Nocturnal sleep-disturbing nicotine craving and accomplishment with a smoking cessation program.

AIMS: To study nocturnal sleep-disturbing nicotine craving (NSDNC), described as a symptom of nicotine dependence, in 2884 patients.
METHODS: All patients were part of a smoking cessation program of the Nicotine Institute in collaboration with the general sick fund of Lower Austria. During the study period, the program (which is ongoing) lasted five weeks and included individual counseling. At all appointments, patients received a questionnaire about smoking habits, illnesses, previous experience in smoking cessation and their motivation to complete the program with the help of an assistant. Carbon monoxide levels in expired air were also measured.
RESULTS: Analysis of NSDNC showed that 22.4% (n = 647) of patients suffered from this symptom with varying intensity: 77.1% (n = 499) awoke rarely; 9.4% (n = 61) awoke several times per week; 6.8% (n = 44) awoke most days and 6.6% (n = 43) awoke daily. NSDNC was associated with nicotine dependence, the number of cigarettes smoked per day, CO level and the craving for cigarettes in general. Consequences for smoking cessation programs are complex. Success rates were influenced by the intensity of NSDNC. Patients who awoke most days or daily had the lowest chance to quit smoking and the lowest compliance with the program.
CONCLUSIONS: Patients suffering from NSDNC, especially those who awoke most days or daily, formed a specific group among cigarette smokers. They can be classified as highly dependent smokers who have special needs regarding treatment strategies and medication. Further developments of specific cessation programs and strategies of tobacco harm reduction are recommended.