Introduction The cue reactivity paradigm allows for systematic evaluation of motivational responses to drug-related cues that may elicit drug use. The literature on this topic has grown substantially in recent decades, and the methodology used to study cue reactivity has varied widely across studies. The present research provided a meta-analytic investigation of variables that have an impact on cue reactivity effects to enhance our understanding of this key feature of tobacco use disorders. Methods A total of 128 publications yielded 249 effect sizes, which were analyzed to investigate the magnitude of the cue reactivity effect and potential moderators. Results Craving generated a moderate-to-large effect size (Hedges’ g=0.71, p<.001), indicating that drug cues produced significantly greater craving than neutral cues. However, physiological variables yielded significantly lower or non-significant effect sizes. Analyses of a variety of empirically and theoretically-relevant moderator variables showed that cue modality, cue personalization, cue reactivity environment, and the use of multiple assessments of cue reactivity were significantly associated with the magnitude of cue-specific craving effects (ps<.001). Effect sizes were not significantly related to abstinence status, gender, CPD, and treatment seeking status. Conclusions The results underscored the strength of self-reported craving as an index of cue reactivity across studies, which support theories that posit cue reactivity is core to the addictive process for daily tobacco cigarette smokers. The present research further elucidates the variables that alter the cue reactivity effects across studies and provides recommendations for future cue reactivity research. Implications A core feature of addiction is that drug-related cues can have a major impact on motivational responses across multiple substance use disorders, including tobacco cigarettes. This paper describes a meta-analysis updating and synthesizing cue reactivity research with tobacco cigarette smokers over the last 20 years, a time of rapid growth for this literature. The study leads to a better understanding of the cue reactivity paradigm across different self-report and physiological variables, and identifies factors that may modulate addictive motivation for tobacco cigarettes.

The findings support the reliability and validity of the QVC and suggest it could be used in laboratory and clinical settings as a psychometrically sound measure of vaping craving.

Recruitment of participants into treatment outcome studies is an important and often challenging aspect of human research. Yet, there have been very few controlled trials that have examined methods of recruiting participants into clinical trials, particularly in populations that may be reluctant to pursue mental health intervention, such as athletes. In this study, 79 NCAA Division I, Club, and Intramural student-athletes volunteered to participate in a study to determine their interest in participating in one of two goal-oriented programs representing two arms in a clinical trial. These programs were aimed at reducing substance abuse and sexually transmitted infections, and improving mental health, relationships, and sport performance. The participants were randomly assigned to Standard Recruitment (SR) or Recruitment Engagement (RE). RE included a review of the aforementioned outcome study and implementation of strategies that were developed to motivate participants to engage in treatment. The SR condition involved a review of the aforementioned treatment outcome study only. After the recruitment interventions were implemented, participants were queried to report any negative consequences that may have occurred from their use of illicit drugs or alcohol. Participants who reported negative consequences were invited to participate in baseline assessment of the aforementioned outcome study. Results indicated that 11 (25.0%) of the participants in the RE condition provided their consent to participate, 9 (20.5%) of whom subsequently completed baseline assessment; only 2 (5.7%) of the SR participants provided their study consent and subsequently participated in baseline assessment for the clinical trial (p < .05). After the respective recruitment intervention was implemented, participants were administered psychometrically validated instruments to assess their overall psychiatric functioning and the extent to which their sport performance was negatively impacted by dysfunctional thoughts and stress. Participants in RE were more likely to report greater dysfunctional thoughts and stress interfering with their sport performance (and, to a lesser extent, greater psychiatric problems) than SR participants, suggesting RE may influence greater disclosure of problem behavior than SR, permitting the interviewers opportunities to empathize with the participants’ concerns. Results are discussed in light of their implications to treatment outcome research and clinical and counseling practice involving student-athletes.

The test procedure used in this research generates multiple indices of nicotine and tobacco motivation and allows for an explicit comparison of those variables in people who use both e-cigarettes and tobacco cigarettes.

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