Tobacco Withdrawal Syndrome and its Modification

• Main Author: McRobbie, Hayden James
• Published: Queen Mary, University of London 2008
• Subjects: 616.89
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.504549

Smokers experience a number of symptoms when they stop, which together compose the tobacco withdrawal syndrome. Most current treatments for smokers exert their effect by ameliorating withdrawal discomfort. The thesis had two objectives. It aimed to enhance our ~nderstanding of the tobacco withdrawal symptomatology and investigated the potential of two treatments in alleviating specific tobacco withdrawal symptoms (TWS). Urges to smoke, irritability, depression, difficulty concentrating, restlessness, insomnia, and hunger are well-documented TWS. The first part of the thesis maps two littleexplored physical symptoms. Two prospective studies examined the occurrence of mouth ulcers and constipation in samples of abstaining smokers (N=585 and N=514) over four weeks. Forty-six percent developed mouth ulcers and 8% rated these as severe. Constipation was reported by 17% of abstinent smokers and 9% who were symptom free at baseline became very or extremely constipated. The studies reported in the second part of the thesis concerned two promising treatments that specifically address TWS. To examine the mechanism of action of rapid smoking (RS) 100 smokers were randomised to a single session of RS or a control procedure imillediately prior to quitting. Compared to the control RS . significantly reduced urges to smoke during the first week of abstinence. To see whether glucose can provide acute withdrawal relief in smokers receiving treatment, 75 one-week abstainers randomly received glucose (12g) or placebo tablets. TWS were measured before, and at 5-minute intervals for 20 minutes after, taking the tablets. Glucose had no effect on urges to smoke, but reduced irritability and hunger in smokers using bupropion. In summary, the thesis has documented that mouth ulcers and constipation are valid TWS and suggest that glucose and RS have promise in modifying TWS. On their own they are unlikely to have substantial effects on cessation; but may be useful when added to contemporary treatments.