Pharmacological, sensorimotor, and expectancy effects on tobacco withdrawal: a preliminary study

Abstract

Objective Research designs for parsing the mechanisms underlying tobacco withdrawal are scant. This study introduced a novel research design that simultaneously manipulated three tobacco withdrawal mechanisms: pharmacological (nicotine dissipation), sensorimotor (elimination of the smoking ritual), and expectancy (activation of beliefs regarding the effects of nicotine deprivation), permitting examination of the effects of each mechanism while holding the other two mechanisms constant. Methods Following overnight abstinence, 32 regular cigarette smokers were randomized in a 2 (Expectancy: Told Patch contains nicotine vs. Told Placebo Patch) × 2 (Drug: Receive 21 mg transdermal Nicotine Patch vs. Receive Placebo Patch) × 2 (Sensorimotor: Smoke Very Low Nicotine Content Cigarettes vs. No Smoking) full factorial between-subjects design. Participants repeatedly completed measures of craving, affect, and anticipated pleasure from and desire for rewarding experiences, followed by a smoking lapse analogue task. Results Receiving nicotine (vs. placebo) increased positive affect and anticipated pleasure from and desire for reward. Expecting nicotine (vs. placebo) reduced negative affect and increased smoking delay. Sensorimotor stimulation from smoking (vs. no smoking) reduced smoking urge and behavior. Conclusion Results provided initial validation of this novel three-mechanism design. This design can be used in the future to advance understanding and treatment of tobacco withdrawal.

Investigating the role of expectancy in caffeine withdrawal using the balanced placebo design

“…Future research should investigate if withdrawal‐related response expectancies influence withdrawal outcomes and/or if self‐reported withdrawal expectancies moderate reactions to stimulus expectancy manipulations (Hendricks & Leventhal, ; Juliano & Brandon, ). A future BPD study could also include a no treatment group to examine withdrawal sequelae when no vehicle is used and there is no exposure to potential drug‐related stimuli, as sensorimotor stimuli alone may impact drug and withdrawal effects (Flaten & Blumenthal, ; Guillot et al, ).…”

“…A handful of prior studies have demonstrated that manipulating the expected nicotine content (i.e., dose expectancies) of nicotine replacement therapies or the types of nicotine withdrawal symptoms to expect (i.e., response expectancies) can sometimes, but not always, influence smoking choice, withdrawal, craving, and other subjective outcomes among smokers attempting abstinence (reviewed in Perkins et al, ; Guillot et al, ; Fucito & Juliano, ; Tate et al, ). There have been few experimental studies investigating expectancy effects in drug withdrawal for drugs other than nicotine (see Francis & Nelson, ; Mills, Boakes, & Colagiuri, ).…”

Anhedonia and Abstinence as Predictors of the Subjective Pleasantness of Positive, Negative, and Smoking-Related Pictures

“…The model proposes that because nicotine acts as a pharmacological reward enhancer, 19 smoking serves to offset inherent deficient motivational responsiveness to nondrug rewards (ie, anhedonia). Then when anhedonic smokers abstain from tobacco, reward process deficits previously suppressed by nicotine become expressed and potentially exacerbated by withdrawal (which increases anhedonia levels 20,21 ). Thus, anhedonic smokers are expected to exhibit deficient responses to stimuli signaling nondrug reward, particularly when nicotine-deprived.…”

Anhedonia in tobacco withdrawal among African-American smokers.

“…Several clinical interventions (e.g., behavioral activation therapy, positive mental imagery training) have demonstrated promise in reducing symptoms of anhedonia (Blackwell et al, 2015; Carl et al, 2016; Pictet et al, 2016; Williams et al, 2015) and potentially increasing smoking cessation success (MacPherson et al, 2010). There is also some evidence that pharmacologic interventions, such as bupropion and nicotine replacement, improve anhedonia during tobacco deprivation (Cook et al, 2017; Guillot et al, 2015; Paterson et al, 2007), although whether anhedonia alleviation is a mechanism of efficacy for these medications merit further inquiry.…”