Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/28811
Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: A randomised placebo-controlled trial of oral hydrocortisone for treating tobacco withdrawal symptoms
Author(s): Ussher, Michael
Aveyard, Paul
Reid, Fiona
West, Robert
Evans, Phil
Clow, Angela
Hucklebridge, Frank
Fuller, Julie
Ibison, Judith
Steptoe, Andrew
Contact Email: michael.ussher@stir.ac.uk
Keywords: Smoking
Nicotine
Tobacco
Cortisol
Withdrawal
Craving
Randomised controlled trial
Issue Date: 31-Jul-2011
Citation: Ussher M, Aveyard P, Reid F, West R, Evans P, Clow A, Hucklebridge F, Fuller J, Ibison J & Steptoe A (2011) A randomised placebo-controlled trial of oral hydrocortisone for treating tobacco withdrawal symptoms. Psychopharmacology, 216 (1), pp. 43-51. https://doi.org/10.1007/s00213-011-2191-x.
Abstract: Rationale: Many smokers experience a decline in cortisol to sub-normal levels during the first days of smoking cessation. A greater decline in cortisol is associated with more intense cigarette withdrawal symptoms, urge to smoke and relapse to smoking. Findings from an uncontrolled study suggest that glucocorticoids could ameliorate cigarette withdrawal. Objectives: We investigated whether taking oral hydrocortisone would reduce withdrawal symptoms and the desire to smoke on the first day of temporary smoking abstinence compared with placebo. Methods: Using a double-blind within-subject randomised crossover design, 48 smokers took a single dose of 40 mg hydrocortisone, 20 mg hydrocortisone or placebo following overnight smoking abstinence. Abstinence was maintained through the afternoon, and withdrawal symptoms and the desire to smoke were rated across the morning. Salivary cortisol was assessed in the afternoon prior to abstinence (baseline) and while abstinent after each treatment. Results: There was a significant dose-response relation between dose of hydrocortisone and reduction in depression and anxiety ratings while abstinent, but there were no other statistically significant associations with dose. Overall, the decline in cortisol following smoking cessation (placebo only) was not significant. Cortisol level on the afternoon of smoking abstinence was not significantly associated with symptom ratings. Conclusions: Supplements of hydrocortisone do not reduce the desire to smoke but may ameliorate withdrawal-related depression and anxiety, although the clinical benefit is slight.
DOI Link: 10.1007/s00213-011-2191-x
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