Study results indicate that bupropion ameliorates some nicotine withdrawal symptoms.

The impact of a transdermal nicotine patch on smokers' craving for cigarettes and reactivity to smoking cues was investigated. Sixty-one smokers were assessed during 2 sessions separated by 6 hr. Cue reactivity to imaginal and in vivo smoking and nonsmoking stimuli was evaluated during both sessions. During the interval between sessions, participants were abstinent from cigarettes and wore either a nicotine transdermal (21 mg) or placebo patch. In both sessions, exposure to in vivo and imaginal smoking stimuli elicited cue-specific increases in craving, negative affect, vividness, heart rate, and skin conductance. The nicotine patch attenuated craving and other effects induced by abstinence from cigarettes but had no selective impact on craving or any other reaction elicited by smoking cues. These results are discussed in terms of models of craving and clinical implications of transdermal nicotine for craving reduction.

From previous studies, chippers (very light, long-time cigarette smokers) seem not to be nicotine dependent, despite decades of smoking. The effect of tobacco deprivation on chippers' withdrawal reactions was examined. Matched groups of 26 chippers and 25 regular smokers were studied while abstaining or smoking for 2-day blocks, with assessments administered 5 times daily by palm-top computers. As hypothesized, chippers showed no changes as a result of nicotine deprivation. In contrast, regular smokers demonstrated distinct changes in craving, mood, arousal, and sleep disturbance. The computers also tested participants' cognitive performance. Unlike chippers, regular smokers' performance on complex tasks was slower under deprivation; the effect could not be explained by changes in motor performance or simple reaction time. Results suggest performance may have been improved by nicotine rather than by worsened by withdrawal.

The extent to which sentence imagery elicits effects comparable to those produced by long narratives was investigated. Smokers imagined sentences with varying affective content and that either contained or were devoid of smoking cues. Physiological responses were monitored, and smokers rated their urges and affect. Startle responses were also collected as an index of negative affect processing. Smoking-cue sentences produced augmented urges and startle responding. Smoking material also elevated negative affect during imagery of positive affect sentences. The affect manipulation produced changes in self-reported affect and facial electomyography consistent with the affective valence of the sentences. This procedure is similar to narrative imagery in the manipulation of smoking urges and affect under laboratory conditions. Results support the hypothesis that smoking urges enhance negative affect processing.Contemporary accounts of smoking behavior suggest that urges are significant contributors to both the maintenance of cigarette smoking and the high rate of relapse experienced typically by smokers after a period of abstinence (e.g., Kozlowski

IntroductionNo existing patient-reported outcome instrument focuses solely on assessment of varicose veins symptoms that are bothersome to patients.MethodsThe VVSymQ® instrument is a five-item patient-reported outcome that assesses symptoms most important to patients with varicose veins (heaviness, achiness, swelling, throbbing and itching). This paper describes how the VVSymQ® instrument was incorporated into an electronic daily diary to monitor key outcomes over time and capture treatment benefit in two randomized, controlled, phase 3 clinical trials.ResultsPatients were highly compliant in completing the electronic daily diary, and the VVSymQ® instrument demonstrated ability to detect overall change and ability to detect change that is meaningful to patients.ConclusionThe VVSymQ® instrument is a reliable, valid instrument responsive to measuring change in the patient experience of varicose vein symptoms pre- and post-intervention, and is uniquely focused on patient-reported symptoms compared with other widely used questionnaires completed by clinicians.