TY - JOUR
T1 - Smoking abstinence symptoms across 67 days compared with randomized controls-Moderation by nicotine replacement therapy, bupropion, and negative-affect traits
AU - Gilbert, David G.
AU - Rabinovich, Norka E.
AU - Gilbert-Matuskowitz, Elizabeth A.
AU - Klein, Keith P.
AU - Pergadia, Michele L.
N1 - Funding Information:
Some of the data from the placebo group and the delayed-quit group were presented as part of a symposium at a recent annual meeting of the Society for Research on Nicotine and Tobacco. However, no other findings from the bupropion or NRT results or any of the trait-related findings of this study have been previously presented on website or other means with the exception that the effects of bupropion on EEG, depressive mood, and task performance during the two sessions prior to quitting have been published (Zhu et al., 2017). The data set is available at the Center for Open Science [https://osf.io/cq495/]. The study was designed by David G. Gilbert and Norka E. Rabinovich. The data were acquired by David G. Gilbert and Norka E. Rabinovich who had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analyses. The analyses were conducted by David G. Gilbert. The manuscript was drafted by David G. Gilbert. All authors contributed substantial critical revisions and approval of the final version of the manuscript. Funding was obtained by David G. Gilbert. Supervision of the study was provided by David G. Gilbert and Norka E. Rabinovich. All authors contributed in a significant way to the manuscript and that all authors have read and approved the final manuscript. We thank the dozens of undergraduate and graduate research assistants who helped conduct various aspects of this study and without whom it would have been impossible to complete. This research was supported by the National Institute on Drug Abuse (NIDA) Grant R01 DA012289 awarded to David G. Gilbert. Clinical Trials Registry: NCT01048944 http://www.clinicaltrials .gov. NIDA had no other role other than financial support.
Publisher Copyright:
© 2019 American Psychological Association.
PY - 2019/12
Y1 - 2019/12
N2 - Accurate knowledge of negative affect (NA)-related smoking abstinence symptoms (SAS) severity and duration and their moderation by pharmacotherapy and NA-related personality traits is critical for efficacious treatments given that elevated state and trait NA are predictors of relapse. However, SAS severity, duration, and moderation are not well characterized. To date, the longest randomized controlled trial (RCT) of NA-related SAS using randomized delayed-quit smoking controls only examined symptoms across 45 days, despite clinical evidence that SAS may last longer. The present RCT assessed SAS across 67 days in dependent smokers (N = 95) who were randomized either to quit or to delay quitting for the course of the trial. The quit group was further randomized to receive either nicotine replacement therapy (NRT), bupropion (BUP), or placebo. Abstinence-related increases in anger-irritability, depressive, anxiety, and general NA symptoms did not resolve relative to the delayed quit group (DQG) levels across the 67 days in any of the 3 quit groups, though craving fell to below DQG and prequit levels. While NRT attenuated Day 3 SAS relative to BUP and placebo, BUP and NRT generally did not reduce SAS. High scores on trait measures of NA/neuroticism predicted greater increases in and duration of NA-related SAS, potentially indicating that smoking abstinence unmasks affective symptoms. Positive affect was not impacted by abstinence or treatment. The results support the views that (a) prequit baseline values are not a valid index of NA SAS recovery, and (b) on average, NA-related SAS take longer than 67 days to resolve.
AB - Accurate knowledge of negative affect (NA)-related smoking abstinence symptoms (SAS) severity and duration and their moderation by pharmacotherapy and NA-related personality traits is critical for efficacious treatments given that elevated state and trait NA are predictors of relapse. However, SAS severity, duration, and moderation are not well characterized. To date, the longest randomized controlled trial (RCT) of NA-related SAS using randomized delayed-quit smoking controls only examined symptoms across 45 days, despite clinical evidence that SAS may last longer. The present RCT assessed SAS across 67 days in dependent smokers (N = 95) who were randomized either to quit or to delay quitting for the course of the trial. The quit group was further randomized to receive either nicotine replacement therapy (NRT), bupropion (BUP), or placebo. Abstinence-related increases in anger-irritability, depressive, anxiety, and general NA symptoms did not resolve relative to the delayed quit group (DQG) levels across the 67 days in any of the 3 quit groups, though craving fell to below DQG and prequit levels. While NRT attenuated Day 3 SAS relative to BUP and placebo, BUP and NRT generally did not reduce SAS. High scores on trait measures of NA/neuroticism predicted greater increases in and duration of NA-related SAS, potentially indicating that smoking abstinence unmasks affective symptoms. Positive affect was not impacted by abstinence or treatment. The results support the views that (a) prequit baseline values are not a valid index of NA SAS recovery, and (b) on average, NA-related SAS take longer than 67 days to resolve.
KW - Bupropion
KW - Negative affect
KW - Nicotine patch
KW - Smoking
KW - Withdrawal symptoms
UR - http://www.scopus.com/inward/record.url?scp=85063435981&partnerID=8YFLogxK
U2 - 10.1037/pha0000278
DO - 10.1037/pha0000278
M3 - Article
C2 - 30920255
AN - SCOPUS:85063435981
VL - 27
SP - 536
EP - 551
JO - Experimental and Clinical Psychopharmacology
JF - Experimental and Clinical Psychopharmacology
SN - 1064-1297
IS - 6
ER -