Diurnal variations in first lapses to smoking for nicotine patch users

Abstract

Amongst those not using nicotine replacement therapy (NRT), first lapses to smoking have been shown to be more common in the afternoons and evenings than the mornings. The present study investigated whether first lapses amongst those using 16 h nicotine patches follow a similar pattern. This is of interest because 16 h patches may not provide sufficient nicotine early in the morning to meet the needs of smokers. 200 male and female smokers attended a cessation programme combining behavioural support and 16 h nicotine patches. During the first 2 weeks of smoking abstinence 70 smokers reported first lapses. The frequency of first lapses was significantly higher in the afternoons (12.00-18.00 h, 30 lapses) and evenings (18.00-24.00, 35 lapses) than in the mornings (24.00-12.00, five lapses, p < 0.001 for both comparisons). There was no detectable difference between the rates of first lapse in the afternoon and evening. In conclusion, abstaining smokers using 16 h nicotine patches are more likely to experience their first lapse in the afternoon or evening rather than in the morning. Despite nicotine patches providing limited nicotine replacement for the first few hours after waking, there is no evidence that this undermines quit attempts by failing to prevent lapses during that time.

Nicotine self-administration: cigarette versus nicotine gum diurnal topography

“…Thus, greater morning use may reflect overall nicotine dependence. A second observation is that higher rates of relapse have been observed in afternoon and evening hours in those receiving behavioral support (Brandon et al, 1986;Shiffman et al, 1996) or behavioral support and NRT (Ussher and West, 2003). In the current study, greater nicotine use in the evening hours may be related to lower relapse only insofar as it indirectly indexes lower dependence.…”

“…In both smokers and non-smokers, mood and energy level tend to decline toward the end of the day (Adan and Sanchez-Turet, 2000;Adan et al, 2004). Ussher and West (2003) have suggested that greater behavioral support and increased nicotine replacement during the afternoon and evening hours might help offset diurnally related increased risk of relapse.…”