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.
Bibliographical noteFunding Information:
This research was supported by Grant # WS2385492 from the Global Research Award for Nicotine Dependence (GRAND) program funded by Pfizer and by grant #UL1TR000114 from the National Institutes of Health’s National Center for Advancing Translational Sciences . The content is solely the responsibility of the authors and does not necessarily represent the views of the funding agencies.
This work was funded by a grant from the Global Research Award for Nicotine Dependence (GRAND) program funded by Pfizer. Dr. Kotlyar has received honoraria from Western Schools for the development of a continuing education program. There are no other conflicts of interest. Appendix A
- Sex differences
- Withdrawal symptoms
PubMed: MeSH publication types
- Journal Article
- Randomized Controlled Trial
- Research Support, N.I.H., Extramural
- Research Support, Non-U.S. Gov't