Cited by 192Smoking Behavior and CessationStress Responses and CortisolSubstance Abuse Treatment and Outcomes

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Attenuated adrenocorticotropic responses to psychological stress are associated with early smoking relapse

al’Absi, Mustafa, Hatsukami, Dorothy, Davis, Gary L.·2005·Psychopharmacology

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Abstract

Rationale Research has demonstrated that psychosocial stressors increase smoking and risk for smoking relapse. Alterations in biological systems involved in the stress response caused by chronic smoking may contribute to early relapse.Objectives We examined the extent to which pituitary-adrenocortical and cardiovascular responses to stress following the first 24 h of a quit attempt predict early relapse.Methods Seventy-two smokers interested in cessation attended a laboratory stress session 24 h after the beginning of their cessation attempt. Adrenocorticotropin (ACTH), plasma and salivary cortisol concentrations, systolic and diastolic blood pressure (BP), and heart rate (HR) responses to acute psychological stressors (public speaking and cognitive challenges) were used to predict relapse over a 4-week follow-up period.Results Those who relapsed within 4 weeks showed attenuated hormonal and cardiovascular responses to stress and exaggerated withdrawal symptoms. Cox proportional hazards survival analysis showed that attenuated ACTH, plasma cortisol, systolic and diastolic BP, positive affect, and exaggerated withdrawal symptoms and smoking urges during acute stress predicted early relapse. Stepwise model showed that ACTH, diastolic BP, and exaggerated withdrawal symptoms remain as significant predictors. When baseline smoking and psychological measures were included in the model, changes in ACTH, diastolic BP, and both factors of smoking urges remained significant predictors of relapse.Conclusions These results demonstrate that altered stress response predicts increased vulnerability for smoking relapse.

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Authors: al’Absi, M., Hatsukami, D., & Davis, G. L.
Affiliations: University of Minnesota (US)
Corresponding author: al’Absi, Mustafa
ORCID: al’Absi, Mustafa
Davis, Gary L.
Venue: Psychopharmacology
Publisher: Springer Science and Business Media LLC
Published: 2005-04-15
Volume: 181
Issue: 1
Pages: 107-117
ISSN: 0033-3158 (ISSN-L)
1432-2072
DOI: 10.1007/s00213-005-2225-3
OpenAlex: W2054126870
Semantic Scholar: b0aaa798e85905b41bad4f90fe30b203072b0f56
Cited by: 192
References: 60
Citations by year: 2026: 4 · 2025: 2 · 2024: 6 · 2023: 5 · 2022: 8 · 2021: 7 · 2020: 9 · 2019: 6 · 2018: 12 · 2017: 12 · 2016: 16 · 2015: 18 · 2014: 12 · 2013: 13 · 2012: 11
FWCI: 4.00
Type: journal article
Language: en
Open access: closed
Licence: www.springer.com/tdm (tdm)
Locations: Psychopharmacology (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (1r03da013435-01)
National Institute on Drug Abuse (DA013435, R01DA016351, DA 016351)
National Cancer Institute (R21CA088272, CA88272)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords: smoking relapse, psychological stress, ACTH, cortisol, pituitary-adrenal axis, cardiovascular stress response, blood pressure, heart rate, nicotine withdrawal symptoms, smoking urges, smoking cessation
MeSH terms: Adrenocorticotropic Hormone, Adult, Blood Pressure, Breath Tests, Carbon Monoxide, Female, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Male, Middle Aged, Recurrence, Regression Analysis, Saliva, Sex Factors, Stress, Psychological, Substance Withdrawal Syndrome, Time Factors, Smoking Cessation

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Attenuated adrenocorticotropic responses to psychological stress are associated with early smoking relapse

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