Chapter 8 
The duration of the nicotine withdrawal syndrome varies across 
individuals, but on average, the acute physical syndrome is worst during 
the first month. Gross and Stitzer (1989) studied the time course of the 
nicotine withdrawal syndrome in detail. In their study, people quit smoking 
and received either active or placebo nicotine gum. People who received 
active gum chewed an average of 6.9 pieces of 2 mg gum per day, which 
provided less nicotine than they were obtaining by smoking cigarettes. 
People given placebo gum gradually decreased their intake from 6.8 pieces 
per day during the first week of treatment to 4.9 pieces per day by the 
10th week. The nicotine gum substantially reduced withdrawal symptom 
severity relative to that observed in placebo subjects. 
Nicotine's Nicotine provides many effects that cigarette smokers may consider useful. 
Beneficial These include weight control, mood control, and preventing withdrawal 
Effects symptoms (U.S. Department of Health and Human Services, 1988). The 
issue of whether nicotine would provide substantial cognitive enhancement 
in healthy persons who had never been nicotine dependent is controversial. 
In nonsmokers, nicotine administration can increase finger-tapping rate 
and slightly (but significantly in some studies) attenuate the deterioration 
in attention that occurs during protracted testing (Heishman et al., 1994). 
However, complex cognitive performance may be impaired by nicotine in 
cigarette smokers as well as nonsmokers (Heishman et al., 1994). On the 
other hand, there is no question that nicotine intake restores withdrawal- 
induced deficits (Snyder and Henningfield, 1989). Nicotine intake also may 
provide some level of cognitive enhancement in persons who are cognitively 
impaired by Alzheimer's disease (Heishman et al., 1994; Sahakian et al., 1989; 
Newhouse and Hughes, 1991). 
One of the Brown and Williamson Tobacco Corporation (B&W) 
documents made available for the National Cancer Institute conference on 
the FTC cigarette test method also supported the conclusion that nicotine's 
central nervous system effects contribute to the strong motivation to use 
tobacco products. The document concluded that 
to understand smoking, just as any other behavior, it is necessary 
to consider it as a process embedded within everyday life .... It 
is apparent that nicotine largely underpins these contributions 
through its role as a generator of central physiological arousal 
effects which express themselves as changes in human 
performance and psychological well being. (Brown and 
Williamson, 1984) 
SMOKING AND Nicotine dosage is an important factor in smoking behavior. 
NICOTINE DOSE Currently available cigarettes allow people to fairly easily administer 
the nicotine dose they need or desire (Henningfield et al., 1994). This was 
true of a low-content cigarette, NEXT, that was marketed a few years ago and 
removed from the market following poor sales, even though taste and draw 
characteristics were similar to conventional cigarettes. With that cigarette, 
the nicotine content was so low that no amount of compensatory puffing 
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