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As nicotine levels drop, symptoms such as restlessness, low mood, and anxiety re-emerge, reinforcing the cycle of dependence. Beyond psychological explanations, nicotines interaction with the hypothalamicpituitaryadrenal (HPA) axis, which regulates the stress response, provides a biological basis for its effects on mood

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Discussion The aim of the present study was to investigate changes in depressive symptomatology over time after a cognitive-behavioural intervention for smoking cessation, among smokers with a history of depressive episode