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Cited by 793Smoking Behavior and CessationSubstance Abuse Treatment and OutcomesPrenatal Substance Exposure Effects

Effects of abstinence from tobacco: Valid symptoms and time course

Hughes, John·2007·Nicotine & Tobacco Research
DOI 10.1080/14622200701188919
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Abstract

This article updates a 1990 review of the effects of tobacco abstinence by reviewing (a) which symptoms are valid indicators of tobacco abstinence and (b) the time course of tobacco abstinence symptoms. The author searched several databases to locate more than 3,500 citations on tobacco abstinence effects between 1990 and 2004; 120 of these were used in this review. Data collection and interpretation were based solely on the author's subjective judgments. For brevity, the review does not evaluate craving, hunger, performance, and several other possible outcomes as withdrawal symptoms. Anger, anxiety, depression, difficulty concentrating, impatience, insomnia, and restlessness are valid withdrawal symptoms that peak within the first week and last 2-4 weeks. Constipation, cough, dizziness, increased dreaming, and mouth ulcers may be abstinence effects. Drowsiness, fatigue, and several physical symptoms are not abstinence effects. In conclusion, no major changes are suggested for DSM-IV criteria for tobacco/nicotine withdrawal, but some deletions are suggested for ICD-10 criteria. Future studies need to investigate several possible new symptoms of withdrawal and to define more clearly the time course of symptoms.

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Crossref · 10.1080/14622200701188919

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141 of 141 references verified0 citation errors · 0 not checkable

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  • Apart from urges to smoke, the most common nicotine abstinence symptoms involve emotional dysregulation and cognitive deficits.

    “Aside from urges to smoke, the most common symptoms involve emotional dysregulation and cognitive deficits (13, 14).”

    From Varenicline improves mood and cognition during smoking abstinence (2009) · cites this paper as [13]

  • Seven nicotine withdrawal symptoms are validated and appear in DSM-IV-TR: irritability/anger/frustration, anxiety, depression/negative affect, concentration problems, impatience, insomnia, and restlessness.

    “Seven nicotine withdrawal symptoms were validated in a recent comprehensive review on the topic [119] and appear in the DSM-IV-TR [120]. The symptoms are irritability/anger/frustration, anxiety, depression/negative affect, concentration problems, impatience, insomnia, and restlessness.”

    From Mechanistic insights into nicotine withdrawal (2011) · cites this paper as [119]

  • Nicotine withdrawal symptoms typically peak within the first week and taper over 3-4 weeks, though some reports say they subside within 10 days and others say they persist past 31 days.

    “Nicotine withdrawal symptoms are typically reported to reach a peak within the first week of abstinence and taper off for the next 3–4 weeks [119, 124]. However, some reports indicate that symptoms can subside within 10 days [125], while others indicate that withdrawal symptoms may persist past 31 days [126, 127].”

    From Mechanistic insights into nicotine withdrawal (2011) · cites this paper as [119]

  • Chronic changes in the central nervous system lead to unpleasant withdrawal symptoms (irritability, depressed mood, anxiety, restlessness, difficulty concentrating and increased appetite) that make the experience of not smoking aversive and generate the need to smoke.

    “In addition to this, chronic changes in the CNS lead to unpleasant withdrawal symptoms (irritability, depressed mood, anxiety, restlessness, difficulty concentrating and increased appetite) that make the experience of not smoking aversive and generate the need to smoke (19,20).”

    From The Multiple Facets of Cigarette Addiction and What They Mean for Encouraging and Helping Smokers to Stop (2009) · cites this paper as [20]

  • Nicotine administration increases extracellular noradrenaline in various parts of the brain.

    “Nicotine administration also increases the extracellular noradrenaline in various parts of the brain (32–35);”

    From Tobacco addiction (2008) · cites this paper as [35]

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Authors
Hughes, J.
Affiliations
University of Vermont (US)
Corresponding author
Hughes, John
Venue
Nicotine & Tobacco Research
Publisher
Oxford University Press (OUP)
Published
2007-03
Volume
9
Issue
3
Pages
315-327
ISSN
1462-2203 (ISSN-L)
DOI
10.1080/14622200701188919
OpenAlex
W2054388960
Cited by
793
References
177
Citations by year
2026: 19 · 2025: 27 · 2024: 39 · 2023: 29 · 2022: 37 · 2021: 28 · 2020: 60 · 2019: 29 · 2018: 47 · 2017: 40 · 2016: 44 · 2015: 59 · 2014: 55 · 2013: 61 · 2012: 44
FWCI
24.76
Type
journal article
Language
en
Open access
closed
Locations
  • Nicotine & Tobacco Research (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
Keywords
smoking abstinence, nicotine withdrawal symptoms, anger, anxiety, depression, insomnia, restlessness, constipation
MeSH terms
Mental Disorders, Female, Humans, Male, Nicotine, Psychomotor Agitation, Substance Withdrawal Syndrome

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