Cortisol levels decrease after acute tobacco abstinence in regular smokers

Jordan A. Wong, Wallace B. Pickworth, Andrew J. Waters, Mustafa Al'Absi, Adam M. Leventhal

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


Objective The aim of this study was to examine the effect of acute tobacco abstinence on cortisol levels in regular smokers, and whether abstinence-induced changes in cortisol levels are correlated with various signs and symptoms of the tobacco withdrawal syndrome. Methods Smokers (N = 77, ≥15 cigarettes/day) attended two counterbalanced sessions (avg = 1 h), one following 12-20 h of abstinence and the other following ad lib smoking. At both sessions, salivary cortisol levels were measured at three time points. Additionally, a battery of self-report questionnaires, physiological assessments, and cognitive performance tasks were administered to measure signs and symptoms of tobacco withdrawal. Results Salivary cortisol levels were significantly lower during the abstinent session versus the non-abstinent session. No significant associations were found between abstinence-induced changes in cortisol and other tobacco withdrawal measures, although there was suggestive evidence that abstinence-induced changes in cortisol levels and hunger were inversely associated to a modest degree. Conclusion Acute tobacco abstinence was associated with decreased cortisol levels. Cortisol dampening during acute tobacco abstinence may reflect nicotine-mediated modulation of hypothalamic-pituitary-adrenal axis activity, which may be relevant to the maintenance of tobacco dependence. Tobacco-withdrawal cortisol changes do not appear to be a cause or consequence of many manifestations of acute tobacco withdrawal with the possible exception of hunger.

Original languageEnglish (US)
Pages (from-to)152-162
Number of pages11
JournalHuman Psychopharmacology
Issue number2
StatePublished - Mar 2014


  • HPA axis
  • acute tobacco abstinence
  • cortisol levels
  • smoking deprivation
  • withdrawal symptoms


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