Catastrophic misinterpretation of nicotine withdrawal symptoms: a placebo-control, double blind study

Introduction: several studies suggested that smokers who experience nicotine withdrawal symptoms (NWS) are vulnerable to panic attacks. Ithas been hypothesized that this vulnerability may be mediated by a catastrophic misinterpretation of NWS; thus, smokers high in anxiety sensitivity (AS) may be more vulnerable to panic. Although a rich literature supports this hypothesis, no studies have been conducted to verify it.The goal of the current investigation was to test whether AS or somatosensory amplification (SSA) mediate the effect of NWS on test inducing panic-like symptoms via the inhalation of 35% carbon dioxide (CO2). Methods: a placebo-controlled, double blind design was used. Participants were 80 regular smokers who were asked to refrain from smoking for 12 hours and wear a placebo patch (abstinence condition) or a nicotine patch (NRT condition).Therefore, subjects completed a 35% CO2challenge. NA, AS, SSA, heart rate, blood pressure, subjective and objective anxiety, fear and discomfort were measured immediately before and after the challenge. The Mann-Whitney test and a hierarchical regression analysis were conducted to compare abstinence versus NRT response to the test and verify the hypothesis of mediation, respectively. Results: abstinence versus NRT condition did not affect the anxiety response to the test (p = n.s.); AS and SSA did not affect the test response as mediator of NWS. Discussion: AS did not mediate the effect of NWS on the 35% CO2 test response.