Effects of nicotine withdrawal on aviator performance

Institution:	Stanford University
Investigator(s):	Jerome Yesavage, M.D.
Award Cycle:	2001 (Cycle 10)	Grant #: 10RT-0186	Award: $515,243
Subject Area:	Nicotine Dependence
Award Type:	Research Project Awards

Abstracts

Initial Award Abstract

Since 1976, national policy towards smoking has changed drastically and most airlines have adopted non-smoking policies. Thousands of pilots remain smokers and are required to fly long-haul missions with temporary cessation of cigarette smoking. Everyday, many passengers leave California on transoceanic flights with a pilot at the controls who is a smoker and is deprived of smoking because of the non-smoking policies of most airlines. According to many studies, temporary smoking cessation can lead to significant impairment of human performance. For example, temporary abstinence from smoking can slow down reaction time and impair alertness and can lead to drowsiness, restlessness and increased aggression. Such effects might hamper flight safety since pilots have a mission that requires alertness, calmness, ability to work as a member of a team and to make quick decisions at critical points of the flight. However, it has not yet been investigated whether withdrawal effects do indeed occur during long-haul flights in pilots who are smokers, in their actual work place situation, the cockpit. Our study is designed to fill this knowledge gap.

The main goal of our study is to answer the following questions:• •Does the performance of aircraft pilots decrease within 12 h of termination of smoking because of nicotine withdrawal effects?• •Does chewing nicotine gum help to reverse the negative withdrawal effects on the performance of aircraft pilots?

In addition to testing these two main questions we will also test if the effects of nicotine withdrawal and of withdrawal relief by nicotine gum differ between younger and older pilots. Furthermore we will investigate how the degree of dependence on nicotine influences the performance of pilots after cessation of smoking and while chewing nicotine gum.

To answer these questions we will test the performance of 100 aircraft pilots who are smokers in a realistic flight simulator. Each pilot will be tested during two 13.5-h test days in our flight simulator. During the first test day, all pilots are allowed to smoke one cigarette per hour, during the second test day, ¼ of the pilots will be allowed to smoke 1 cigarette per hour, ¼ will be allowed to chew one 4 mg nicotine gum per hour, ¼ will be allowed to chew one placebo gum per hour and ¼ will not be allowed to smoke any cigarette or chew any gum. The pilots who receive gum will not be told whether the gum includes nicotine or not.

In sum, this study is designed to find out whether or not withdrawal from nicotine leads to significant performance impairment in aircraft pilots during a simulation of a long flight and to find out if nicotine gum can effectively reduce this impairment. It will also investigate the influence of age and nicotine dependence on the effects of nicotine on flight performance. It is our goal to provide new knowledge that might increase flight safety while keeping the cockpit a smoke-free environment.

Publications

Psychoactive drugs and pilot performance: a comparison of nicotine, donepezil and alcohol effects.
Periodical: Neuropsychopharmacology			Index Medicus:
Authors: Mumenthaler MS, Yesavage JA, Taylor JL, O'Hara R, Friedman L, Lee H, Kraemer HC				ART
Yr: 0	Vol:	Nbr:	Abs:	Pg:

The assesment of pilot performance under heavy workload.
Periodical: Aviation, Space, and Environmental Medicine			Index Medicus:
Authors: Mumenthaler MS, Taylor JL, Yesavage JA				ABS
Yr: 2004	Vol: 75	Nbr: 4	Abs:	Pg: Supplement: B80

Pilot performance of smokers six hours after smoking cessation: preliminary results of an ongoing study.
Periodical: TRDRP Annual Report to the State of California Legislature			Index Medicus:
Authors: Mumenthaler MS, Taylor JL, Wilson L, Friedman L, Yesavage JA				ABS
Yr: 2003	Vol:	Nbr:	Abs:	Pg:

Effects of cholinergic drugs on pilot performance.
Periodical: Annals of General Hospital Psychiatry			Index Medicus:
Authors: Mumenthaler MS, Taylor JL, O'Hara R, Friedman L, Yesavage JA				ABS
Yr: 2003	Vol: 2	Nbr: Supp. 1	Abs:	Pg: 17

Psychoactive drugs and pilot performance: a comparison of nicotine, donepezil and alcohol effects.
Periodical: Neuropsychopharmacology			Index Medicus:
Authors: Mumenthaler MS, Yesavage JA, Taylor JL, O'Hara R, Friedman L, Lee H, Kraemer HC				ART
Yr: 0	Vol:	Nbr:	Abs:	Pg:

The assesment of pilot performance under heavy workload.
Periodical: Aviation, Space, and Environmental Medicine			Index Medicus:
Authors: Mumenthaler MS, Taylor JL, Yesavage JA				ABS
Yr: 2004	Vol: 75	Nbr: 4	Abs:	Pg: Supplement: B80

Pilot performance of smokers six hours after smoking cessation: preliminary results of an ongoing study.
Periodical: TRDRP Annual Report to the State of California Legislature			Index Medicus:
Authors: Mumenthaler MS, Taylor JL, Wilson L, Friedman L, Yesavage JA				ABS
Yr: 2003	Vol:	Nbr:	Abs:	Pg:

Effects of cholinergic drugs on pilot performance.
Periodical: Annals of General Hospital Psychiatry			Index Medicus:
Authors: Mumenthaler MS, Taylor JL, O'Hara R, Friedman L, Yesavage JA				ABS
Yr: 2003	Vol: 2	Nbr: Supp. 1	Abs:	Pg: 17