***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Buspirone , a non‐sedating anxiolytic , has yielded contradictory results in smoking cessation pilot studies and trials . We tested  buspirone ( n = 51 ) versus placebo ( n = 49 ) in a placebo‐controlled , double‐blind trial of smoking cessation .  Survival analyses were performed with use of strict abstinence criteria for efficacy ( carbon monoxide levels ≤ 8 ppm ; no self‐reported slips to smoking ) . No treatment differences were observed between active and placebo groups . There were also no differences among “ anxiety ” level groups formed post hoc from high versus low , pre‐quit anxiety test scores . A number of withdrawal symptoms increased significantly after subjects quit smoking for both the active drug and placebo groups , but these symptoms were not relieved by treatment . There appears to be little evidence that buspirone is effective in smoking cessation of in the relief of withdrawal associated with cessation in a general sample . Selecting for generalized anxiety or anxiety related to cessation is suggested for future testing Summary One hundred and eighteen cigarette smokers who wished to give up were r and omly assigned to receive either clonidine ( a=42 ) , diazepam ( n=38 ) or placebo ( n=38 ) in a double-blind trial . All subjects also received at least three sessions of behavioural treatment . End of treatment abstinence rates for clonidine , diazepam and placebo groups were 69 % , 40 % and 40 % respectively ( p<0.01 ) . At later follow-up , averaging 4.5 months from the end of treatment , abstinence rates were 57 % , 37 % and 37 % respectively ( NS ) . Compared with diazepam and placebo , clonidine received more positive ratings ( p<0.005 ) and was more effective in relieving withdrawal symptoms ( p<0.05 ) . This report demonstrates that clonidine helps  smokers to quit . The mechanism of action may involve decreased firing of α-2-noradrenergic cells in the locus coeruleus Recent studies in the animal laboratory indicate that 5-hydroxytryptamine3 ( 5-HT3 ) antagonists reduce the reinforcing effects of several psychoactive drugs , including nicotine . The purpose of our study was to determine if ondansetron , a selective 5-HT3 antagonist , affected tobacco cigarette consumption in smokers . In the first experiment , a prospect i ve , crossover , placebo-controlled trial was used in which subjects ( N = 7 ) were exposed in an inpatient research unit to 0 , 0.15 , 0.3 , or 0.45 mg/kg ondansetron in three equally divided doses given 4 h apart . In the second experiment , seven different subjects were exposed to the same trial except the dose range was reduced to about 10 % : 0 , 0.01 , 0.02 , or 0.04 mg/kg . In each experiment , order of dosing conditions was determined by a Latin square design . Dependent measures included number of cigarettes smoked during the 24-h session , biologic exposure levels ( carbon monoxide and plasma nicotine levels ) , and mood . Number of cigarettes smoked and biologic exposure levels did not differ across drug conditions in either experiment . There were also no effects of ondansetron on mood . From our study results , we conclude that acute administration of ondansetron , at doses appropriate for antiemesis or at markedly lower doses , does not alter tobacco consumption or smoke exposure in humans One hundred one smokers were divided into high and low trait anxiety groups on the basis of a normalized score on the Profile of Mood States Anxiety/Tension Scale and were r and omly assigned to receive buspirone or placebo in a double-blind fashion . After a 1-week baseline , smokers were exposed to an 8-week drug and behavioral intervention involving buspirone or placebo ( up to 60 mg/day ) with concurrent group cognitive behavioral intervention . All smokers were to quit smoking on the target date , set at 4 weeks after the program began . Medication was provided for an additional 4 weeks after group treatment ended . The results showed that buspirone had a beneficial effect on smoking abstinence but only among smokers who were already relatively high in anxiety and only for as long as the drug was available . Moreover , when provided to smokers who were relatively low in anxiety , the drug appeared to interfere with abstinence , although these effects also reversed when the drug was withdrawn . These effects were associated with an attenuation of the expected rise in anxiety before the quit date and its actual reversal thereafter , but only in the buspirone high-anxiety group . One-month abstinence averaged 88 , 61 , 60 , and 89 % for the buspirone high-anxiety , placebo high-anxiety , buspirone low-anxiety , and placebo low-anxiety groups , respectively . By 12 months , abstinence for the buspirone and placebo high- and low-anxiety groups fell to 12 , 23 , 41 , and 36 % , respectively . No differences were observed for measures of self-efficacy , symptoms of withdrawal , medication side effects , or compliance The authors compared the outcome of 208 smokers treated with fixed-dose transdermal nicotine ( n = 69 ) , tapered-dose transdermal nicotine ( n = 71 ) , or buspirone ( n = 68 ) . At baseline , there were no significant differences among the three treatment groups with regard to age , gender , educational level , duration of smoking , number of cigarettes smoked per day , concomitant disease states or drug use , or Fagerstrom score . All smokers participated in a behavior modification program . Fixed-dose transdermal nicotine was given at a dose of 21 or 22 mg/day for 6 weeks . Tapered-dose transdermal nicotine was given at a dose of 21 or 22 mg/day for 4 weeks , 14 mg/day for 4 weeks and 7 mg/day for 4 weeks . Both transdermal nicotine regimens were initiated on the evening before the attempted quit date . Buspirone was started 21 days before the quit attempt and continued for 7 days after the quit attempt . Buspirone was initiated at 5 mg TID for 7 days and then 10 mg TID for 21 days . Smoking cessation was assessed by patient diaries and r and om plasma thiocyanate determinations . Dropouts for any reason were considered treatment failures . Quit rates were as shown in the Table I. Discontinuation of treatment for perceived side effects and dropouts for all reasons were not significantly different among the treatment groups . The authors conclude that fixed-dose transdermal nicotine , tapered-dose transdermal nicotine , and buspirone are associated with similar efficacy and safety when combined with behavior modification in smoking cessation Background : Withdrawal symptoms hinder smoking cessation in nicotine-dependent smokers . This prospect i ve , double-blind , placebo-controlled clinical trial was conducted to evaluate buspirone for nicotine withdrawal symptoms . Methods : Fifty-four heavy smokers ( mean 33.1 cigarettes per day for 24 years ) were r and omly prescribed 30 mg/d of buspirone or placebo beginning 3 weeks before abrupt smoking cessation . Vali date d nicotine withdrawal and anxiety scales were administered at baseline and serially for 2 weeks after cessation . Results : Baseline demographic and nicotine-dependence measures were similar for each group . Three smokers ( 1 on buspirone , 2 on placebo ) dropped out of the protocol prior to the quit date . Both groups had significant withdrawal effects over time ( analysis of variance [ ANOVA ] P = 0.0001 ) . There was no significant buspirone effect on any nicotine withdrawal symptoms ( ANOVA , α = 0.05 ) . Smokers who relapsed , regardless of group , reported significantly worse craving , irritability , anxiety , and difficulty concentrating than abstainers ( P < 0.05 ) . Relapse rates at follow-up visits were not significantly different between groups . Two-week abstinence rates were 52 percent for placebo and 62 percent for buspirone ( chi-square , P = 0.760 ) . Conclusions : In these heavy smokers  , buspirone offered no relief from nicotine withdrawal symptoms . Regardless of treatment , relapsing smokers experienced more intense nicotine withdrawal Tobacco withdrawal symptoms hamper smoking cessation . This was a pilot study of buspirone , a new azapirone anxiolytic , for tobacco withdrawal . Thirteen smokers entered an open clinical trial . Smokers were titrated to 30 mg/day of oral buspirone for 2 weeks prior to cessation . Tobacco withdrawal and Spielberger state-anxiety scales were used at baseline , on the quit date , and then at 24 hours , 48 hours , 1 week , and 2 weeks after abrupt cessation . At the final visit , smokers compared their withdrawal experience with previous cessation attempts . Two patients ( 15 percent ) could not tolerate the medication and did not attempt smoking cessation . Of the remaining 11 smokers , 3 ( 27 percent ) rated withdrawal relief “ very definite , ” 6 ( 55 percent ) “ moderate , ” and 2 ( 18 percent ) “ slight . ” More than two-thirds of the smokers believed that their difficulty concentrating , craving , restlessness , and anxiety were improved compared with earlier tobacco withdrawal attempts . Five patients ( 46 percent ) reported decreased smoking urges during the 2-week medication titration period . Tobacco withdrawal symptoms and state-anxiety scores changed significantly during the study ( P < 0.05 ) . These results are encouraging , but they should be interpreted with caution because of the small sample size and lack of placebo control . Buspirone effect on tobacco withdrawal symptoms should be studied in a r and omized , controlled clinical trial BACKGROUND Preliminary information suggests that buspirone hydrochloride ameliorates symptoms of nicotine withdrawal .  In a double-blind , r and omized , placebo-controlled trial , we determined the effects of buspirone on the withdrawal symptoms associated with smoking cessation in 40 long-term cigarette smokers . METHODS Subjects were r and omized to 4 weeks of treatment with either buspirone ( n = 20 ) or placebo ( n = 20 ) . Subjects were instructed to maintain their usual cigarette intake during the first 21 days of treatment and to cease smoking on day 22 of treatment . Withdrawal symptoms were subjectively rated before and during smoking cessation . RESULTS Before smoking cessation , there were no significant differences in the intensity of any withdrawal symptom between the buspirone- and placebo-treated subjects , with the exception of a significantly higher rating for drowsiness in the buspirone group . During the smoking cessation period , the ratings for craving , anxiety , irritability , restlessness , and sadness were significantly lower in the buspirone group than the placebo group . There were no significant differences between the groups in their ratings for hunger , inability to concentrate , or drowsiness . Fifteen buspirone-treated subjects and nine placebo-treated subjects were able to abstain from cigarettes during the entire 7-day smoking cessation period . No subject dropped out of the study for perceived drug side effects . Eight buspirone-treated subjects and five placebo-treated subjects reported side effects , all of which were mild . CONCLUSIONS Buspirone ameliorated most of the short-term withdrawal symptoms associated with smoking cessation . Further controlled studies will be needed to define the benefit in smoking cessation A controlled trial was carried out into the relative efficacy of two beta-blocking agents ( oxprenolol and metoprolol ) as adjuncts to group therapy in a smoking withdrawal clinic . There was no evidence to indicate that these were of specific value in assisting smoking withdrawal OBJECTIVE DSM-IV lists increased anxiety as a nicotine withdrawal symptom . Increased anxiety has been reported to follow smoking cessation in most but not all studies . Indeed , there is some evidence for a reduction in anxiety , compared with precessation levels , after the first few weeks of abstinence . This study reports data from 101 smokers who attempted to stop smoking and who satisfied DSM-III-R criteria for nicotine dependence . METHOD Unlike most studies in this area , a strict criterion of lapse-free abstinence was adopted . It is argued that lapses during an attempt at cessation may underlie a transient increase in anxiety . Anxiety was measured both by a single rating typical in withdrawal studies and by the State-Trait Anxiety Inventory -- State Form X. Patients were rated 2 weeks and 1 week before cessation , immediately before cessation , 24 hours after cessation , and 1 , 2 , 3 , and 4 weeks after cessation . RESULTS Seventy patients were abstinent for the 4-week follow-up period . There was no evidence of an increase in anxiety following smoking cessation . However , there was a significant decrease in anxiety from the first week of abstinence . CONCLUSIONS The results weaken the view that increased anxiety is a robust and central element of the nicotine withdrawal syndrome and suggest that giving up smoking is quite rapidly followed by a reduction in anxiety that may reflect removal of an anxiogenic agent , nicotine A placebo-controlled double-blind clinical trial was conducted to determine whether propranolol helps cigarette smokers to stop smoking ; 73 subjects entered the trial but at the end of eight weeks 
    Output:
    
None of the trials showed strong evidence of an effect for any of these drugs in helping  smokers to quit .
However , confidence intervals were wide , and an effect of anxiolytics can not be ruled out on current evidence .
REVIEW ER 'S CONCLUSIONS There is no consistent evidence that anxiolytics aid smoking cessation , but the available evidence does not rule out a possible effect