The Pharmaceutical Journal
Vol 271 No 7257 p38
12 July 2003

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Afternoon and evening hardest time for smokers to abstain

Smokers who use 16-hour nicotine patches to help them quit are more likely to experience their first lapse in the afternoon or evening rather than in the morning, say researchers from St George's Hospital Medical School, London.

This may be because plasma nicotine levels are reducing, but could also be attributed to fewer smoking restrictions in the evenings or a reduction in cortisol levels at this time, they add.

In a study of 200 smokers, supported by Cancer Research UK, 7 per cent of relapses occurred during the 12-hour period between midnight and noon, while 93 per cent occurred during the afternoon and evening. "Despite nicotine patches providing limited nicotine replacement for the first few hours after waking, there is no evidence that this undermines quit attempts by failing to prevent lapses during that time," the researchers say. They point out that the first lapse has been shown reliably to predict complete relapse to smoking and suggest that coping strategies should be focused on the time of day smokers feel most tempted to smoke, ie, afternoons and evenings.