A quantitative analysis of subjective, cognitive, and physiological manifestations of the acute tobacco abstinence syndrome

Abstract

Rationale: Previous studies have documented the existence of signs and symptoms of the acute tobacco abstinence syndrome; however, less attention has been paid to quantifying the magnitude of these effects.

Objective: The present study quantified the relative magnitude of subjective, cognitive, and physiological manifestations of acute tobacco abstinence.

Method: Smokers (N=203, ≥ 15 cig/day) attended two counterbalanced laboratory sessions, one following 12-h of abstinence and the other following ad-lib smoking. At both sessions, they completed an extensive battery of self-report measures (withdrawal, affect, hunger, craving, subjective attentional bias towards smoking cues), physiological assessments (heart rate, blood pressure, brain EEG), and cognitive performance tasks (psychomotor processing, sustained attention, objective attentional bias).

Results: Abstinence effects were largest for craving, subjective attentional bias, negative affect, overall withdrawal severity, concentration difficulty, hunger, and heart rate. Effects were moderate for positive affect and EEG power. Effects were small, but reliable, for psychomotor speed, sustained attention, and somatic symptoms. Effects on performance-based indices of attentional bias towards smoking-related cues were small and reliable for some indices but not others. Effects were small and inconsistent for blood pressure and EEG frequency. Variation in internal consistency accounted for 33% of the variation in abstinence effect sizes across measures.

Conclusions: There was a wide range of effect sizes both across and within domains, indicating that the acute tobacco abstinence syndrome is not a monotonic phenomenon. These findings may be indicative of the relative magnitudes of signs and symptoms that the average smoker may exhibit during acute abstinence.

Figure 1

Absolute value of Cohen’s d effect size estimates for abstinence-induced change as a function of internal consistency reliability. Each measure represents a single observation. Split-half coefficients of internal consistency are illustrated for cognitive (even vs. odd trials) and EEG (even vs. odd epochs) measure. Cronbach’s alpha internal consistency estimates are illustrated for subjective measures.