Effect of nicotine lozenge use prior to smoking cue presentation on craving and withdrawal symptom severity.
BACKGROUND
Smokers are often advised to use nicotine lozenge after cravings or withdrawal symptoms are present, which may be too late to prevent lapses. This study assesses if lozenge use prior to smoking cue exposure attenuates cue-induced increases in symptom severity.


METHODS
In this randomized, cross-over study, participants completed three laboratory sessions at which they proceeded through 4 "rooms" in a virtual reality environment. The first and last "rooms" contained neutral cues and the others contained smoking cues. At one session, a 4 mg nicotine lozenge was not given until after cue exposure (to approximate current use: i.e., after craving and withdrawal symptoms occur). At the other two sessions either a nicotine or placebo lozenge was used 15 min before cue exposure procedures. Craving and withdrawal symptoms were measured throughout each laboratory session.


RESULTS
Of 58 participants randomized; 40 completed all 3 labs. Absolute levels of craving and withdrawal symptom severity during cue exposure were lower when placebo or active lozenge was used prior to cue presentation procedures vs. no treatment until after cue presentation procedures (all p-values <0.05). There were no differences among conditions in the magnitude of symptom severity increase occurring between the first neutral room and the cue rooms.


CONCLUSIONS
Lozenge use prior to cue exposure may minimize cue induced symptom severity but when taken 15 min prior to cues the decrease is not different than placebo. Research is needed to determine if another time-frame relative to cue exposure would be more effective.
['Kotlyar|Michael|M|', 'Vogel|Rachel I|RI|', 'Dufresne|Sheena R|SR|', 'Mills|Anne M|AM|', 'Vuchetich|John P|JP|']
D000293:Adolescent D000328:Adult D066249:Craving D018592:Cross-Over Studies D003463:Cues D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D012907:Smoking D016540:Smoking Cessation D013375:Substance Withdrawal Syndrome D061485:Tobacco Use Cessation Devices D016896:Treatment Outcome D000076142:Virtual Reality D055815:Young Adult
Smoking Cues Craving Withdrawal symptoms Sex differences