Psychological and pharmacological influences in cigarette smoking withdrawal: Effects of nicotine gum and expectancy on smoking withdrawal symptoms and relapse

To determine the relative effects of expectancy and nicotine depletion on aversive withdrawal symp-toms, we gave 109 smokers attempting to quit either nicotine gum or placebo within a balanced placebo design and monitored their withdrawal symptoms and smoking for 2 weeks. Subjects who believed they were getting nicotine gum reported less physical symptoms of withdrawal, showed less arousal, and smoked fewer cigarettes during the first week of quitting when compared with those who thought they were receiving placebo gum. The actual nicotine content of gum had no effect on withdrawal or relapse. Smokers attempting to quit often experience withdrawal symptoms that begin within a few hours of quitting and may last from 2 to 4 weeks (Shiffman, 1979). Withdrawal is an im-portant phenomenon because many studies implicate it as a major factor in relapse (Cummings, Gordon, & Marlatt, 1980). The extent to which psychological and physiological factors contribute to withdrawal is poorly understood. Recent double-blind studies of nicotine gum have shown that subjects receivin