Severity of negative mood and anxiety symptoms occurring during acute abstinence from tobacco: A systematic review and meta-analysis

Abstract

This review was conducted with the following goals: To quantify the severity of mood and anxiety symptoms emerging during acute abstinence from tobacco (1). To explore sex differences related to the experience of specific symptoms (2). To investigate the early time course of symptoms (3).A meta-analysis was performed from 28 studies assessing mood and anxiety symptoms during the earliest phases of tobacco abstinence (up to 24hrs post-quit) conducted from 1999 to 2019. Results revealed a significant (p<0.0001) increase in 'anxiety', 'anger/irritability', 'depressed mood /sadness', and composite negative affect ('NA') in the 24 hours following smoking cessation. The largest effect size was detected for 'anxiety' (0.63). A qualitative analysis was performed to investigate sex differences and the time course of the specific symptoms. Results indicated that female smokers may experience worse mood symptoms compared to male smokers and that these symptoms may emerge within 3hrs post-quit. Smoking cessation programs should implement sex-tailored interventions in order to improve their effectiveness, while future research should focus on alternative methods of nicotine administration.

Nicotine and the nicotinic cholinergic system in COVID‐19

“…Indeed, therapeutic potentials for selective nicotinic receptor agonists in various neuropsychiatric and neurodegenerative disorders have been suggested. These include Parkinson's disease and Alzheimer's disease, schizophrenia, depression, pain, and smoking cessation [12][13][14][15]. The potential role of nicotinic receptors in high-order cognitive processing has been recently reviewed [16].…”

“…The established anti-inflammatory effects of nicotine, together with its capability to improve olfactory impairment in a mouse model of Parkinson's disease [74], provide further credence to its potential usefulness in COVID-19, as loss of smell is also a common symptom of COVID-19 [75]. Moreover, nicotine might counter some of the neurological effects of COVID-19, not only because of its anti-inflammatory, but also because of its neuroprotectant and mood improvement properties [13][14][15]. Indeed, it has been proposed that COVID-19 may be a disease of the cholinergic nicotinic system [76].…”

Acute nicotine abstinence amplifies subjective withdrawal symptoms and threat-evoked fear and anxiety, but not extended amygdala reactivity

“…Among them, there is abundant clinical, experience-sampling, and experimental work demonstrating that anxiety and negative reinforcement mechanisms-smoking to alleviate 'tension' and emotional distress-play a central role in nicotine dependence and relapse (Baker, Japuntich, Hogle, McCarthy, & Curtin, 2006;Baker, Piper, McCarthy, Majeskie, & Fiore, 2004;Fronk, Sant'Ana, Kaye, & Curtin, 2020;Koob, 2008Koob, , 2015Shiffman, 1984). Acute nicotine abstinence is associated with heightened negative emotions-with the strongest meta-analytic effects evident for anxiety (d=.63)and anxiety serves as a diagnostic criterion for nicotine withdrawal in DSM-5 (APA, 2022;Conti, Tolomeo, Steele, & Baldacchino, 2020;Hughes, 2007). Daily diary and ecological momentary assessment (EMA) studies paint a similar picture, showing that nicotine abstinence leads to pervasive increases in tonic anxiety and amplified reactivity to social conflict and other daily stressors (McCarthy, Piasecki, Fiore, & Baker, 2006;Shiffman, Paty, Gnys, Kassel, & Hickcox, 1996).…”

Novel Pharmacotherapies in Parkinson’s Disease

“…Indeed, a potential role of nAChRs in high-order cognitive processing has been suggested (Koukouli and Changeux 2020 ). Therapeutic potential for selective nAChR agonists in various neuropsychiatric and neurodegenerative disorders including PD (Quik et al 2019 ; Tizabi et al 2019 ; Liu 2020 ), depression (Gandelman et al 2018 ; Tizabi et al 2019 ; Conti et al 2020 ), mild cognitive impairment or Alzheimer’s disease (Vega et al 2019 ; Azimi et al 2020 ; Hahn et al 2020 ; Koukouli and Changeux 2020 ), ischemia (Han et al 2020b ), schizophrenia (Terry and Callahan, 2020 ), pain (Bagdas et al 2018 ), as well as energy balance (Seoane-Collazo et al 2021 ) have been proposed. Given that there is a relatively high comorbid existence between depression and PD, a nicotinic intervention may have the added advantage of addressing both issues at the same time (Tizabi et al 2019 ).…”