Does carbon monoxide play a role in cigarette smoke dependence

Purpose: Nicotine is the primary constituent of cigarette smoke responsible for dependence but other components may play a role. Carbon monoxide (CO) is one candidate since it is synthesized endogenously with multiple physiological effects. This investigation was conducted to determine whether CO alters cravings associated with cigarette smoke withdrawal.Methods: With ethics approval and consent, 131 smokers were assigned to receive: (1) inhaled CO + Nicotine nasal spray (2) Air + Nicotine nasal spray (3) CO + Placebo nasal spray or (4) Air + Placebo nasal spray. Two craving scales (adapted from Hughes and Hatsukami [Hughes, J.R., & Hatsukami, D. (1986). Signs and symptoms of tobacco withdrawal. Archives of General Psychiatry, 43, 289–294] and Shiffman-Jarvik [Shiffman, S.M., & Jarvik, M.E. (1976). Smoking withdrawal symptoms in two weeks of abstinence. Psychopharmacology, 50, 35–39] referred to as HH and SJ, respectively) and a mood state questionnaire were used to assess withdrawal relief.Results: Cravi...