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Hypothesizing the existence of a subgroup of female smokers for whom nicotine masks, and abstinence unmasks, a tendency toward hyperphagia and perhaps even subthreshold disordered eating, we compared female “weight-control smokers” (WC; n = 46) and “non-weight-control smokers” (NWC; n = 52) on smoking- and eating-related variables. We also examined the relationship between weight-control smoking and withdrawal symptomatology during 48hours of nicotine abstinence (n = 23). Although WC were not more depressed, anxious, or nicotine-dependent than NWC, they were significantly more likely to report weight gain and increased hunger during abstinence; they also scored higher on Cognitive Restraint and Disinhibition (Three-Factor Eating Questionnaire). The expected correlation of cotinine with weight emerged for NWC but not for WC. Weight-control smoking correlated with increased eating during abstinence. Our findings suggest that WC use dietary restraint as well as smoking to manage weight, and that abstinence may precipitate episodes of disinhibited or binge eating. If WC overinclude women vulnerable to excess or unpredictable eating and consequently to substantial weight gain that can be managed by nicotine, highly focused’treatment strategies may be helpful. The peculiar and fascinating combination of pharmacological and sociocultural factors involved in weight-control smoking has generated considerable research over the past few years. Despite these efforts, however, attempts to determine the net impact of weight-control smoking on treatment efficacy, both in terms of attracting such smokers to treatment and achieving sustained abstinence, have produced a somewhat confusing picture. In the current climate of interest in treatment matching, a question no less appropriate than that of whether weightcontrol smoking is likely to deter cessation efforts or promote relapse is that of whether treatment success rates for people motivated to smoke by nicotine’s anorectic properties can be improved upon; an answer to that question will

The Tridimensional Personality Questionnaire (TPQ) was developed by Cloninger (1986) to measure heritable variation in three patterns of response to environmental stimuli: novelty seeking, harm avoidance, and reward dependence. Cloninger (1987) used the TPQ to identify two types of alcoholism: Type 1 (low novelty seeking, high harm avoidance and reward dependence; both male and female) and Type 2 (high novelty seeking, low harm avoidance and reward dependence; predominantly male). To determine whether characteristic patterns exist in smokers, we administered the TPQ to 119 female and 121 male smokers, along with the Fagerstrom Tolerance Questionnaire (FTQ, a measure of nicotine dependence), the Russell Motives for Smoking Questionnaire (RMSQ), and the Spielberger State-Trait Anxiety Inventory (STAI/trait). Compared with a normative sample, our sample exhibited elevated scores on the Novelty-Seeking scale; female smokers were somewhat overrepresented in the highest quartile of the Harm-Avoidance scale; both genders tended to be clustered in the lower quartiles of the Sentimentality-Attachment-Dependence subscale of the Reward-Dependence scale and in the highest quartile of the Persistence subscale. Female smokers showed a significant positive association between Harm Avoidance and FTQ scores, and Harm Avoidance was positively correlated with several RMSQ factors (including Additive smoking) in both genders. These findings suggest that the likelihood of becoming a smoker may be a function of novelty seeking and reward dependence, whereas degree of dependence or addiction once the habit is entrained may be linked to harm avoidance. Our observations establish the potential utility of the TPQ as a tool for examining environmental and heritable variation in smoking behavior and may contribute to improved strategies for prevention and treatment of smoking.

Tridimensional Personality Questionnaire (TPQ) scores are compared for three groups of adults: (a) current smokers with Attention Deficit Hyperactivity Disorder (ADHDSmk, n = 14); (b) current smokers without ADHD (NonADHDSmk, n = 21); and (c) ADHD never smokers (ADHDNevSmk, n = 17). The ADHDSmk participants started smoking at a significantly younger age than NonADHDSmk participants. On the TPQ Novelty Seeking (NS) scale, all groups scored more than a standard deviation above the norm, and ADHDSmk participants scored significantly higher than NonADHDSmk participants. The earlier onset of smoking in ADHD adults suggests that smoking prevention efforts may be particularly important for ADHD children. Previous studies have reported that both smokers and ADHD patients have elevated NS scores; this study suggests an additive effect for smokers with ADHD. This exaggerated tendency towards thrill seeking in ADHDSmk participants may complicate smoking-cessation treatment in this population, because the health consequences of smoking may be of less concern to ADHD smokers.

Previous work has shown that adolescent hyperactivity patients are significantly more likely to smoke than controls. To determine whether this pattern persists in adults, we studied a series of 71 patients (55 males, 16 females; mean age +/- SD: 33.9 +/- 11.4 years) diagnosed with ADHD. Of the males, 23 (42%) were current smokers, 7 (13%) were ex-smokers, and 25 (45%) were never smokers. Comparable figures for males in the general population in 1991, unselected for ADHD, were 28.1%, 29.1%, and 42.1%, respectively. Of the females, 6 (38%) were current smokers, 5 (31%) were ex-smokers, and 5 (31%) had never smoked, as compared with 23.5%, 19.0%, and 57.6%, respectively, in the general population. Quit ratio (percentage of ever-smokers who were ex-smokers) was 29% for ADHD patients, compared with 48.5% in the general population. The discrepancy was accounted for by the males, whose quit ratio was 23%, compared with 51.6% in the general population; the figure for ADHD females (45%) was similar to that in the general population (44.7%). Smokers recalled experiencing a significantly higher number of ADHD symptoms (11.5 +/- 1.7) as children than never smokers (9.9 +/- 2.3; p.01) and scored significantly higher on several indices of childhood and adult comorbidity. Our findings suggest that ADHD patients overinclude smokers, and that these smokers find it extremely difficult to quit. For ADHD smokers, smoking may have begun as an attempt to manage deficits in attention and concentration, as suggested by greater childhood symptomatology in these patients.

To determine whether cigarette smoking and other drug use are affected by menstrual phase, daily diaries rating menstrual symptomatology, smoking, and alcohol and caffeine intake in female smokers were examined. Women with premenstrual symptomatology were excluded. Menstrual symptomatology peaked during menses and was accounted for primarily by symptoms indicative of physical discomfort. Smoking did not differ as a function of menstrual phase, nor did there emerge any systematic intrasubject correlation between symptomatology and smoking. Alcohol and caffeine intake also failed to show phase-related differences. It was concluded that substance intake is highly stable across the menstrual cycle in female smokers.

Investigations of gender differences in the frequency and/or intensity of smoking withdrawal symptomatology have yielded conflicting findings. Several studies using measures collected both before abstinence and at the peak of symptomatology have failed to find gender differences. Yet, when asked to rate symptomatology experienced during past quit attempts, women have repeatedly been shown to endorse significantly more symptomatology than men. A possible explanation is that, although men and women show no differences when rating symptoms prospectively, women remember their past withdrawal symptoms as being more severe than do men, either because women exaggerate the difficulties they experience or because men downplay them. To test this hypothesis, and to determine whether men or women were more accurate in their recollections, we combined data from two studies in which subjects were asked to assess symptoms prospectively following 2 days of abstinence, and also to rate withdrawal during past quit attempts. As predicted, we found the effects of abstinence to be similar when assessed prospectively but different when assessed retrospectively, with women reporting more symptomatology than men. Men whose retrospective and prospective responses were discordant consistently underestimated the likelihood of experiencing symptomatology; women showed no consistent trends. The total number of symptoms reported retrospectively by women was similar to the total number reported prospectively, whereas men significantly underestimated the number of symptoms that they actually experienced. These findings may suggest ways in which treatment strategies can be tailored to the differences between male and female styles in recalling past experiences with abstinence from smoking.

This study tested the temporal stability and within-subject consistency of the Diagnostic and Statistical Manual-III-R (DSM-III-R) nicotine withdrawal symptoms in 39 (21 female, 18 male) regular smokers. Subjects provided withdrawal symptom ratings while smoking ad libitum and during two 48-hour abstinence periods that were separated by 1 week. All but two symptoms, increased eating and hunger, demonstrated adequate temporal stability (i.e., stability coefficients > or = .70). Within-subject consistency was found for impatience, anxiety, difficulty concentrating, and irritability. The total (average) score emerged as the most stable and consistent indicator of withdrawal. Results of a cluster analysis suggest the presence of two groups of smokers based on the withdrawal experience. Possible reasons for variability in nicotine withdrawal symptom reports are discussed.

There has been a notable lack of dialogue between neuroscientists, who use nicotine in their work as they would any other pharmacological tool, and public policy and health researchers, who view nicotine dependence with increasing dismay and see the continued use of tobacco products as a modern day scourge. This special journal issue attempts to foster communication among nicotine researchers working along the continuum from basic to applied science. An additional objective is to convey a sense for the special problems and opportunities in the study of nicotine and tobacco use that may be of general interest to those concerned with substance abuse. The articles that follow explore two themes, (1) nicotine as a tool to probe neural activity, and (2) tobacco use as a health hazard and societal problem, by examining nicotine from pharmacochemical, biobehavioral, and econo-social perspectives. The rationale for the integration is that there may be benefits from viewing nicotine in a context broader than those dictated by custom and technological specialization.

Smoking is the most important preventable risk factor for coronary heart disease. Reactivity to psychological stressors is also believed to be cardiopathologic. More recently, evidence has been accumulating that these putative risk factors in combination may be particularly harmful, both because smoking increases in stressful situations and because the cardiovascular effects of smoking combined with those of psychological stress may be greater than those of either alone. This paper reviews the literature on the cardiovascular effects of smoking and psychological stress in the light of epidemiological data and discusses mechanisms by which they may contribute to coronary heart disease.

The Fagerstrom Tolerance Questionnaire (TQ) is widely used in both clinical and research settings as a measure of physiological dependence on nicotine. In the light of claims that the efficacy of nicotine gum is related to degree of dependence and that outcomes can be improved by tailoring gum strength to degree of dependence, the availability of a simple, noninvasive test of dependence assumes additional importance. Recently, a number of articles have expressed reservations about various aspects of the TQ: 1) Several TQ items suffer from flaws or ambiguities that undermine their usefulness, and 2) the TQ may not measure what it purports to measure. The present paper reviews these issues, assembles data and observations that bear on the problems, and makes suggestions that may help in refining the TQ or producing a better instrument.