An acute dose of nicotine enhances cue-induced cocaine craving

Drug Alcohol Depend. 1998 Jan 1;49(2):95-104. doi: 10.1016/s0376-8716(97)00144-0.


The present study examined whether the active component in tobacco, nicotine, can modulate cocaine craving in patients with a history of smoking crack cocaine when exposed to crack cocaine related environmental cues. Twenty patients, all cigarette smokers, were randomly assigned to nicotine (two 22 mg transdermal patches) or placebo in a single-dose, placebo-controlled, crossover, double-blind study. Craving and anxiety were measured before and after cocaine cues with visual analog scales for desire to use cocaine and mood. Skin conductance and skin temperature were recorded before and during cocaine cues. Following exposure to cocaine cues, all patients reported an increase in cocaine craving and anxiety relative to the pre-cue measures. Cue exposure also produced an increase in skin conductance and decrease in skin temperature. The cue-induced increase in cocaine craving was strongly enhanced by nicotine, while the increase in anxiety was slightly augmented. Cue-induced skin conductance and temperature responses were unaffected by nicotine. These findings show that cue-induced cocaine craving is enhanced by nicotine. This occurred in the absence of any tobacco smoking-related cues, suggesting that nicotine may have direct psychopharmacological effects on conditioned cocaine craving.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Analysis of Variance
  • Anxiety / chemically induced
  • Anxiety / physiopathology
  • Behavior, Addictive / physiopathology
  • Cocaine-Related Disorders / complications
  • Cocaine-Related Disorders / physiopathology*
  • Cocaine-Related Disorders / psychology
  • Conditioning, Psychological / drug effects*
  • Crack Cocaine*
  • Cross-Over Studies
  • Cues*
  • Double-Blind Method
  • Drive
  • Female
  • Galvanic Skin Response / drug effects
  • Humans
  • Male
  • Middle Aged
  • Nicotine / pharmacology*
  • Nicotinic Agonists / pharmacology*
  • Skin Temperature / drug effects
  • Substance Withdrawal Syndrome / physiopathology
  • Substance Withdrawal Syndrome / psychology
  • Tobacco Use Disorder / complications*
  • Tobacco Use Disorder / physiopathology
  • Tobacco Use Disorder / psychology


  • Crack Cocaine
  • Nicotinic Agonists
  • Nicotine