Tobacco withdrawal: no link to quitting.

Smokers trying to kick their nicotine habit experience withdrawal symptoms that include irritability, anxiety, difficulty concentrating, hunger, and restlessness. Yet many ex-smokers eventually start using cigarettes again for reasons unrelated to nicotine withdrawal reactions, according to a six-month study of adults who quit cigarettes on their own and shunned tobacco for at least 30 days.

No clear culprits emerge as instigators of a smoking relapse, asserts psychiatrist John R. Hughes of the University of Vermont in Burlington. The new findings indicate that important questions about nicotine addiction remain unanswered, including why withdrawal symptoms strike some people with greater intensity, why some succeed and others fail to give up smoking permanently, and how nicotine gum and nicotine patches make cigarette abstinence easier, Hughes contends.

He presents his data in the October JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY.

Some earlier studies have found that former smokers with more severe withdrawal signs show a greater probability of resuming their tobacco habit, whereas other trials have uncovered no such pattern. All but one of those studies, however, focused on the fewer than 5 percent of smokers who attempt to quit through a treatment program, Hughes points out. Such smokers display stronger signs of dependence on nicotine than self-quitters, he says.

Hughes used newspaper and radio advertisements to recruit smokers who were about to quit on their own. Participants stopped smoking about one week after an initial interview. Hughes then tracked 178 individuals who remained abstinent for 30 days. He also studied control groups of 56 ex-smokers abstinent for more than one year, 67 current smokers, and 61 nonsmokers.

A total of 78 volunteers who gave up smoking remained abstinent for the entire six-month study.

Except for hunger and weight gain, nicotine withdrawal symptoms among self-quitters largely disappeared two to four weeks after smoking ceased. Self-quitters gained an average of 3.2 pounds over the study period, reaching an average weight similar to that of exsmokers but greater than that of non-smokers and current smokers.

Depression did not increase among self-quitters, and cravings for nicotine decreased throughout the study. Nevertheless, participants reported considerable cigarette cravings just before quitting, and many cited continued, though diminished, craving six months later.

Alcohol and caffeine consumption did not change among self-quitters.

None of the common nicotine withdrawal symptoms appears linked to the ability to stop smoking for the entire six months. However, participants whose depressive symptoms increased in the month after quitting cigarettes displayed a modestly greater tendency to suffer a smoking relapse than did those whose symptoms stayed the same or decreased.