DOES NICOTINE WITHDRAWAL AFFECT SMOKING CESSATION - CLINICAL AND THEORETICAL ISSUES

Pharmacological theories of smoking relapse emphasize the role of nico tine withdrawal al in the maintenance of smoking behavior and general failure of treatment interventions. In this article, prospective studi es are reviewed which examine the relationship of nicotine withdrawal to unsuccessful smoking cessation and relapse. The relative effectiven ess of smoking treatments that directly address nicotine withdrawal is also discussed If is concluded that the research to date does not app ear to strongly implicate nicotine withdrawal in adversely affecting s moking cessation or maintenance of abstinence. Some major obstacles to our understanding of the predictive validity of nicotine withdrawal a re addressed including: (a) measurement problems, (b) exclusion bias, and (c) insufficient research on nicotine withdrawal in certain subgro ups of highly nicotine-dependent smokers. Other factors which may acco unt for smoking relapse, including behavioral and psychosocial variabl es, as well as their possible interaction with nicotine withdrawal, ar e also considered. Recommendations for further research are offered.