Effects of nicotine on attention and inhibitory control in healthy nonsmokers.

Nicotine improves cognitive functioning in smokers and psychiatric populations, but its cognitive-enhancing effects in healthy nonsmokers are less well understood. Nicotine appears to enhance certain forms of cognition in nonsmokers, but its specificity to subtypes of cognition is not known. This study sought to replicate and extend previous findings on the effects of nicotine on cognitive performance in healthy nonsmokers. Healthy young adults (N = 40, 50% women) participated in a placebo-controlled, double-blind, repeated measures experiment examining the effects of 7 mg transdermal nicotine or placebo. Participants completed tests of attention (Attention Network Test), behavioral inhibition (stop signal task, Stroop test), reward responsiveness (signal detection task), and risk-taking behavior (Balloon Analogue Risk Task). Physiological (heart rate, blood pressure) and subjective (Profile of Mood States, Drug Effects Questionnaire) measures were also obtained. Nicotine significantly improved performance only on the Stroop test, but it impaired performance on one aspect of the Attention Network Test, the orienting effect. Nicotine produced its expected effects on physiologic and subjective measures within the intended time course. The findings of this study contribute to a growing literature indicating that nicotine differentially affects specific subtypes of cognitive performance in healthy nonsmokers. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Nicotine reduces the frequency of anger reports in smokers and nonsmokers with high but not low hostility: An ambulatory study.

Two studies were conducted to determine the anger-attenuating effects of nicotine as a function of trait hostility. The 1st study examined the effects of nicotine on diary ratings of anger during a 24-hr period in a natural setting in 30 smokers and 30 nonsmokers. Participants took part in 2 monitoring sessions involving the administration of a nicotine patch and a placebo patch. Participants were categorized as high or low on trait hostility on the basis of their scores on the Cook-Medley Hostility scale. Administration of the nicotine patch, compared with the placebo patch, resulted in a significant reduction in diary reports of anger from 24% to 13% in high-hostile participants. In low-hostile participants, nicotine had no effect on reports of anger during the day. The anger-palliative effects of nicotine were greatest among participants more frequently reporting anger on the placebo-patch day. These effects were independent of smoking status and gender. The 2nd study, which was restricted to high-hostile smokers (n?=?19) and nonsmokers (n?=?23), found that, compared with a placebo patch, administration of nicotine resulted in significant reductions in reports of anger in smokers and nonsmokers. The results of these 2 studies clearly link nicotine to reduced reports of anger in high-hostile individuals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Quitting chew: Results from a randomized trial using nicotine patches.

The authors examined the efficacy of transdermal nicotine replacement for cessation in 410 adult nonsmoking chewing tobacco users. Participants were randomly assigned to 6 weeks of 15-mg nicotine patch plus behavioral treatment or placebo patch plus behavioral treatment. All participants received the same behavioral treatment of 2 pharmacy visits, 2 support calls, and self-help materials. At 6 months after treatment, biochemically confirmed point-prevalence rates (no chewing in the last 7 days) in the active (38%) and placebo (34%) groups were high and not significantly different. The difference in relapse (no chewing for 7 consecutive days) between the active patch group (33%) and placebo group (48%) was significant at 6 months (p?=?.003). Nicotine dependence and age predicted nonrelapse at 6 months. The results suggest that nicotine replacement may improve chewers' chances of abstinence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of transdermal nicotine on symptoms, moods, and cardiovascular activity in the everyday lives of smokers and nonsmokers with attention-deficit/hyperactivity disorder.

The aim of the study was to test the self-medication hypothesis by examining the effects of nicotine in the everyday lives of smokers and nonsmokers with attention-deficit/hyperactivity disorder (ADHD). Fifty-two adults with ADHD (25 abstinent smokers and 27 nonsmokers) participated in a double-blind placebo controlled study with one nicotine patch condition and one placebo patch condition in counterbalanced order. Each condition continued for two consecutive days in which patches were administered each morning. The effects of nicotine on ADHD symptoms, moods, and side effects were assessed with electronic diaries. Cardiovascular activity was recorded with ambulatory blood pressure monitors and physical activity was monitored with actigraphs. Nicotine reduced reports of ADHD symptoms by 8% and negative moods by 9%, independent of smoking status. In addition, nicotine increased cardiovascular activity during the first 3 to 6 hours after nicotine patch administration. The results support the self-medication hypothesis for nicotine in adults with ADHD and suggest that smoking cessation and prevention efforts for individuals with ADHD will need to address both the symptom reducing and mood enhancing effects of nicotine. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Greater sensitivity to subjective effects of nicotine in nonsmokers high in sensation seeking.

The personality characteristic of sensation seeking is associated with risk of smoking, perhaps because of greater initial sensitivity to nicotine. Young healthy nonsmokers (N?=?37) were administered 0, 10, and 20 μg/kg nicotine by nasal spray in 3 separate sessions, and subjective responses were assessed. Sensation-Seeking Scale (SSS) scores were then correlated with these responses. A comparison group of smokers (N?=?55) was included to determine whether sensation seeking was associated specifically with initial sensitivity to nicotine or with general sensitivity regardless of past nicotine exposure. SSS subscales, particularly Experience Seeking and Disinhibition, were correlated with subjective responses to nicotine in nonsmokers but generally not in smokers. These findings indicate that sensation seeking is associated with greater initial sensitivity to nicotine's subjective effects and may provide directions for further study of individual-differences characteristics that predispose people to the risk of becoming smokers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of transdermal nicotine patches on abstinence-induced and cue-elicited craving in cigarette smokers.

The impact of a transdermal nicotine patch on smokers' craving for cigarettes and reactivity to smoking cues was investigated. Sixty-one smokers were assessed during 2 sessions separated by 6 hr. Cue reactivity to imaginal and in vivo smoking and nonsmoking stimuli was evaluated during both sessions. During the interval between sessions, participants were abstinent from cigarettes and wore either a nicotine transdermal (21 mg) or placebo patch. In both sessions, exposure to in vivo and imaginal smoking stimuli elicited cue-specific increases in craving, negative affect, vividness, heart rate, and skin conductance. The nicotine patch attenuated craving and other effects induced by abstinence from cigarettes but had no selective impact on craving or any other reaction elicited by smoking cues. These results are discussed in terms of models of craving and clinical implications of transdermal nicotine for craving reduction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Do desirability ratings moderate the validity of probability ratings on the Smoking Consequences Questionnaire.

Smokers' responses to the Smoking Consequences Questionnaire--Adult (A. L. Copeland, T. H. Brandon, and E. P. Quinn, 1995) were used to determine whether smoking outcome expectancies are moderated by subjective evaluations (desirability ratings) in their effect on smoking-related variables. Hierarchical regression in a reanalysis of data from A. L. Copeland et al indicated that the product of probability and desirability ratings accounted for a significant amount of variance in smoking rate, nicotine dependence, saliva cotinine, and posttreatment smoking status above that accounted for by probability and desirability ratings alone. Results indicate that desirability ratings serve as moderators to probability ratings in explaining current smoking, nicotine dependence, and continued smoking. Effects were modest in magnitude but suggest that it may be important to address subjective evaluations of outcomes in smoking cessation and relapse prevention efforts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Do adolescent smokers experience withdrawal effects when deprived of nicotine?

This is the first controlled prospective study of the effects of nicotine deprivation in adolescent smokers. Heart rate and subjective withdrawal symptoms were measured over and 8-hr period while participants smoked normally. Seven days later, participants were randomized to wear a 15-mg (16-hr) nicotine patch or placebo patch for 8 hr, and they refrained from smoking during the session. Those wearing the placebo experienced a decrease in heart rate across sessions and an increase in subjective measures of nicotine withdrawal. Those wearing the active patch also reported significant increases for some subjective symptoms. Expectancy effects were also observed. The findings indicate that adolescent smokers experience subjective and objective changes when deprived of nicotine. As in previous research with adults, expectancies concerning the effects of nicotine replacement also influenced perceptions of withdrawal. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effect of transdermal nicotine on digital perfusion in reformed habitual smokers

The effects of transdermal nicotine-assisted smoking cessation on digital perfusion and health-related quality of life were assessed in 10 chronic smokers. Components of digital blood flow were evaluated by digital temperature and laser Doppler fluxmetry before, during, and after a standardized cold challenge. Nutritional flow was measured by vital capillaroscopy; a quantitative perfusion profile was obtained by laser Doppler perfusion imaging. A battery of validated measures were used to evaluate health-related quality of life. The microvascular response of smokers was evaluated before smoking cessation and at 2 and 7 days after smoking cessation and was compared with the response of nonsmoking controls. Results demonstrated that a (1) cutaneous microvascular perfusion was lower in smokers than nonsmokers, (2) the acute administration of transdermal nicotine did not decrease cutaneous perfusion, (3) smoking cessation and transdermal nicotine normalized digital microvascular perfusion by 7 days, and (4) transdermal nicotine and smoking cessation did not negatively impact health-related quality of life.     

Examination of predictors and moderators for self-help treatments of binge-eating disorder.

Predictors and moderators of outcomes were examined in 75 overweight patients with binge-eating disorder (BED) who participated in a randomized clinical trial of guided self-help treatments. Age variables, psychiatric and personality disorder comorbidity, and clinical characteristics were tested as predictors and moderators of treatment outcomes. Current age and age of BED onset did not predict outcomes. Key dimensional outcomes (binge frequency, eating psychopathology, and negative affect) were predominately predicted, but not moderated, by their respective pretreatment levels. Presence of personality disorders, particularly Cluster C, predicted both posttreatment negative affect and eating disorder psychopathology. Negative affect, but not major depressive disorder, predicted attrition, posttreatment negative affect, and eating disorder psychopathology. Despite the prognostic significance of these findings for dimensional outcomes, none of the variables tested were predictive of binge remission (i.e., a categorical outcome). No moderator effects were found. The present study found poorer prognosis for patients with negative affect and personality disorders, suggesting that treatment outcomes may be enhanced by attending to the cognitive and personality styles of these patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Acute effects of a glucose energy drink on behavioral control.

There has been a dramatic rise in the consumption of glucose energy drinks (e.g., Amp, Monster, and Red Bull) in the past decade, particularly among high school and college students. However, little laboratory research has examined the acute objective and subjective effects of energy drinks. The purpose of this study was to investigate the acute effects of a glucose energy drink (Red Bull) on cognitive functioning. Participants (N = 80) were randomly assigned to one of five conditions: 1.8 ml/kg energy drink, 3.6 ml/kg energy drink, 5.4 ml/kg energy drink, placebo beverage, or no drink. Participants completed a well-validated behavioral control task (the cued go/no-go task) and subjective measures of stimulation, sedation, and mental fatigue both before and 30 minutes following beverage administration. The results indicated that compared with the placebo and no drink conditions, the energy drink doses decreased reaction times on the behavioral control task, increased subjective ratings of stimulation and decreased ratings of mental fatigue. Greatest improvements in reaction times and subjective measures were observed with the lowest dose and improvements diminished as the dose increased. The findings suggest that energy drink consumption can improve cognitive performance on a behavioral control task, potentially explaining the dramatic rise in popularity of these controversial new beverages. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emotional stimuli and context moderate effects of nicotine on specific but not global affects.

The authors tested the hypothesis that the effects of nicotine on affect are moderated by the presence or absence of emotionally positive and negative stimuli and by attentional choice to avoid attending to emotionally negative stimuli. Thirty-two habitual smokers were assigned to tasks allowing attentional freedom to look back and forth at 2 simultaneously presented pictures, whereas another 32 habitual smokers viewed single pictures without attentional choice. Picture contents in both tasks were 1 of 4 combinations: emotionally negative + neutral, negative + positive, positive + neutral, or neutral + neutral. Participants wore a nicotine patch on 1 day and placebo patch on another day. Nicotine reduced anxiety most when negative pictures were presented in combination with neutral pictures, but it had no effect on anxiety when negative pictures were presented in combination with positive pictures and when negative pictures were not presented. In contrast, nicotine only reduced depressive affect when the participant had attentional choice between positive and negative pictures. Nicotine also enhanced positive affect and reduced negative affect as measured by the Positive and Negative Affect Schedule, but these effects were not moderated by task manipulations. Overall, the findings support the view that nicotine's ability to reduce specific negative affects is moderated by emotional context and attentional freedom. Nicotine tended to enhance eye-gaze orientation to emotional pictures versus neutral pictures in women, but it had no significant effect on eye-gaze in men. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The acute effects of nicotine on positive and negative affect in adolescent smokers.

Although adolescent cigarette smoking remains a critical public health concern, little is known about the reinforcing mechanisms governing smoking in this vulnerable population. To assess predictions derived from both positive and negative reinforcement models of drug use, the authors measured the acute effects of nicotine, as administered via tobacco cigarettes, on both positive and negative affect in a group of 15- to 18-year-old smokers. A matched group of nonsmokers served as a comparison group. Findings revealed that whereas adolescents who smoked a cigarette experienced reductions in both positive and negative affect, the observed reductions in negative affect were moderated by nicotine content of the cigarette (high yield vs. denicotinized), level of nicotine dependence, level of baseline craving, and smoking expectancies pertinent to negative affect regulation. Nonsmokers experienced no change in affect over the 10-min assessment period, and no interaction effects were observed for positive affect. Overall, the findings conform to a negative reinforcement model of nicotine effects and strongly suggest that, even among young light smokers, nicotine dependence and resultant withdrawal symptomatology may serve as motivating factors governing smoking behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effect of nicotine and attention allocation on physiological and self-report measures of induced anxiety in PTSD: A double-blind placebo-controlled trial.

Rates of smoking among populations with psychiatric disorders are more than twice as high as among the general population, yet there are few controlled studies of the mechanisms of this relationship. This trial examined the effect of nicotine by way of cigarette smoking on both self-report and autonomic parameters of anxiety among individuals with PTSD who were also heavy smokers. Half of the participants were randomized to an anxiety-eliciting condition, whereas the other half were assigned to a condition of neutral emotional content. Within each of these conditions, participants were randomized into a nicotine condition (high-yield nicotine cigarette) or a placebo condition (denicotinized cigarette). The final layer of randomization involved assigning participants to either an attention-demanding task or a no task condition. We examined the interactive effects of nicotine and attentional demand on parameters of anxious responding. Nicotine exerted an anxiolytic effect relative to placebo on self-report measures; however, nicotine did not interact with attentional demand in producing this effect. In contrast to the findings on the self-report measures of distress, nicotine enhanced autonomic reactivity to trauma cues, thereby suggesting a decoupling of self-reported anxiety and autonomic arousal associated with responding to trauma-relevant cues. The implications for understanding smoking and psychiatric comorbidity are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Testing the influence of external and internal cues on smoking motivation using a community sample.

Exposing smokers to either external cues (e.g., pictures of cigarettes) or internal cues (e.g., negative affect induction) can induce urge to smoke and other behavioral and physiological responses. However, little is known about whether the two types of cues interact when presented in close proximity, as is likely the case in the real word. Additionally, potential moderators of cue reactivity have rarely been examined. Finally, few cue-reactivity studies have used representative samples of smokers. In a randomized 2 × 2 crossed factorial between-subjects design, the current study tested the effects of a negative affect cue intended to produce anxiety (speech preparation task) and an external smoking cue on urge and behavioral reactivity in a community sample of adult smokers (N = 175), and whether trait impulsivity moderated the effects. Both types of cues produced main effects on urges to smoke, despite the speech task failing to increase anxiety significantly. The speech task increased smoking urge related to anticipation of negative affect relief, whereas the external smoking cues increased urges related to anticipation of pleasure; however, the cues did not interact. Impulsivity measures predicted urge and other smoking-related variables, but did not moderate cue-reactivity. Results suggest independent rather than synergistic effects of these contributors to smoking motivation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Responses to an in-basket activity: the role of work stress, behavioral control, and informational control

This study was undertaken to examine the main and interactive effects of work stress and work control on levels of adjustment. Work stress, behavioral control, and informational control were manipulated in an experimental setting in which participants (N = 192) completed an in-basket activity. Although minimal support was found for the main and interactive effects of objective work stress, behavioral control, and informational control on adjustment, analyses involving the subjective measures of these variables revealed strong support for the proposal that work stress, behavioral control, and informational control would exert main effects on adjustment. There was also evidence that subjective levels of behavioral control buffered the negative effects of subjective work stress on positive mood, subjective task performance, and task satisfaction.     

Naltrexone alteration of the nicotine-induced EEG and mood activation response in tobacco-deprived cigarette smokers.

The neural mechanisms contributing to the arousal-eliciting actions of smoking and nicotine involve multiple neurotransmitter systems. The current study examined the role of opioid neurotransmission in modulating the neuroelectric- and mood-activating response to acute nicotine administration in overnight tobacco-deprived smokers. In a randomized, double-blind, placebo-controlled design involving 18 (10 male, 8 female) overnight tobacco-abstinent smokers, spectrally analyzed electroencephalographic (EEG) activity and subjective reports of mood, euphoria, and smoking withdrawal were assessed in response to nicotine gum (4 mg) after pretreatment with placebo or with 50 mg of the opioid antagonist naltrexone. In addition to reducing withdrawal symptoms and increasing euphoria ratings, as well as subjective alertness in male participants, nicotine induced an EEG arousal response consisting of diffuse slow wave (delta, theta) amplitude reductions, frontal fast alpha wave amplitude increments, and elevations in beta wave amplitude, which were greater in female than in male smokers. Naltrexone attenuated the alerting and euphoric actions of nicotine but did not affect nicotine's ameliorating effects on withdrawal symptoms. Nicotine-induced frontal reductions in delta and global reductions in theta were prevented by naltrexone pretreatment, as were increases in anterior recordings of relative fast alpha. These findings suggest that the opioid system is involved in nicotine-induced subjective and neuroelectric arousal and implicate opioid-cholinergic interactions in the elicitation of these arousal responses to nicotine. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pharmacokinetics of nicotine carbomer enemas: a new treatment modality for ulcerative colitis

BACKGROUND: Ulcerative colitis is largely a disease of nonsmokers, and transdermal nicotine is of therapeutic value in the active disease. Because side effects are common, we developed a topical enema formulation of nicotine. OBJECTIVE: To study the pharmacokinetics of nicotine complexed with a polyacrylic carbomer and administered by enema to eight healthy volunteers and to eight patients with active ulcerative colitis, verified sigmoidoscopically. PATIENTS AND METHODS: All 16 subjects were nonsmokers. The mean age for normal subjects was 33 years; the mean for patients with ulcerative colitis was 60 years. Median stool frequency for patients with ulcerative colitis was four daily. Patients were taking 5-amino salicylic acid compounds and five were taking oral prednisolone (median dose, 12 mg daily). Nicotine, 6 mg, complexed with carbomer 974P, 400 mg, was administered in a 100 ml enema after an overnight fast, with serial blood measurements taken over 8 hours. Serum nicotine and cotinine were measured by gas liquid chromatography. Area under the concentration-time curves were calculated by the trapezoidal method, and the terminal elimination half-life was derived by extrapolation of the log-linear terminal phase. RESULTS: With the exception of nicotine time to reach peak concentration, which was longer in patients (median of 60 minutes compared with 45 minutes; p < 0.005), other comparisons between normal subjects and patients showed no statistically significant difference, although there was considerable inter-subject variation. Maximum concentration of nicotine, 8.1 +/- 3.5 ng/ml, in the 16 subjects occurred after a median of 60 minutes (range, 30 to 180 minutes); maximum cotinine concentrations of 60.4 +/- 11.5 ng/ml occurred after 4 hours. Side effects in five subjects were mild (four subjects) or moderate (one subject) and included lightheadedness, nausea, and headache; these five subjects were female lifelong nonsmokers of low body weight. CONCLUSION: Because most of the active ingredient of nicotine is converted to continine on the first pass through the liver, substantial concentrations can be achieved at the site of disease with only modest rises in serum nicotine, which are responsible for side effects; cotinine has low pharmacologic activity. Topical administration of nicotine may be useful treatment for distal ulcerative colitis.     

Combined effects of venlafaxine, nicotine replacement, and brief counseling on smoking cessation.

In this study, 147 smokers were randomly assigned to receive either venlafaxine or placebo in conjunction with behavioral counseling (9 weekly sessions) and transdermal nicotine replacement therapy (22 mg/day). Patients began medication 2 weeks before quitting and continued for 18 weeks after quitting, with the daily dose titrated from 150 to 225 mg. in response to symptoms of negative affect and relapse. The results showed no main effect of treatment on abstinence. Post hoc analysis revealed that both at the end of treatment and at the 1-year follow-up smokers consuming less than a pack of cigarettes a day benefited from the addition of venlafaxine to the treatment regimen. Venlafaxine also reduced negative affect for all smokers for up to 6 weeks postcessation. The findings suggest that venlafaxine could have some role to play in the treatment of lighter smokers, in addition to the expected benefits of nicotine replacement therapy and behavioral counseling. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neurotransmission-related genetic polymorphisms, negative affectivity traits, and gender predict tobacco abstinence symptoms across 44 days with and without nicotine patch.

Genetic and personality trait moderators of tobacco abstinence–symptom trajectories were assessed in a highly controlled study. Based on evidence suggesting their importance in stress reactivity and smoking, moderators studied were serotonin transporter gene (5-HTTLPR) and dopamine D2 receptor gene (DRD2) polymorphisms and personality traits related to negative affect (NA). Smokers were randomly assigned to quit smoking with nicotine or placebo patches. Financial incentives resulted in 80% verified abstinence across the 44-day study. Individuals with 1 or 2 short alleles of 5-HTTLPR (S carriers) experienced larger increases in NA symptoms than did those without a short allele. Nicotine replacement therapy (NRT) alleviated anxiety only in S carriers. NRT reduced NA to a greater extent in DRD2 A1 carriers than in A2A2 individuals during the 1st 2 weeks of treatment (when on the 21-mg patch); however, A1 carriers experienced a renewal of NA symptoms when switched to the 7-mg patch and when off the patch, while A2A2 individuals continued to benefit from NRT. The results suggest that the effects of genotype and treatment may vary across different durations of abstinence, treatment doses, and genotypes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)