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Symptoms of Tobacco Withdrawal:  A Replication and Extension

John R. Hughes, MD; Steven W. Gust, PhD; Kelli Skoog; Robert M. Keenan, PhD; James W. Fenwick, PhD
Arch Gen Psychiatry. 1991;48(1):52-59. doi:10.1001/archpsyc.1991.01810250054007.
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• Smokers (n = 315) who wished to quit were randomly assigned in a double-blind manner to groups using either nicotine or placebo gum. Self-reported and observed symptoms of tobacco withdrawal were collected before cessation and at follow-ups of 1 to 2 weeks, 1 month, and 6 months. Self-reported and/or observed anger, anxiety, craving, difficulty concentrating, hunger, impatience, and restlessness were the most prominent symptoms of tobacco withdrawal. These symptoms had returned to precessation levels by 1 month except increased weight, hunger, and craving continued for 6 months in many smokers. Nicotine gum decreased most symptoms, including craving and hunger but not weight. Abstinent smokers with more intense withdrawal were not more likely to relapse. Abstinent smokers who gained more weight were less likely to relapse.

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