Effects of smoking and paroxetine on stress-induced craving and withdrawal symptoms

ABSTRACT

Background: When smokers relapse, many cite stressful circumstances as the cause. Most smoking cessation medications do not prevent stress-induced increases in craving and withdrawal symptom severity; however, the effect of smoking prior to stress exposure on symptom severity is unclear.

Methods: We examined how smoking a cigarette immediately prior to a stressful task affects craving and withdrawal symptom severity by analyzing data from a double-blind, crossover study assessing paroxetine’s effects on the physiological response to the combination of stress and smoking. Measures were obtained prior to and following smoking/stress exposure and following a subsequent 30-min period at two laboratory sessions (i.e., after 1 month each of paroxetine and placebo).

Results: Among study completers (n = 63), severity of craving decreased from the beginning of the session to immediately following the smoking/stress exposure (p < 0.01) and severity of smoking urges decreased from the beginning to the end of the laboratory session (p < 0.001). Withdrawal symptoms were less severe while taking paroxetine vs. placebo (p < 0.05) but no treatment  × time effects were observed.

Conclusions: Additional research is needed to identify interventions that could similarly decrease stress-induced craving in order to determine if smoking cessation rates can be increased.

KEYWORDS:

• Smoking
• craving
• withdrawal symptoms
• paroxetine
• stress

Additional information

Funding

This research was supported by Grant K23DA017307 (to MK) from the National Institute on Drug Abuse and Grant M01-RR000400 from the General Clinical Research Centers program of the National Center for Research Resources. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.