Severity of nicotine withdrawal symptoms after smoking cessation

Background: Smoking is among the most common preventable causes of early death in the world. Implementation of smoking cessation programs is among the effective strategies of tobacco control. More than half the smokers experience nicotine withdrawal syndrome after quitting and this could be one of the main reasons of unsuccessful smoking cessation. This study evaluated the severity of nicotine withdrawal symptoms 14 days after quitting (the last visit of smokers to the smoking cessation clinic).Materials and Methods: This was a cross sectional study conducted on volunteers for smoking cessation from Nov. 2006 to Nov. 2007. During a one month course, volunteers attended 4 sessions of treatment and training (1 session per week). Since the 2^nd session, they stopped smoking with the aid of nicotine gum and behavioral therapy under the supervision of a physician. Fourteen days after quitting (4^th session), the severity of nicotine withdrawal symptoms was evaluated using the Minnesota test and was compared between males and females using the Chi square test. Results: A total of 197 participants were studied, 65% of which were males, 76.6% were married, 49.2% successfully quit smoking during the study period, 12.2% cut down smoking, and 38.6% did not finish the course. The mean score for increase in appetite, irritability and depression was 4.6±3.4, 4.3±3.4 and 3.6±3.3, respectively. The mean score for severity of depression was 4.5±3.4 in women and 3.19±3.2 in men (p=0.03). The mean score for severity of anxiety was 4.6±3.6 in women and 2.6±2.9 in men (p=0.004). Also, the mean score for severity of irritability was 5.7±3.3 and 3.6±3.3 in women and men, respectively (p=0.002).Conclusion: The severity of symptoms related to nicotine withdrawal syndrome was considerably low 14 days following abstinence. However, the severity of nicotine craving was significantly higher compared to other symptoms. Severity of more than half the symptoms was significantly higher in women but further investigations are required in this regard.