Reasons for smoking and severity of residual nicotine withdrawal symptoms when using nicotine chewing gum

Prior to smoking cessation treatment using nicotine chewing gum, 65 smokers completed the Horn Reasons for Smoking Test, the Fagerstrom Tolerance Questionnaire and were assessed on measures of smoking history including saliva cotinine concentration. These measures were used to predict severity of residual nicotine withdrawal symptoms and urges to smoke assessed on a daily basis during the first 2 weeks of attempted abstinence. Univariate analyses indicated that smoking for reasons of handling, craving and to cope with negative affect correlated positively with both residual withdrawal symptoms and urges during the first week. Smoking for reasons of stimulation and habit were also correlated positively with residual withdrawal, and smoking for pleasure correlated with urges to smoke. After controlling for concurrent level of nicotine gum use, analyses suggested that only smoking for reasons of stimulation predicted residual withdrawal. Urges to smoke were positively related to level of smoking during treatment and also to smoking for reasons of craving and handling. Thus, it appears that individual differences in reasons for smoking influence severity of residual nicotine withdrawal symptoms and urges to smoke while chewing nicotine gum. The findings for stimulation smoking and withdrawal are discussed in terms of the reinforcing properties of nicotine with different routes of administration.