Generalized craving, self-report of arousal, and cue reactivity after brief abstinence

Abstract

Introduction: Numerous studies report smokers ' increased craving and physiological arousal when exposed to cigarette stimuli. These responses are attributed to learning processes (e.g., classical conditioning) and are associated with motivational factors that maintain nicotine dependence. However, much less is known about the degree to which these responses are maintained or diminished during quitting.Methods: Treatment-seeking smokers ( N = 104) were randomly assigned to continue smoking or to enter a 2-week treatment program. Abstainers ( n = 25) were continuously abstinent for 14 -17 days at the time of testing. Control subjects ( n = 38) continued to smoke at their usual rate. Participants who were assigned to treatment but resumed smoking during the study ( n = 41) were considered to be relapsers. Approximately 2 weeks after baseline measurements, abstainers and controls viewed a series of neutral ( n = 12) and cigarette ( n = 12) pictures, rating them for craving and arousal (feelings of calm vs. excitement).Results: Non-cued craving (measured during exposure to neutral cues) was diminished in abstaining smokers. However, cigarette cues produced craving increases of the same magnitude in both abstainers and controls, showing that these cues still had evocative power for both groups. Abstaining smokers, who were not physiologically monitored, had lower self-reports of arousal to cigarette pictures than did controls, but the groups did not differ in arousal to neutral pictures. Discussion: These fi ndings suggest that the foundations of cueinduced craving, generalized craving, and physiological arousal associated with craving may arise from separate processes.

The Geneva Smoking Pictures: Development and Preliminary Validation

“…These stimuli are of critical importance in addiction research for the study of attentional bias [6] and substance-related cue reactivity (e.g. physiological activation) [1,7,8] as well as functional neuroimaging studies [9,10] . Unfortunately, in most studies that have used tobacco and substance-related pictures, the pictures were selected from databases that were not previously validated (e.g.…”

Examining the effects of initial smoking abstinence on response to smoking-related stimuli and response inhibition in a human laboratory model

“…These results suggest that to the extent that reductions in craving during the initial weeks of a quit attempt in this laboratory model are related to relapse risk in naturalistic settings, it is reductions in the absolute levels of generalized craving rather than changes in reaction to smoking-related stimuli (i.e., cue reactivity) per se that are most important. As was mentioned in the “Introduction” to the present report, we know of at least two prior studies that compared craving levels following exposure to smoking-related and neutral stimuli among smokers abstinent for 14–17 days (Carter et al 2009) and up to 35 days (Bedi et al 2011), respectively. The results reported by Carter et al (2009) are consistent with the present results, with an initial period of abstinence resulting in significant reductions in absolute craving levels in the presence of both neutral and smoking-related stimuli and no change in the difference in craving intensity following exposure to neutral versus smoking-related stimuli (i.e., cue reactivity).…”

“…As was mentioned in the “Introduction” to the present report, we know of at least two prior studies that compared craving levels following exposure to smoking-related and neutral stimuli among smokers abstinent for 14–17 days (Carter et al 2009) and up to 35 days (Bedi et al 2011), respectively. The results reported by Carter et al (2009) are consistent with the present results, with an initial period of abstinence resulting in significant reductions in absolute craving levels in the presence of both neutral and smoking-related stimuli and no change in the difference in craving intensity following exposure to neutral versus smoking-related stimuli (i.e., cue reactivity). Worth noting is that while the present study involved participants not seeking to quit in the near future, Carter et al studied treatment seekers suggesting that the present results may have implications for clinical populations.…”

“…We know of only two studies examining longer (≥14 days) durations of experimentally manipulated abstinence and cue reactivity (Bedi et al 2011; Carter et al 2009). In Carter et al (2009), cue reactivity was examined as a function of 14–17 days of abstinence compared to a control condition consisting of smokers who continued smoking as usual (Carter et al 2009).…”

“…We know of only two studies examining longer (≥14 days) durations of experimentally manipulated abstinence and cue reactivity (Bedi et al 2011; Carter et al 2009). In Carter et al (2009), cue reactivity was examined as a function of 14–17 days of abstinence compared to a control condition consisting of smokers who continued smoking as usual (Carter et al 2009). Those who were abstinent for 14–17 days reported significantly lower mean absolute craving levels than controls in the presence of both smoking-related and neutral stimuli, but the craving levels observed following exposure to smoking-related versus neutral stimuli (i.e., cue reactivity) was not different between abstainers and smokers.…”