Timing of nicotine lozenge administration to minimize trigger induced craving and withdrawal symptoms

Abstract Introduction Smokers are often told to use nicotine lozenge when craving or withdrawal symptoms occur. This may be too late to prevent lapses. This study assessed if nicotine lozenge use prior to a common smoking trigger can minimize trigger induced increases in craving and withdrawal sympt...

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Bibliographic Details
Published in:Addictive behaviors 2017-08, Vol.71, p.18-24
Main Authors: Kotlyar, Michael, Lindgren, Bruce, Vuchetich, John P, Le, Chap, Mills, Anne M, Amiot, Elizabeth, Hatsukami, Dorothy K
Format: Article
Language:English
Subjects:
Craving
Nicotine
Nicotine Lozenge
Psychiatry
Smoke
Smoking
Smoking cessation
Stress
Withdrawal symptoms
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Summary:Abstract Introduction Smokers are often told to use nicotine lozenge when craving or withdrawal symptoms occur. This may be too late to prevent lapses. This study assessed if nicotine lozenge use prior to a common smoking trigger can minimize trigger induced increases in craving and withdrawal symptoms. Methods Eighty-four smokers completed two laboratory sessions in random order. At one session, nicotine lozenge was given immediately after a stressor (to approximate current recommended use – i.e., after craving and withdrawal symptoms occur); at the other session subjects were randomized to receive nicotine lozenge at time points ranging from immediately to 30 min prior to the stressor. Withdrawal symptoms and urge to smoke were measured using the Minnesota Nicotine Withdrawal Scale and the Questionnaire of Smoking Urges (QSU). Results Relative to receiving lozenge after the stressor, a smaller increase in pre-stressor to post-stressor withdrawal symptom scores occurred when lozenge was used immediately prior (p = 0.03) and 10 min prior (p = 0.044) to the stressor. Results were similar for factors 1 and 2 of the QSU when lozenge was used immediately prior to the stressor (p < 0.03) and for factor 1 of the QSU when lozenge was used 10 min prior to the stressor (p = 0.028). Absolute levels of withdrawal symptoms and urge to smoke severity were also lower when lozenge was given prior versus after a stressor. Conclusions Administering the nicotine lozenge prior to a smoking trigger can decrease trigger induced craving and withdrawal symptoms. Future studies are needed to determine if such use would increase cessation rates. Clinicaltrials.gov # NCT01522963
ISSN:0306-4603
1873-6327
DOI:10.1016/j.addbeh.2017.02.018