VANCOUVER, B.C. – Women appear to experience a 2- to 5-day period of heightened withdrawal and craving symptoms just prior to smoking relapse, offering what could be a golden opportunity for intervention, researchers reported at the annual meeting of the North American Primary Care Research Group.
The finding was a serendipitous discovery from a larger trial investigating associations between the menstrual cycle and smoking withdrawal, explained Dr. Bruce A. Center of the department of family practice and community health at the University of Minnesota, Minneapolis.
Participants included 137 female smokers aged 18–40 years who completed an intensive, month-long study as part of a larger, longitudinal smoking cessation trial sponsored by the National Institutes of Health. At baseline and for 30 days following an assigned quit date, they completed daily logs of specific symptoms of withdrawal, nicotine craving, and smoking urges, as well as negative affect.
Despite education, phone counseling, and monitoring, 111 enrollees relapsed over the course of the study.
The intensity of craving, withdrawal, and smoking urges rose quite precipitously during the 2–5 days prior to relapse, when it peaked. All of the symptoms declined after relapse occurred.
“Frankly, I didn't think there would be a window [of symptom escalation], or if there was, it would be 15 minutes,” Dr. Center said. The next step will be to design and test an intervention that educates women in how to recognize and monitor their symptoms and take steps to prevent relapse once they recognize an escalation.
More work will be necessary to determine the most effective tools for staving off relapse when an uptick in symptoms is recognized, Dr. Center said.