Double-blind placebo-controlled trial of fluoxetine in smoking cessation treatment including nicotine patch and cognitive-behavioral group therapy.

Smoking cessation attempts are often complicated by dysphoria/depression, weight gain, craving, and other nicotine withdrawal symptoms. Fluoxetine's antidepressant and anorectant properties, along with its capacity to attenuate compulsive behavior, suggest that this medication might facilitate smoking cessation treatment. We examined the effect of fluoxetine on smoking cessation in the context of a program that included group cognitive-behavioral therapy (six weeks) and transdermal nicotine patch(ten weeks). In a double-blind randomized trial of fluoxetine for smoking cessation, 150 daily smokers were assigned to placebo (n=48), 20 mg (n=51), or 40 mg fluoxetine (n=51). Fluoxetine did not significantly improve smoking cessation rates, either for those with or without major depressive disorder(MDD)histories or elevated current depression. Our results suggest that fluoxetine may moderate withdrawal symptoms, even if that was not manifested in improved smoking cessation rates. Our results, however, clearly favor the use of fluoxetine if weight gain is a major clinical obstacle to smoking cessation.

The representation of smoking expectancies by single-word adjectives and their relationship to smoking characteristics.

A pool of single-word adjectives representing smoking outcome expectancies was derived and tested in two studies. In Study One, smoking-related words were generated and then clustered together to form 39 categories representing smoking expectancy nodes. Analysis of the number of times words in each category were generated indicated that expectancies varied as a function of smoking status (measured at two levels: Ever smoked daily vs. never smoked daily), smoking history (current vs. past smoker), and dependence (nondependent vs. dependent). In Study Two, participants rated the words in terms of expectations of smoking outcomes. A principal components analysis of the ratings indicated that three components accounted for 74.10% of the variance in participants' ratings: Component 1 (adverse effects), 30.92%; component 2 (positive image), 28.08%; and component 3 (positive mood), 15.09%. Further analyses revealed that ratings of words comprising the three components differed as a function of smoking status (measured at three levels: Never smoked daily, daily nondependent smoker, daily dependent smoker), with dependent smokers rating the outcomes associated with all three components as occurring more frequently when they smoked compared with nondependent smokers or those who never smoked daily. The results suggest that the single-word adjectives are appropriate for use in research investigating smoking outcome expectancies.