The relationship between level of cigarette consumption and latency to the onset of retrospectively reported withdrawal symptoms

Psychopharmacology (Berl). 2006 Oct;188(3):335-42. doi: 10.1007/s00213-006-0497-x. Epub 2006 Sep 5.


Rationale: Subthreshold smokers (who smoke < or =5 cigarettes/day) experience withdrawal symptoms, yet they smoke less than is required to maintain serum nicotine levels.

Objectives: For study 1, our aim was to determine (1) if adult subthreshold smokers report withdrawal symptoms; (2) how they rate symptom severity; (3) the length of their latency to withdrawal symptoms; (4) and the relationship between level of cigarette consumption and latency to withdrawal. The aim of study 2 was to attempt to replicate the results of study 1 in a nationally representative sample and to compare subthreshold and threshold (> or =6 cigarettes/day) smokers.

Methods: Study 1 was conducted through telephone interviews. Study 2 was conducted through secondary analysis of data from the National Youth Tobacco Survey (self-administered in schools).

Results: In study 1, all subjects experienced withdrawal symptoms. The mean number of symptoms was 4.3; mean intensity of each symptom was >6 (1-10 scale). A quarter of the subjects could go for > or =2 days before experiencing withdrawal. More frequent smokers had a shorter latency to withdrawal (r=-0.43, p<0.001, n=36). In study 2, 63% of subthreshold smokers reported feeling at least one withdrawal symptom. Median latency to withdrawal was 168 h for subthreshold and 2 h for threshold smokers. A negative correlation between level of cigarette consumption and latency to withdrawal was observed for both groups.

Conclusions: Although subthreshold smokers experience significant withdrawal symptoms, they can smoke infrequently because symptoms may not appear for one to several days. Consistent with the sensitization-homeostasis theory, low doses of nicotine can suppress withdrawal symptoms over long periods.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Female
  • Health Surveys
  • Humans
  • Male
  • Middle Aged
  • Recurrence
  • Reproducibility of Results
  • Smoking / epidemiology
  • Smoking / psychology*
  • Smoking Cessation / statistics & numerical data
  • Substance Withdrawal Syndrome / diagnosis
  • Substance Withdrawal Syndrome / epidemiology
  • Substance Withdrawal Syndrome / parasitology*
  • Surveys and Questionnaires / standards
  • Time Factors
  • Tobacco Use Disorder / diagnosis
  • Tobacco Use Disorder / epidemiology
  • Tobacco Use Disorder / psychology
  • United States / epidemiology