Cortisol and response to dexamethasone as predictors of withdrawal distress and abstinence success in smokers

Background: Glucocorticoids have been linked to self-administration of a wide range of drugs in animals and are increased endogenously by chronic nicotine intake. Corticosteroids have also been shown to regulate nicotine receptor sensitivity and to be involved in behavioral sensitization to nicotine, Methods: Cortisol levels and cortisol suppression in response to dexamethasone were measured in a sample of smokers participating in a smoking cessation treatment trial, Results: Cortisol levels dropped significantly during the early quitting process (2 weeks post-quit) and returned to a level below baseline I month post-quit, The magnitude of the initial drop in cortisol was strongly related to post-quit distress and marginally predictive of abstinence. Neither baseline nor post-quit changes in percent cortisol suppression after dexamethasone were related to abstinence success or withdrawal distress, Conclusions: Withdrawal from cigarette smoking is marked by a reduction in cortisol levels that appears to be related to the degree of distress experienced during the early quitting period, Further work is needed to determine whether withdrawal-related cortisol changes or distress are predictive of abstinence success. (C) 1998 Society of Biological Psychiatry.