Withdrawal Symptoms From E-Cigarette Abstinence Among Former Smokers: A Pre–Post Clinical Trial

Author:

Hughes John R12ORCID,Peters Erica N3,Callas Peter W4,Peasley-Miklus Catherine12,Oga Emmanuel3,Etter Jean-Francois5,Morley Nicholas12

Affiliation:

1. Department of Psychiatry, Vermont Center for Behavior and Health, University of Vermont, Burlington, VT

2. Department of Psychological Science, Vermont Center for Behavior and Health, University of Vermont, Burlington, VT

3. Battelle Public Health Center for Tobacco Research, Baltimore, MD

4. Medical Biostatistics, University of Vermont, Burlington, VT

5. Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland

Abstract

Abstract Introduction The major aim of this study was to test whether abstinence from e-cigarettes causes withdrawal symptoms in former smokers. Methods We conducted an unblinded, within-participants, pre–post clinical trial in which 109 former smokers who were current daily electronic cigarette (e-cigarette) users used their own e-cigarette for 7 days followed by 6 days of biologically confirmed abstinence engendered via an escalating contingency payment system. Participants monitored symptoms of nicotine withdrawal daily via an Interactive Voice Response system. They also attended three laboratory visits per week for carbon monoxide and cotinine testing to verify abstinence. Results Half of participants completely abstained for a week. All the Diagnostic and Statistical Manual, Fifth Edition (DSM-5) tobacco withdrawal symptoms, craving for e-cigarettes, craving for tobacco cigarettes, and the four possible new withdrawal symptoms (anhedonia, impulsivity, mood swings, and positive affect) increased during abstinence. Weight increased and heart rate decreased with abstinence. Symptoms showed the prototypical inverted U time pattern of a withdrawal state. The magnitude of withdrawal appeared to be somewhat less than that in a prior study of abstinent daily tobacco cigarette smokers. More severe withdrawal on the first 2 days of abstinence did not predict abstinence on the last day of the study. Conclusions Former smokers who are daily e-cigarette users transfer physical dependence on tobacco cigarettes to dependence on e-cigarettes. The severity of withdrawal from e-cigarettes appears to be only somewhat less than that from daily tobacco cigarette use. Replication tests that include placebo controls, testing for pharmacological specificity, and including never-smokers, non-daily e-cigarette users and dual users are indicated. Implications Our results indicate e-cigarettes can maintain physical dependence. This adverse effect should be included in any risk vs. benefit calculation. Also, potential and current e-cigarette users should be informed that abrupt cessation of e-cigarettes can cause withdrawal symptoms. Trial registration NCT02825459.

Funder

National Cancer Institute

Publisher

Oxford University Press (OUP)

Subject

Public Health, Environmental and Occupational Health

Reference23 articles.

1. Gateway effects and electronic cigarettes;Etter;Addiction,2018;113(10):1776–1783.

2. Electronic cigarettes for smoking cessation: a systematic review;Malas;Nicotine Tob Res.,2016

3. Development of a questionnaire for assessing dependence on electronic cigarettes among a large sample of ex-smoking and e-cigarette users;Foulds;Nicotine Tob Res,2015

4. Saliva cotinine levels in users of electronic cigarettes;Etter;Eur Respir J.,2011

Cited by 10 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3