Time dependency of craving and response inhibition during nicotine abstinence

Abstract

Background: Nicotine withdrawal produces increased craving for cigarettes and deficits in response inhibition, and these withdrawal symptoms are predictive of relapse. Although it is well established that these symptoms emerge early during abstinence, there is mixed evidence regarding whether they occur simultaneously. Given the importance of the early withdrawal period, this study examined craving and response inhibition at 24 h and 72 h abstinence. Methods: Twenty-one non-treatment seeking adult smokers were evaluated at baseline, 24 h, and 72 h abstinence for craving (Questionnaire on Smoking Urges – Brief) and response inhibition (Stop Signal Task, Stroop Task, Continuous Performance Task). Generalised linear regression models were used for primary outcomes, and Pearson correlations for examining the association between craving and response inhibition. Results: Factor 2 craving (anticipated relief of negative affect) increased from baseline to 24 h abstinent (p = 0.004), which subsided by 72 h (p = 0.08). Deficits in response inhibition measured by the Stop Signal Task were observed at 72 h (p = 0.046), but not 24 h (p = 0.318). No correlation was found between response inhibition and craving at any time point (p values>0.19), except between the Stroop Task and the factor 1 craving at baseline (p = 0.025). Conclusions: Factor 2 craving peaked at 24 h, whereas deficits in response inhibition did not emerge until 72 h, indicating that need to target craving and cognitive function during early abstinence may not occur simultaneously. Further characterizing the time course of withdrawal symptoms may guide development of targeted treatments for smoking cessation.