treat 10:181-7
Hughes, J R (1993) Possible effects of smoke-free inpatient units on psychiatric diagnosis and treatment. J Clin Psychiatry 54:109-14
Hughes, J R; Gulliver, S B; Fenwick, J W et al. (1992) Smoking cessation among self-quitters. Health Psychol 11:331-4
Hughes, J R (1992) Tobacco withdrawal in self-quitters. J Consult Clin Psychol 60:689-97
Hughes, J R (1991) Combined psychological and nicotine gum treatment for smoking: a critical review. J Subst Abuse 3:337-50
Hughes, J R (1991) Distinguishing withdrawal relief and direct effects of smoking. Psychopharmacology (Berl) 104:409-10
Newhouse, P A; Hughes, J R (1991) The role of nicotine and nicotinic mechanisms in neuropsychiatric disease. Br J Addict 86:521-6
Hughes, J R (1990) Utility of observer reports of smoking status. J Subst Abuse 2:249-53
Hughes, J R; Gulliver, S B; Amori, G et al. (1989) Effect of instructions and nicotine on smoking cessation, withdrawal symptoms and self-administration of nicotine gum. Psychopharmacology (Berl) 99:486-91