Multimodal assessment of the effect of chewing gum on nicotine withdrawal

Abstract

The relationship between cigarette smoking and gum chewing is important to psychological research. Wrigley's has long believed that when smokers are in situations where smoking is prohibited, chewing gum will lessen their craving to smoke. This belief, however, was not backed up by scientific evidence until recently. In a previous study conducted in our laboratory (Cohen, Collins, & Britt, 1997), we found that based solely on self-report data, dependent cigarette smokers who were not permitted to smoke during a 4-hour time period, but were asked to chew gum, experienced significantly less total withdrawal symptoms when compared to a group of smokers who were not permitted chew gum during this time. In addition to reporting less overall withdrawal, those smokers that were permitted to chew gum reported less "craving" for a cigarette than their counterparts who did not have gum. These findings empirically validate Wrigley Chewing Gum commercials that assert "When you cannot smoke, chew gum." The present study was designed to examine the usefulness of the substitution of gum for cigarettes when a smoker is unable to smoke using both self-report and physiological (i.e., salivary cortisol) measures.

Twenty male smokers who reported smoking at least 16 cigarettes per day served as subjects. Potential subjects were called and asked to come to the lab for a brief orientation session where subjects were exposed to the laboratory setting. During this initial session, informed consent was obtained and subjects were given an idea of what to expect during the two experimental sessions. For each of the two experimental sessions, subjects were asked to relax for approximately 20 minutes upon arrival, provide a small sample of their saliva (sample 1) and smoke a cigarette. Upon completion of the cigarette, subjects were again asked to relax for approximately 20 minutes and were asked to rate their current withdrawal symptoms by completing the WSC (Time 1 ). From this point forward, there was no access to cigarettes until the completion of the protocol. Next, subjects were asked to provide a small sample of their saliva (sample 2) and to watch a movie selected from a list. When the movie was over, subjects were asked to fill out the WSC (Time 2) and provide another sample of their saliva (sample 3). Subjects were then asked to remain in the lab and read magazines for one hour. During this hour, the research assistant came in once, half way through the period, where the subject was asked to fill out the WSC (Time 3) and provide another sample of their saliva (sample 4). At the end of the hour period the subject was again asked to fill out the WSC (Time 4) and provide a sample of their saliva (sample 5). During one of the experimental sessions, subjects had access to chewing gum from the start of the movie until the termination of the protocol, while on the other occasion they did not.

Results from this study are consistent with previous studies which show that chewing gum helps to reduce nicotine withdrawal when a nicotine dependent person cannot smoke. That is, when smokers were asked to chew gum they reported significantly less withdrawal as compared to sessions where they were not permitted to chew gum. In fact, as the withdrawal period lengthened, differences between the two experimental sessions (Gum Day and No-Gum Day) become more pronounced. When subjects were asked to chew gum, however, they did not report less "craving" for a cigarette compared to the sessions in which they were not permitted to chew gum. These findings suggest that chewing gum can produce a significant reduction in one's nicotine withdrawal but does little to influence craving for nicotine. Finally, this study examined salivary cortisol as a potential physiological marker in the study of nicotine withdrawal. The results of these analyses were not very strong but did lend optimism for the use of salivary cortisol to be used as a physiological marker for nicotine withdrawal in future studies. In sum, considering both the self-report and the cortisol data, it appears that chewing gum helps with nicotine withdrawal at both a psychological and physiological level.