The DOI matches its Crossref record; 140 of the 177 references it cites were found in a registry or an index.
Effects of abstinence from tobacco: Valid symptoms and time course
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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In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“Nicotine administration also increases the extracellular noradrenaline in various parts of the brain (32–35);”
From Tobacco addiction (2008) · cites this paper as [35]
In the citing paper
“Most nicotine withdrawal symptoms in adults peak at one week.18”
From Maternal Smoking during Pregnancy and Newborn Neurobehavior: Effects at 10 to 27 Days (2009) · cites this paper as [18]
In the citing paper
“These symptoms include difficulty concentrating, increased craving, depressed mood, and increased anxiety (Hughes, 1992(Hughes, , 2007)).”
From Activation of α4β2*/α6β2* nicotinic receptors alleviates anxiety during nicotine withdrawal without upregulating nicotinic receptors (2014) · cites this paper as Hughes, 2007
In the citing paper
“This is in line with evidence from ex-smokers who report that withdrawal symptoms abate a few weeks after smoking cessation (Hughes, 2007).”
From An application of the stress-diathesis model: A review about the association between smoking tobacco, smoking cessation, and mental health (2023) · cites this paper as Hughes, 2007
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Items 101–200 of 782
Sheffer, C. E., Bickel, W. K., Brandon, T. H., Franck, C. T., Deen, D., Panissidi, L., Abdali, S. A., Pittman, J. C., Lunden, S. E., Prashad, N., et al. (2017) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2017.09.037 · Cited by 73
“The MNWS craving item was used to assess craving level (Hughes, 2007b; Hughes and Hatsukami, 1986).”
Ditre, J. W., Zale, E. L., LaRowe, L. R., Kosiba, J. D., & Vita, M. J. D. (2018) · Journal of Abnormal Psychology · doi:10.1037/abn0000353 · Cited by 73
“…effect (i.e., a biphasic transient change after abstinence) or a nicotine offset effect (i.e., a unidirectional change after abstinence; e.g., Hughes, 2007), and we did not account for factors that can influence plasma nicotine levels (e.g., trough levels, individual differences in…”
Smoking and sleep disorders in Chinese adolescents
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“These differential associations may help explain the mixed findings in the literature [35,38–41].”
BackgroundResultSleep changes in smokers before, during and 3 months after nicotine withdrawal
Jaehne, A., Unbehaun, T., Feige, B., Cohrs, S., Rodenbeck, A., Schütz, A.-L., Uhl, V., Zober, A., & Riemann, D. W. (2014) · Addiction Biology · doi:10.1111/adb.12151 · Cited by 72
“…nicotine withdrawal symptoms usually begin after 6–12 hours after discontinuation, reach maximum intensity within 1–3 days and can last up to 3 weeks (Hughes 2007), subjects were asked to complete three different sleep laboratory sessions: during smoking (baseline), 24–36 hours after they stopped…”
BackgroundMethodInfluentialPortugal, G. S., & Gould, T. J. (2008) · Behavioural Brain Research · doi:10.1016/j.bbr.2008.05.006 · Cited by 73
Dorner, T. E., Trostl, A., Womastek, I., & Groman, E. (2011) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntr179 · Cited by 71
Piper, M. E., Vasilenko, S. A., Cook, J. W., & Lanza, S. T. (2016) · Addiction · doi:10.1111/add.13613 · Cited by 68
Cellular, molecular, and genetic substrates underlying the impact of nicotine on learning
Gould, T. J., & Leach, P. T. (2013) · Neurobiology of Learning and Memory · doi:10.1016/j.nlm.2013.08.004 · Cited by 72
Pang, R. D., & Leventhal, A. M. (2013) · Experimental and Clinical Psychopharmacology · doi:10.1037/a0033429 · Cited by 67
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BackgroundInfluentialCohen, A., & George, O. (2013) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2013.00041 · Cited by 70
“Nicotine withdrawal and the escalation of nicotine intake Discontinuation of smoking, even for only several hours, leads to withdrawal symptoms that peak within 1 week and may persist for up to 6 months (Hughes et al., 1991; Hughes, 2007; Markou, 2008).”
BackgroundMechanistic insights into nicotine withdrawal
Paolini, M., & De Biasi, M. (2011) · Biochemical Pharmacology · doi:10.1016/j.bcp.2011.07.075 · Cited by 66
Damage to the insula leads to decreased nicotine withdrawal during abstinence
Abdolahi, A., Williams, G. C., Benesch, C. G., Wang, H. Z., Spitzer, E. M., Scott, B. E., Block, R., & van Wijngaarden, E. (2015) · Addiction · doi:10.1111/add.13061 · Cited by 67
“Since withdrawal symptoms typically emerge within a few hours following the last smoked cigarette and peak within a few days to one week(28, 29), this period represents an ideal window to assess the presence and intensity of these symptoms.”
BackgroundAnother major function of the anterior cingulate cortex: The representation of requirements
Weston, C. S. E. (2011) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2011.04.014 · Cited by 66
The role of impulsivity on smoking maintenance
VanderVeen, J. W., Cohen, L. M., Cukrowicz, K. C., & Trotter, D. R. M. (2008) · Nicotine & Tobacco Research · doi:10.1080/14622200802239330 · Cited by 65
“Despite the fact that withdrawal symptoms have been shown to occur within hours of abstinence (McCarthy, Piasecki, Fiore, & Baker, 2006), the present study utilized a 48-hour period of abstinence in order to build upon previous research assessing impulsivity and relapse (Doran et al., 2004) and because tobacco withdra…”
BackgroundMethodInfluentialNollen, N. L., Mayo, M. S., Sanderson Cox, L., Benowitz, N. L., Tyndale, R. F., Ellerbeck, E. F., Scheuermann, T. S., & Ahluwalia, J. S. (2019) · JNCI: Journal of the National Cancer Institute · doi:10.1093/jnci/djz001 · Cited by 62
“Treatment process measures included baseline and change (baseline to week 26) in nicotine withdrawal (73), cravings (74), reinforcing effects of nicotine (75), and medication-related side effects (weeks 1–16) (76,77).”
BackgroundThe relationship between distress tolerance and cigarette smoking: A systematic review and synthesis
Veilleux, J. C. (2019) · Clinical Psychology Review · doi:10.1016/j.cpr.2019.01.003 · Cited by 70
Rodent models for nicotine withdrawal
Chellian, R., Behnood‐Rod, A., Bruijnzeel, D. M., Wilson, R., Pandy, V., & Bruijnzeel, A. W. (2021) · Journal of Psychopharmacology · doi:10.1177/02698811211005629 · Cited by 71
“The highly aversive nicotine withdrawal symptoms make it challenging to maintain abstinence (Hughes, 2007; Hughes et al., 1991).”
BackgroundVarenicline ameliorates nicotine withdrawal-induced learning deficits in C57BL/6 mice.
Raybuck, J. D., Portugal, G. S., Lerman, C., & Gould, T. J. (2008) · Behavioral Neuroscience · doi:10.1037/a0012601 · Cited by 62
“…of this animal model is that the effects of nicotine withdrawal on learning observed in our model are consistent with the disruption of cognition that is reported during human smoking cessation (Hughes et al, 1991; Jacobsen et al, 2005; Mendrek et al, 2006, Hughes, 2007; Jacobsen et al, 2007).”
ResultHuang, W., King, J. A., Ursprung, W. W. S., Zheng, S., Zhang, N., Kennedy, D. N., Ziedonis, D. M., & DiFranza, J. R. (2014) · Brain and Behavior · doi:10.1002/brb3.227 · Cited by 61
“(Hughes 2007) Of these, only WIC is addressed by the theory being tested.”
BackgroundLeventhal, A. M., Kahler, C. W., Ray, L. A., & Zimmerman, M. A. (2008) · Addictive Behaviors · doi:10.1016/j.addbeh.2008.11.008 · Cited by 61
Does Tobacco Abstinence Decrease Reward Sensitivity? A Human Laboratory Test
Hughes, J. R., Budney, A. J., Muellers, S. R., Lee, D. C., CALLAS, P. W., Sigmon, S. C., Fingar, J. R., & Priest, J. S. (2017) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntw204 · Cited by 62
Self-citationDawkins, L., Turner, J. J., & Crowe, E. (2013) · Psychopharmacology · doi:10.1007/s00213-013-2983-2 · Cited by 61
“…whether as part of a quit attempt or associated with enforcement of non-smoking laws, is accompanied by tobacco withdrawal symptoms including cigarette craving/desire to smoke, irritability, anxiety, depression and difficulty concentrating (American Psychiatric Association 2000; Hughes 2007).”
BackgroundBiała, G., Staniak, N., & Budzyńska, B. (2010) · Naunyn-Schmiedeberg s Archives of Pharmacology · doi:10.1007/s00210-010-0498-5 · Cited by 62
“Moreover, withdrawal from nicotine results in a combination of both psychological and physical symptoms leading to cravings and a continued desire to smoke (Hughes 2007; West et al. 2006).”
BackgroundClinical and public health significance of treatments to aid smoking cessation
West, R., & Stapleton, J. (2008) · European Respiratory Review · doi:10.1183/09059180.00011005 · Cited by 60
“1) Many smokers experience powerful motivation to smoke, and adverse mood and physical symptoms if they attempt abstinence [15, 16 ].”
BackgroundSmoking cessation and response to periodontal treatment
Alexandridi, F., Tsantila, S., & Pepelassi, E. (2017) · Australian Dental Journal · doi:10.1111/adj.12568 · Cited by 67
“Most of these symptoms are mostly intense 2–48 h after ceasing tobacco and they usually get significantly less within 2–4 weeks.(46) In case of assisted cessation attempts, clinicians should monitor all patients for possible intense psychological changes.”
BackgroundAlcohol, Nicotine, and Iatrogenic Withdrawals in the ICU
Awissi, D., Lebrun, G., Fagnan, M., & Skrobik, Y. K. (2013) · Critical Care Medicine · doi:10.1097/ccm.0b013e3182a16919 · Cited by 60
Development of the Highly Processed Food Withdrawal Scale
LaFata, E. M., Smeal, J. K., Lewis, J., & Gearhardt, A. N. (2018) · Appetite · doi:10.1016/j.appet.2018.09.013 · Cited by 64
Franklin, T. R., Wang, Z., Li, Y., Suh, J. J., Goldman, M., Lohoff, F. W., Cruz, J., Hazan, R., Jens, W., Detre, J. A., et al. (2011) · Addiction Biology · doi:10.1111/j.1369-1600.2010.00277.x · Cited by 59
“Inability to combat withdrawal-induced craving, which declines within a month (Hughes 2007), plays a major role in relapse in the first few weeks after quitting.”
BackgroundConcurrent alcohol and tobacco treatment: Effect on daily process measures of alcohol relapse risk.
Cooney, N. L., Litt, M. D., Sevarino, K. A., Levy, L., Kranitz, L. S., Sackler, H., & Cooney, J. L. (2015) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0038633 · Cited by 58
“The 9-item version of the Minnesota Nicotine Withdrawal Scale-Revised (MNWS-R; Hughes, 2007; Hughes & Hatsukami, 1986) was included to measure the severity of nicotine withdrawal symptoms (anger, anxiety, craving, depression, difficulty concentrating, hunger, impatience, insomnia, and restlessness).”
Aveyard, P. N., Johnson, C. J., Fillingham, S. C., Parsons, A. C., & Murphy, M. F. (2008) · BMJ · doi:10.1136/bmj.39545.852616.be · Cited by 57
Motivational Processes Underlying Substance Abuse Disorder
Meyer, P., King, C. P., & Ferrario, C. R. (2015) · Current topics in behavioral neurosciences · doi:10.1007/7854_2015_391 · Cited by 59
“While the physiological, flu-like symptoms of withdrawal for most commonly abused drugs (shakes, nausea, malaise) subside within two to three weeks after drug use is discontinued, the hedonic effects, including mood alterations that manifest as depression and anxiety, may last longer (Soto et al. 1985; Ashton 1991; Ro…”
BackgroundGentry, S. V., Craig, J. V., Holland, R., & Notley, C. J. (2017) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2017.07.043 · Cited by 57
“Increased negative affect, including feelings of anger, anxiety and depression are inherent to nicotine withdrawal in the short term, lasting up to 4 weeks (58).”
Harrison, R., Munafo, M. R., Smith, G. D., & Wootton, R. E. (2020) · The British Journal of Psychiatry · doi:10.1192/bjp.2020.68 · Cited by 60
Gould, T. J., Portugal, G. S., André, J. M., Tadman, M. P., Marks, M. J., Kenney, J. W., Yildirim, E., & Adoff, M. (2012) · Neuropharmacology · doi:10.1016/j.neuropharm.2012.01.003 · Cited by 56
Pregabalin for the Treatment of Drug and Alcohol Withdrawal Symptoms: A Comprehensive Review
Freynhagen, R., Bačkonja, M., Schug, S. A., Lyndon, G. J., Parsons, B., WATT, S. J., & Behar, R. (2016) · CNS Drugs · doi:10.1007/s40263-016-0390-z · Cited by 55
“Nicotine withdrawal symptoms peak within the first week after ceasing tobacco use, and may include anxiety and depression, anger, impatience, difficulty concentrating, and insomnia, amongst others [14].”
BackgroundImproving smoking cessation approaches at the individual level
Aveyard, P. N., & Raw, M. (2012) · Tobacco Control · doi:10.1136/tobaccocontrol-2011-050348 · Cited by 54
“The period of withdrawal varies by symptom, but typically lasts a few weeks.(4) Therefore most smokers’ experience of not smoking is state of withdrawal and perhaps beliefs that smoking is a stress reliever, for example, stem from experiencing withdrawal during abstinence.”
BackgroundSmoking and Cloninger's Temperament and Character Inventory
Etter, J. (2010) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntq116 · Cited by 54
Taylor, G. M. J., & Treur, J. L. (2023) · International Journal of Clinical and Health Psychology · doi:10.1016/j.ijchp.2022.100335 · Cited by 50
“This is in line with evidence from ex-smokers who report that withdrawal symptoms abate a few weeks after smoking cessation (Hughes, 2007).”
ResultDepression moderates smoking behavior in response to a sad mood induction.
Fucito, L. M., & Juliano, L. M. (2009) · Psychology of Addictive Behaviors · doi:10.1037/a0016529 · Cited by 53
“…1991), the Urge Rating Scale (Kozlowski, Pillitteri, Sweeney, Whitfield & Graham, 1996); the Minnesota Nicotine Withdrawal Scale – Revised (Hughes, 1992; 2007); the Beck Depression Inventory – II (Current) (Beck, Steer, & Brown, 1996); the Film Questionnaire (Rottenberg et al., 2007), a…”
Impact of symptoms experienced by varenicline users on tobacco treatment in a real world setting
Halperin, A. C., McAfee, T. A., Jack, L. M., Catz, S. L., McClure, J. B., Deprey, T. M., Richards, J. A., Zbikowski, S. M., & Swan, G. E. (2008) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2008.09.001 · Cited by 53
“They were asked if they had experienced a range of symptoms in the last month that included probable varenicline side effects and common nicotine abstinence or withdrawal effects (Hughes, 2007; see Table 2).”
Smoking cessation and depressive symptoms at 1-, 3-, 6-, and 12-months follow-up
Rodríguez-Cano, R., López-Durán, A., del Río, E. F., Martínez-Vispo, C., Martínez, Ú., & Becoña, E. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.11.042 · Cited by 47
Burton, S., Hoek, J. A., Nesbit, P., & Khan, A. (2015) · Journal of Business Research · doi:10.1016/j.jbusres.2015.03.004 · Cited by 56
“In addition to the internal biological drives caused by nicotine withdrawal (Hughes, 2007), learned associations, and social and environmental effects also appear to encourage smoking.”
BackgroundInfluentialA 51-Year-Old Woman With Bipolar Disorder Who Wants to Quit Smoking
Schroeder, S. A. (2009) · JAMA · doi:10.1001/jama.2008.982 · Cited by 51
Garza, D., Murphy, M. F., Tseng, L., Riordan, H., & Chatterjee, A. K. (2011) · Biological Psychiatry · doi:10.1016/j.biopsych.2010.12.005 · Cited by 50
The First 7 Days of a Quit Attempt Predicts Relapse
Ashare, R. L., Wileyto, E. P., Perkins, K. A., & Schnoll, R. A. (2013) · Journal of Addiction Medicine · doi:10.1097/adm.0b013e31829363e1 · Cited by 53
“Furthermore, withdrawal symptoms peak during the first few days of abstinence (Shiffman et al., 2006; Hughes, 2007), and these symptoms, in turn, predict relapse (Killen and Fortmann, 1997; Rukstalis et al., 2005; Patterson et al., 2010).”
Sweitzer, M. M., Denlinger, R. L., & Donny, E. C. (2012) · Nicotine & Tobacco Research · doi:10.1093/ntr/nts080 · Cited by 48
“Withdrawal typically increases and peaks within the fi rst week of abstinence ( Hughes, 2007 ), so that increases in symptoms may have covaried with the decreasing schedule of abstinence incentives, leaving it unclear as to which factor was more infl uential.”
BackgroundSweitzer, M. M., Geier, C. F., Addicott, M. A., Denlinger, R. L., Raiff, B. R., Dallery, J., McClernon, F. J., & Donny, E. C. (2016) · Neuropsychopharmacology · doi:10.1038/npp.2016.56 · Cited by 51
“The impact of withdrawal on brain function is particularly important given that most smokers relapse during early stages of a quit attempt, when withdrawal is heightened (Hughes, 2007).”
Hurt, R. T., Ebbert, J. O., Croghan, I. T., Schroeder, D. R., Hurt, R. D., & Hays, J. T. (2018) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2017.11.017 · Cited by 48
“Cigarette smokers with past and current alcohol abuse or dependence are more tobacco dependent than smokers without this history (Hughes and Kalman, 2006; Hurt et al., 1995).”
Kahler, C. W., Spillane, N. S., Busch, A. M., & Leventhal, A. M. (2010) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntq213 · Cited by 50
Varenicline for smoking cessation: nausea severity and variation in nicotinic receptor genes
Swan, G. E., Javitz, H. S., Jack, L. M., Wessel, J., Michel, M., Hinds, D. A., Stokowksi, R. P., McClure, J. B., Catz, S. L., Richards, J. A., et al. (2011) · The Pharmacogenomics Journal · doi:10.1038/tpj.2011.19 · Cited by 50
DiFranza, J. R., Ursprung, W. W. S., Lauzon, B., Bancej, C. M., Wellman, R. J., Ziedonis, D. M., Kim, S. S., Gervais, A., Meltzer, B., McKay, C. E., et al. (2009) · Addictive Behaviors · doi:10.1016/j.addbeh.2009.12.013 · Cited by 49
The Natural History and Diagnosis of Nicotine Addiction
DiFranza, J. R., Wellman, R. J., Mermelstein, R. J., Pbert, L. A., Klein, J. D., Sargent, J. D., Ahluwalia, J. S., Lando, H. A., Ossip, D. J., Wilson, K. M., et al. (2011) · Current Pediatric Reviews · doi:10.2174/157339611795735648 · Cited by 49
“Nicotine withdrawal has long been recognized to include symptoms such as irritability, anxiety, restlessness, moodiness, impatience, difficulty concentrating and trouble sleeping [12-14, 37].”
BackgroundBaker, T. B., Piper, M. E., Schlam, T. R., Cook, J. W., Smith, S. S., Loh, W., & Bolt, D. M. (2012) · Journal of Abnormal Psychology · doi:10.1037/a0027889 · Cited by 56
“…withdrawal severity, and have different relations with other measures.1 Their meaningful association reflects the fact that they share some causal influences in common (e.g., tobacco deprivation; Hughes, 2007), and that negative affect per se is causally determinant of craving (Baker et al., 2004).”
Reitzel, L. R., Mazas, C. A., Cofta-Woerpel, L., Li, Y.-S., Cao, Y.-M., Businelle, M., Cinciripini, P., & Wetter, D. (2010) · Addiction · doi:10.1111/j.1360-0443.2009.02875.x · Cited by 50
“As withdrawal effects emerge very soon after quitting [27,28,30] and generally peak during the initial 2 weeks following the quit attempt [31], affective mediators of an SSSabstinence relationship might be examined ideally during the period of acute withdrawal from smoking.”
InfluentialTargeting GLP-1 receptors to reduce nicotine use disorder: Preclinical and clinical evidence
Herman, R. J., & Schmidt, H. D. (2024) · Physiology & Behavior · doi:10.1016/j.physbeh.2024.114565 · Cited by 54
Determinants of continuity and change over 10 years in young women's smoking
McDermott, L. J., Dobson, A. J., & Owen, N. G. (2009) · Addiction · doi:10.1111/j.1360-0443.2008.02452.x · Cited by 47
Anxiogenic-like effects of chronic nicotine exposure in zebrafish
Stewart, A., Grossman, L., Collier, A. D., Echevarria, D. J., & Kalueff, A. V. (2015) · Pharmacology Biochemistry and Behavior · doi:10.1016/j.pbb.2015.01.016 · Cited by 48
“Finally, nicotine is well known to evoke clinical and experimental withdrawal (Cohen and George, 2013; Hughes, 2007; Irvine et al., 2001), raising the possibility that nicotine withdrawal models can be developed for zebrafish as well.”
Chaffee, B. W., Couch, E. T., & Ryder, M. I. (2016) · Periodontology 2000 · doi:10.1111/prd.12120 · Cited by 48
“Dental practitioners can assure the patient that most of these symptoms peak 2–48 h after quitting and subside within 2–4 weeks (65).”
BackgroundFunctional Neurocircuits and Neuroimaging Biomarkers of Tobacco Use Disorder
Sutherland, M. T., & Stein, E. A. (2018) · Trends in Molecular Medicine · doi:10.1016/j.molmed.2017.12.002 · Cited by 50
“Anxiety, irritability, tobacco craving, and difficulty concentrating are nicotine withdrawal symptoms that make short-term cessation difficult for most smokers [14].”
BackgroundEffects of oxytocin on nicotine withdrawal in rats
Manbeck, K. E., Shelley, D., Schmidt, C. E., & Harris, A. C. (2013) · Pharmacology Biochemistry and Behavior · doi:10.1016/j.pbb.2013.11.002 · Cited by 44
“Avoidance of nicotine withdrawal symptoms is thought to play a critical role in maintaining tobacco use (Baker et al., 2004; Hughes, 2007a; Koob and Le Moal, 2008; Markou, 2008; Paolini and De Biasi, 2011; Watkins et al., 2000a).”
Tobacco withdrawal symptoms mediate motivation to reinstate smoking during abstinence.
Aguirre, C., Madrid, J., & Leventhal, A. M. (2015) · Journal of Abnormal Psychology · doi:10.1037/abn0000060 · Cited by 45
“…syndrome, negative affect and urge to smoke appear to be most robustly altered by abstinence and tend to predict relapse more consistently (Hughes, 2007a, 2007b; Kassel, Stroud, & Paronis, 2003; Leventhal, Waters, Moolchan, Heishman, & Pickworth, 2010; Nørregaard, Tønnesen, & Petersen,…”
BackgroundInfluentialPhysiological and psychological symptoms and predictors in early nicotine withdrawal
Morrell, H. E. R., Cohen, L. M., & Al’Absi, M. (2008) · Pharmacology Biochemistry and Behavior · doi:10.1016/j.pbb.2007.12.020 · Cited by 46
“Such goals necessitate a more complete knowledge of early nicotine withdrawal (i.e., within the first 24 h of smoking cessation), including order of symptom onset and potential symptom stages (Hughes, 2007b).”
BackgroundResultInfluentialAubin, H., Peiffer, G., Stœbner-Delbarre, A., Vicaut, É., Jeanpetit, Y., Solesse, A., Bonnelye, G., & Thomas, D. (2010) · BMC Public Health · doi:10.1186/1471-2458-10-100 · Cited by 45
“Anxiety, irritability, and depression are withdrawal symptoms that last 2-4 weeks [24].”
BackgroundEffects of chronic nicotine on food intake and anxiety-like behaviour in CB1 knockout mice
Bura, S. A., Burokas, A., Martín‐García, E., & Maldonado, R. J. (2010) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2010.02.003 · Cited by 45
“In addition, different physical and emotional manifestations of withdrawal appear after smoking cessation (Hughes, 2007).”
Increase in anger symptoms after smoking cessation predicts relapse
Patterson, F., Kerrin, K., Wileyto, E. P., & Lerman, C. E. (2008) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2008.01.013 · Cited by 44
“Introduction Support for anger as a nicotine abstinence induced withrawal symptom (Hughes, 2007) comes from data showing that nger symptoms increase post cessation (Gilbert et al., 2002; ard et al., 2001) and that nicotine reduces feelings of anger Jamner et al., 1999).”
BackgroundHsieh, S.-J. J., Shum, M., Lee, A. N., Hasselmark, F., & Gong, M. N. (2013) · Annals of the American Thoracic Society · doi:10.1513/annalsats.201301-001oc · Cited by 45
Menossi, H. S., Goudriaan, A. E., Périco, C. D. A.-M., Nicastri, S., de Andrade, A. G., D’Elia, G., Li, C. R., & Castaldelli-Maia, J. M. (2013) · CNS Drugs · doi:10.1007/s40263-013-0092-8 · Cited by 48
“[2 6] N ic ot in e pa tc h vs pl ac eb o 31 , (4 2) 8 m al e an d 13 fe m al e”
BackgroundRíos‐Bedoya, C. F., Snedecor, S. M., Pomerleau, C. S., & Pomerleau, O. F. (2008) · Addictive Behaviors · doi:10.1016/j.addbeh.2008.04.005 · Cited by 42
Sleep Disturbance During Smoking Cessation: Withdrawal or Side Effect of Treatment?
Ashare, R. L., Lerman, C., Tyndale, R. F., Hawk, L. W., George, T. P., Cinciripini, P., & Schnoll, R. A. (2017) · Journal of Smoking Cessation · doi:10.1017/jsc.2016.11 · Cited by 42
Conti, A. A., Tolomeo, S., Steele, J. D., & Baldacchino, A. (2020) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2020.04.018 · Cited by 41
“…mood are milder (SDM=0.27) and appear late compared to symptoms of anxiety and irritability, thus supporting the findings of another review (Hughes, 2007b) in which depression and dysphoric mood symptoms were found to increase with the length of abstinence, and to peak at 1-3 weeks…”
BackgroundResultInfluentialFucito, L. M., Redeker, N. S., Ball, S. A., Toll, B. A., Ikomi, J. T., & Carroll, K. M. (2013) · The Journal of Smoking Cessation · doi:10.1017/jsc.2013.19 · Cited by 43
“IP address: 54.70.40.11, on 09 Dec 2019 at 00:26:29, subject to the Cambridge Core terms of use, available at https://www.cambridge.org/core/terms & Morin, 2012; Hughes, 2007; Wetter & Young, 1994).”
BackgroundInfluentialHendricks, P. S., & Leventhal, A. M. (2013) · Psychopharmacology · doi:10.1007/s00213-013-3169-7 · Cited by 43
“However, it is possible that the use of participants paid to abstain from smoking overnight may have attenuated the relationships between abstinence-related expectancies and withdrawal, as this research paradigm tends to yield muted withdrawal effects (Hughes 2007a).”
Kleykamp, B. A., & Heishman, S. J. (2011) · JAMA · doi:10.1001/jama.2011.1221 · Cited by 42
“1) years.(9) Thus, current knowledge of tobacco withdrawal is based on individuals who are approximately 30 years younger than older smokers.”
Miller, M. E., & Sigmon, S. C. (2015) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntv030 · Cited by 42
Nakajima, M., & Al’Absi, M. (2014) · Psychophysiology · doi:10.1111/psyp.12241 · Cited by 42
“These symptoms may peak within the first week of cessation and linger for two to four weeks (Hughes, 2007) or longer (Gilbert et al., 2002).”
BackgroundFranklin, T. R., Wang, Z., Sciortino, N., Harper, D., Li, Y., Hakun, J. G., Kildea, S., Kampman, K. M., Ehrman, R., Detre, J. A., et al. (2011) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2011.01.015 · Cited by 44
“First, our goal was to determine if and how baclofen affected resting baseline brain activity independent of withdrawal (symptoms of which last up to one month) (Hughes, 2007), as it has been shown that withdrawal itself can affect brain activity (Wang et al., 2007).”
BackgroundHandling relapse in smoking cessation: strategies and recommendations
Caponnetto, P., Keller, E., Bruno, C. M., & Polosa, R. (2012) · Internal and Emergency Medicine · doi:10.1007/s11739-012-0864-z · Cited by 43
“relapse within the first month of abstinence, and only about 3–5 % remain abstinent at 6 months [3].”
BackgroundDEPRESSION AND SMOKING: A 5-YEAR PROSPECTIVE STUDY OF PATIENTS WITH MAJOR DEPRESSIVE DISORDER
Holma, I. A. K., Holma, K. M., Melartin, T. K., Ketokivi, M. A., & Isometsä, E. T. (2013) · Depression and Anxiety · doi:10.1002/da.22108 · Cited by 44
“Smoking appears to increase the risk of depression approximately twofold[16, 17] However, a self-medication hypothesis of depression causing smoking is supported by studies showing that smoking cessation results in depression,[18–20] and depressive mood is usually part of the nicotine withdrawal syndrome.[21, 22] Smok…”
BackgroundNicotinic Receptors, Memory, and Hippocampus
Kutlu, M. G., & Gould, T. J. (2015) · Current topics in behavioral neurosciences · doi:10.1007/978-3-319-13665-3_6 · Cited by 42
Hays, J. T., Ebbert, J. O., & Sood, A. (2009) · Mayo Clinic Proceedings · doi:10.4065/84.8.730 · Cited by 40
Stoker, A. K., Olivier, B., & Markou, A. (2011) · Psychopharmacology · doi:10.1007/s00213-011-2578-8 · Cited by 40
“One of the primary symptoms of nicotine and cocaine withdrawal syndromes in humans is depressed mood and anhedonia, with anhedonia defined as the inability to experience pleasure from rewarding stimuli (American Psychiatric Association 2000; Hughes 2007).”
BackgroundEffects of varenicline and bupropion on cognitive processes among nicotine-deprived smokers.
Ashare, R. L., & McKee, S. A. (2011) · Experimental and Clinical Psychopharmacology · doi:10.1037/a0025594 · Cited by 41
“During nicotine deprivation, many smokers report withdrawal symptoms such as difficulty concentrating, impatience, feeling easily distracted, and restlessness (Hughes, 2007).”
BackgroundTaylor, G. M. J., Baker, A., Fox, N., Kessler, D. S., Aveyard, P. N., & Munafo, M. R. (2020) · BJPsych Advances · doi:10.1192/bja.2020.52 · Cited by 38
Is It Prime Time for Alpha2-Adrenocepter Agonists in the Treatment of Withdrawal Syndromes?
Albertson, T. E., Chenoweth, J., Ford, J. B., Owen, K. P., & Sutter, M. E. (2014) · Journal of Medical Toxicology · doi:10.1007/s13181-014-0430-3 · Cited by 39
“Symptoms of NWS peak within the first week and can last for 2–4 weeks [115].”
BackgroundLeal, I. M., Taing, M., Correa-Fernández, V., Obasi, E. M., Kyburz, B., Le, K., Koshy, L., Chen, T. A., Williams, T., Casey, K., et al. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18115764 · Cited by 41
“Research indicates that former smokers will reap the psychological benefits of quitting by around 3 weeks, due to the abating of withdrawal symptoms [66].”
BackgroundHeckman, B. W., MacQueen, D. A., Marquinez, N. S., MacKillop, J., Bickel, W. K., & Brandon, T. H. (2017) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000197 · Cited by 39
“Nicotine withdrawal is characterized by an aversive array of behavioral, affective, cognitive, and physiological symptoms that emerge as nicotine levels decrease (Hughes, 2007a, 2007b, 2007c; Shiffman, West, & Gilbert, 2004).”
Sirota, A. D., Rohsenow, D. J., MacKinnon, S. V., Martin, R. A., Eaton, C. A., Kaplan, G. B., Monti, P. M., Tidey, J. W., & Swift, R. M. (2010) · Addictive Behaviors · doi:10.1016/j.addbeh.2010.02.014 · Cited by 38
Hooten, W. M., Townsend, C. O., Hays, J. T., Ebnet, K. L., Gauvin, T. R., Gehin, J. C., Laures, H. J., Patten, C. A., & Warner, D. O. (2013) · Addictive Behaviors · doi:10.1016/j.addbeh.2013.11.010 · Cited by 38
“The severity of nicotine withdrawal symptoms was assessed using the Minnesota Nicotine Withdrawal Scale-Revised (MNWS-R) (Hughes, 2007; Hughes & Hatsukami, 1986).”
MethodInfluentialAnxiety Sensitivity and Negative Urgency
Guillot, C. R., Pang, R. D., & Leventhal, A. M. (2014) · Journal of Addiction Medicine · doi:10.1097/adm.0000000000000017 · Cited by 38
“Furthermore, anxiety and other negative affective states are among the most common and severe symptoms expressed in regular smokers abstinent from tobacco (Hughes, 2007; Leventhal et al., 2010).”
BackgroundSmoking Abstinence and Neurocognition: Implications for Cessation and Relapse
McClernon, F. J., Addicott, M. A., & Sweitzer, M. M. (2015) · Current topics in behavioral neurosciences · doi:10.1007/978-3-319-13665-3_8 · Cited by 39
“Withdrawal symptoms occur within hours of smoking cessation and can persist for weeks (Gilbert et al. 2004; Hendricks et al. 2006; Hughes 2007).”
BackgroundHindocha, C., Freeman, T. P., Grabski, M., Crudgington, H., Davies, A. C., Stroud, J., Das, R. K., Lawn, W., Morgan, C. J. A., & Curran, H. V. (2018) · Scientific Reports · doi:10.1038/s41598-018-25846-2 · Cited by 37
The latency to the onset of nicotine withdrawal: A test of the sensitization-homeostasis theory
DiFranza, J. R., & Ursprung, W. W. S. (2008) · Addictive Behaviors · doi:10.1016/j.addbeh.2008.04.011 · Cited by 36
Cosgrove, K., Esterlis, I., McKee, S. A., Bois, F., Alagille, D., Tamagnan, G. D., Seibyl, J. P., Krishnan‐Sarin, S., & Staley, J. K. (2010) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntq040 · Cited by 37
Guimond, A., Audet-Croteau, V., Savard, M., Bernard, P., Ivers, H., & Savard, J. (2016) · Annals of Behavioral Medicine · doi:10.1007/s12160-016-9834-4 · Cited by 37
A test of proposed new tobacco withdrawal symptoms
Etter, J., USSHER, M. H., & Hughes, J. R. (2012) · Addiction · doi:10.1111/j.1360-0443.2012.03981.x · Cited by 36
Self-citationDiFranza, J. R., Wellman, R. J., & Savageau, J. A. (2011) · Psychopharmacology · doi:10.1007/s00213-011-2411-4 · Cited by 36
“However, tobacco withdrawal produces other symptoms including irritability, difficulty sleeping, restlessness, impatience and increased appetite (Hughes 2007).”
BackgroundInfluentialReduced-Nicotine Cigarettes in Young Smokers: Impact of Nicotine Metabolism on Nicotine Dose Effects
Faulkner, P., Ghahremani, D. G., Tyndale, R. F., Cox, C. M., Kazanjian, A. S., Paterson, N. E., Lotfipour, S., Hellemann, G., Petersen, N., Vigil, C., et al. (2017) · Neuropsychopharmacology · doi:10.1038/npp.2017.18 · Cited by 35
“However, difficulty concentrating is a symptom of nicotine withdrawal that typically peaks within 2–3 days and wanes after ~ 4–6 days (Hughes, 2007; Hughes and Hatsukami, 1986).”
BackgroundSmoking Cessation in Adolescents: targeted approaches that work
Towns, S. J., DiFranza, J. R., Jayasuriya, G., Marshall, T., & Shah, S. (2015) · Paediatric Respiratory Reviews · doi:10.1016/j.prrv.2015.06.001 · Cited by 36
“While symptoms such as irritability, anxiety, restlessness, moodiness, impatience, difficulty concentrating and trouble sleeping have long been recognized as withdrawal symptoms [49–52], it has only recently become apparent that the earliest and most important sign of physical dependence is the urge to smoke [53].”
BackgroundNeuropeptide systems and new treatments for nicotine addiction
Bruijnzeel, A. W. (2017) · Psychopharmacology · doi:10.1007/s00213-016-4513-5 · Cited by 36
“It should be noted that somatic withdrawal signs in humans are mild and that relapse to smoking is mainly driven by dysphoria and craving (Bruijnzeel 2012; Hughes 2007; Koob and Volkow 2016).”
Pistillo, F., Fasoli, F., Moretti, M., McClure‐Begley, T. D., Zoli, M., Marks, M. J., & Gotti, C. (2015) · Pharmacological Research · doi:10.1016/j.phrs.2015.11.016 · Cited by 34
Metadata
- 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)
- OpenAlex
- W2054388960
- Cited by
- 801
- References
- 177
- Citations by year
- 2026: 27 · 2025: 32 · 2024: 39 · 2023: 29 · 2022: 36 · 2021: 26 · 2020: 61 · 2019: 30 · 2018: 49 · 2017: 43 · 2016: 43 · 2015: 62 · 2014: 55 · 2013: 59 · 2012: 46
- FWCI
- 6.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nicotine & Tobacco Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Drug Abuse (DA000490)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › 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, cough, dizziness, oral ulcers
- MeSH terms
- Mental Disorders, Female, Humans, Male, Nicotine, Psychomotor Agitation, Substance Withdrawal Syndrome, Tobacco Use Disorder, Meta-Analysis as Topic, Smoking Cessation
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