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.
Overview
Integrity signals
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Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
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
Citations
Cites
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Signs and Symptoms of Tobacco Withdrawal
Hughes, J. R. (1986) · Archives of General Psychiatry · doi:10.1001/archpsyc.1986.01800030107013 · Cited by 1,669
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Best evidence synthesis: An intelligent alternative to meta-analysis
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Cited by
Sorted by citations
Breast Cancer, Version 4.2017, NCCN Clinical Practice Guidelines in Oncology
Gradishar, W. J., Anderson, B. O., Balassanian, R., Blair, S. L., Burstein, H. J., Cyr, A. E., ELIAS, A. D., Farrar, W. B., Forero, A., Giordano, S. H., et al. (2018) · Journal of the National Comprehensive Cancer Network · doi:10.6004/jnccn.2018.0012 · Cited by 1,612
Change in mental health after smoking cessation: systematic review and meta-analysis
Taylor, G., McNeill, A., Girling, A., Farley, A., Lindson-Hawley, N., & Aveyard, P. (2014) · BMJ · doi:10.1136/bmj.g1151 · Cited by 1,039
The role of sleep hygiene in promoting public health: a review of empirical evidence
Irish, L. A., Kline, C. E., Gunn, H. E., Buysse, D. J., & Hall, M. H. (2015) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2014.10.001 · Cited by 931
Caponnetto, P., Campagna, D., Cibella, F., Morjaria, J. B., Caruso, M., Russo, C., & Polosa, R. (2013) · PLoS ONE · doi:10.1371/journal.pone.0066317 · Cited by 737
Meta-analysis of the acute effects of nicotine and smoking on human performance
Heishman, S. J., Kleykamp, B. A., & Singleton, E. G. (2010) · Psychopharmacology · doi:10.1007/s00213-010-1848-1 · Cited by 681
“Difficulty concentrating is a valid symptom of nicotine withdrawal (APA 2000; Hughes 2007).”
Background
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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