Effects of abstinence from tobacco: Etiology, animal models, epidemiology, and significance: A subjective review

Hughes, John

doi:10.1080/14622200701188927

Cited by 173Smoking Behavior and CessationNicotinic Acetylcholine Receptors StudyPrenatal Substance Exposure Effects

Effects of abstinence from tobacco: Etiology, animal models, epidemiology, and significance: A subjective review

Hughes, John·2007·Nicotine & Tobacco Research

DOI 10.1080/14622200701188927

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Abstract

This article updates a 1990 review of the effects of tobacco abstinence by reviewing (a) the etiology, (b) animal models, (c) the epidemiology, and (d) the clinical significance of tobacco abstinence effects. The author searched several databases to locate more than 3,500 citations on tobacco abstinence effects between 1990 and 2004. For brevity, the review does not evaluate these effects in regard to craving, hunger, or performance. Data collection and study conclusions were based on the author's subjective judgment. The most validated etiological model suggests that withdrawal is related to decreased dopaminergic activity, but how this relates to nicotine receptor changes is unclear. The two most validated animal models describe increases in intracranial self-stimulation thresholds or observable physical signs. Significant withdrawal symptoms occur in at least half of smokers when they try to quit. Withdrawal appears to produce clinically significant distress and impairment. Increases in depression after abstinence, but not other symptoms, prospectively predict relapse. In conclusion, the proposed neurobiological mechanisms by which withdrawal occurs leave several unanswered questions. Although animal models have been developed, how well they mimic withdrawal in humans is unclear. Tobacco withdrawal is common and can be distressing. Withdrawal-induced depression appears to undermine the smoker's ability to remain abstinent.

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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 [19]
Depressed mood early on in the quit attempt appears to be the one most strongly associated with relapse.
“Of these, depressed mood early on in the quit attempt appears to be the one most strongly associated with relapse (19)”
From The Multiple Facets of Cigarette Addiction and What They Mean for Encouraging and Helping Smokers to Stop (2009) · cites this paper as [19]
Chronic financial stress and depression, which deplete mental energy, are associated with greater risk of relapse.
“It has also been found that chronic financial stress (26) and depression (19), which deplete mental energy are associated with greater risk of relapse.”
From The Multiple Facets of Cigarette Addiction and What They Mean for Encouraging and Helping Smokers to Stop (2009) · cites this paper as [19]

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“Somatic symptoms include bradycardia, insomnia, and gastrointestinal discomfort, whereas negative affective symptoms include anger, anxiety, craving, depression, difficulty concentrating, impatience, insomnia, and restlessness (Hughes, 2007a).”
Background
New Methods for Tobacco Dependence Treatment Research
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Hughes, J. R. (2007) · Psychology of Addictive Behaviors · doi:10.1037/0893-164x.21.2.127 · Cited by 76 · see citing works
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Breaking the habit: a qualitative exploration of barriers and facilitators to smoking cessation in people with enduring mental health problems
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Is There Evidence for Symptoms of Cannabis Withdrawal in the National Epidemiologic Survey of Alcohol and Related Conditions?
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Improving smoking cessation approaches at the individual level
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Role of α7- and β4-Containing Nicotinic Acetylcholine Receptors in the Affective and Somatic Aspects of Nicotine Withdrawal: Studies in Knockout Mice
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Mecamylamine elicits withdrawal-like signs in rats following a single dose of nicotine
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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: 329-339
ISSN: 1462-2203 (ISSN-L)
DOI: 10.1080/14622200701188927
OpenAlex: W2100829515
Semantic Scholar: b62e71eeaaa699df395760582dbbf7df27b7e55e
Cited by: 173
References: 116
Citations by year: 2026: 1 · 2025: 2 · 2024: 3 · 2023: 5 · 2022: 3 · 2021: 6 · 2020: 36 · 2019: 6 · 2018: 4 · 2017: 6 · 2016: 7 · 2015: 10 · 2014: 12 · 2013: 10 · 2012: 7
FWCI: 8.01
Type: journal article
Language: en
Open access: closed
Locations: Nicotine & Tobacco Research (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute on Drug Abuse (DA00490)
Topics: Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Nicotinic Acetylcholine Receptors Study
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
Keywords: smoking abstinence, nicotine withdrawal, smoking cessation, withdrawal symptoms, depression, relapse, dopaminergic activity, nicotinic acetylcholine receptors, intracranial self-stimulation
MeSH terms: Animals, Mental Disorders, Disease Models, Animal, Humans, Nicotine, Research Design, Substance Withdrawal Syndrome, Tobacco Use Disorder, Randomized Controlled Trials as Topic, Smoking Cessation

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Effects of abstinence from tobacco: Etiology, animal models, epidemiology, and significance: A subjective review

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