Natural history of nicotine withdrawal
Abstract
AIMS: To examine the natural history of nicotine withdrawal and individual differences associated with withdrawal duration and severity. DESIGN AND SETTING: Prospective study of withdrawal symptoms among smokers who quit for at least 24 hours. Participants used Ecological Momentary Assessment to monitor symptoms in their natural environment using an Electronic Diary (ED). PARTICIPANTS: A total of 214 cigarette smokers (59% female, 92% Caucasian). INTERVENTION: All participants received a clinic-based, behavioral, group cessation intervention. Severity and duration of withdrawal was not addressed explicitly in treatment. MEASUREMENTS: Participants were 'beeped' by the ED approximately five times/day to complete affect assessments (negative affect, arousal, attention disturbance, restlessness), and daily assessments of sleep disturbance (at waking) and of cognitive performance (each evening) for a week prior to quitting and for up to 21 days after quitting. Withdrawal was considered resolved when withdrawal scores returned to baseline levels for at least 2 consecutive days. FINDINGS: All symptoms returned to baseline levels within 10 days of quitting. All variables except arousal and sleep disturbance showed change over time. No robust predictors of individual differences in withdrawal responses emerged. CONCLUSIONS: The time-course of withdrawal may be shorter than previously reported. The natural history of nicotine withdrawal may have implications for theories of withdrawal and smoking relapse and for smoking cessation treatment.
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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 [125]
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- Authors
- Shiffman, S., Patten, C., Gwaltney, C., Paty, J., Gnys, M., Kassel, J., Hickcox, M., Waters, A., & Balabanis, M.
- Affiliations
- University of Pittsburgh (US)
- Corresponding author
- Patten, Christi
- Venue
- Addiction
- Publisher
- Wiley
- Published
- 2006-11-24
- Volume
- 101
- Issue
- 12
- Pages
- 1822-1832
- ISSN
- 0965-2140 (ISSN-L)
- 1360-0443
- OpenAlex
- W2093765112
- Cited by
- 104
- References
- 67
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 4 · 2023: 4 · 2022: 1 · 2021: 2 · 2020: 2 · 2019: 7 · 2018: 6 · 2017: 2 · 2016: 11 · 2015: 6 · 2014: 7 · 2013: 9 · 2012: 5
- FWCI
- 4.86
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Addiction (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Drug Abuse (DA 06084, R01DA006084)
- 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
- nicotine withdrawal, smoking cessation, withdrawal severity, individual differences, sleep disorders, cognitive performance, negative affect, arousal, attention deficits, smoking relapse
- MeSH terms
- Adult, Behavior Therapy, Female, Humans, Male, Middle Aged, Prospective Studies, Psychomotor Performance, Surveys and Questionnaires, Sleep Wake Disorders, Substance Withdrawal Syndrome, Smoking Cessation
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