Subjective response to cigarette smoking following airway anesthetization

Subjective response to cigarette smoking was assessed after partial blockade of upper and lower airway sensations by the topical application of lidocaine. Pack-a-day smokers were given one cigarette after each of four conditions: (1) mouth anesthesia, obtained by rinsing the mouth with 2% lidocaine; (2) mouth and pharyngeal anesthesia, in which subjects rinsed their mouths and gargled with 2% lidocaine; (3) upper and lower airway anesthesia, in which subjects rinsed their mouths and gargled with a 2% lidocaine solution, and inhaled a mist containing 4% lidocaine (60 breaths); and (4) saline control, in which all solutions (rinse, gargle and inhalation) were saline. A significant linear decline in cigarette craving occurred with increasing anesthesia, and desirability ratings over the first several puffs were also reduced by anesthesia. These results suggest that sensory cues are important factors in smoking satisfaction, and their influence can be analyzed with the use of local anesthetics.