Signs and Symptoms of Tobacco Withdrawal

TLDR

The study evaluated the validity, magnitude, and clinical significance of DSM‑III defined tobacco withdrawal signs and symptoms by measuring observed and reported symptoms in 50 smokers during two days of ad lib smoking and the first four days of abstinence. The authors measured observed and self‑reported DSM‑III withdrawal symptoms in 50 smokers over two days of ad lib smoking followed by four days of abstinence. After cessation, smokers experienced heightened craving, irritability, anxiety, concentration difficulty, restlessness, bradycardia, impatience, somatic complaints, insomnia, hunger, and increased eating; symptom severity varied but overall distress paralleled that of psychiatric outpatients, and greater withdrawal discomfort correlated with greater tolerance to nicotine’s cardiovascular effects yet did not lower cessation rates.

Abstract

• To test the validity, magnitude, and clinical significance of the signs and symptoms of tobacco withdrawal defined by<i>DSM-III</i>, both observed and reported signs and symptoms were measured in 50 smokers during two days of ad lib smoking and then during the first four days of abstinence. Observer and subject ratings of the<i>DSM-III</i>symptoms of craving for tobacco, irritability, anxiety, difficulty concentrating, and restlessness increased after cessation. In addition, bradycardia, impatience, somatic complaints, insomnia, increased hunger, and increased eating occurred after cessation. The frequency and intensity of these symptoms varied across subjects; however, the average distress from tobacco withdrawal was similar to that observed in psychiatric outpatients. Subjects who had more withdrawal discomfort were more tolerant to the cardiovascular effects of nicotine. Subjects who had more withdrawal discomfort did not have a lower rate of smoking cessation.