Skip to main content
Search
Search
    Quick Search anywhere
    Quick search in Citations
Advanced Search
Skip main navigationClose Drawer MenuOpen Drawer Menu
Previous article
Next article
Article

The Effects of Nicotine and Nicotine Abstinence on Stress-Induced Cardiovascular Reactivity

Do Habitual and Light/Intermittent Cigarette Smokers Differ?

Published Online:July 27, 2016https://doi.org/10.1027/0269-8803/a000174

Abstract

Abstract. The effects of 12 hr nicotine administration and abstinence on stress-induced cardiovascular reactivity were assessed within Light/Intermittent cigarette smokers and Habitual cigarette smokers. One hundred thirty-two male smokers (66 Habitual, 66 Light/Intermittent) were assigned to a Nicotine (21 mg) or Placebo patch condition. Cardiovascular reactivity was assessed during Baseline, a 6-min mental arithmetic task (Paced Auditory Serial Arithmetic Task) and a 5-min mirror-tracing task (Star Mirror Tracing Task). Within the Nicotine condition, Light/Intermittent smokers showed greater cardiac output (CO) increases, smaller stroke volume decreases, and smaller total peripheral resistance (TPR) increases than Light/Intermittent smokers in the Placebo condition. No condition differences in cardiovascular reactivity were demonstrated for Habitual smokers. Light/Intermittent smokers also showed greater CO increases than Habitual smokers during the mirror-tracing task but during the Nicotine condition only. During mental arithmetic, Light/Intermittent smokers had greater CO increases and smaller TPR increases than Habitual smokers across nicotine conditions. Habitual smokers responded to stress with increases in peripheral responses whereas Light/Intermittent smokers responded myocardially. Light/Intermittent smokers may have increased density of β-adrenergic receptors whereas Habitual smokers may have decreased density due to chronic smoking.

References

  • Agaku, I. T., King, B. A. & Dube, S. R. (2014). Current cigarette smoking among adults – United States, 2005–2012. Morbidity and Mortality Weekly Report, 63, 29–34. First citation in articleGoogle Scholar

  • al’Absi, M., Amunrud, T. & Wittmers, L. E. (2002). Psychophysiological effects of nicotine abstinence and behavioral challenges in habitual smokers. Pharmacology Biochemistry and Behavior, 72, 707–716. First citation in articleCrossref, Google Scholar

  • al’Absi, M., Wittmers, L. E., Erickson, J., Hatsukami, D. & Crouse, B. (2003). Attenuated adrenocortical and blood pressure responses to psychological stress in ad libitum and abstinent smokers. Pharmacology, Biochemistry and Behavior, 74, 401–410. First citation in articleCrossref, Google Scholar

  • American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: American Psychiatric Association. First citation in articleGoogle Scholar

  • An, L. C., Berg, C. J., Klatt, C. M., Perry, C. L., Thomas, J. L., Luo, X., … Ahluwalia, J. S. (2009). Symptoms of cough and shortness of breath among occasional young adult smokers. Nicotine & Tobacco Research, 11, 126–133. doi: 10.1093/ntr/ntp015 First citation in articleCrossref, Google Scholar

  • Benowitz, N. L. (1988). Drug therapy. Pharmacologic aspects of cigarette smoking and nicotine addition. The New England Journal of Medicine, 319, 1318–1330. doi: 10.1056/NEJM198811173192005 First citation in articleCrossref, Google Scholar

  • Benowitz, N. L. (1999). Biomarkers of environmental tobacco smoke exposure. Environmental Health Perspectives, 107, 349–355. First citation in articleCrossref, Google Scholar

  • Bernert, J. T., Turner, W. E., Pirkle, J. L., Sosnoff, C. S., Akins, J. R., Waldrep, M. K., … Sampson, E. J. (1997). Development and validation of sensitive method for determination of serum cotinine in smokers and nonsmokers by liquid chromatography/atmospheric pressure ionization tandem mass spectrometry. Clinical Chemistry, 43, 2281–2291. First citation in articleGoogle Scholar

  • Bjartveit, K. & Tverdal, A. (2005). Health consequences of smoking 1–4 cigarettes per day. Tobacco Control, 14, 315–320. doi: 10.1136/tc.2005.011932 First citation in articleCrossref, Google Scholar

  • Cohen, J. (1969). Statistical power analysis for the behavioral sciences. New York, NY: Academic Press. First citation in articleGoogle Scholar

  • Cooke, R., Bullen, C., Whittaker, R., McRobbie, H., Chen, M. & Walker, N. (2008). Diagnostic accuracy of NicAlert cotinine test strips in saliva for verifying smoking status. Nicotine & Tobacco Research, 10, 607–612. First citation in articleCrossref, Google Scholar

  • Delaney, J. P. A. & Brodie, D. A. (2000). Effects of short-term psychological stress on the time and frequency domains of heart-rate variability. Perceptual and Motor Skills, 91, 515–524. doi: 10.2466/pms.2000.91.2.515 First citation in articleCrossref, Google Scholar

  • Dickerson, S. S. & Kemeny, M. E. (2004). Acute stressors and cortisol responses: A theoretical integration and synthesis of laboratory research. Psychological Bulletin, 130, 355–391. doi: 10.1037/0033-2909.130.3.355 First citation in articleCrossref, Google Scholar

  • Dinas, P. C., Koutedakis, Y. & Flouris, A. D. (2013). Effects of active and passive tobacco cigarette smoking on heart rate variability. International Journal of Cardiology, 163, 109–115. doi: 10.1016/j.ijcard.2011.10.140 First citation in articleCrossref, Google Scholar

  • Fagerström, K. O. (1978). Measuring degree of physical dependency to tobacco smoking with reference to individualization of treatment. Addictive Behaviors, 3, 235–241. doi: 10.1016/0306-4603(78)90024-2 First citation in articleCrossref, Google Scholar

  • Feise, R. J. (2002). Do multiple outcome measures require p-value adjustment? BMC Medical Research Methodology, 2, 1–4. First citation in articleCrossref, Google Scholar

  • Ferdousi, S., Ferdous, M. & Islam, M. (2014). Impact of smoking status on autonomic functions assessed by spectral analysis of heart rate variability. International Journal of Clinical and Expermental Physiology, 1, 57–62. doi: 10.4103/2348-8093.129741 First citation in articleCrossref, Google Scholar

  • Gaddis, M. L. (1998). Statistical methodology: IV. Analysis of variance, analysis of covariance, and multivariate analysis of variance. Academic Emergency Medicine, 5, 258–265. First citation in articleCrossref, Google Scholar

  • Girdler, S. S., Jamner, L. D., Jarvik, M., Soles, J. R. & Shapiro, D. (1997). Smoking status and nicotine administration differentially modify hemodynamic stress reactivity in men and women. Psychosomatic Medicine, 59, 294–306. First citation in articleCrossref, Google Scholar

  • Greenhouse, S. W. & Geisser, S. (1959). On methods in the analysis of profile data. Psychometrika, 24, 95–112. First citation in articleCrossref, Google Scholar

  • Haass, M. & Kubler, W. (1997). Nicotine and sympathetic neurotransmission. Cardiovascular Drugs and Therapy, 10, 657–665. First citation in articleCrossref, Google Scholar

  • Heatherton, T. F., Kozlowski, L. T., Frecker, R. C. & Fagerström, K. O. (1991). The Fagerström test for nicotine dependence: A revision of the Fagerström tolerance questionnaire. British Journal of Addiction, 86, 1119–1127. First citation in articleCrossref, Google Scholar

  • Henningfield, J., Schuh, L. & Heishman, S. (1995). Pharmacological determinants of cigarette smoking. In P. ClarkeM. QuickF. AdlkoferK. ThurauEds., Effects of Nicotine on Biological Systems II (pp. 247–256). Basel, Switzerland: Birkhauser Verlag. First citation in articleGoogle Scholar

  • Hering, D., Kucharska, W., Kara, T., Somers, V. K. & Narkiewicz, K. (2010). Smoking is associated with chronic sympathetic activation in hypertension. Blood Pressure, 19, 152–155. doi: 10.3109/08037051.2010.484150 First citation in articleCrossref, Google Scholar

  • Hjemdahl, P., Larsson, K., Johansson, M. C., Zetterlund, A. & Eklund, A. (1990). Beta-adrenoreceptors in human alveolar macrophages isolated by elutriation. British Journal of Clinical Pharmacology, 30, 673–682. First citation in articleCrossref, Google Scholar

  • Jacob, P. & Byrd, G. D. (1999). Use of gas chromatographic and mass spectrometric techniques for the determination of nicotine metabolites. In J. W. GorrodP. JacobEds., Analytical Determination of Nicotine and Related Compounds and Their Metabolites (pp. 191–224). Amsterdam, Netherlands: Elsevier Science. First citation in articleGoogle Scholar

  • Jarvis, M. J., Tunstall-Pedoe, H., Feyerabend, C., Vesey, C. & Saloojee, Y. (1987). Comparison of tests used to distinguish smokers from nonsmokers. American Journal of Public Health, 77, 1435–1438. First citation in articleCrossref, Google Scholar

  • Kaplan, J. R., Manuck, S. B., Adams, M. R., Weingand, K. W. & Clarkson, T. B. (1987). Inhibition of coronary atherosclerosis by propranolol in behaviorally predisposed monkeys fed an atherogenic diet. Circulation, 76, 1364–1372. First citation in articleCrossref, Google Scholar

  • Kasprowicz, A. L., Manuck, S. B., Malkoff, S. B. & Krantz, D. A. (1990). Individual differences in behaviorally evoked cardiovascular response: Temporal stability and hemodynamic patterning. Psychophysiology, 27, 605–619. First citation in articleCrossref, Google Scholar

  • Kirschbaum, C., Strasburger, C. J. & Langkrär, J. (1993). Attenuated cortisol response to psychological stress but not to CRH or ergometry in young habitual smokers. Pharmacology Biochemistry and Behavior, 44, 527–531. doi: 10.1016/0091-3057(93)90162-M First citation in articleCrossref, Google Scholar

  • Kirschbaum, C., Wüst, S. & Strasburger, C. (1992). ‘Normal’ cigarette smoking increases free cortisol in habitual smokers. Life Sciences, 50, 435–442. First citation in articleCrossref, Google Scholar

  • Klabunde, R. (2012). Cardiovascular Physiology Concepts (2nd ed.). Baltimore, MD: Wolters Kluwer Health. First citation in articleGoogle Scholar

  • Koval, J. J. & Pederson, L. L. (1999). Stress-coping and other psychosocial risk factors: A model for smoking in grade 6 students. Addictive Behaviors, 24, 207–218. doi: 10.1016/S0306-4603(98)00037-9 First citation in articleCrossref, Google Scholar

  • Kubicek, W. G., Karnegis, J. N., Patterson, R. D., Witsoe, D. A. & Mattson, R. H. (1966). Development and evaluation of an impedance cardiography system. Aerospace Medicine, 37, 1208–1212. First citation in articleGoogle Scholar

  • Laustiola, K. E., Lassila, R., Kaprio, J. & Koskenvuo, M. (1988). Decreased beta-adrenergic receptor density and catecholamine response in male cigarette smokers. A study of monozygotic twin pairs discordant for smoking. Circulation, 78, 1234–1240. doi: 10.1161/01.cir.78.5.1234 First citation in articleCrossref, Google Scholar

  • Lipsitz, L. A., Nyquist, R. P., Wei, J. Y. & Rowe, J. W. (1983). Postprandial reduction in blood pressure in the elderly. New England Journal of Medicine, 309, 81–83. doi: 10.1056/NEJM198307143090205 First citation in articleCrossref, Google Scholar

  • Lorr, M. & McNair, D. M. (1965). Expansion of the interpersonal behavior circle. Journal of Personality and Social Psychology, 2, 823–830. First citation in articleCrossref, Google Scholar

  • Lucini, D., Di Fede, G., Parati, G. & Pagani, M. (2005). Impact of chronic psychosocial stress on autonomic cardiovascular regulation in otherwise healthy subjects. Hypertension, 46, 1201–1206. doi: 10.1161/01.HYP.0000185147.32385.4b First citation in articleCrossref, Google Scholar

  • Luoto, R., Uutela, A. & Puska, P. (2000). Occasional smoking increases total and cardiovascular mortality among men. Nicotine & Tobacco Research, 2, 133–139. doi: 10.1080/713688127 First citation in articleCrossref, Google Scholar

  • MacDougall, J. M., Musante, L., Howard, J. A., Hanes, R. L. & Dembroski, T. M. (1986). Individual differences in cardiovascular reactions to stress and cigarette smoking. Health Psychology, 5, 531–544. doi: 10.1037/0278-6133.5.6.531 First citation in articleCrossref, Google Scholar

  • Mann, S. J., James, G. D., Wang, R. S. & Pickering, T. G. (1991). Elevation of ambulatory systolic blood pressure in hypertensive smokers: A case-control study. The Journal of the American Medical Association, 265, 2226–2228. doi: 10.1001/jama.1991.03460170080037 First citation in articleCrossref, Google Scholar

  • McCarty, R., Horwatt, K. & Konarska, M. (1988). Chronic stress and sympathetic-adrenal medullary responsiveness. Social Science & Medicine, 26, 333–341. doi: 10.1016/0277-9536(88)90398-X First citation in articleCrossref, Google Scholar

  • McNair, M., Lorr, A. & Droppleman, L. F. (1971). Manual for the profile of mood states. San Diego, CA: Educational and Industrial Testing Service. First citation in articleGoogle Scholar

  • Middlekauff, H. R., Park, J., Agrawal, H. & Gornbein, J. A. (2013). Abnormal sympathetic nerve activity in women exposed to cigarette smoke: A potential mechanism to explain increased cardiac risk. American Journal of Physiology – Heart and Circulatory Physiology, 305, H1560–H1567. doi: 10.1152/ajpheart.00502.2013 First citation in articleCrossref, Google Scholar

  • Middlekauff, H. R., Park, J. & Moheimani, R. S. (2014). Adverse effects of cigarette and noncigarette smoke exposure on the autonomic mervous system mechanisms and implications for cardiovascular risk. Journal of the American College of Cardiology, 64, 1740–1750. doi: 10.1016/j.jacc.2014.06.1201 First citation in articleCrossref, Google Scholar

  • Miller, J. C. & Horvath, S. M. (1978). Impedance cardiography. Psychophysiology, 15, 80–91. doi: 10.1111/j.1469-8986.1978.tb01340.x First citation in articleCrossref, Google Scholar

  • Monk, T. H. (1989). A visual analogue scale technique to measure global vigor and affect. Psychiatry Research, 27, 89–99. First citation in articleCrossref, Google Scholar

  • Ockene, I. S. & Miller, N. H. (1997). Cigarette smoking, cardiovascular disease, and stroke: A statement for healthcare professionals from the American Heart Association. Circulation, 96, 3243–3247. doi: 10.1161/01.cir.96.9.3243 First citation in articleCrossref, Google Scholar

  • Okuyemi, K. S., Harris, K. J., Scheibmeir, M., Choi, W. S., Powell, J. & Ahluwalia, J. S. (2002). Light smokers: Issues and recommendations. Nicotine & Tobacco Research, 4, S103–S112. doi: 10.1080/1462220021000032726 First citation in articleCrossref, Google Scholar

  • Ottaviani, C., Shapiro, D., Goldstein, I. B., James, J. E. & Weise, R. (2006). Hemodynamic profile, compensation deficit, and ambulatory blood pressure. Psychophysiology, 43, 46–56. First citation in articleCrossref, Google Scholar

  • Perkins, K. A., Epstein, L. H., Jennings, J. R. & Stiller, R. (1986). The cardiovascular effects of nicotine during stress. Psychopharmacology, 90, 373–378. doi: 10.1007/bf00179194 First citation in articleCrossref, Google Scholar

  • Perkins, K. A. & Grobe, J. E. (1992). Increased desire to smoke during acute stress. British Journal of Addiction, 87, 1037–1040. doi: 10.1111/j.1360-0443.1992.tb03121.x First citation in articleCrossref, Google Scholar

  • Perneger, T. V. (1998). What’s wrong with Bonferroni adjustments. British Medical Journal, 316(7139), 1236–1238. First citation in articleCrossref, Google Scholar

  • Pierce, J. P., White, M. M. & Messer, K. (2009). Changing age-specific patterns of cigarette consumption in the United States, 1992–2002: Association with smoke-free homes and state-level tobacco control activity. Nicotine & Tobacco Research, 11, 171–177. doi: 10.1093/ntr/ntp014 First citation in articleCrossref, Google Scholar

  • Pojer, R., Whitfield, J. B., Poulos, V., Eckhard, I. F., Richmond, R. & Hensley, W. J. (1984). Carboxyhemoglobin, cotinine, and thiocyanate assay compared for distinguishing smokers from non-smokers. Clinical Chemistry, 30, 1377–1380. First citation in articleGoogle Scholar

  • Pomerleau, C. S., Carton, S. M., Lutzke, M. L., Flessland, K. A. & Pomerleau, O. F. (1994). Reliability of the Fagerström tolerance questionnaire and the Fagerström test for nicotine dependence. Addictive Behaviors, 19, 33–39. doi: 10.1016/0306-4603(94)90049-3 First citation in articleCrossref, Google Scholar

  • Pomerleau, C. S. & Pomerleau, O. F. (1987). The effects of a psychological stressor on cigarette smoking and subsequent behavioral and physiological responses. Psychophysiology, 24, 278–285. doi: 10.1111/j.1469-8986.1987.tb00295.x First citation in articleCrossref, Google Scholar

  • Prescott, E., Scharling, H., Osler, M. & Schnohr, P. (2002). Importance of light smoking and inhalation habits on risk of myocardial infarction and all-cause mortality. A 22 year follow up of 12, 149 men and women in The Copenhagen City Heart Study. Journal of Epidemiology and Community Health, 56, 702–706. doi: 10.1136/jech.56.9.702 First citation in articleCrossref, Google Scholar

  • Richards, J. M., Stipelman, B. A., Bornovalova, M. A., Daughters, S. B., Sinha, R. & Lejuez, C. W. (2011). Biological mechanisms underlying the relationship between stress and smoking: State of the science and directions for future work. Biological Psychology, 88, 1–12. doi: 10.1016/j.biopsycho.2011.06.009 First citation in articleCrossref, Google Scholar

  • Robertson, D., Frölich, J. C., Carr, R. K., Watson, J. T., Hollifield, J. W., Shand, D. G. & Oates, J. A. (1978). Effects of caffeine on plasma renin activity, catecholamines and blood pressure. New England Journal of Medicine, 298, 181–186. doi: 10.1056/NEJM197801262980403 First citation in articleCrossref, Google Scholar

  • Rosengren, A., Wilhelmsen, L. & Wedel, H. (1992). Coronary heart disease, cancer and mortality in male middle-aged light smokers. Journal of Internal Medicine, 231, 357–362. First citation in articleCrossref, Google Scholar

  • Rubenstein, M. L., Benowitz, N. L., Auerback, G. M. & Moscicki, A. (2009). Withdrawal in adolescent light smokers following 24-hour abstinence. Nicotine & Tobacco Research, 11, 185–189. First citation in articleCrossref, Google Scholar

  • Russell, M. H., Peto, J. & Patel, U. A. (1974). The classification of smoking by factorial structure of motives. Journal of the Royal Statistical Society. Series A (General), 137, 313–346. doi: 10.2307/2344953 First citation in articleCrossref, Google Scholar

  • Sayette, M. A., Martin, C. S., Wertz, J. M., Shiffman, S. & Perrott, M. A. (2001). A multi-dimensional analysis of cue-elicited craving in heavy smokers and tobacco chippers. Addiction, 96, 1419–1432. doi: 10.1080/09652140120075152 First citation in articleCrossref, Google Scholar

  • Schane, R. E., Glantz, S. A. & Ling, P. M. (2009). Nondaily and social smoking: an increasingly prevalent pattern. Archives of Internal Medicine, 169, 1742–1744. doi: 10.1001/archinternmed.2009.315 First citation in articleCrossref, Google Scholar

  • Schane, R. E., Ling, P. M. & Glantz, S. A. (2010). Health effects of light and intermittent smoking: A review. Circulation, 121, 1518–1522. doi: 10.1161/circulationaha.109.904235 First citation in articleCrossref, Google Scholar

  • Sherwood, A., Allen, M. T., Fahrenberg, J., Kelsey, R. M., Lovallo, W. R. & van Doornen, L. J. P. (1990). Methodological guidelines for impedance cardiography. Psychophysiology, 27, 1–23. First citation in articleCrossref, Google Scholar

  • Shiffman, S. (1989). Tobacco “Chippers”: Individual differences in tobacco dependence. Psychopharmacology, 97, 539–547. First citation in articleCrossref, Google Scholar

  • Shiffman, S., Hickcox, M., Paty, J. A., Gnys, M., Kassel, J. D. & Richards, T. J. (1996). Progression from a smoking lapse to relapse: Prediction from abstinence violation effects, nicotine dependence, and lapse characteristics. Journal of Consulting and Clinical Psychology, 64, 993–1002. doi: 10.1037/0022-006x.64.5.993 First citation in articleCrossref, Google Scholar

  • Shiffman, S., Paty, J. A., Gnys, M., Kassel, J. D. & Elash, C. (1995). Nicotine withdrawal in chippers and regular smokers: Subjective and cognitive effects. Health Psychology, 14, 301–309. doi: 10.1037/0278-6133.14.4.301 First citation in articleCrossref, Google Scholar

  • Shiffman, S., Zettler-Segal, M., Kassel, J., Paty, J., Benowitz, N. L. & O’Brien, G. (1992). Nicotine elimination and tolerance in non-dependent cigarette smokers. Psychopharmacology, 109, 449–456. First citation in articleCrossref, Google Scholar

  • D. W. Sifton (1995). Physician’s Desk Reference. Montvale, NJ: Medical Economics Data Production Company. First citation in articleGoogle Scholar

  • Sigfússon, N., Sigurdsson, G., Aspelund, T. & Gudnason, V. (2006). The health risk associated with smoking has been seriously underestimated. The Reykjavik study. Laeknabladid, 92, 263–269. First citation in articleGoogle Scholar

  • Sinha, R. (2009). Modeling stress and drug craving in the laboratory: Implications for addiction treatment development. Addiction Biology, 14, 84–98. doi: 10.1111/j.1369-1600.2008.00134.x First citation in articleCrossref, Google Scholar

  • Sjoberg, N. & Saint, D. A. (2011). A single 4 mg dose of nicotine decreases heart rate variability in healthy nonsmokers: Implications for smoking cessation programs. Nicotine & Tobacco Research, 13, 369–372. doi: 10.1093/ntr/ntr004 First citation in articleCrossref, Google Scholar

  • Taylor, J. A. (1953). A personality scale of manifest anxiety. Journal of Abnormal Psychology, 48, 285–290. First citation in articleCrossref, Google Scholar

  • Taylor, P. (1980). Ganglionic stimulating and blocking agents. In G. A. GilmanL. S. GoodmanA. GilmanEds., The Pharmacological Basis of Therapeutics (6th ed., pp. 211–219). New York, NY: Macmillan. First citation in articleGoogle Scholar

  • Tsuda, A., Steptoe, A., West, R., Fieldman, G. & Kirschbaum, C. (1996). Cigarette smoking and psychophysiological stress responsiveness: Effects of recent smoking and temporary abstinence. Psychopharmacology, 126, 226–233. doi: 10.1007/bf02246452 First citation in articleCrossref, Google Scholar

  • United States Department of Health and Human Services. (2014a). The Health Consequences of Smoking: 50 Years of Progress: A Report of the Surgeon General. Retrieved from http://www.cdc.gov/tobacco/data_statistics/sgr/50th-anniversary/index.htm#report First citation in articleGoogle Scholar

  • United States Department of Health and Human Services. 2014b. Tobacco Use. Retrieved from http://www.healthypeople.gov/2020/topics-objectives/topic/tobacco-use/objectives#5287 First citation in articleGoogle Scholar

  • VanderKaay, M. M. & Patterson, S. M. (2006). Nicotine and acute stress: Effects of nicotine versus nicotine withdrawal on stress-induced hemoconcentration and cardiovascular reactivity. Biological Psychology, 71, 191–201. doi: 10.1016/j.biopsycho.2005.04.006 First citation in articleCrossref, Google Scholar

  • Wardle, M. C., Munafò, M. R. & de Wit, H. (2011). Effect of social stress during acute nicotine abstinence. Psychopharmacology, 218, 39–48. First citation in articleCrossref, Google Scholar

  • Watson, D., Clark, L. A. & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54, 1063–1070. First citation in articleCrossref, Google Scholar

  • Welsch, S. K., Smith, S. S., Wetter, D. W., Jorenby, D. E., Fiore, M. C. & Baker, T. B. (1999). Development and validation of the Wisconsin smoking withdrawal scale. Experimental and Clinical Psychopharmacology, 7, 354–361. First citation in articleCrossref, Google Scholar

  • Willemsen, G., Ring, C., Carroll, D., Evans, P., Clow, A. & Hucklebridge, F. (1998). Secretory immunoglobulin A and cardiovascular reactions to mental arithmetic and cold pressor and cold pressor. Psychophysiology, 35, 252–259. First citation in articleCrossref, Google Scholar