has been shown to decline after stopping smoking and this decline has been associated with smoking relapse and with reports of increased withdrawal severity and distress. We examined whether a decrease in cortisol
is evident in smokers trying to quit using nicotine patches
and whether cortisol
is related to withdrawal symptoms
, smoking urges, subjective stress
, nicotine dependence, and smoking relapse.
Among 112 smokers trying to quit using 15-mg patches, salivary cortisol
and reports of stress
, withdrawal, and urges were measured before quitting smoking and up to 6 weeks of abstinence among abstinent smokers using 15-mg nicotine patches
. Thirty participants both remained abstinent and provided cortisol
samples at all measurement times.
Relative to preabstinence, there was a significant decline in cortisol
after abstinence of 1 day, and after 1, 2, and 6 weeks (p
< .05). The decline in cortisol
on the first day of abstinence was positively associated with reported cigarette consumption (p
< .01) and tended (nonsignificant) to be associated with smoking relapse at 6 weeks (p
= .07). A lower absolute level of cortisol
, but not the change in cortisol
, on the first day of abstinence was significantly associated with increased reports of urges, withdrawal symptoms
, and stress
< .05), independently of reported cigarette consumption.
Smokers using 15-mg nicotine patches
are likely to experience a decline in cortisol
on stopping smoking. This decline is likely to be greater among heavier smokers and may predict relapse to smoking. Those with lower cortisol
after cessation may experience increased withdrawal symptoms
, urges to smoke
, and subjective stress
HPA = hypothalamic–pituitary–adrenocortical; NRT = nicotine replacement therapy; FTND = Fagerström Test for Nicotine Dependence; CO = carbon monoxide; PPM = parts per million; RPM = revolutions per minute; °C = degrees centigrade; S-IgA = salivary immunoglobulin-A; nmol/L = nanomole/liter; ACTH = adrenocorticotrophic hormone; SD = standard deviation.