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Reduction in cortisol after smoking cessation among users of nicotine patches

Ussher, M; West, R; Evans, P; Steptoe, A; McEwen, A; Clow, A; Hucklebridge, F; (2006) Reduction in cortisol after smoking cessation among users of nicotine patches. PSYCHOSOM MED , 68 (2) 299 - 306. 10.1097/01.psy.0000204926.27215.a1.

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Abstract

Objective: Cortisol has been shown to decline after stopping smoking and this decline has been associated with smoking relapse and with reports of increased withdrawal severity and distress. We examined whether a decrease in cortisol is evident in smokers trying to quit using nicotine patches and whether cortisol is related to withdrawal symptoms, smoking urges, subjective stress, nicotine dependence, and smoking relapse. Methods: Among 112 smokers trying to quit using 15-mg patches, salivary cortisol and reports of stress, withdrawal, and urges were measured before quitting smoking and up to 6 weeks of abstinence among abstinent smokers using 15-mg nicotine patches. Thirty participants both remained abstinent and provided cortisol samples at all measurement times. Results: Relative to preabstinence, there was a significant decline in cortisol after abstinence of I day, and after 1, 2, and 6 weeks (p < .05). The decline in cortisol on the first day of abstinence was positively associated with reported cigarette consumption (p < .01) and tended (nonsignificant) to be associated with smoking relapse at 6 weeks (p = .07). A lower absolute level of cortisol, but not the change in cortisol, on the first day of abstinence was significantly associated with increased reports of urges, withdrawal symptoms, and stress (p < .05), independently of reported cigarette consumption. Conclusions: Smokers using 15-mg nicotine patches are likely to experience a decline in cortisol on stopping smoking. This decline is likely to be greater among heavier smokers and may predict relapse to smoking. Those with lower cortisol after cessation may experience increased withdrawal symptoms, urges to smoke, and subjective stress.

Type: Article
Title: Reduction in cortisol after smoking cessation among users of nicotine patches
DOI: 10.1097/01.psy.0000204926.27215.a1
Keywords: cortisol, smoking cessation, nicotine patches, urges to smoke, stress, withdrawal symptoms, RANDOMIZED CONTROLLED-TRIAL, PITUITARY-ADRENAL AXIS, CIGARETTE-SMOKING, WITHDRAWAL SYMPTOMS, PSYCHOLOGICAL STRESS, SALIVARY CORTISOL, TOBACCO WITHDRAWAL, SECRETORY ACTIVITY, BETA-ENDORPHIN, QUIT SMOKING
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
URI: http://discovery.ucl.ac.uk/id/eprint/149601
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