Reduced craving associated with nicotine replacement therapy use is frequently attributed to the effects of nicotine pharmacology, however non-pharmacological factors may also play a role. This study examined the impact of nicotine pharmacology and non-pharmacological components of an acute nicotine lozenge (4 mg) on cigarette craving, mood and heart rate in 70 daily smokers (36 male). Smoking-related stimuli were used to assess cue-induced craving. Participants were randomly assigned to one of four conditions in a balanced placebo design where half the participants were provided deceptive information regarding the nicotine content of a lozenge. Subjective ratings of craving and mood were collected and heart rate was assessed before and after neutral and smoking cues. Nicotine expectancy reduced withdrawal-related craving (p=0.006) regardless of actual nicotine administration while combined nicotine expectancy and administration reduced intentions to smoke (p=0.046) relative to each of the other conditions. Exposure to smoking-related stimuli increased cigarette craving (p≤0.001) and negative affect (p≤0.001) regardless of expectancy or pharmacology. Following the smoking cue, women reported a greater increase in withdrawal-related craving than men (p=0.027). Findings suggest that both pharmacological and non-pharmacological components of nicotine lozenge administration contribute to its acute effects on craving, yet neither appears effective in preventing craving triggered by exposure to environmental smoking stimuli.
BarrettSP (2010) The effects of nicotine, denicotinized tobacco, and nicotine-containing tobacco on cigarette craving, withdrawal, and self-administration in male and female smokers. Behav Pharmacol21: 144–152.
2.
BenowitzNL (2008) Clinical pharmacology of nicotine: implications for understanding, preventing, and treating tobacco addiction. Clin Pharmacol Ther83: 531–541.
3.
BenowitzNL. (2009) Nicotine chemistry, metabolism, kinetics and biomarkers. In: HenningfieldJA. (eds) Handbook of Experimental Pharmacology. Berlin: Springer-Verlag, pp.29–60.
4.
BondALaderM (1974) The use of analogue scales in rating subjective feelings. Br J Med Psychol47: 211–218.
5.
CoxLS. (2001) Evaluation of the Brief Questionnaire of Smoking Urges (QSU-brief) in laboratory and clinical settings. NicotineTob Res3: 7–16.
6.
DarRRosen-KorakenNShapiraO. (2010) The craving to smoke in flight attendants: relations with smoking deprivation, anticipation of smoking, and actual smoking. J Abnorm Psychol119: 248–253.
7.
DarredeauCBarrettSP (2010) The role of nicotine content information in smokers’ subjective responses to nicotine and placebo inhalers. Hum Psychopharmacol25: 577–581.
8.
ErblichJ. (2005) Effects of dopamine D2 receptor (DRD2) and transporter (SLC6A3) polymorphisms on smoking cue-induced cigarette craving among African-American smokers. Mol Psychiatry10: 407–414.
9.
FergusonSGShiffmanS (2009) The relevance and treatment of cue-induced craving in tobacco dependence. J Subst Abuse Treat36: 235–243.
10.
FieldMDukaT (2004) Cue reactivity in smokers: the effects of perceived cigarette availability and gender. Pharmacol Biochem Behav78: 647–652.
11.
FucitoLMJulianoLM (2007) Effects of instructions on responses to the nicotine patch: a laboratory study. Psychopharmacology194: 475–483.
12.
GottliebAW. (1987) Psychological and pharmacological influences in cigarette smoking withdrawal: effects of nicotine gum and expectancy on smoking withdrawal symptoms and relapse. J Consult Clin Psychol55: 606–608.
13.
GueorguievaRKrystalJH (2004) Move over ANOVA: progress in analyzing repeated-measures data and its reflection in papers published in the Archives of General Psychiatry. Arch Gen Psychiatry61: 310–217.
14.
HeathertonTKozlowskiLTFreckerRC. (1991) The Fagerström Test for Nicotine Dependence: a revision of the Fagerström Tolerance Questionnaire. Br J Addict86: 1119–1127.
15.
HendricksPSBrandonTH (2008) Smokers’ expectancies for smoking versus nicotine. Psychol Addict Behav22: 135–140.
16.
HughesJR. (1989) Effect of instructions and nicotine on smoking cessation, withdrawal symptoms and self-administration of nicotine gum. Psychopharmacology99: 486–491.
17.
HughesJR. (2000) Treatment resistant smokers: a pilot study of nicotine nasal spray and inhaler. J Addict Dis19: 95–100.
18.
JulianoLMBrandonTH (2002) Effects of nicotine dose, instructional set, and outcome expectancies on the subjective effects of smoking in the presence of a stressor. J Abnorm Psychol111: 88–97.
19.
JulianoLMFucitoLMHarrellPT. (2011) The influence of nicotinedose and nicotine dose expectancy on the cognitive and subjective effects of cigarette smoking. Exp Clin Psychopharmacol19: 105–115.
20.
KelemenWLKaighobadiF (2007) Expectancy and pharmacology influence the subjective effects of nicotine in a balanced-placebo design. Exp Clin Psychopharmacol15: 93–101.
21.
KellyJT. (2004) Level of abstinence mediates heart-rate response to cue-elicited craving in smokers. Mcgill J Med8: 50–57.
22.
McBrideDBarrettSPKellyJT. (2006) Effects of expectancy and abstinence on the neural response to smoking cues in cigarette smokers: An fMRI Study. Neuropsychopharmacology31: 2728–2738.
23.
McEwenA. (2008) Nicotine absorption from seven current nicotine replacement products and a new wide-bore nicotine delivery device. J Smok Cessat3: 117–123.
24.
McGrathDS. (2013) The influence of acutely administered nicotine on cue-induced craving for gambling in at-risk video terminal gamblers who smoke. Behav Pharmacol24: 124–132.
25.
MaxwellSEDelaneyHD (2004) Designing Experiments and Analyzing Data: A model Comparison Perspective. New York: Psychology Press.
26.
PerkinsKA. (1999) Sex differences in nicotine effects and self-administration: review of human and animal evidence. Nicotine Tob Res1: 301–315.
27.
PerkinsKA. (2003) Placebo effects of tobacco smoking and other nicotine intake. Nicotine Tob Res5: 695–706.
28.
PerkinsKA. (2009) Mood, nicotine, and dose expectancy effects on acute responses to nicotine spray. Nicotine Tob Res11: 540–546.
29.
RabinoffM. (2007) Pharmacological and chemical effects of cigarette additives. Am J Public Health97: 1981–1991.
30.
RobbinsSJEhrmanRNChildressAR. (1999) Comparing levels of cocaine cue reactivity in male and female outpatients. Drug Alcohol Depend53: 223–230.
31.
SayetteMA. (2010) Counterbalancing in smoking cue research: A critical analysis. Nicotine Tob Res12: 1068–1079.
32.
ShiffmanS. (2005) Nicotine delivery systems. Expert Opin Drug Deliv2: 563–577.
SuttonSR (1991) Great expectations: some suggestions for applying the balanced placebo design to nicotine and smoking. Br J Addict86: 659–662.
35.
TiffanySDrobesD (1991) The development and initial validation of a questionnaire on smoking urges. Br J Addict86: 1467–1476.
36.
TollBAKatulakNAMcKeeSA. (2006) Investigating the factor structure of the Questionnaire on Smoking Urges-Brief (QSU-Brief). Addict Behav31: 1231–1239.
37.
TongCBovbjergDHErblichJ. (2007) Smoking-related videos for use in cue-induced craving paradigms. Addict Behav32: 3034–3044.
38.
US Department of Health and Human Services (1988) The health consequences of smoking: Nicotine addiction: A report of the Surgeon General. Report for the Department of Health and Human Services, Public Health Service, Centers for Disease Control. Atlanta, Georgia: National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.
39.
US Department of Health and Human Services (2010) How tobacco smoke causes disease: the biology and behavioral basis for smoking-attributable disease: a report of the Surgeon General. Report for the Department of Health and Human Services, Centers for Disease Control and Prevention. Atlanta, Georgia: National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health
