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Creswell KG, Sayette MA. How laboratory studies of cigarette craving can inform the experimental alcohol craving literature. Alcohol Clin Exp Res 2022; 46:344-358. [PMID: 35037262 PMCID: PMC8920775 DOI: 10.1111/acer.14773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 01/03/2022] [Accepted: 01/05/2022] [Indexed: 11/28/2022]
Abstract
Interest in alcohol and other drug craving has flourished over the past two decades, and evidence has accumulated showing that craving can be meaningfully linked to both drug use and relapse. Considerable human experimental alcohol craving research since 2000 has focused on craving as a clinical phenomenon. Self-reported craving to drink typically has served as a catch-all for the craving construct in these studies, whereas few studies have considered craving as a process (or hypothetical construct) that interacts with other phenomena to affect use. In contrast to alcohol, we believe that recently there has been more mechanistic work targeting cigarette craving-related processes. Here, we briefly present a narrative review of studies of acute alcohol craving in humans that have been conducted during the past two decades. We then specify important ways in which alcohol and tobacco differ (e.g., the role of withdrawal), and we note the unique challenges in inducing robust alcohol craving states in the laboratory. Finally, we offer recommendations for how the alcohol field might advance its conceptual understanding of craving by adopting ideas and methods drawn from the smoking research literature. Specifically, we suggest that researchers extend their studies to not only examine the link between alcohol craving and relapse but also to focus on why and, in some instances, how alcohol cravings matter clinically, and the circumstances under which craving especially matters. We propose research to investigate the shifts in alcohol-related cognitive and affective processing that occur during alcohol craving states. Furthermore, we highlight the value of research examining the level of insight that individuals with varying levels of alcohol involvement possess about their own craving-related processing shifts. We believe that laboratory studies can provide rich opportunities to examine conceptual questions about alcohol craving that are central to addiction.
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Affiliation(s)
- Kasey G. Creswell
- Department of PsychologyCarnegie Mellon UniversityPittsburghPennsylvaniaUSA
| | - Michael A. Sayette
- Department of PsychologyUniversity of PittsburghPittsburghPennsylvaniaUSA
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Motschman CA, Tiffany ST. Combined smoking and alcohol cues: Effects on craving, drug-seeking, and consumption. Alcohol Clin Exp Res 2021; 45:1864-1876. [PMID: 34469584 DOI: 10.1111/acer.14662] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/15/2021] [Accepted: 06/17/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Alcohol and cigarettes are commonly used together, but little is known about their joint motivational impact. Cue reactivity studies have customarily examined alcohol and smoking cues in isolation, despite the potential for cues to elicit stronger motivational responses when combined. This study used a validated cue reactivity procedure (Choice Behavior Under Cued Conditions) systematically to disentangle the separate and joint effects of alcohol and cigarette cues on substance use motivation. METHODS Participants were 110 adults (Mage = 34.0, SD = 10.8) who consumed both cigarettes and alcohol. Participants completed 40 cue reactivity trials with four in vivo cue types: water, alcohol, cigarette, and combined cigarette and alcohol. Participants rated their craving prior to receiving opportunities to spend real money to gain access to the cues. Spending larger amounts of money increased the probability that the substance(s) would be available for consumption. When granted access, participants took one cigarette puff and/or sip of the beverage. A multimethod approach assessed three key motivational indices: craving, drug-seeking (spending, latency to access the cue), and consumption (puff duration, alcohol consumed). Effects of cue type and rates of substance use (cigarettes per day, drinks per day, relative frequency of co-use) were assessed using hierarchical linear models. RESULTS Both alcohol and smoking cues enhanced cue-specific craving but not craving for the alternative substance. In a novel finding, combined cues elicited higher craving and greater spending than single-drug cues. All drug cues elicited greater spending than water cues, and spending was moderated by the relative frequency of co-use. CONCLUSIONS We found that combined alcohol and cigarette cues provoke more powerful craving and drug-seeking responses and, therefore, may be more motivationally potent among individuals who use multiple substances.
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Affiliation(s)
- Courtney A Motschman
- Department of Psychology, University at Buffalo, The State University of New York, Buffalo, New York, USA.,Department of Psychological Sciences, University of Missouri, Columbia, Columbia, Missouri, USA
| | - Stephen T Tiffany
- Department of Psychology, University at Buffalo, The State University of New York, Buffalo, New York, USA
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Karelitz JL. Differences in Magnitude of Cue Reactivity Across Durations of Smoking History: A Meta-analysis. Nicotine Tob Res 2020; 22:1267-1276. [PMID: 31050735 PMCID: PMC7364848 DOI: 10.1093/ntr/ntz071] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 04/29/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Cue-elicited craving may vary due to duration of smoking history, increasing as more years of smoking strengthen associations between nicotine intake and cues. However, research on this relationship is virtually absent. This project assessed the relationship between cue reactivity and years of smoking. METHODS Data from 53 studies (68 effect sizes) were analyzed. Eligible studies were those measuring self-reported craving following cue exposure in nontreatment seeking smokers and reporting mean years smoking. Preliminary subgroup analyses identified methodological factors influencing cue-reactivity effect sizes; primary meta-regression analysis assessed differences across years smoking; exploratory analyses assessed potential for ceiling effects. RESULTS Effect sizes varied due to abstinence requirement and cue presentation modality, but not dependence severity. Unexpectedly, meta-regression analysis revealed a decline in effect sizes across years smoking. Exploratory analyses suggested declines may have been due to a ceiling effect in craving measurement for those with longer smoking histories-more experienced smokers reported higher levels of craving at baseline or following neutral cue exposure, but all reported similar levels of craving after smoking cue exposure. CONCLUSIONS Methodological factors and duration of smoking history influenced measurement of cue reactivity. Highlighted were important relationships between years smoking and magnitude of cue reactivity, depending on use of baseline or neutral cue comparisons. Further research is needed to assess differences in cue reactivity due to duration of smoking history using participant-level data, directly testing for ceiling effects. In addition, cue-reactivity studies are needed across young adults to assess onset of associations between nicotine intake and cues. IMPLICATIONS This meta-analysis project contributes to the cue-reactivity literature by reporting on the previously ignored relationship between duration of smoking history and magnitude of cue-elicited craving. Results suggest that declines in cue-reactivity effect sizes across years of smoking may have been due to study-level methodological factors, but not due to differences in sample-level dependence severity. Cue-reactivity effect sizes were stable across years of smoking in studies using a neutral cue comparison but declined sharply in studies when baseline assessment (typically coupled with an abstinence requirement) was used.
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Affiliation(s)
- Joshua L Karelitz
- Department of Psychology, University of Pittsburgh, PA
- Department of Psychiatry, University of Pittsburgh, PA
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Cui Y, Engelmann JM, Gilbert DG, Waters AJ, Cinciripini PM, Robinson JD. The impact of nicotine dose and instructed dose on smokers' implicit attitudes to smoking cues: An ERP study. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2019; 33:710-720. [PMID: 31657594 DOI: 10.1037/adb0000523] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
It is unclear whether nicotine and perceived nicotine exposure can influence automatic evaluations of cigarette stimuli. In the present study, we investigated the effects of nicotine dose and instructed dose on motivational responses to smoking cues. Forty overnight nicotine-deprived smokers completed an Implicit Association Test (IAT) at each of the four laboratory sessions in a balanced-placebo design that crossed nicotine dose (Given-NIC [given nicotine] vs. Given-DENIC [given denicotinized]) with instructed dose expectancy (Told-NIC [told-nicotine] vs. Told-DENIC. [told-denicotinized]). We measured participants' behavioral performance, including reaction time (RT) and accuracy rate, and the early posterior negativity (EPN) component using the event-related potential (ERP) technique to the target pictures. During congruent trials when the categorization condition was smoking or unpleasant, smokers had greater classification accuracy, shorter RT latency, and greater EPN amplitudes compared to the incongruent trials when the categorization condition was smoking or pleasant. The Given-NIC condition was associated with increased classification accuracy, longer RT latency, and decreased EPN amplitudes compared to the Given-DENIC condition. Similarly, the Told-NIC condition was associated with increased accuracy and decreased EPN amplitudes compared to the Told-DENIC condition, but with shorter RT latency. Cigarette-related pictures produced greater EPN amplitudes than neutral pictures. Both behavioral and ERP results suggest that smokers have negative implicit attitudes toward smoking. While both nicotine dose and expected dose facilitated stimulus categorization, there was no evidence that either factor altered smokers' negative attitudes toward smoking cues. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Yong Cui
- Department of Behavioral Science
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5
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Sayette MA, Marchetti MA, Herz RS, Martin LM, Bowdring MA. Pleasant olfactory cues can reduce cigarette craving. JOURNAL OF ABNORMAL PSYCHOLOGY 2019; 128:327-340. [PMID: 30985171 DOI: 10.1037/abn0000431] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cigarette craving is a cardinal feature of smoking, which is the leading preventable cause of death. Despite its clinical relevance, there remains a pressing need to develop new approaches for controlling craving. Although olfactory cues (OCs) are especially well suited to reduce affectively charged cravings, there has been surprisingly little research on the topic. We investigated the strategic use of OCs to reduce cigarette craving. Abstinent smokers (N = 232) initially sampled and rated a series of OCs. Participants then were exposed to in vivo smoking cues, which produced robust cigarette cravings. During peak craving, they were randomly assigned to sniff one of three types of OCs (all of which they had previously sampled) while their craving, and a set of responses thought to be associated with craving, were assessed. OCs that a participant had rated as pleasant reduced craving more than did exposure to odor blank (i.e., neutral) or tobacco-related OCs. This effect persisted over the course of 5 min. In addition, smokers with the most specific autobiographical memory systems were most responsive to the craving-reducing effects of pleasant OCs. About 90% of participants reported they could imagine using a pleasant OC to curb their craving in the natural environment. The present data suggest that OCs show promise for controlling cravings and highlight the need to conduct further research to test whether OCs may prove useful alone or in combination with existing approaches as a smoking cessation intervention. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Changes in Smoking Behaviors following Exposure to Health Shocks in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122905. [PMID: 30572581 PMCID: PMC6313584 DOI: 10.3390/ijerph15122905] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 12/12/2018] [Accepted: 12/14/2018] [Indexed: 11/17/2022]
Abstract
Background: Evidence suggests that following major individual health shocks, smokers change their smoking behaviors. However, little is known about the association between spousal health shocks and smoking. This study examined the contemporaneous and long-term effects of individual and spousal health shocks on males’ smoking behaviors in China. Methods: This study employed a nation-wide data base from the 1991–2011 China Health and Nutrition Study. Random effects models were estimated to ascertain the impacts of health shocks on males’ smoking behavior. Smoking behaviors were measured by smoking status, smoking consumption and smoking cessation. Results: In the short term, respondents who incurred health shocks decreased their likelihood of smoking by 10%. In addition, health shocks decreased the likelihood of heavy smoking versus the combined moderate and light categories by 41.6%, and increased their likelihood of quitting by 85.3% for ever smokers. Spousal health shocks had no significant effects on individual smoking behaviors. The long-term effects were similar to the short term impacts. Conclusions: People changed their smoking behaviors in response to their own health experiences but not those of their spouses. Antismoking messages about the health effects on others are unlikely to influence individual smoking behaviors, unless individuals believed that they are personally vulnerable to smoking-related diseases.
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Hahn B, Wells AK, Lenartowicz A, Yuille MB. Nicotine effects on associative learning in human non-smokers. Neuropsychopharmacology 2018; 43:2190-2196. [PMID: 30131565 PMCID: PMC6135766 DOI: 10.1038/s41386-018-0183-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 07/27/2018] [Accepted: 08/08/2018] [Indexed: 12/31/2022]
Abstract
Tobacco smoking is the most common preventable cause of death in the US. Nicotine is considered the primary constituent responsible for tobacco addiction. Its paradoxically high abuse potential may reflect behavioral control by drug-associated stimuli, which appears to play a larger role for tobacco dependence than for other abused drugs. We tested a potential explanation, hypothesizing that nicotine enhances associative learning, the mechanism underlying the conditioning of drug-associated stimuli. Thirty-two non-smokers were exposed to transdermal nicotine (7 mg/24 h) and placebo in a double-blind cross-over study and tested with behavioral paradigms designed to isolate incidental stimulus-stimulus or stimulus-response learning. The stop signal task required speeded gender judgments of face stimuli. A tone signaled when to withhold the response. Unbeknownst to participants, some faces were always paired with stop trials. Nicotine enhanced the facilitation of stop-responses to these stimuli, and the slowing of go-responses when previously stop-associated stimuli were paired with go trials, indicating stronger associations between paired stimuli and the stop signal/stop response. Another task required feedback-based learning of associations between pairs of shape stimuli. Five pairs were made from either ten different stimuli, or from different combinations of two identical sets of five stimuli with correct associations depending on contextual information. Nicotine increased incorrect choices of stimuli that were associated in a different context, indicating stronger stimulus-stimulus associations at the expense of flexible context-adaptive behavior. The results indicate that nicotine can enhance incidental associative learning, a mechanism that may promote the formation of smoking-associated stimuli and cue-controlled drug-taking.
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Affiliation(s)
- Britta Hahn
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, P.O. Box 21247, Baltimore, MD, 21228, USA.
| | - Ashleigh K. Wells
- 0000 0001 2175 4264grid.411024.2Maryland Psychiatric Research Center, University of Maryland School of Medicine, P.O. Box 21247, Baltimore, MD 21228 USA
| | - Agatha Lenartowicz
- 0000 0000 9632 6718grid.19006.3eSemel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA USA
| | - Marie B. Yuille
- 0000 0001 2175 4264grid.411024.2Maryland Psychiatric Research Center, University of Maryland School of Medicine, P.O. Box 21247, Baltimore, MD 21228 USA
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Hall PA, Bickel WK, Erickson KI, Wagner DD. Neuroimaging, neuromodulation, and population health: the neuroscience of chronic disease prevention. Ann N Y Acad Sci 2018; 1428:240-256. [PMID: 29863790 PMCID: PMC6175225 DOI: 10.1111/nyas.13868] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 04/24/2018] [Accepted: 05/04/2018] [Indexed: 01/10/2023]
Abstract
Preventable chronic diseases are the leading cause of death in the majority of countries throughout the world, and this trend will continue for the foreseeable future. The potential to offset the social, economic, and personal burdens associated with such conditions depends on our ability to influence people's thought processes, decisions, and behaviors, all of which can be understood with reference to the brain itself. Within the health neuroscience framework, the brain can be viewed as a predictor, mediator, moderator, or outcome in relation to health-related phenomena. This review explores examples of each of these, with specific reference to the primary prevention (i.e., prevention of initial onset) of chronic diseases. Within the topic of primary prevention, we touch on several cross-cutting themes (persuasive communications, delay discounting of rewards, and self-control), and place a special focus on obesity as a disorder influenced by both eating behavior and exercise habits.
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Affiliation(s)
- Peter A. Hall
- School of Public Health and Health SystemsUniversity of WaterlooWaterlooOntarioCanada
| | - Warren K. Bickel
- Departments of PsychologyNeuroscience and Health Sciences, Virginia TechRoanokeVirginia
| | - Kirk I. Erickson
- Department of PsychologyUniversity of PittsburghPittsburghPennsylvania
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VanderKaay Tomasulo MM, Scanlin MC, Patterson SM. The Effects of Nicotine and Nicotine Abstinence on Stress-Induced Cardiovascular Reactivity. J PSYCHOPHYSIOL 2017. [DOI: 10.1027/0269-8803/a000174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. The effects of 12 hr nicotine administration and abstinence on stress-induced cardiovascular reactivity were assessed within Light/Intermittent cigarette smokers and Habitual cigarette smokers. One hundred thirty-two male smokers (66 Habitual, 66 Light/Intermittent) were assigned to a Nicotine (21 mg) or Placebo patch condition. Cardiovascular reactivity was assessed during Baseline, a 6-min mental arithmetic task (Paced Auditory Serial Arithmetic Task) and a 5-min mirror-tracing task (Star Mirror Tracing Task). Within the Nicotine condition, Light/Intermittent smokers showed greater cardiac output (CO) increases, smaller stroke volume decreases, and smaller total peripheral resistance (TPR) increases than Light/Intermittent smokers in the Placebo condition. No condition differences in cardiovascular reactivity were demonstrated for Habitual smokers. Light/Intermittent smokers also showed greater CO increases than Habitual smokers during the mirror-tracing task but during the Nicotine condition only. During mental arithmetic, Light/Intermittent smokers had greater CO increases and smaller TPR increases than Habitual smokers across nicotine conditions. Habitual smokers responded to stress with increases in peripheral responses whereas Light/Intermittent smokers responded myocardially. Light/Intermittent smokers may have increased density of β-adrenergic receptors whereas Habitual smokers may have decreased density due to chronic smoking.
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Nair US, Patterson F, Rodriguez D, Collins BN. A telephone-based intervention to promote physical activity during smoking cessation: a randomized controlled proof-of-concept study. Transl Behav Med 2017; 7:138-147. [PMID: 27896797 PMCID: PMC5526805 DOI: 10.1007/s13142-016-0449-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Smoking and physical inactivity contribute to disproportionate disease burden among underserved adults. Telephone-based interventions (quitlines) are becoming the standard care for addressing smoking. There is increasing interest to determine whether quitlines can be utilized to administer interventions for other unhealthy behaviors. This study aims to examine the proof-of-concept and potential efficacy of a telephone-based behavioral counseling intervention to boost daily low-to-moderate physical activity among low-income, physically inactive smokers. Participants (N = 101) were randomized to receive 4 weeks of counseling prior to their smoking quit day that included either standard smoking cessation counseling (control) or the Step-up to Quit (SUTQ) intervention. SUTQ promoted daily walking to foster physical activity as a primary smoking urge management strategy and facilitate incremental increases in daily steps with the goal of achieving 7500 steps/day by the quit day in week 4. Exploratory structural equation modeling tested SUTQ effects on six measures of low-to-moderate physical activity (primary outcome) and smoking cue reactivity (secondary outcome) simultaneously in a single multivariate model with controlling variables. The sample was 51 % female and 77 % African-American, with a mean age of 42.1 years (SD = 10.9). Compared to the control condition, SUTQ intervention was associated with greater physical activity at week 4 (b = 0.51, z = 1.71, p = 0.08), with between-group differences sustained at follow-up. At week 4, the SUTQ group had higher 7-day mean steps/day (M = 7,207.25, SD = 4,276.03) than controls (M = 3,947.03, SD = 3,655.03) (t = 3.35; p < .01); and had more participants reach the >7500 steps/day goal (49% vs. 11 %, c2 = 10.78; p < .01), a difference that was sustained at 1-month follow-up (X2 = 9.04, p < .01) Effects of SUTQ treatment on cue reactivity were in the hypothesized direction but not significant (b = -0.29; z = -1.09, p = 0.27). To our knowledge, this is the first study to promote physical activity using telephone counseling in an underserved population of smokers known to have greater challenges with physical activity adoption and smoking cessation. The SUTQ approach suggests that integration of physical activity advice and support within the context of smoking cessation treatment has the potential to promote physical activity among smokers intending to quit.
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Affiliation(s)
- Uma S Nair
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, 3950 S. Country Club, STE 300, Tucson, AZ, 85714, USA.
| | - Freda Patterson
- Department of Behavioral Health and Nutrition, Center of Biomedical Research Excellence (COBRE) in Cardiovascular Health, University of Delaware, Newark, DE, USA
| | - Daniel Rodriguez
- School of Nursing and Health Sciences, La Salle University, Philadelphia, PA, USA
| | - Bradley N Collins
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
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Heckman BW, MacQueen DA, Marquinez NS, MacKillop J, Bickel WK, Brandon TH. Self-control depletion and nicotine deprivation as precipitants of smoking cessation failure: A human laboratory model. J Consult Clin Psychol 2017; 85:381-396. [PMID: 28333537 PMCID: PMC5364802 DOI: 10.1037/ccp0000197] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The need to understand potential precipitants of smoking relapse is exemplified by relapse rates as high as 95%. The Self-Control Strength model, which proposes that self-control is dependent upon limited resources and susceptible to fatigue, may offer insight into relapse processes. The current study tested the hypothesis that self-control depletion (SCD), produced from engagement in emotional suppression, would serve as a novel antecedent for cessation failure, as indexed by a validated laboratory analogue of smoking lapse and relapse. We also examined whether SCD effects interacted with those of a well-established relapse precipitant (i.e., nicotine deprivation). Craving and behavioral economic indices (delay discounting and demand) were tested as hypothesized mechanisms for increased cessation failure. Ultimately, a moderated mediation model was used to test nicotine deprivation as a hypothesized moderator of SCD effects. METHOD We used a 2 × 2 (12-hr deprivation vs. no deprivation; SCD vs. no SCD) factorial between-subjects design (N = 128 smokers). RESULTS The primary hypothesis of the study was supported, as SCD increased lapse behavior (p = .04). Nicotine deprivation significantly increased craving, cigarette demand, delay discounting, and lapse behavior. No main effects were found for SCD on putative mediators (i.e., craving, demand, and discounting), but the SCD and deprivation manipulations interacted upon craving (p = .04). The moderated mediation model was significant. SCD was found to increase craving among nicotine deprived smokers, which mediated effects on lapse behavior. CONCLUSIONS SCD appears to play an important role in smoking relapse and may be a viable target for intervention. (PsycINFO Database Record
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Affiliation(s)
- Bryan W Heckman
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina
| | | | | | - James MacKillop
- Department of Psychiatry & Behavioural Neurosciences, Peter Boris Centre for Addictions Research, McMaster University
| | - Warren K Bickel
- Department of Psychiatry and Behavioral Medicine, Virginia Tech Carilion Research Institute
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Sayette MA, Dimoff JD. In search of anticipatory cigarette cravings: The impact of perceived smoking opportunity and motivation to seek treatment. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2016; 30:277-86. [PMID: 27099960 DOI: 10.1037/adb0000177] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Craving has long been considered central to addiction, but it remains unclear just how it contributes to drug use or relapse. Improved understanding of its role in addiction requires a more fine-grained examination of craving, including the context in which it occurs. This study used a novel set of smoking-related and unrelated stimuli to investigate the responses of 227 nicotine-deprived smokers under conditions that manipulated perceived smoking opportunity and motivation to quit smoking. Specifically, we contrasted features of preconsumptive states when active smokers anticipate smoking soon to states when smokers do not have this expectation. Results indicated that under certain conditions (smokers not interested in quitting who expected to be able to smoke soon), exposure to smoking cues becomes attractive. Specifically, these smokers found smoking-related images to be more pleasant than did smokers who were either motivated to quit smoking within the next month or who were informed that they would not be permitted to smoke during the experiment. More broadly, the study raises the possibility that the loss of routinely experienced pleasant cravings upon quitting smoking may yield challenges to staying quit and requires greater clinical attention. (PsycINFO Database Record
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Effects of cognitive load on neural and behavioral responses to smoking-cue distractors. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2016; 16:588-600. [PMID: 27012714 DOI: 10.3758/s13415-016-0416-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Smoking cessation failures are frequently thought to reflect poor top-down regulatory control over behavior. Previous studies have suggested that smoking cues occupy limited working memory resources, an effect that may contribute to difficulty achieving abstinence. Few studies have evaluated the effects of cognitive load on the ability to actively maintain information in the face of distracting smoking cues. For the present study, we adapted an fMRI probed recall task under low and high cognitive load with three distractor conditions: control, neutral images, or smoking-related images. Consistent with a limited-resource model of cue reactivity, we predicted that the performance of daily smokers (n = 17) would be most impaired when high load was paired with smoking distractors. The results demonstrated a main effect of load, with decreased accuracy under high, as compared to low, cognitive load. Surprisingly, an interaction revealed that the effect of load was weakest in the smoking cue distractor condition. Along with this behavioral effect, we observed significantly greater activation of the right inferior frontal gyrus (rIFG) in the low-load condition than in the high-load condition for trials containing smoking cue distractors. Furthermore, load-related changes in rIFG activation partially mediated the effects of load on task accuracy in the smoking-cue distractor condition. These findings are discussed in the context of prevailing cognitive and cue reactivity theories. These results suggest that high cognitive load does not necessarily make smokers more susceptible to interference from smoking-related stimuli, and that elevated load may even have a buffering effect in the presence of smoking cues under certain conditions.
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14
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Carim-Todd L, Mitchell SH, Oken BS. Impulsivity and Stress Response in Nondependent Smokers (Tobacco Chippers) in Comparison to Heavy Smokers and Nonsmokers. Nicotine Tob Res 2015; 18:547-56. [PMID: 26391579 DOI: 10.1093/ntr/ntv210] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 09/11/2015] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Tobacco chippers are light smokers with stable patterns of smoking that exhibit lower nicotine dependence severity than heavy smokers. Chippers may provide valuable information about the factors influencing drug dependence. Impulsivity and stress are two factors known to influence smoking. By comparing nondependent smokers (tobacco chippers, n = 25) to dependent smokers (heavy smokers, n = 23) and nonsmokers (n = 25), this study examines the relationship between nicotine dependence, impulsivity, chronic stress, and stress reactivity. METHODS A total of 73 adult participants completed a study visit that included questionnaires to measure nicotine dependence, chronic stress, personality, affect, withdrawal, and craving. Impulsivity was measured with the delay discounting task and the flanker task. Stress reactivity was assessed by monitoring respiration, heart rate, and salivary cortisol during performance of a titrated Stroop task. Effects of acute stress on affect and craving were examined. RESULTS Tobacco chippers were as impulsive as heavy smokers on the delay discounting task but no different from nonsmokers on the flanker task. Heavy smokers reported higher perceived stress than chippers and nonsmokers. Perceived stress was a significant predictor of discounting only in heavy smokers. Acute stress induced changes in respiration, heart rate, and heart rate variability. Craving and negative affect increased after stress in both smoking groups, but craving was associated with affect only in chippers. CONCLUSIONS Tobacco chippers do not differ from heavy smokers in impulsivity, but do differ in perceived stress. One's perception and experience of stress might be associated to nicotine dependence resistance and could inform smoking cessation treatments. IMPLICATIONS By examining impulsivity, chronic stress, and stress reactivity in nondependent smokers (tobacco chippers) compared to dependent smokers and nonsmokers, this study contributes to the understanding of nicotine addiction and informs smoking cessation programs.
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Affiliation(s)
- Laura Carim-Todd
- Department of Neurology, Oregon Health & Science University (OHSU), Portland, OR; Oregon Center for Complementary and Alternative Medicine in Neurological Disorders (ORCCAMIND), Oregon Health & Science University, Portland, OR;
| | - Suzanne H Mitchell
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR; Department of Psychiatry, Oregon Health & Science University, Portland, OR
| | - Barry S Oken
- Department of Neurology, Oregon Health & Science University (OHSU), Portland, OR; Oregon Center for Complementary and Alternative Medicine in Neurological Disorders (ORCCAMIND), Oregon Health & Science University, Portland, OR; Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR
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Abstract
The capacity for self-regulation allows people to control their thoughts, behaviors, emotions, and desires. In spite of this impressive ability, failures of self-regulation are common and contribute to numerous societal problems, from obesity to drug addiction. Such failures frequently occur following exposure to highly tempting cues, during negative moods, or after self-regulatory resources have been depleted. Here we review the available neuroscientific evidence regarding self-regulation and its failures. At its core, self-regulation involves a critical balance between the strength of an impulse and an individual's ability to inhibit the desired behavior. Although neuroimaging and patient studies provide consistent evidence regarding the reward aspects of impulses and desires, the neural mechanisms that underlie the capacity for control have eluded consensus, with various executive control regions implicated in different studies. We outline the necessary properties for a self-regulation control system and suggest that the use of resting-state functional connectivity analyses may be useful for understanding how people regulate their behavior and why they sometimes fail in their attempts.
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Affiliation(s)
- William M. Kelley
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, New Hampshire 03755;
| | - Dylan D. Wagner
- Department of Psychology, The Ohio State University, Columbus, Ohio 43210
| | - Todd F. Heatherton
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, New Hampshire 03755;
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Germeroth LJ, Wray JM, Tiffany ST. Response Time to Craving-Item Ratings as an Implicit Measure of Craving-Related Processes. Clin Psychol Sci 2015; 3:530-544. [PMID: 26405616 PMCID: PMC4577239 DOI: 10.1177/2167702614542847] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Drug craving is typically measured through explicit ratings of craving levels. We examined response time to craving ratings as an implicit measure of craving processes in cigarette smokers. Response time and inter-item variability were investigated as potential indices of certainty in craving ratings. Cigarette smokers, categorized as tobacco dependent or nondependent, completed multiple cue-reactivity sessions with smoking and neutral cues. After each cue, craving level and response time was assessed. Significant inverted-U relationships emerged between craving level and both response time and inter-item variability across conditions, sessions, and groups. Faster response times and less inter-item variability emerged after neutral relative to smoking cues for nondependent smokers and after smoking relative to neutral cues for dependent smokers. Response time provided incremental validity beyond craving level in predicting dependence. Results support use of response time as an implicit measure of craving processes and further distinguish craving experiences between dependent and nondependent smokers.
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Affiliation(s)
- Lisa J Germeroth
- Department of Psychology, University at Buffalo, The State University of New York
| | - Jennifer M Wray
- Department of Psychology, University at Buffalo, The State University of New York
| | - Stephen T Tiffany
- Department of Psychology, University at Buffalo, The State University of New York
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Dijkstra A, Menninga K. Experimentally induced states of mind determine abstinent smokers' level of craving in reaction to smoking-cues. Addict Behav Rep 2015. [PMID: 29531985 PMCID: PMC5845922 DOI: 10.1016/j.abrep.2015.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction The present study aims to contribute to our knowledge on the causes of variations in experienced craving of (ex)smokers. The general idea is tested that when (ex)smokers are exposed to a smoking-cue, their level of craving is determined by the momentary state of mind through which the smoking-cue is interpreted. Methods A cue-reactivity paradigm in temporary abstinent smokers is applied to trigger craving responses under different experimentally induced states of mind. Craving is assessed with a three-item self-report measure. In study 1 (N = 120) a self-affirmation procedure is applied right before abstinent smokers were exposed to their own smoking paraphernalia. In study 2 (N = 140) abstinent smokers received bogus feedback inducing a high or low self-efficacy and strong or weak positive outcome expectations. Results Study 1 showed a significant interaction: When involvement was high, self-affirmation increased the level of craving but when involvement was low self-affirmation lowered craving. Study 2 also showed a significant interaction: Only when the positive outcome expectation of smoking were high, self-efficacy lowered the level of craving. All analyses were controlled for the number of cigarettes smoked a day and number of past quit attempts. Conclusions The present studies provide experimental evidence that levels of craving can be determined by momentary states of mind. This theoretical perspective can be integrated in existing conditioning and social cognitive learning perspectives on craving and substance use.
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Affiliation(s)
- Arie Dijkstra
- University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands
| | - Karin Menninga
- University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands
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Germeroth LJ, Tiffany ST. An examination of reactivity to craving assessment: craving to smoke does not change over the course of a multi-item craving questionnaire. Addict Behav 2015; 45:74-8. [PMID: 25644591 PMCID: PMC4374001 DOI: 10.1016/j.addbeh.2015.01.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 12/31/2014] [Accepted: 01/12/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Self-report measures are typically used to assess drug craving, but researchers have questioned whether completing these assessments can elicit or enhance craving. Previous studies have examined cigarette craving reactivity and found null craving reactivity effects. Several methodological limitations of those studies, however, preclude definitive conclusions. The current study addresses limitations of previous studies and extends this area of research by using a large sample size to examine: (1) item-by-item changes in craving level during questionnaire completion, (2) craving reactivity as a function of craving intensity reflected in item content, (3) craving reactivity differences between nicotine dependent and nondependent smokers, and (4) potential reactivity across multiple sessions. This study also used a more comprehensive craving assessment (the 32-item Questionnaire on Smoking Urges; QSU) than employed in previous studies. METHODS Nicotine dependent and nondependent smokers (n=270; nicotine dependence determined by the Nicotine Addiction Taxon Scale) completed the QSU on six separate occasions across 12 weeks. Craving level was observed at the item level and across various subsets of items. RESULTS Analyses indicated that there was no significant effect of item/subset position on craving ratings, nor were there any significant interactions between item/subset position and session or level of nicotine dependence. CONCLUSIONS These findings indicate that, even with relatively sensitive procedures for detecting potential reactivity, there was no evidence that completing a craving questionnaire induces craving.
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Affiliation(s)
- Lisa J Germeroth
- Department of Psychology, University at Buffalo, The State University of New York, Park Hall Room 204, Buffalo, NY 14260, USA.
| | - Stephen T Tiffany
- Department of Psychology, University at Buffalo, The State University of New York, Park Hall Room 204, Buffalo, NY 14260, USA.
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Albrithen AA, Singleton EG. Brief Arabic tobacco craving questionnaire: An investigation into craving and heavy smoking in Saudi Arabian males. J Family Community Med 2015; 22:8-12. [PMID: 25657605 PMCID: PMC4317997 DOI: 10.4103/2230-8229.149573] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Research in the United States has shown that craving tobacco is associated with smoking, yet no investigation has been done into the relationship between craving and the use of tobacco in Saudi Arabian smokers. The aim of this cross-sectional study was to examine the craving of tobacco by Saudi males and its influence on daily smoking. Subjects were recruited under the auspices of the Tobacco Control Program in Jeddah City and Riyadh. METHODS The American English version of the tobacco craving questionnaire (TCQ-12) is a valid measure of four distinct aspects (factors) of tobacco craving. The TCQ-12 was translated into Arabic tobacco craving questionnaire (ATCQ-12) and administered to a sample of 322 male smokers. Predictive validity was determined by examining the relationship between the factors and the number of cigarettes smoked per day (CPD). RESULTS In a general linear multivariate analysis of variance model, CPD increased significantly as either ATCQ-12 Factor 1 (emotionality) or Factor 3 (compulsiveness) increased. A significant Factor 1 by Factor 3 interaction indicated that Factor 1 was a better predictor of heavy smoking, but only when Factor 3 was low. Factor 3 was a better predictor of heavy smoking, but only when Factor 1 was low. CONCLUSIONS The ATCQ-12 is a rapid measure of craving and valid predictor of CPD and heavy smoking. Craving in anticipation of smoking as relief from a negative mood (emotionality) is an indicator of psychological withdrawal symptoms, while craving in anticipation of the inability to control tobacco use (compulsiveness) is an indicator of physical dependence.
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20
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Ashe ML, Newman MG, Wilson SJ. Delay discounting and the use of mindful attention versus distraction in the treatment of drug addiction: a conceptual review. J Exp Anal Behav 2014; 103:234-48. [PMID: 25545725 DOI: 10.1002/jeab.122] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 11/13/2014] [Indexed: 01/21/2023]
Abstract
In recent decades, researchers have integrated measurements of delay discounting, how the subjective valuation of a reward changes as a function of time, into their study of addiction. Research has begun to explore the idea that delay discounting may serve as both a marker for the effectiveness of existing treatments for addiction and a potential target for novel intervention strategies. As this work is in its infancy, many potentially significant connections between the construct of delay discounting and the treatment of addiction have yet to be explored. Here, we present a conceptual review highlighting novel points of intersection between delay discounting and two approaches to treating addiction that have become increasingly popular in recent years: those that focus on the development of mindfulness skills and those that emphasize the use of distraction techniques. Viewing these two techniques through the lens of delay discounting is particularly intriguing because of the very different way that they address the experience of drug cravings in the present moment (nonjudgmentally attending to vs. shifting attention away from subjective cravings, respectively). We propose that these opposing strategies for dealing with cravings may interact with delay discounting in ways that have important implications for treatment effectiveness.
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Dunbar MS, Shiffman S, Kirchner T, Tindle H, Scholl S. Nicotine dependence, "background" and cue-induced craving and smoking in the laboratory. Drug Alcohol Depend 2014; 142:197-203. [PMID: 25028339 PMCID: PMC4140567 DOI: 10.1016/j.drugalcdep.2014.06.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 06/13/2014] [Accepted: 06/13/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND Nicotine dependence has been associated with higher "background" craving and smoking, independent of situational cues. Due in part to conceptual and methodological differences across past studies, the relationship between dependence and cue-reactivity (CR; e.g., cue-induced craving and smoking) remains unclear. METHODS 207 daily smokers completed six pictorial CR sessions (smoking, negative affect, positive affect, alcohol, smoking prohibitions, and neutral). Individuals rated craving before (background craving) and after cues, and could smoke following cue exposure. Session videos were coded to assess smoking. Participants completed four nicotine dependence measures. Regression models assessed the relationship of dependence to cue-independent (i.e., pre-cue) and cue-specific (i.e., pre-post cue change for each cue, relative to neutral) craving and smoking (likelihood of smoking, latency to smoke, puff count). RESULTS Dependence was associated with background craving and smoking, but did not predict change in craving across the entire sample for any cue. Among alcohol drinkers, dependence was associated with greater increases in craving following the alcohol cue. Only one dependence measure (Wisconsin Inventory of Smoking Dependence Motives) was consistently associated with smoking reactivity (higher likelihood of smoking, shorter latency to smoke, greater puff count) in response to cues. CONCLUSION While related to cue-independent background craving and smoking, dependence is not strongly associated with laboratory cue-induced craving under conditions of minimal deprivation. Dependence measures that incorporate situational influences on smoking correlate with greater cue-provoked smoking. This may suggest independent roles for CR and traditional dependence as determinants of smoking, and highlights the importance of assessing behavioral CR outcomes.
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Affiliation(s)
- Michael S. Dunbar
- Smoking Research Group, Department of Psychology, University of Pittsburgh, 130 N. Bellefield Avenue, Suite 510, Pittsburgh, PA 15213, USA
| | - Saul Shiffman
- Smoking Research Group, Department of Psychology, University of Pittsburgh, 130 N. Bellefield Avenue, Suite 510, Pittsburgh, PA 15213, USA
| | - Thomas Kirchner
- Schroeder Institute for Tobacco Research and Policy Studies, 1724 Massachusetts Avenue NW, Washington, DC 20036, USA
| | - Hilary Tindle
- Division of General Internal Medicine, University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh, PA 15213, USA
| | - Sarah Scholl
- Smoking Research Group, Department of Psychology, University of Pittsburgh, 130 N. Bellefield Avenue, Suite 510, Pittsburgh, PA 15213, USA
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Shiffman S, Dunbar MS, Li X, Scholl SM, Tindle HA, Anderson SJ, Ferguson SG. Smoking patterns and stimulus control in intermittent and daily smokers. PLoS One 2014; 9:e89911. [PMID: 24599056 PMCID: PMC3943840 DOI: 10.1371/journal.pone.0089911] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 01/24/2014] [Indexed: 11/23/2022] Open
Abstract
Intermittent smokers (ITS) – who smoke less than daily – comprise an increasing proportion of adult smokers. Their smoking patterns challenge theoretical models of smoking motivation, which emphasize regular and frequent smoking to maintain nicotine levels and avoid withdrawal, but yet have gone largely unexamined. We characterized smoking patterns among 212 ITS (smoking 4–27 days per month) compared to 194 daily smokers (DS; smoking 5–30 cigarettes daily) who monitored situational antecedents of smoking using ecological momentary assessment. Subjects recorded each cigarette on an electronic diary, and situational variables were assessed in a random subset (n = 21,539 smoking episodes); parallel assessments were obtained by beeping subjects at random when they were not smoking (n = 26,930 non-smoking occasions). Compared to DS, ITS' smoking was more strongly associated with being away from home, being in a bar, drinking alcohol, socializing, being with friends and acquaintances, and when others were smoking. Mood had only modest effects in either group. DS' and ITS' smoking were substantially and equally suppressed by smoking restrictions, although ITS more often cited self-imposed restrictions. ITS' smoking was consistently more associated with environmental cues and contexts, especially those associated with positive or “indulgent” smoking situations. Stimulus control may be an important influence in maintaining smoking and making quitting difficult among ITS.
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Affiliation(s)
- Saul Shiffman
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- * E-mail:
| | - Michael S. Dunbar
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Xiaoxue Li
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Sarah M. Scholl
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Hilary A. Tindle
- Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Stewart J. Anderson
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
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Acker J, MacKillop J. Behavioral economic analysis of cue-elicited craving for tobacco: a virtual reality study. Nicotine Tob Res 2013; 15:1409-16. [PMID: 23322768 PMCID: PMC3715390 DOI: 10.1093/ntr/nts341] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Accepted: 12/11/2012] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Subjective craving is a prominent construct in the study of tobacco motivation; yet, the precise measurement of tobacco craving poses several difficulties. A behavioral economic approach to understanding drug motivation imports concepts and methods from economics to improve the assessment of craving. METHODS Using an immersive virtual reality (VR) cue reactivity paradigm, this study tested the hypothesis that, compared with neutral cues, tobacco cues would result in significant increases in subjective craving and diverse aspects of demand for tobacco in a community sample of 47 regular smokers. In addition, the study examined these motivational indices in relation to a dual-component delay and cigarette consumption self-administration paradigm. RESULTS In response to the VR tobacco cues, significant increases were observed for tobacco craving and the demand indices of Omax (i.e., maximum total expenditure toward cigarettes) and Breakpoint (i.e., price at which consumption is completely suppressed), whereas a significant decrease was observed for Elasticity (i.e., lower cigarette price sensitivity). Continuous analyses revealed trend-level inverse associations between Omax and Intensity in relation to delay duration and significant positive associations between subjective craving, Omax, and Elasticity in relation to the number of cigarettes purchased. CONCLUSIONS The results from this study provide further evidence for the utility of behavioral economic concepts and methods in understanding smoking motivation. These data also reveal the incremental contribution of behavioral economic indices beyond subjective craving in predicting in vivo cigarette consumption. Relationships to previous studies and methodological considerations are discussed.
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Affiliation(s)
- John Acker
- Department of Psychology, University of Georgia, Athens, GA;
| | - James MacKillop
- Department of Psychology, University of Georgia, Athens, GA;
- Department of Behavioral and Social Sciences, Brown University, Providence, RI
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Sayette MA, Tiffany ST. Peak provoked craving: an alternative to smoking cue-reactivity. Addiction 2013; 108:1019-25. [PMID: 23075138 PMCID: PMC3549313 DOI: 10.1111/j.1360-0443.2012.04013.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Revised: 04/10/2012] [Accepted: 06/29/2012] [Indexed: 11/30/2022]
Abstract
Smoking cue-exposure research has provided a powerful tool for examining cravings in the laboratory. A key attraction of this method is that tightly controlled experimental procedures can model craving experiences that are presumed to relate to addiction. Despite its appeal, key assumptions underlying the clinical relevance of smoking cue-reactivity studies have been questioned recently. For both conceptual and methodological reasons it may be difficult to tease apart cue-based and abstinence-based cravings. Moreover, conventional cue-reactivity procedures typically generate levels of craving with only minimal clinical relevance. We argue here that sometimes it is unfeasible-and in some instances conceptually misguided-to disentangle abstinence-based and cued components of cigarette cravings. In light of the challenges associated with cue-reactivity research, we offer an alternative approach to smoking cue-exposure experimental research focusing on peak provoked craving (PPC) states. The PPC approach uses nicotine-deprived smokers and focuses on urges during smoking cue-exposure without subtracting out urge ratings during control cue or baseline assessments. This design relies on two factors found in many cue-exposure studies-nicotine deprivation and exposure to explicit smoking cues-which, when combined, can create powerful craving states. The PPC approach retains key aspects of the cue-exposure method, and in many circumstances may be a viable design for studies examining robust laboratory-induced cravings.
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Cue reactivity in non-daily smokers: effects on craving and on smoking behavior. Psychopharmacology (Berl) 2013; 226:321-33. [PMID: 23142992 PMCID: PMC3581749 DOI: 10.1007/s00213-012-2909-4] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Accepted: 10/17/2012] [Indexed: 10/27/2022]
Abstract
RATIONALE Non-daily, or intermittent smokers (ITS), are increasingly prevalent. Their smoking may be more situational than that of daily smokers (DS), and thus is hypothesized to be more influenced by cues. OBJECTIVES To assess ITS' response to cues, and compare it to that of DS. METHODS Samples of 239 ITS and 207 DS (previously reported in Shiffman et al. 2012a) were studied in 2,586 laboratory cue-reactivity sessions. Craving (Questionnaire of Smoking Urges) and smoking (probability, latency, puff parameters, and carbon monoxide increases) in response to cues was assessed following exposure to neutral cues and cues related to smoking, alcohol, negative affect, positive affect, and smoking prohibitions. Mixed effects models, generalized estimating equations and random-effects survival analyses were used to assess response to cues and differences between DS and ITS. RESULTS ITS' craving increased following exposure to smoking and alcohol cues and decreased following positive affect cues, but cues had little effect on smoking behaviors. Cue reactivity was similar in ITS and DS. Among ITS, craving intensity predicted smoking probability, latency, and intensity, and the effects on latency were stronger among ITS than DS. CONCLUSIONS Contrary to hypotheses, ITS were not more responsive to laboratory cues than DS. Results show that ITS do experience craving and craving increases that are then associated with smoking.
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Bidwell LC, Leventhal AM, Tidey JW, Brazil L, Niaura RS, Colby SM. Effects of abstinence in adolescent tobacco smokers: withdrawal symptoms, urge, affect, and cue reactivity. Nicotine Tob Res 2013; 15:457-64. [PMID: 22949582 PMCID: PMC3611993 DOI: 10.1093/ntr/nts155] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Accepted: 05/24/2012] [Indexed: 11/13/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate abstinence effects in adolescent daily smokers by examining the effects of experimentally manipulated acute smoking abstinence on measures including: (a) withdrawal symptoms, (b) reactive irritability, (c) smoking urges, (d) affect, and (e) responses to smoking cues. METHODS Participants (ages 13-19, 74 daily smokers, and 22 nonsmokers) completed baseline questionnaires and laboratory assessments (Session 1) and returned 1-4 days later to repeat the laboratory assessments (Session 2); half of the smokers were randomly assigned to overnight tobacco abstinence preceding Session 2. RESULTS During Session 2, abstinent smokers reported significantly greater increases in withdrawal symptoms, smoking urges, and negative affect compared with smokers who did not abstain and compared with nonsmokers. Although there was not a significant effect of abstinence on differential reactivity to smoking versus neutral cues, abstinence did result in significantly increased peak provoked urges and negative effect. There was not a significant effect of abstinence on positive affect or reactive irritability, CONCLUSIONS Our results suggest that adolescents experience increases in withdrawal symptoms, smoking urges (un-cued and peak provoked), and negative affect (un-cued and peak provoked) after acute smoking abstinence, but do not experience the increases in reactive irritability or decreases in positive affect that have been shown in adult smokers. Overall findings support the withdrawal relief and negative reinforcement models of smoking maintenance in adolescents and point to withdrawal, urge, and negative affect as important targets for treatment.
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Affiliation(s)
- L Cinnamon Bidwell
- Center for Alcohol and Addiction Studies Brown University, Providence RI 02912, USA.
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Wilson SJ, Creswell KG, Sayette MA, Fiez JA. Ambivalence about smoking and cue-elicited neural activity in quitting-motivated smokers faced with an opportunity to smoke. Addict Behav 2013; 38:1541-1549. [PMID: 22483100 PMCID: PMC3428430 DOI: 10.1016/j.addbeh.2012.03.020] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Revised: 03/01/2012] [Accepted: 03/14/2012] [Indexed: 01/01/2023]
Abstract
Many cigarette smokers appear to experience ambivalence about smoking, defined as the simultaneous co-occurrence of a strong desire to smoke and a strong wish to quit smoking. Research suggests that this ambivalence about smoking affects how smokers respond to cigarette-related stimuli, but many important questions remain about precisely how smoking ambivalence influences cognitive and affective processing during cigarette cue exposure. We used functional magnetic resonance imaging (fMRI) to address this knowledge gap by examining the relation between self-reported ambivalence about smoking and cue-reactivity in quitting-motivated smokers presented with an opportunity to smoke. Eighty-two quitting-motivated cigarette smokers completed a measure assessing their ambivalence about smoking. Subsequently, participants initiated an attempt to quit smoking and underwent an fMRI session, during which they were asked to hold and view a cigarette. Consistent with hypotheses, results indicated that self-reported smoking ambivalence was negatively correlated with cigarette-related activation in brain areas linked to reward-related processing, motivation, and attention (i.e., rostral anterior cingulate and medial prefrontal cortex, caudate nucleus, visual cortex). Self-reported ambivalence was not, however, correlated with activation in brain regions related to conflict processing. This pattern of results is discussed with respect to the process of change for those attempting to quit smoking.
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Affiliation(s)
| | | | - Michael A Sayette
- University of Pittsburgh, United States; Center for the Neural Basis of Cognition, United States
| | - Julie A Fiez
- University of Pittsburgh, United States; Center for the Neural Basis of Cognition, United States
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Shiffman S, Dunbar M, Kirchner T, Li X, Tindle H, Anderson S, Scholl S. Smoker reactivity to cues: effects on craving and on smoking behavior. JOURNAL OF ABNORMAL PSYCHOLOGY 2013; 122:264-80. [PMID: 22708884 PMCID: PMC3988583 DOI: 10.1037/a0028339] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We assessed craving and smoking in response to smoking-relevant cues. Two hundred seven daily smokers viewed images related to 1 of 6 cue sets (cigarettes, positive and negative affect, alcohol, smoking prohibitions, and neutral cues) in separate sessions. Compared with neutral cues, cigarette cues significantly increased craving, and positive affect cues significantly decreased craving. When subjects were then allowed to smoke during continuing cue exposure, cues did not affect the likelihood of smoking or the amount smoked (number of cigarettes, number of puffs, puff time, or increased carbon monoxide). However, craving intensity predicted likelihood of smoking, latency to smoke, and amount smoked, with craving increases after cue exposure making significant independent contributions. Some craving effects were curvilinear, suggesting that they are subject to thresholds and might not be observed under some circumstances.
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Affiliation(s)
- Saul Shiffman
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15213, USA.
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Heinz AJ, Lilje TC, Kassel JD, de Wit H. Quantifying reinforcement value and demand for psychoactive substances in humans. CURRENT DRUG ABUSE REVIEWS 2012; 5:257-72. [PMID: 23062106 PMCID: PMC3566575 DOI: 10.2174/1874473711205040002] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Revised: 08/17/2012] [Accepted: 09/28/2012] [Indexed: 11/22/2022]
Abstract
Behavioral economics is an emerging cross-disciplinary field that is providing an exciting new contextual framework for researchers to study addictive processes. New initiatives to study addiction under a behavioral economic rubric have yielded variable terminology and differing methods and theoretical approaches that are consistent with the multidimensional nature of addiction. The present article is intended to provide an integrative overview of the behavioral economic nomenclature and to describe relevant theoretical models, principles and concepts. Additionally, we present measures derived from behavioral economic theories that quantify demand for substances and assess decision making processes surrounding substance use. The sensitivity of these measures to different contextual elements (e.g., drug use status, acute drug effects, deprivation) is also addressed. The review concludes with discussion of the validity of these approaches and their potential for clinical application and highlights areas that warrant further research. Overall, behavioral economics offers a compelling framework to help explicate complex addictive processes and it is likely to provide a translational platform for clinical intervention.
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Affiliation(s)
- Adrienne J Heinz
- Center for Health Care Evaluation - Palo Alto VA Health Care System, USA.
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Litvin EB, Kovacs MA, Hayes PL, Brandon TH. Responding to tobacco craving: experimental test of acceptance versus suppression. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2012; 26:830-7. [PMID: 23106639 DOI: 10.1037/a0030351] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Acceptance and Commitment Therapy (ACT) provides a theoretical rationale for "acceptance" of thoughts and feelings, and proscribes suppression, a more intuitive and commonly used coping strategy. Suppression is theorized to have negative consequences not applicable to acceptance, including depletion in self-control and ironic postsuppression rebound effects. However, it remains largely unknown whether these strategies differentially affect frequency of drug-related thoughts, craving intensity, drug use behavior, or other relevant outcomes. Adult smokers (N = 162) were randomly assigned to receive a brief laboratory-based coping intervention (acceptance or suppression) or were not given coping instructions (control group) and then were exposed to smoking cues. Results indicated that the suppression group was successful at suppressing thoughts of smoking, as they reported fewer thoughts of smoking than the other two groups. Also, both coping strategies were associated with benefits with respect to craving and affect. However, there were no group differences in depletion, and rebound effects did not occur when coping was discontinued. Following the laboratory session, all participants attempted to quit or at least reduce their smoking for 3 days; the acceptance and suppression groups resumed use of their strategy. At 3-day follow-up, the acceptance and suppression groups reported greater self-efficacy for avoiding smoking when experiencing craving compared to the control group. However, there were no group differences in the number of cigarettes smoked during the 3 days. This study provides support for the value of acceptance-based coping, but it also suggests that more research is needed to differentiate its benefits compared to suppression.
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Affiliation(s)
- Erika B Litvin
- Department of Psychology, University of South Florida, Tampa, Florida, USA.
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Ditre JW, Oliver JA, Myrick H, Henderson S, Saladin ME, Drobes DJ. Effects of divalproex on smoking cue reactivity and cessation outcomes among smokers achieving initial abstinence. Exp Clin Psychopharmacol 2012; 20:293-301. [PMID: 22468897 PMCID: PMC4421892 DOI: 10.1037/a0027789] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Divalproex, a GABA agonist, may be a useful agent in the treatment of tobacco dependence. Cue reactivity assessment paradigms are ideally suited to explore basic mechanisms underlying the pharmacological effects of medications that purport to have efficacy for smoking cessation. Our primary goal in the current study was to examine the effects of divalproex on in-treatment reactivity to smoking-relevant and affective cues, and to determine if these reactions were predictive of posttreatment smoking behavior. There were 120 nicotine dependent smokers enrolled in an 8-week double-blind clinical trial and randomly assigned to either divalproex or placebo conditions. Of these, 72 smokers (60% female) who achieved a minimal level of abstinence underwent an in-treatment cue reactivity assessment. Contrary to expectations, divalproex was associated with greater craving and arousal during smoking cue presentation. Divalproex also inhibited cardiovascular response to pleasant cues. Although no significant differences in cessation-related outcomes between divalproex- and placebo-treated participants were observed, cue-elicited craving to smoke predicted end-of-treatment and posttreatment smoking rates. These findings suggest that in-treatment cue reactivity assessment may proactively and dynamically inform ongoing treatment as well as provide a tool for screening potential medications for smoking cessation.
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Abstract
AIMS To provide an initial abuse liability assessment of an electronic cigarette (EC) in current tobacco cigarette smokers. DESIGN The first of four within-subject sessions was an EC sampling session that involved six, 10-puff bouts (30 seconds inter-puff interval), each bout separated by 30 minutes. In the remaining three sessions participants made choices between 10 EC puffs and varying amounts of money, 10 EC puffs and a varying number of own brand cigarette (OB) puffs, or 10 OB puffs and varying amounts of money using the multiple-choice procedure (MCP). The MCP was completed six times at 30-minute intervals, and one choice was reinforced randomly at each trial. SETTING Clinical laboratory. PARTICIPANTS Twenty current tobacco cigarette smokers. MEASUREMENTS Sampling session outcome measures included plasma nicotine, cardiovascular response and subjective effects. Choice session outcome was the cross-over value on the MCP. FINDINGS EC use resulted in significant nicotine delivery, tobacco abstinence symptom suppression and increased product acceptability ratings. On the MCP, participants chose to receive 10 EC puffs over an average of $1.06 or three OB puffs and chose 10 OB puffs over an average of $1.50 (P < 0.003). CONCLUSIONS Electronic cigarettes can deliver clinically significant amounts of nicotine and reduce cigarette abstinence symptoms and appear to have lower potential for abuse relative to traditional tobacco cigarettes, at least under certain laboratory conditions.
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Affiliation(s)
- Andrea R Vansickel
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA 23298, USA
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Cui Y, Robinson JD, Versace F, Lam CY, Minnix JA, Karam-Hage M, Dani JA, Kosten TR, Wetter DW, Brown VL, Cinciripini PM. Differential cigarette-related startle cue reactivity among light, moderate, and heavy smokers. Addict Behav 2012; 37:885-9. [PMID: 22571920 PMCID: PMC3358408 DOI: 10.1016/j.addbeh.2012.02.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Revised: 01/25/2012] [Accepted: 02/07/2012] [Indexed: 10/14/2022]
Abstract
In this study, we examined the relationship between the level of daily cigarette consumption and the startle response to affective and cigarette-related cues among treatment-seeking smokers. Before receiving any behavioral or pharmacological treatment, 136 smokers attended a baseline laboratory session, during which we recorded their reflexive eyeblink responses to acoustic startle probes while they were viewing pleasant, unpleasant, neutral, and cigarette-related pictures. We found that 1) cigarette-related and pleasant pictures similarly reduced the startle magnitude compared to neutral pictures; 2) the magnitude of startle modulation rendered by pleasant or unpleasant pictures did not differ among light, moderate, and heavy smokers; and 3) startle attenuation by cigarette-related pictures was greater in heavy smokers than in light smokers. These results suggest that similar to pleasant stimuli, cigarette-related cues are motivationally salient for smokers, and that this salience increases with nicotine dependence.
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Affiliation(s)
- Yong Cui
- Graduate Program in Translational Biology and Molecular Medicine and Department of Neuroscience, Baylor College of Medicine, USA
| | - Jason D. Robinson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, USA
| | - Francesco Versace
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, USA
| | - Cho Y. Lam
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, USA
| | - Jennifer A. Minnix
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, USA
| | - Maher Karam-Hage
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, USA
| | - John A. Dani
- Graduate Program in Translational Biology and Molecular Medicine and Department of Neuroscience, Baylor College of Medicine, USA
| | - Thomas R. Kosten
- Graduate Program in Translational Biology and Molecular Medicine and Department of Neuroscience, Baylor College of Medicine, USA
| | - David W. Wetter
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, USA
| | - Victoria L. Brown
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, USA
| | - Paul M. Cinciripini
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, USA
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Weinberger AH, McKee SA, George TP. Smoking cue reactivity in adult smokers with and without depression: a pilot study. Am J Addict 2012; 21:136-44. [PMID: 22332857 DOI: 10.1111/j.1521-0391.2011.00203.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Little is known about the relationship between Major Depressive Disorder (MDD) and smoking-related behaviors such as cue-induced urges to smoke. The purpose of this pilot study was to examine: (1) differences in smoking cue reactivity by MDD history and (2) the association of a diagnosis of MDD, current depressive symptoms, and smoking variables to cue-induced urges to smoke. Participants (N = 52) were n = 31 smokers with no MDD history and n = 21 smokers with past MDD. Participants completed a 2-hour laboratory session during which they were exposed to neutral (eg, pencils) and smoking cues (eg, cigarettes) after smoking one of their preferred brand cigarettes (Satiated Condition) and when it had been 1 hour since they smoked (Brief Deprivation Condition). Cue-induced urges increased with exposure to smoking cues and this increase did not significantly differ by diagnosis group. Current symptoms of depression, but not a diagnosis of MDD, were significantly and positively related to cue-induced cravings in satiated adult smokers. The association between depression symptoms and smoking urges was not significant in the Brief Deprivation Condition. Smoking cue reactivity may be a useful procedure for studying aspects of smoking behavior in adults with depression.
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Affiliation(s)
- Andrea H Weinberger
- Division of Substance Abuse, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut 06519, USA.
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MacKillop J, Brown CL, Stojek MK, Murphy CM, Sweet L, Niaura RS. Behavioral economic analysis of withdrawal- and cue-elicited craving for tobacco: an initial investigation. Nicotine Tob Res 2012; 14:1426-34. [PMID: 22416117 DOI: 10.1093/ntr/nts006] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION The role of craving in nicotine dependence remains controversial and may be a function of measurement challenges. The current study used behavioral economic approach to test the hypotheses that subjective craving from acute withdrawal and exposure to tobacco cues dynamically increases the relative value of cigarettes. METHODS Using a 2 (1-hr/12-hr deprivation) × 2 (neutral/tobacco cues) within-subjects design, 33 nicotine dependent adults completed 2 laboratory sessions. Assessment included subjective craving and behavioral economic indices of cigarette demand, namely Intensity (i.e., cigarette consumption at zero cost), O(max) (i.e., maximum total expenditure), Breakpoint (i.e., highest acceptable price for cigarettes), P(max) (i.e., price at which consumption becomes sensitive to price), and elasticity (i.e., price sensitivity). Behavioral economic indices were generated using a Cigarette Purchase Task in which participants selected between cigarettes for a subsequent 2-hr self-administration period and money. RESULTS Main effects of deprivation and tobacco cues were present for subjective craving and multiple behavioral economic indices of cigarette demand. Interestingly, deprivation significantly increased Breakpoint (p ≤ .01) and P(max) (p ≤ .05) and had trend-level effects on Intensity and O(max) (p ≤ .10); whereas cues significantly reduced elasticity (p ≤ .01), reflecting lower sensitivity to increasing prices. Heterogeneous associations were evident among the motivational variables but with aggregations suggesting variably overlapping motivational channels. CONCLUSIONS These findings further support a behavioral economic approach to craving and a multidimensional conception of acute motivation for addictive drugs. Methodological considerations, including potential order effects, and the need for further refinement of these findings are discussed.
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Affiliation(s)
- James MacKillop
- Department of Psychology, University of Georgia, Athens, GA 30602, USA.
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Engelmann JM, Gewirtz JC, Cuthbert BN. Emotional reactivity to emotional and smoking cues during smoking abstinence: potentiated startle and P300 suppression. Psychophysiology 2011; 48:1656-68. [PMID: 24015407 PMCID: PMC3772548 DOI: 10.1111/j.1469-8986.2011.01235.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Negative affect is thought to be an important factor in the maintenance of cigarette smoking, and thus it is important to further develop objective measures of smoking-related emotional responses. Nonsmokers, non abstinent smokers, and abstinent smokers participated in a cue reactivity task where eyeblink startle amplitude and startle probe P300 (P3) suppression were measured during the presentation of emotional pictures.During unpleasant pictures, the amplitude of both measures was smaller in non abstinent smokers than in nonsmokers or abstinent smokers. P3 suppression, but not startle amplitude, was larger in abstinent smokers than in nonsmokers. Abstinence-induced increases in cigarette craving were associated with P3 suppression during tobacco-related pictures. Results suggest that tobacco abstinence increases emotional reactivity to unpleasant stimuli, which is consistent with negative reinforcement models of tobacco addiction.
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Affiliation(s)
- Jeffery M Engelmann
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA.
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Littel M, Franken IHA. Intentional modulation of the late positive potential in response to smoking cues by cognitive strategies in smokers. PLoS One 2011; 6:e27519. [PMID: 22087333 PMCID: PMC3210181 DOI: 10.1371/journal.pone.0027519] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Accepted: 10/18/2011] [Indexed: 11/19/2022] Open
Abstract
Attentional bias is considered an important concept in addiction since it has been found to correlate with subjective craving and is strongly associated with relapse after periods of abstinence. Hence, investigating in ways to regulate attention for drug cues would be of major clinical relevance. The present study examined deliberate, cognitive modulation of motivated attention for smoking cues in smokers. The effects of three different reappraisal strategies on an electrophysiological measure of attentive processing were investigated. Early and late LPP components in response to passively viewed neutral and smoking pictures were compared with LPPs in response to smoking pictures that were reappraised with three different reappraisal strategies. Results show that when smokers actively imagine how pleasant it would be to smoke (pleasant condition), their early LPP in response to smoking cues increases, but when smokers actively focus on an alternative stimulus (distraction condition) or think of a rational, uninvolved interpretation of the situation (rational condition), smoking-related late LPP amplitude decreases to the processing level of neutral stimuli. Present results are the first to indicate that smoking cue-elicited LPP amplitudes can be modulated by cognitive strategies, suggesting that attentive processing of smoking cues can be intentionally regulated by smokers with various levels of dependence. Although cognitive strategies can lead to enhanced processing of smoking cues, it is not completely clear whether cognitive strategies are also successful in reducing smoking-related motivated attention. Although findings do point in this direction, present study is best considered preliminary and a starting point for other research on this topic. A focus on the distraction strategy is proposed, as there are indications that this strategy is more successful than the rational strategy in decreasing LPP amplitude.
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Affiliation(s)
- Marianne Littel
- Institute of Psychology, Erasmus University Rotterdam, Rotterdam, The Netherlands.
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Wilson SJ, Sayette MA, Fiez JA. Quitting-unmotivated and quitting-motivated cigarette smokers exhibit different patterns of cue-elicited brain activation when anticipating an opportunity to smoke. JOURNAL OF ABNORMAL PSYCHOLOGY 2011; 121:198-211. [PMID: 21859165 DOI: 10.1037/a0025112] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The authors examined the effects of smoking expectancy on cue-reactivity among those motivated and those unmotivated to quit smoking using functional MRI. Cue-elicited activation was observed in the rostral prefrontal cortex (PFC) in smokers who expected to smoke within seconds, but not in those who expected to have to wait hours before having the chance to smoke, regardless of quitting motivation. For quitting-unmotivated smokers expecting to smoke, rostral PFC activation was strongly positively correlated with the activation of several areas previously linked to cue-reactivity, including the medial orbitofrontal cortex (OFC) and rostral anterior cingulate cortex (ACC). In contrast, there was a nonsignificant negative relationship between activation of the rostral PFC and activation of the medial OFC/rostral ACC in quitting-motivated smokers expecting to smoke. Results extend previous work examining the effects of smoking expectancy and highlight the utility of examining interregional covariation during cue exposure. Findings also suggest that investigators may need to pay close attention to the motivational contexts associated with their experiments when studying cue-reactivity, as these contexts can modulate not only responses to drug cues, but perhaps also the functional implications of observed activity.
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Affiliation(s)
- Stephen J Wilson
- Department of Psychology, The Pennsylvania State University, University Park, PA 16802, USA.
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A quantitative analysis of subjective, cognitive, and physiological manifestations of the acute tobacco abstinence syndrome. Addict Behav 2010; 35:1120-30. [PMID: 20807673 DOI: 10.1016/j.addbeh.2010.08.007] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2010] [Revised: 07/02/2010] [Accepted: 08/04/2010] [Indexed: 11/22/2022]
Abstract
RATIONALE Previous studies have documented the existence of signs and symptoms of the acute tobacco abstinence syndrome; however, less attention has been paid to quantifying the magnitude of these effects. OBJECTIVE The present study quantified the relative magnitude of subjective, cognitive, and physiological manifestations of acute tobacco abstinence. METHOD Smokers (N=203, ≥ 15 cig/day) attended two counterbalanced laboratory sessions, one following 12-h of abstinence and the other following ad-lib smoking. At both sessions, they completed an extensive battery of self-report measures (withdrawal, affect, hunger, craving, subjective attentional bias towards smoking cues), physiological assessments (heart rate, blood pressure, brain EEG), and cognitive performance tasks (psychomotor processing, sustained attention, objective attentional bias). RESULTS Abstinence effects were largest for craving, subjective attentional bias, negative affect, overall withdrawal severity, concentration difficulty, hunger, and heart rate. Effects were moderate for positive affect and EEG power. Effects were small, but reliable, for psychomotor speed, sustained attention, and somatic symptoms. Effects on performance-based indices of attentional bias towards smoking-related cues were small and reliable for some indices but not others. Effects were small and inconsistent for blood pressure and EEG frequency. Variation in internal consistency accounted for 33% of the variation in abstinence effect sizes across measures. CONCLUSIONS There was a wide range of effect sizes both across and within domains, indicating that the acute tobacco abstinence syndrome is not a monotonic phenomenon. These findings may be indicative of the relative magnitudes of signs and symptoms that the average smoker may exhibit during acute abstinence.
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Sayette MA, Griffin KM, Sayers WM. Counterbalancing in smoking cue research: a critical analysis. Nicotine Tob Res 2010; 12:1068-79. [PMID: 20884695 DOI: 10.1093/ntr/ntq159] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Cue exposure research has been used to examine key issues in smoking research, such as predicting relapse, testing new medications, investigating the neurobiology of nicotine dependence, and examining reactivity among smokers with comorbid psychopathologies. Determining the order that cues are presented is one of the most critical steps in the design of these investigations. It is widely assumed that cue exposure studies should counterbalance the order in which smoking and control (neutral) cues are presented. This article examines the premises underlying the use of counterbalancing in experimental research, and it evaluates the degree to which counterbalancing is appropriate in smoking cue exposure studies. METHODS We reviewed the available literature on the use of counterbalancing techniques in human smoking cue exposure research. RESULTS Many studies counterbalancing order of cues have not provided critical analyses to determine whether this approach was appropriate. Studies that have reported relevant data, however, suggest that order of cue presentation interacts with type of cue (smoking vs. control), which raises concerns about the utility of counterbalancing. Primarily, this concern arises from potential carryover effects, in which exposure to smoking cues affects subsequent responding to neutral cues. CONCLUSIONS Cue type by order of cue interactions may compromise the utility of counterbalancing. Unfortunately, there is no obvious alternative that is optimal across studies. Strengths and limitations of several alternative designs are considered, and key questions are identified to advance understanding of the optimal conditions for conducting smoking cue exposure studies.
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Affiliation(s)
- Michael A Sayette
- Department of Psychology, 3137 Sennott Square, University of Pittsburgh, Pittsburgh, PA 15260, USA.
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MacKillop J, O’Hagen S, Lisman SA, Murphy JG, Ray LA, Tidey JW, McGeary JE, Monti PM. Behavioral economic analysis of cue-elicited craving for alcohol. Addiction 2010; 105:1599-607. [PMID: 20626376 PMCID: PMC4853028 DOI: 10.1111/j.1360-0443.2010.03004.x] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS Craving as a motivational determinant of drug use remains controversial because of ambiguous empirical findings. A behavioral economic approach may clarify the nature of craving, theorizing that subjective craving functionally reflects an acute increase in a drug's value. The current study tested this hypothesis via a multidimensional assessment of alcohol demand over the course of an alcohol cue reactivity procedure. DESIGN One-way within-subjects design. SETTING Human laboratory environment. PARTICIPANTS Heavy drinkers (n = 92) underwent exposures to neutral (water) cues followed by personalized alcohol cues. ASSESSMENTS Participants were assessed for craving, alcohol demand, affect, and salivation following each exposure. FINDINGS Alcohol versus neutral cues significantly increased craving and multiple behavioral economic measures of the relative value of alcohol, including alcohol consumption under conditions of zero cost (intensity), maximum expenditure on alcohol (O(max)), persistence in drinking to higher prices (breakpoint) and proportionate price insensitivity (normalized P(max)). Craving was significantly correlated with demand measures at levels ranging from 0.21-0.43. CONCLUSIONS These findings support the potential utility of a behavioral economic approach to understanding the role of environmental stimuli in alcohol-related decision making. Specifically, they suggest that the behavioral economic indices of demand may provide complementary motivational information that is related to though not entirely redundant with measures of subjective craving.
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Affiliation(s)
- James MacKillop
- Department of Psychology, University of Georgia, Athens, GA 30602, USA.
| | | | - Stephen A. Lisman
- Department of Psychology, State University of New York at Binghamton, Binghamton, NY
| | - James G. Murphy
- Department of Psychology, University of Memphis, Memphis, TN
| | - Lara A. Ray
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA
| | - Jennifer W. Tidey
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI
| | - John E. McGeary
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI
| | - Peter M. Monti
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI,Providence Veterans Affairs Medical Center, Providence, RI
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Effects of dopamine antagonists on drug cue-induced reinstatement of nicotine-seeking behavior in rats. Behav Pharmacol 2010; 21:153-60. [PMID: 20168211 DOI: 10.1097/fbp.0b013e328337be95] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Dopaminergic neurotransmission has been implicated in associative learning processes related to drugs of abuse. However, it is not clear whether blockade of activation of dopamine receptors alters conditioned incentive properties of nicotine-associated cues. Using a response-reinstatement procedure, this study examined the effects of antagonists selective for the D1 and the D2 subtypes of dopamine receptors on cue-induced reinstatement of nicotine-seeking behavior. Male Sprague-Dawley rats were trained in 30 daily 1 h sessions to intravenously self-administer nicotine (0.03 mg/kg/infusion) on a fixed ratio 5 schedule and associate a conditioned stimulus (cue) with each nicotine delivery. After extinction of responding by withholding nicotine (saline substitution) and its cue, the reinstatement tests were conducted following subcutaneous administration of a D1 antagonist SCH23390 (0, 5, 10, 30 microg/kg) or a D2 antagonist eticlopride (0, 5, 10, 30 microg/kg) in different groups of animals. Both SCH23390 and eticlopride significantly attenuated the magnitude of cue-elicited reinstatement of nicotine-seeking responding. These results indicate that activation of dopaminergic D1 and D2 receptors may play a role in mediating the conditioned motivational effects of nicotine-associated cues as measured in the response-reinstatement procedure. These findings suggest that manipulation of dopaminergic neurotransmission at D1 and/or D2 receptors may prove to be a potential target for the development of pharmacotherapy for prevention of environmental nicotine cue-triggered smoking relapse.
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Heishman SJ, Lee DC, Taylor RC, Singleton EG. Prolonged duration of craving, mood, and autonomic responses elicited by cues and imagery in smokers: Effects of tobacco deprivation and sex. Exp Clin Psychopharmacol 2010; 18:245-56. [PMID: 20545389 PMCID: PMC2896221 DOI: 10.1037/a0019401] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Increases in self-reported craving and changes in autonomic functioning are reliably elicited when smokers are exposed to tobacco-related stimuli compared with neutral stimuli. However, few studies have reported the time course of cue-elicited craving or have directly compared the effectiveness of smoking cues versus imagery to evoke a craving response. In addition to these two issues, we investigated the influence of tobacco deprivation and sex on craving, mood, and autonomic responses. Sixty cigarette smokers (30 men, 30 women) were tested in two counterbalanced sessions, one after overnight tobacco deprivation and one during ad libitum smoking. At each session, participants were exposed to four randomized experimental trials: smoking imagery, neutral imagery, smoking cues, and neutral cues. Tobacco craving and mood were assessed repeatedly and physiological measures were recorded continuously for 30 min after imagery or cue exposure. Compared with neutral trials, smoking cues and smoking imagery reliably increased tobacco craving, negative mood, heart rate, and blood pressure and decreased positive mood ratings. Changes were observed immediately after cue and imagery presentation and remained unchanged for 30 min. Responding was greater in the nondeprived condition, and cues elicited more robust responding than imagery for most measures. Women responded more robustly to smoking cues only in the nondeprived condition, whereas imagery evoked greater responses in men during both conditions. These findings provide new data on the time course, magnitude, and tobacco deprivation effects on elicited craving. Sex differences were dependent on stimulus type and deprivation condition.
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Affiliation(s)
- Stephen J Heishman
- Nicotine Psychopharmacology Section, NIDA Intramural Research Program, 251 Bayview Boulevard, Suite 200, Baltimore, MD 21224, USA.
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MacKillop J, Miranda R, Monti PM, Ray LA, Murphy JG, Rohsenow DJ, McGeary JE, Swift RM, Tidey JW, Gwaltney CJ. Alcohol demand, delayed reward discounting, and craving in relation to drinking and alcohol use disorders. JOURNAL OF ABNORMAL PSYCHOLOGY 2010; 119:106-14. [PMID: 20141247 DOI: 10.1037/a0017513] [Citation(s) in RCA: 203] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A behavioral economic approach to alcohol use disorders (AUDs) emphasizes both individual and environmental determinants of alcohol use. The current study examined individual differences in alcohol demand (i.e., motivation for alcohol under escalating conditions of price) and delayed reward discounting (i.e., preference for immediate small rewards compared to delayed larger rewards) in 61 heavy drinkers (62% with an AUD). In addition, based on theoretical accounts that emphasize the role of craving in reward valuation and preferences for immediate rewards, craving for alcohol was also examined in relation to these behavioral economic variables and the alcohol-related variables. Intensity of alcohol demand and delayed reward discounting were significantly associated with AUD symptoms, but not with quantitative measures of alcohol use, and were also moderately correlated with each other. Likewise, craving was significantly associated with AUD symptoms, but not with alcohol use, and was also significantly correlated with both intensity of demand and delayed reward discounting. These findings further emphasize the relevance of behavioral economic indices of motivation to AUDs and the potential importance of craving for alcohol in this relationship.
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Affiliation(s)
- James MacKillop
- Department of Psychology, University of Georgia, and Center for Alcohol and Addiction Studies, Brown University, USA.
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Berlin I, Singleton EG, Heishman SJ. Validity of the 12-item French version of the Tobacco Craving Questionnaire in treatment-seeking smokers. Nicotine Tob Res 2010; 12:500-7. [PMID: 20335281 DOI: 10.1093/ntr/ntq039] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION The French version of the Tobacco Craving Questionnaire (FTCQ) is a valid and reliable 47-item self-report instrument that assesses tobacco craving in four factors: emotionality, expectancy, compulsivity, and purposefulness. For use in research and clinical settings, we constructed a 12-item version of the FTCQ (FTCQ-12). METHOD The FTCQ-12 was administered to treatment-seeking French smokers (n = 310) enrolled in the Adjustment of DOses of NIcotine in Smoking Cessation (ADONIS) trial. We conducted confirmatory factor analysis (CFA) and examined congruence in factor loadings between the FTCQ and FTCQ-12 to determine the validity and reliability of the FTCQ-12. Measures of tobacco craving, withdrawal, smoking patterns, and smoking history were included to explore the concurrent validity of the FTCQ-12. We used craving scores to distinguish participants who were highly dependent on nicotine from those less dependent on nicotine. RESULTS CFA indicated excellent fit for a four-factor model, with congruence coefficients indicating moderate similarity in factor patterns and loadings between the FTCQ and FTCQ-12. Individual factors of the FTCQ-12 correlated positively with smoking history and withdrawal variables. Participants who were highly dependent on nicotine were nearly six times more likely to score >5 on the General Craving Score (maximum: 7) than those less dependent on nicotine. DISCUSSION Findings suggest that the FTCQ-12 measures the same four factors as the FTCQ and TCQ, and these four constructs have unique properties. The FTCQ-12 yields valid and reliable indices of tobacco craving and has potential clinical utility for rapid assessment of tobacco craving in smokers seeking treatment.
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Affiliation(s)
- Ivan Berlin
- Département de Pharmacologie, Hôpital Pitié-Salpêtrière, Faculté de médicine, Université P. & M. Curie-INSERM U894, Paris, France.
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Kober H, Kross EF, Mischel W, Hart CL, Ochsner KN. Regulation of craving by cognitive strategies in cigarette smokers. Drug Alcohol Depend 2010; 106:52-5. [PMID: 19748191 PMCID: PMC2814914 DOI: 10.1016/j.drugalcdep.2009.07.017] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2009] [Revised: 05/30/2009] [Accepted: 07/16/2009] [Indexed: 10/20/2022]
Abstract
Cigarette craving is an important contributor to cigarette smoking, and clinical approaches that focus on regulation of craving are effective in reducing rates of relapse. However, a laboratory model that targets the use of cognitive strategies to regulate craving is lacking. To develop such a model, twenty heavy cigarette smokers (>12/day), twenty-two tobacco "chippers" (<6/day), and twenty non-smoking controls completed this outpatient study, during which they were presented with photographs of cigarettes and foods that have been previously shown to induce craving. During each trial, participants were instructed to think of the stimulus in one of two ways: by focusing either on the short-term consequences associated with consuming the item (e.g., it will taste good) or on the long-term consequences associated with regular consumption (e.g., I may get lung cancer). Participants reported significantly reduced food cravings when focusing on the long-term consequences associated with eating. For cigarette-smoking participants, cigarette craving was significantly reduced when focusing on the long-term consequences associated with smoking. This latter finding confirms clinical data and extends it by highlighting the importance of cognition in the modulation of craving. Future studies using this laboratory model could test the efficacy of different cognitive strategies and develop targeted interventions for smoking cessation based on the regulation of craving.
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Affiliation(s)
- Hedy Kober
- Department of Psychology, Columbia University, New York, NY 10027, USA.
| | - Ethan F. Kross
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Walter Mischel
- Department of Psychology, Columbia University, New York, NY 10027, USA
| | - Carl L. Hart
- Department of Psychology, Columbia University, New York, NY 10027, USA, Division on Substance Abuse, New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, 1051 Riverside Drive, Unit 120, New York, NY 10032, USA
| | - Kevin N. Ochsner
- Department of Psychology, Columbia University, New York, NY 10027, USA
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Light and intermittent cigarette smokers: a review (1989-2009). Psychopharmacology (Berl) 2009; 207:343-63. [PMID: 19830407 DOI: 10.1007/s00213-009-1675-4] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2009] [Accepted: 09/10/2009] [Indexed: 10/20/2022]
Abstract
RATIONALE Growing proportions of smokers in the USA do not smoke everyday and can be referred to as light and intermittent smokers (LITS). Despite a current prevalence of LITS in the USA estimated at 25-33% of all smokers, a systematic review of the literature on this group of smokers has yet to be written. OBJECTIVES The aim of this paper is to review and evaluate research on LITS and to identify, describe and discuss commonalities and differences between LITS and daily smokers. METHODS The primary databases used to search for publications were Pub Med (National Library of Medicine) and SCOPUS (Elsevier). RESULTS LITS inhale smoke and have post-smoking blood nicotine concentrations that are broadly equivalent to those found in daily smokers. However, LITS differ from daily smokers with regard to cigarette consumption and frequency of cigarette use, sociodemographic and socioeconomic characteristics, motives, personality traits, dependence, withdrawal and craving, response to smoking-related cues, quitting perception, past-smoking status, and initiation. CONCLUSIONS In contrast to daily smokers, LITS show few or no signs of dependence as currently defined by DSM-IV criteria, appear to exercise more self-control, seem to be less impulsive, and their smoking experience is primarily associated with positive rather than negative reinforcement. Conclusions drawn from the reviewed literature highlight the multivariate factors that must be taken into account when defining LITS and emphasize the importance of further research on this increasing fraction of smokers. The potential implications of increased LITS prevalence on smoking-related disease risks remain to be thoroughly investigated.
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Field M, Munafò MR, Franken IHA. A meta-analytic investigation of the relationship between attentional bias and subjective craving in substance abuse. Psychol Bull 2009; 135:589-607. [PMID: 19586163 DOI: 10.1037/a0015843] [Citation(s) in RCA: 376] [Impact Index Per Article: 25.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Theoretical models of addiction suggest that attentional bias for substance-related cues should be associated with self-reported craving. The authors evaluated the strength of the association by performing a meta-analysis on 68 independent data sets from which correlation coefficients between subjective craving and attentional bias indices were derived. Additional stratified analyses were conducted to identify any variables that might moderate the association between craving and attentional bias. The primary meta-analysis indicated a significant, albeit weak (r=.19), association between attentional bias and craving. Stratified analyses revealed that the association was larger for illicit drug and caffeine craving than for alcohol and tobacco craving, larger for direct measures of attention (eye movement measures and event-related potential measures) than for indirect behavioral measures of attentional bias, and larger when craving strength was high than when it was low (all ps<.05). The size of the correlation did not differ among patients in treatment and individuals who were not seeking treatment. These results suggest that attentional bias and craving are related phenomena, although the relationship is generally modest and appears to be moderated by various factors. Theoretical implications are discussed.
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Affiliation(s)
- Matt Field
- School of Psychology, University of Liverpool, Liverpool, UK.
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Carpenter MJ, Saladin ME, DeSantis S, Gray KM, LaRowe SD, Upadhyaya HP. Laboratory-based, cue-elicited craving and cue reactivity as predictors of naturally occurring smoking behavior. Addict Behav 2009; 34:536-41. [PMID: 19395178 PMCID: PMC2685198 DOI: 10.1016/j.addbeh.2009.03.022] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2008] [Revised: 01/23/2009] [Accepted: 03/17/2009] [Indexed: 11/18/2022]
Abstract
Cigarette craving, one hallmark sign of nicotine dependence, is often measured in laboratory settings using cue reactivity methods. How lab measures of cue reactivity relate to real world smoking behavior is unclear, particularly among non-treatment seeking smokers. Within a larger study of hormonal effects on cue reactivity (N=78), we examined the predictive relationship of cue reactivity to smoking, each measured in several ways. Results indicated that cue-evoked craving in response to stressful imagery, and to a lesser extent, in vivo smoking cues, significantly predicted smoking behavior during the week following testing. However, this predictive relationship was absent upon controlling for reactivity to neutral cues. Nicotine dependence may moderate the relationship between cue reactivity and actual smoking, such that this predictive relationship is less robust among highly dependent smokers than among smokers low in nicotine dependence. The question of whether cue-elicited craving predicts smoking among smokers not in treatment is best answered with a qualified yes, depending on how craving is manipulated and measured. Our findings highlight important methodological and theoretical considerations for cue reactivity research.
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Affiliation(s)
- Matthew J Carpenter
- Medical University of South Carolina, Department of Psychiatry & Behavioral Sciences, Hollings Cancer Center, 86 Jonathan Lucas St. PO Box 250955 Charleston, SC 29425, USA.
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Sayette MA, Loewenstein G, Griffin KM, Black JJ. Exploring the cold-to-hot empathy gap in smokers. Psychol Sci 2009; 19:926-32. [PMID: 18947359 DOI: 10.1111/j.1467-9280.2008.02178.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Many decisions related to cigarette smoking require people in an affectively neutral, or "cold," state to predict how they will feel or behave when in a craving, or "hot," state. Research in other domains has revealed that individuals in cold states often underestimate the impact of being in a hot state on their own future behavior. In a study testing whether this is true of cigarette craving, 98 smokers were assigned to one of three conditions: hot (during a high-craving first session, they made predictions about a high-craving state in a second session), cold (during a low-craving first session, they made predictions about a high-craving state in a second session), and comparison (they experienced a high-craving session only). As predicted, in contrast to smokers in the hot group, smokers in the cold group underpredicted the value they would place on smoking during the second session. Results support the existence of a cold-to-hot empathy gap in smokers and help to explain diverse aspects of tobacco addiction.
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Affiliation(s)
- Michael A Sayette
- Department of Psychology, University of Pittsburgh, 3137 Sennott Square, Pittsburgh, PA 15260, USA.
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