This study investigates the clinical significance of a cannabis withdrawal syndrome in 104 adult, non-treatment-seeking, primarily cannabis users who reported at least one serious attempt to stop using cannabis. Retrospective self-report data were obtained on eighteen potential cannabis withdrawal symptoms derived from the literature, including co-occurrence, time course, and any actions taken to relieve the symptom. Study findings provide evidence for the clinical significance of a cannabis withdrawal syndrome, based on the high prevalence and co-occurrence of multiple symptoms that follow a consistent time course and that prompt action by the subjects to obtain relief, including serving as negative reinforcement for cannabis use.
Gender differences in tobacco withdrawal are of considerable clinical importance, but research findings on this topic have been mixed. Methodological variation in samples sizes, experimental design, and measures across studies may explain the inconsistent results. The current study examined whether male (n = 101) and female (n = 102) smokers (≥15 cigarettes/day) differed in abstinenceinduced changes on a battery of self-report measures (withdrawal, affect, craving), cognitive performance tasks (attention, psychomotor performance), and physiological responses (heart rate, blood pressure, brain electroencephalogram). Participants attended 2 counterbalanced laboratory sessions, 1 following 12 hr of abstinence and the other following ad libitum smoking. Results showed that women reported greater abstinence-induced increases in negative affect, withdrawal-related distress, and urge to smoke to relieve withdrawal distress. In contrast, both genders reported similar abstinence-induced changes in positive affect and urge to smoke for pleasure. Men and women exhibited generally similar abstinence-induced changes in physiological and cognitive performance measures. In addition, gender did not moderate the association between withdrawal symptoms and baseline measures of smoking behavior and dependence. Abstinence-induced changes in withdrawal distress mediated the effect of gender on latency until the 1st cigarette of the day at trend levels (p < .10). These findings suggest that there are qualitative gender differences in the acute tobacco withdrawal syndrome that may underlie gender-specific smoking patterns. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptResearch suggests that women are less likely than men to successfully quit smoking. Recent meta-analyses of smoking cessation trials showed lower abstinence rates for women than men, regardless of whether individuals received group or individual counseling (Wetter, Kenford, et al., 1999), nicotine replacement therapy (Cepeda-Benito, Reynoso, & Erath, 2004;Wetter, Kenford, et al., 1999) or placebo nicotine patch (Wetter, Kenford, et al., 1999), or bupropion sustained release or placebo (Collins et al., 2004;Scharf & Shiffman, 2004). Although there is debate over whether women's quit rates are lower than men's at the population level (Gritz, Nielsen, & Brooks, 1996) or whether differences are large enough to be clinically significant (Killen, Fortmann, Varady, & Kraemer, 2002), it is important to identify gender-specific processes underlying tobacco addiction so that interventions can be tailored to gender.In recent years, researchers have investigated several variables that might differentially impact smoking behavior in men and women. These include attitudes toward cessation (Etter, Prokhorov, & Perneger, 2002), concerns about weight gain (Borrelli, Spring, Niaura, Hitsman, & Papandonatos, 2001), depressive and anxious symptomatology (Borrelli, Bock, King, & Pinto, 1996), nicotine reinforcement (Perkins, Donny, & Caggiula, 1999), mens...
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