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Sloan ME, Sells JR, Vaughan CL, Morris JK, Ortega NE, Sundar S, Soundararajan S, Stangl BL, Gowin J, Chawla S, Diazgranados N, McKee SA, Waters A, Ramchandani VA. Modeling ability to resist alcohol in the human laboratory: A pilot study. DRUG AND ALCOHOL DEPENDENCE REPORTS 2022; 5:100105. [PMID: 36844167 PMCID: PMC9948911 DOI: 10.1016/j.dadr.2022.100105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 09/15/2022] [Accepted: 10/03/2022] [Indexed: 05/25/2023]
Abstract
Background Roughly half of patients with alcohol use disorder prefer non-abstinence based approaches to treatment. However, only individuals who can limit their alcohol use after low-risk consumption are most likely to benefit from these approaches. This pilot study developed a laboratory-based intravenous alcohol self-administration paradigm to determine the characteristics of individuals who could successfully resist consuming alcohol after an initial exposure. Methods Seventeen non-treatment seeking heavy drinkers completed two versions of an intravenous alcohol self-administration paradigm designed to assess impaired control over alcohol use. In the paradigm, participants received a priming dose of alcohol and then entered a 120-min resist phase, in which they received monetary rewards if they resisted self-administering alcohol. We used Cox proportional hazards regression to determine the impact of craving and Impaired Control Scale scores on rate of lapse. Results 64.7% of participants across both versions of the paradigm were unable to resist alcohol for the duration of the session. Craving at baseline (HR = 1.07, 95% CI 1.01-1.13, p = 0.02) and following priming (HR = 1.08, 95% CI 1.02-1.15, p = 0.01) were associated with rate of lapse. Individuals who lapsed endorsed greater attempts to control their drinking over the prior six months compared to individuals who resisted. Conclusions This study provides preliminary evidence that craving may be predictive of risk of lapse in individuals who are trying to limit alcohol intake after consuming a small initial amount of alcohol. Future studies should test this paradigm in a larger and more diverse sample.
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Affiliation(s)
- Matthew E. Sloan
- Addictions Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Division of Neurosciences and Clinical Translation, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada
- Department of Psychological Clinical Science, University of Toronto Scarborough, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Joanna R. Sells
- Department of Medical and Clinical Psychology, Uniformed Services University of Health Science, USA
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, 10 Center Drive, Rm 2-2352, Bethesda, MD 20892, USA
| | - Courtney L. Vaughan
- Department of Medical and Clinical Psychology, Uniformed Services University of Health Science, USA
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, 10 Center Drive, Rm 2-2352, Bethesda, MD 20892, USA
| | - James K. Morris
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, 10 Center Drive, Rm 2-2352, Bethesda, MD 20892, USA
| | - Nancy E. Ortega
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, 10 Center Drive, Rm 2-2352, Bethesda, MD 20892, USA
| | - Sachin Sundar
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, 10 Center Drive, Rm 2-2352, Bethesda, MD 20892, USA
| | - Soundarya Soundararajan
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, 10 Center Drive, Rm 2-2352, Bethesda, MD 20892, USA
| | - Bethany L. Stangl
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, 10 Center Drive, Rm 2-2352, Bethesda, MD 20892, USA
| | - Joshua Gowin
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, 10 Center Drive, Rm 2-2352, Bethesda, MD 20892, USA
- Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Sumedha Chawla
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, 10 Center Drive, Rm 2-2352, Bethesda, MD 20892, USA
| | - Nancy Diazgranados
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | | | - Andrew Waters
- Department of Medical and Clinical Psychology, Uniformed Services University of Health Science, USA
| | - Vijay A. Ramchandani
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, 10 Center Drive, Rm 2-2352, Bethesda, MD 20892, USA
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McKee SA, Verplaetse TL. A novel human laboratory alcohol self-administration paradigm for medication screening: Modeling the ability to resist drinking and heavy drinking. DRUG AND ALCOHOL DEPENDENCE REPORTS 2022; 4:100085. [PMID: 36120181 PMCID: PMC9481061 DOI: 10.1016/j.dadr.2022.100085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background Human laboratory analogues of drinking behavior provide an efficient, cost-effective mechanistic evaluation of a medication signal on drinking. We developed a novel alcohol self-administration paradigm which models the ability to resist drinking and heavy drinking. Methods We compared a de-escalating schedule of monetary reinforcement (n=16, 50% female) to no schedule (n=16, 50% female) on the ability to resist drinking (i.e., latency to start drinking) and subsequent ad-libitum alcohol consumption of preferred alcoholic beverage in participants with alcohol use disorder (AUD). Participants completed two laboratory sessions designed to model the ability to resist drinking using stress (versus neutral imagery, within-subject factor) as a prime for drinking. Results Participants consumed more alcohol with no schedule (74.2%) versus with the de-escalating reinforcement schedule (40.3%,). The de-escalating schedule reduced alcohol consumption by 49%. Eighty-one percent of participants drank heavily with no schedule and this was reduced with the schedule. Use of the de-escalating schedule also increased the latency to pour and sip the first drink. Participants poured and sipped alcohol faster following stress imagery (vs. neutral), had greater craving, and consumed more alcohol in the first 30 minutes. Conclusions Our novel alcohol self-administration model generated heavy drinking. Over 80% of participants without reinforcement consumed more than 2/3 of their preferred alcoholic beverage designed to increase blood alcohol levels to 0.12 mg% within a 2-hour window. Our model was sensitive to stress, and the de-escalating schedule highlighted stress effects on drinking. Thus, this model is ideal for a cross-over design to test medications for AUD.
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Li Q, Chen X, Li X, Gorowska M, Li Z, Li Y. The Effects of Immediate vs Gradual Reduction in Nicotine Content of Cigarettes on Smoking Behavior: An Ecological Momentary Assessment Study. Front Psychiatry 2022; 13:884605. [PMID: 35633808 PMCID: PMC9130591 DOI: 10.3389/fpsyt.2022.884605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 04/20/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In recent years, much research has examined the effects of various interventions and treatments for smoking cessation. The results suggest that interventions targeting changes of nicotine content can help smokers reduce tobacco use or quit smoking. A number of clinical studies show that smokers who received an immediate reduction in nicotine content to very low levels have significantly greater reductions in the number of cigarettes smoked and toxic substance exposure compared to those with gradual reductions. However, from the perspective of smoking craving, whether the immediate and gradual reduction in nicotine content reduce smoking by reducing cravings needs further investigation. METHODS 74 eligible Participants were randomly allocated to one of the two experimental conditions: (1) immediate reduction to 0.1 mg of nicotine per cigarette (n = 40); (2) gradual reduction from 1.0 (0.8 g ~ 1.2 mg) to 0.1 mg of nicotine per cigarette (n = 34). All participants completed 1-week baseline period during which they smoked their usual cigarette, followed by 16-week of interventions. The primary outcomes included cigarette cravings and number of cigarettes smoked per day (CPD); secondary outcomes included the number of cigarette-free day and emotional states. RESULTS Among the 52 participants [51 (98.1%) men; mean (SD) age, 33.44 (6.71) years; mean (SD) CPD, 16.83 (9.94)] who completed the trial, significantly lower cravings for cigarettes were observed in the immediate (n = 25) vs. gradual nicotine reduction group (n = 27) in the morning (t = -2.072, p = 0.039) and after dinner (t = -2.056, p = 0.041). Compared with the baseline daily smoking, the number of cigarettes smoked per day was significantly reduced at the beginning of week 12 in the immediate nicotine reduction group (p = 0.001) and at week 16 in the gradual nicotine reduction group (p < 0.001). The number of participants with any cigarette-free day was not significantly different between the groups (p = 0.198). The number of cigarette-free days was significantly more in the immediate vs. gradual nicotine reduction group (p = 0.027). CONCLUSIONS The significantly lower cravings were observed in the immediate vs. gradual nicotine reduction group, and led to faster reduction in the number of CPD, and a significant increase in the number of cigarette-free days. These findings add to the evidence base for reduced nicotine content in cigarettes. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, identifier: ChiCTR2100048216.
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Affiliation(s)
- Qianling Li
- Chinese Academy of Sciences (CAS) Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xijing Chen
- Chinese Academy of Sciences (CAS) Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
| | - Xiuli Li
- YiDu Central Hospital of Weifang, Weifang, China
| | - Monika Gorowska
- Chinese Academy of Sciences (CAS) Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Zimin Li
- Chinese Academy of Sciences (CAS) Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yonghui Li
- Chinese Academy of Sciences (CAS) Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Schlagintweit HE, Tyndale RF, Hendershot CS. Acute effects of a very low nicotine content cigarette on laboratory smoking lapse: Impacts of nicotine metabolism and nicotine dependence. Addict Biol 2021; 26:e12930. [PMID: 32573054 DOI: 10.1111/adb.12930] [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: 02/28/2020] [Revised: 04/29/2020] [Accepted: 05/31/2020] [Indexed: 12/13/2022]
Abstract
Reducing cigarette nicotine content to nonaddictive levels facilitates smoking cessation; however, very low nicotine content cigarettes (VLNCs) may not be equally effective across heterogeneous smokers. We evaluated the impact of acute VLNC smoking versus control (sham puffs) on craving, withdrawal and smoking lapse behaviour and whether genetically influenced differences in nicotine metabolism and individual differences in nicotine dependence moderate observed effects. Thirty-three overnight-abstinent smokers (15 slow vs. 17 normal nicotine metabolizers; 17 low vs. 16 high nicotine dependence) smoked a 0.05-mg nicotine VLNC during one session and took sham VLNC puffs during another session, in a counterbalanced order. Craving and withdrawal were assessed before and after smoking and sham puffing. Next, participants completed the McKee Smoking Lapse Task, which measures ability to resist smoking and quantity of ad libitum smoking. VLNC (vs. sham) reduced craving and withdrawal, increased ability to resist smoking and reduced ad libitum smoking. VLNC-induced reduction in craving for positive reinforcement was greater in slow (vs. normal) metabolizers. Nicotine metabolism did not moderate any other VLNC responses. High-dependence (vs. low-dependence) participants engaged in greater ad lib smoking across VLNC and sham conditions. Nicotine dependence did not moderate VLNC responses. VLNC reduced craving, withdrawal and smoking lapse behaviour. Individual differences in nicotine metabolism and dependence had a minimal impact on VLNC responses; however, VLNCs were less effective at reducing craving for positive reinforcement among normal (vs. slow) metabolizers. These findings suggest that desirable VLNC effects may extend across heterogeneous groups of smokers.
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Affiliation(s)
- Hera E. Schlagintweit
- Campbell Family Mental Health Research Institute Centre for Addiction and Mental Health Toronto Ontario Canada
| | - Rachel F. Tyndale
- Campbell Family Mental Health Research Institute Centre for Addiction and Mental Health Toronto Ontario Canada
- Department of Pharmacology and Toxicology University of Toronto Toronto Ontario Canada
- Department of Psychiatry University of Toronto Toronto Ontario Canada
| | - Christian S. Hendershot
- Campbell Family Mental Health Research Institute Centre for Addiction and Mental Health Toronto Ontario Canada
- Department of Pharmacology and Toxicology University of Toronto Toronto Ontario Canada
- Department of Psychiatry University of Toronto Toronto Ontario Canada
- Institute for Mental Health Policy Research Centre for Addiction and Mental Health Toronto Ontario Canada
- Department of Psychology University of Toronto Toronto Ontario Canada
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Bello MS, Liautaud MM, De La Cerda JT, Pang RD, Ray LA, Ahluwalia JA, Leventhal AM. Association of frequency of perceived exposure to discrimination with tobacco withdrawal symptoms and smoking lapse behavior in African Americans. Addiction 2021; 116:914-925. [PMID: 32860477 PMCID: PMC7914272 DOI: 10.1111/add.15238] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 01/23/2020] [Accepted: 08/24/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND AIMS Frequent experiences of discrimination could increase vulnerability to tobacco withdrawal and smoking lapse in populations subject to tobacco-related health disparities. This laboratory study (2013-17) examined whether individual differences in perceived exposure to discrimination in one's daily life predicted tobacco withdrawal symptoms and smoking lapse behavior following acute tobacco deprivation in African American smokers. DESIGN Mixed design with the between-subjects continuous variable of perceived discrimination crossed with the within-subject variable of tobacco deprivation status (deprived versus non-deprived). SETTING Academic medical center in Los Angeles, CA, USA. PARTICIPANTS African American non-treatment seeking daily cigarette smokers (n = 607, ≥ 10 cig/day). MEASUREMENTS At a baseline visit, self-reported frequency of perceived exposure to discrimination in one's daily life was measured [everyday discrimination scale (EDDS)]. At two subsequent counterbalanced experimental visits (16-hour tobacco deprivation versus ad-libitum smoking), self-report assessments of various tobacco withdrawal symptom domains [Brief Questionnaire of Smoking Urges), Wisconsin Smoking Withdrawal Scale (WSWS), Profile of Mood States (POMS), Snaith-Hamilton Pleasure Scale (SHAPS) and Current Impulsivity Scale (CIS)) and a behavioral smoking lapse analogue task were measured. FINDINGS Adjusted models demonstrated that greater frequency of perceived exposure to discrimination was associated with larger deprivation-induced increases in acute urges to smoke to alleviate negative mood, several negative mood states and subjective cognitive functioning-effect sizes were small in magnitude (βs = 0.09-0.13; Ps < 0.02). Data were inconclusive for associations between perceived exposure to discrimination and deprivation-induced changes in cravings, urges to smoke for pleasure, positive mood reduction, other symptoms or smoking reinstatement behavior. CONCLUSIONS Frequency of perceived exposure to discrimination appears to be modestly associated with increased severity of some deprivation-induced tobacco withdrawal symptoms in African American smokers.
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Affiliation(s)
- Mariel S. Bello
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Madalyn M. Liautaud
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Julianne T. De La Cerda
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Raina D. Pang
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lara A. Ray
- University of California Los Angeles, Department of Psychology, Los Angeles, CA, USA
| | - Jasjit A. Ahluwalia
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Adam M. Leventhal
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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6
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Otto MW, Zvolensky MJ, Rosenfield D, Hoyt DL, Witkiewitz K, McKee SA, Bickel WK, Smits JAJ. A randomized controlled trial protocol for engaging distress tolerance and working memory to aid smoking cessation in low socioeconomic status (SES) adults. Health Psychol 2020; 39:815-825. [PMID: 32833483 PMCID: PMC8489738 DOI: 10.1037/hea0000858] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Low income and low educational attainment are among the strongest predictors of both smoking prevalence and lapse (i.e., return) to smoking after cessation attempts. Treatment refinement is limited by inadequate knowledge of the specific lapse- or relapse-relevant vulnerabilities characteristic of populations that should be the target of treatment. In the context of a randomized clinical trial design, we describe an experimental medicine approach for evaluating the role of 2 specific lapse-relevant targets relative to the higher stress characteristic of low-socioeconomic contexts: low distress tolerance and low working memory capacity. Furthermore, we use an innovative approach for understanding risk of smoking lapse in smokers undergoing a quit attempt to examine candidate mechanistic targets assessed not only during nicotine use, but also during the conditions smokers will face upon a cessation attempt-during stressful nicotine-deprivation windows. This study is designed to show the incremental value of assessments during deprivation windows, in part because of the way in which specific vulnerabilities are modified by, and interact with, the heightened stress and withdrawal symptoms inherent to nicotine-deprivation states. Specifically, the study is designed to evaluate whether a novel mindfulness intervention (mindfulness combined with interoceptive exposure) can improve upon existing mindfulness interventions and extend therapeutic gains to the modification of mechanistic targets assessed in high-stress or negative affectivity contexts. The overall goal is to validate mechanistic targets and associated interventions for the purpose of expanding treatment options for at-risk smokers. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Michael W. Otto
- Department of Psychological and Brain Sciences, Boston University
| | | | | | - Danielle L. Hoyt
- Department of Psychological and Brain Sciences, Boston University
| | | | - Sherry A. McKee
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06519
| | - Warren K. Bickel
- Addiction Recovery Research Center, Fralin Biomedical Research Institute
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Rose JE, Davis JM. Combination Lorcaserin and Nicotine Patch for Smoking Cessation Without Weight Gain. Nicotine Tob Res 2020; 22:1627-1631. [PMID: 31589323 PMCID: PMC7443600 DOI: 10.1093/ntr/ntz149] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 08/30/2019] [Indexed: 11/13/2022]
Abstract
INTRODUCTION This study explored the efficacy of combination lorcaserin and nicotine patch for smoking cessation treatment and prevention of postsmoking cessation weight gain. METHODS We conducted a trial in which 61 adult daily smokers were asked to quit smoking using a combination of lorcaserin and nicotine patch. During the first 2 weeks of treatment prior to the quit day, participants were randomized to receive either lorcaserin (10 mg twice daily) plus nicotine patch (21 mg) or placebo plus nicotine patch (21 mg). Following this 2-week period, participants received both medications for 12 weeks. Outcomes included 4-week continuous smoking abstinence at the end of treatment (weeks 7-10 postquit attempt), weight change, ad libitum smoking, withdrawal symptoms, and ratings of cigarette reward. RESULTS Biochemically confirmed continuous smoking abstinence from 7 to 10 weeks postquit attempt was 31.1% (90% confidence interval, 21.4%-40.8%). Participants who quit smoking showed no weight gain; in fact, mean weight change was minus 0.16 kg (SD = 3.27) over the study period. There was an unexpected but strong association (p = .006) between a decrease in sensory enjoyment of smoking and successful quit outcome on this regimen. During the prequit randomization period, lorcaserin versus placebo reduced the impact of smoking to relieve craving for cigarettes as well as the sensory enjoyment of smoking (p = .005). Adherence and tolerability to lorcaserin and nicotine patch was good. CONCLUSIONS The combination of lorcaserin and nicotine patch was well tolerated, associated with a relatively high smoking abstinence rate, and effectively prevented weight gain associated with quitting smoking. IMPLICATIONS This report provides an important contribution to the literature because it details evidence of a medication combination-lorcaserin and nicotine-that is effective for smoking cessation and for ameliorating weight gain associated with smoking cessation. For many smokers, postcessation weight gain is a major obstacle to quitting, and this medication combination provides a suitable treatment option for these smokers. CLINICAL TRIAL REGISTRATION NCT02906644.
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Affiliation(s)
- Jed E Rose
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | - James M Davis
- Division of Internal Medicine, Department of Medicine, Duke University, Durham, NC
- Duke Cancer Institute, Durham, NC
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8
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Rogers AH, Shepherd JM, Buckner JD, Garey L, Manning K, Orr MF, Schmidt NB, Zvolensky MJ. Current cannabis use and smoking cessation among treatment seeking combustible smokers. Drug Alcohol Depend 2020; 209:107928. [PMID: 32092636 PMCID: PMC8802811 DOI: 10.1016/j.drugalcdep.2020.107928] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 02/13/2020] [Accepted: 02/16/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Combustible tobacco smoking and cannabis use frequently occur together, and the use of both substances is associated with overall greater severity of tobacco and cannabis related problems. Observational work has found that cannabis use is associated with tobacco cessation failure, but research directly testing the longitudinal associations of cannabis use on tobacco cessation during smoking cessation treatment is lacking. The current study examined the impact of current cannabis use on combustible tobacco cessation outcomes. METHODS 207 daily combustible tobacco smokers (Mage = 38.24 years, SD = 14.84, 48.1 % male) were enrolled in a randomized controlled smoking cessation trial. Survival analyses and multi-level modeling were used to assess lapse and relapse behavior through 12-week follow up. The current study is a secondary data analysis. RESULTS Results of the current study suggest that cannabis use is associated with faster time to lapse (OR = 0.644, se = .188, p = .019), but not relapse (OR = -0.218, se = .403, p = .525), compared to combustible tobacco-only smokers. Additionally, cannabis use was associated with lower likelihood of achieving any 7-day point prevalence abstinence during the 12 week follow up (b = 0.93, se = 0 0.24, p = 0.0001). CONCLUSIONS The current study provides novel evidence that cannabis use may be related to combustible tobacco use in terms of faster time to lapse and lower likelihood of any 7-day point prevalence abstinence following smoking cessation treatment. Developing integrated cannabis-tobacco cessation treatments is an important next step in research focused on tobacco-cannabis use.
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Affiliation(s)
- Andrew H. Rogers
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Justin M. Shepherd
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Julia D. Buckner
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Kara Manning
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Michael F. Orr
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Norman B. Schmidt
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, TX, United States.,Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, Texas, United States.,HEALTH Institute, University of Houston, Houston, TX, United States
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Powers JM, LaRowe LR, Heckman BW, Ditre JW. Pain characteristics and nicotine deprivation as predictors of performance during a laboratory paradigm of smoking cessation. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2019; 34:341-350. [PMID: 31750703 DOI: 10.1037/adb0000532] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Although smokers with co-occurring pain report expectations for experiencing greater nicotine withdrawal and difficulty quitting, limited work has examined the role of pain in cessation-related outcomes. The goal of this study was to examine clinically relevant pain characteristics (pain persistence, pain intensity, pain-related disability) as predictors of withdrawal and smoking lapse/relapse outcomes using a laboratory paradigm of cessation. Participants (N = 120 daily cigarette smokers; 48% male; Mage = 36.17, SD = 12.16; MCigarettes Per Day = 20.51, SD = 6.99) were randomized to either nondeprived or 12-hr nicotine deprivation conditions prior to an experimental study visit. Upon arrival to the laboratory, participants completed measures of pain characteristics and nicotine withdrawal symptoms. Primary outcomes included nicotine withdrawal scores and analogues of smoking lapse (latency to initiating smoking) and relapse (number of cigarettes smoked). We hypothesized that smokers with greater pain persistence, pain intensity, and pain-related disability would endorse more severe nicotine withdrawal and greater lapse/relapse behavior, and that these positive associations would be stronger among those who were nicotine deprived. Results indicated that, above and beyond the effect of nicotine deprivation, persistent pain predicted more severe nicotine withdrawal, and that greater pain-related disability predicted quicker latency to lapse during the laboratory paradigm. Contrary to expectation, nicotine deprivation did not moderate effects of pain characteristics on withdrawal or lapse/relapse outcomes. Clinical implications include that different pain processes may influence different cessation outcomes, and that smokers in pain may benefit from the provision of pharmacological aids to better control withdrawal symptoms. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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10
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Cortland CI, Shapiro JR, Guzman IY, Ray LA. The ironic effects of stigmatizing smoking: combining stereotype threat theory with behavioral pharmacology. Addiction 2019; 114:1842-1848. [PMID: 31140666 DOI: 10.1111/add.14696] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 10/01/2018] [Accepted: 05/17/2019] [Indexed: 12/01/2022]
Abstract
AIMS Public service announcements often create media messages intended to stigmatize negative behaviors to reduce and prevent these behaviors. Drawing on social and cognitive psychology, we hypothesize that stigmatizing messages can create stereotype threat would be associated with shorter latency to first cigarette in the laboratory compared to the control condition. DESIGN A double-blind, randomized, controlled trial in which participants completed two smoking lapse tasks, one at baseline and one post-intervention/control. SETTING An experimental psychopharmacology laboratory in the western United States. PARTICIPANTS A community sample of non-treatment-seeking daily smokers (n = 77) received either a stereotype threat (n = 39) or neutral/control (n = 38) message. INTERVENTION Participants received either a stereotype threat message that stigmatized smoking or a control message. MEASUREMENTS The primary outcome measure was participants' ability to delay smoking during the smoking lapse task in the experimental session FINDINGS: The difference in delay time during the experimental session at the point where 50% of each group had smoked was 3 minutes. Cox proportional hazard models revealed that participants in the stereotype threat group were significantly less able to delay initiating smoking compared to the control group (hazard ratio = 0.504, P = 0.010, 95% confidence interval = 0.30, 0.85), after controlling for baseline latency to smoke. CONCLUSIONS Messages that elicit negative stereotypes of smokers operated as 'smoking-promoting messages' in the context of our controlled laboratory investigation.
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Affiliation(s)
- Clarissa I Cortland
- Department of Psychology, The University of California, Los Angeles, CA, USA
| | - Jenessa R Shapiro
- Department of Psychology, The University of California, Los Angeles, CA, USA
| | - Iris Y Guzman
- Department of Psychology, The University of California, Los Angeles, CA, USA
| | - Lara A Ray
- Department of Psychology, The University of California, Los Angeles, CA, USA
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11
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al'Absi M, Lemieux A, Hodges JS, Allen S. Circulating orexin changes during withdrawal are associated with nicotine craving and risk for smoking relapse. Addict Biol 2019; 24:743-753. [PMID: 30117237 DOI: 10.1111/adb.12643] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 05/11/2018] [Accepted: 05/17/2018] [Indexed: 01/09/2023]
Abstract
We examined the extent to which orexin measured during smoking and the early phase of abstinence was related to craving, withdrawal, stress hormones, and risk for smoking relapse in men and women. Considering its role in modulating nicotine-related reward, we predicted that a reduction in circulating orexin during withdrawal would be associated with increased craving and risk for smoking relapse. Two hundred and eighty five participants provided biological samples and self-report information to identify predictors of smoking relapse. All participants attended two laboratory sessions, which were before and after a period of required abstinence from smoking. After quitting, participants also attended four weekly sessions to track smoking relapse. Only smokers who relapsed within the follow-up period exhibited reduced orexin levels during the initial withdrawal period; ACTH, but not craving nor cortisol, increased across the abstinence period for successful abstainers but not for relapsers. Sex differences in orexin and craving or withdrawal associations also emerged. Adding sex, HPA hormones, and self-reported measures of craving and withdrawal as potential mediators had minimal effects on the above abstinence and orexin effects. These results provide the first evidence that circulating orexin may be a useful marker of risk for relapse; and sex, adrenal hormones, and self-reported craving and withdrawal were not mediators of this effect. The results point to a promising pathway to investigate objective biological markers for craving and smoking relapse and highlight the complexity of the neurobiology of relapse.
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Affiliation(s)
- Mustafa al'Absi
- Department of Family Medicine and Biobehavioral HealthUniversity of Minnesota Medical School Duluth MN USA
- PsychiatryUniversity of Minnesota, Twin Cities Minneapolis MN USA
| | - Andrine Lemieux
- Department of Family Medicine and Biobehavioral HealthUniversity of Minnesota Medical School Duluth MN USA
| | - James S. Hodges
- Division of BiostatisticsUniversity of Minnesota, Twin Cities Minneapolis MN USA
| | - Sharon Allen
- Department of Family Medicine and Community HealthUniversity of Minnesota, Twin Cities Minneapolis MN USA
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Mathew AR, Heckman BW, Froeliger B, Saladin ME, Brown RA, Hitsman B, Carpenter MJ. Multi-method assessment of distress tolerance and smoking-related factors among adult daily smokers. Exp Clin Psychopharmacol 2019; 27:136-145. [PMID: 30589279 PMCID: PMC6561662 DOI: 10.1037/pha0000238] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Although distress tolerance (DT) is associated with smoking lapse and relapse outcomes, few studies have conducted a rigorous assessment of DT across domain and method in the context of acute abstinence. In a human laboratory-based study of 106 adult daily smokers, we examined between multiple indices of DT and smoking lapse, withdrawal processes, and motivation to quit. We expected that low DT would be associated with shorter latency to smoke, greater withdrawal severity, and lower motivation to quit. Following a smoking abstinence period (≥ 6 hr deprived), participants completed an assessment battery including both behavioral (mirror-tracing, serial addition, cold pressor, and breath-holding tasks) and self-report measures of DT (general and smoking-specific), withdrawal processes (craving, negative affect, and positive affect), and motivation to quit. Latency to smoke (range = 0-50 min) was assessed in a laboratory analogue task in which delaying smoking was monetarily rewarded. Behavioral and self-report DT indices displayed only modest intercorrelations, indicating different facets of this construct by domain and method of assessment. Tolerance of physical pain was uniquely associated with smoking choice. Both self-report DT measures were associated with abstinence-induced increases in negative affect, while only smoking-specific DT was positively associated with craving. Results are discussed within the context of guiding targeted behavioral interventions. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Amanda R. Mathew
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Bryan W. Heckman
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Brett Froeliger
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC
- Department of Neurosciences, Medical University of South Carolina, Charleston, SC
| | - Michael E. Saladin
- Department of Health Science and Research, Medical University of South Carolina, Charleston, SC
| | | | - Brian Hitsman
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Matthew J. Carpenter
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC
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Falcone M, Bernardo L, Wileyto EP, Allenby C, Burke AM, Hamilton R, Cristancho M, Ashare RL, Loughead J, Lerman C. Lack of effect of transcranial direct current stimulation (tDCS) on short-term smoking cessation: Results of a randomized, sham-controlled clinical trial. Drug Alcohol Depend 2019; 194:244-251. [PMID: 30497056 PMCID: PMC6312458 DOI: 10.1016/j.drugalcdep.2018.10.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 09/19/2018] [Accepted: 10/10/2018] [Indexed: 01/25/2023]
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) has been shown to improve measures of executive cognitive function and reduce cigarette consumption. Studies conducted to date have been small, and the results are mixed. METHODS This randomized, double-blind, parallel arm clinical trial tested the effects of active anodal tDCS targeted to the left dorsolateral prefrontal cortex (versus sham) on 7-day smoking cessation in 106 treatment-seeking smokers. Participants received three sessions of sham (n = 35), 1 mA (n = 35), or 2 mA (n = 36) tDCS in the context of a validated smoking lapse paradigm then received brief smoking cessation counseling and completed a monitored quit attempt. The primary outcome was total number of days of abstinence confirmed via exhaled carbon monoxide. RESULTS During the quit period, there were no effects of dose group on days of abstinence (sham, M (SD): 2.5 days (±2.5); 1 mA: 2.5 days (±2.5); 2 mA: 2.4 days (±2.3); β = -0.08; p = 0.76) or on change in daily smoking rate (sham, M (SD): 12.6 CPD (±4.8); 1 mA: -11.8 CPD (±4.4); 2 mA: -11.7 CPD (±5.3); β = 0.42, p = 0.49), nor were there effects of dose group on latency to smoke or number of cigarettes smoked during the smoking lapse paradigm. Side effects of tDCS were generally mild (<5 out of 10), and participants were not able to distinguish between active and sham treatment. CONCLUSIONS These results do not support the efficacy of tDCS targeted to the left dorsolateral prefrontal cortex (DLPFC) for smoking cessation.
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Affiliation(s)
- Mary Falcone
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
| | - Leah Bernardo
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - E Paul Wileyto
- Dept of Biostatistics, Epidemiology & Informatics, University of Pennsylvania, Philadelphia, PA, USA
| | - Cheyenne Allenby
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Anne Marie Burke
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Roy Hamilton
- Laboratory for Cognition and Neural Stimulation, University of Pennsylvania, Philadelphia, PA, USA
| | - Mario Cristancho
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Rebecca L Ashare
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - James Loughead
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Caryn Lerman
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
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Motschman CA, Germeroth LJ, Tiffany ST. Momentary changes in craving predict smoking lapse behavior: a laboratory study. Psychopharmacology (Berl) 2018; 235:2001-2012. [PMID: 29704217 DOI: 10.1007/s00213-018-4898-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 04/05/2018] [Indexed: 01/12/2023]
Abstract
RATIONALE Current research on factors that predict smoking lapse behavior is limited in its ability to fully characterize the critical moments leading up to decisions to smoke. OBJECTIVES We used a validated and widely used experimental analogue for smoking lapse to assess how moment-to-moment dynamics of craving relate to decisions to smoke. METHODS Heavy smokers (N = 128, M age = 35.9) participated in a 50-min laboratory delay to smoking task on 2 consecutive days, earning money for each 5 min they remained abstinent or ending the task by choosing to smoke. Participants rated craving and negative affect levels immediately prior to each choice. Participants were randomized to smoking as usual (n = 50) or overnight abstinence (n = 50 successfully abstained, n = 22 failed abstaining) prior to session 2. Discrete-time hazard models were used to examine craving and negative affect as time-varying predictors of smoking. RESULTS Higher craving levels prior to smoking opportunities predicted increased risk of smoking. When controlling for craving levels, incremental increases in craving predicted increased smoking risk. Increases in negative affect incrementally predicted increased smoking risk at session 2 only. Smokers who failed to abstain were at a higher risk of smoking than those who successfully abstained, whereas abstinent and non-abstinent smokers did not differ in smoking risk. CONCLUSIONS Findings demonstrate an extension of the smoking lapse paradigm that can be utilized to capture momentary changes in craving that predict smoking behavior. Evaluations of nuanced craving experiences may inform clinical and pharmacological research on preventing smoking lapse and relapse.
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Affiliation(s)
- Courtney A Motschman
- Department of Psychology, University at Buffalo, The State University of New York, 206B Park Hall, Buffalo, NY, 14260, USA
| | - Lisa J Germeroth
- Department of Psychology, University at Buffalo, The State University of New York, 206B Park Hall, Buffalo, NY, 14260, USA.,Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Stephen T Tiffany
- Department of Psychology, University at Buffalo, The State University of New York, 206B Park Hall, Buffalo, NY, 14260, USA.
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King AC, Smith LJ, McNamara PJ, Cao D. Second Generation Electronic Nicotine Delivery System Vape Pen Exposure Generalizes as a Smoking Cue. Nicotine Tob Res 2018; 20:246-252. [PMID: 28082323 PMCID: PMC7207065 DOI: 10.1093/ntr/ntw327] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 01/03/2017] [Indexed: 11/17/2022]
Abstract
Introduction Second generation electronic nicotine delivery systems (ENDS; also known as e-cigarettes, vaporizers or vape pens) are designed for a customized nicotine delivery experience and have less resemblance to regular cigarettes than first generation "cigalikes." The present study examined whether they generalize as a conditioned cue and evoke smoking urges or behavior in persons exposed to their use. Methods Data were analyzed in N = 108 young adult smokers (≥5 cigarettes per week) randomized to either a traditional combustible cigarette smoking cue or a second generation ENDS vaping cue in a controlled laboratory setting. Cigarette and e-cigarette urge and desire were assessed pre- and post-cue exposure. Smoking behavior was also explored in a subsample undergoing a smoking latency phase after cue exposure (N = 26). Results The ENDS vape pen cue evoked both urge and desire for a regular cigarette to a similar extent as that produced by the combustible cigarette cue. Both cues produced similar time to initiate smoking during the smoking latency phase. The ENDS vape pen cue elicited smoking urge and desire regardless of ENDS use history, that is, across ENDS naїve, lifetime or current users. Inclusion of past ENDS or cigarette use as covariates did not significantly alter the results. Conclusions These findings demonstrate that observation of vape pen ENDS use generalizes as a conditioned cue to produce smoking urge, desire, and behavior in young adult smokers. As the popularity of these devices may eventually overtake those of first generation ENDS cigalikes, exposure effects will be of increasing importance. Implications This study shows that passive exposure to a second generation ENDS vape pen cue evoked smoking urge, desire, and behavior across a range of daily and non-daily young adult smokers. Smoking urge and desire increases after vape pen exposure were similar to those produced by exposure to a first generation ENDS cigalike and a combustible cigarette, a known potent cue. Given the increasing popularity of ENDS tank system products, passive exposures to these devices will no doubt increase, and may contribute to tobacco use in young adult smokers.
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Affiliation(s)
- Andrea C King
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago IL
| | - Lia J Smith
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago IL
| | - Patrick J McNamara
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago IL
| | - Dingcai Cao
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago IL
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16
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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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Smoking Abstinence-Induced Changes in Resting State Functional Connectivity with Ventral Striatum Predict Lapse During a Quit Attempt. Neuropsychopharmacology 2016; 41:2521-9. [PMID: 27091382 PMCID: PMC4987851 DOI: 10.1038/npp.2016.56] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Revised: 03/19/2016] [Accepted: 04/12/2016] [Indexed: 01/13/2023]
Abstract
The ventral and dorsal striatum are critical substrates of reward processing and motivation and have been repeatedly linked to addictive disorders, including nicotine dependence. However, little is known about how functional connectivity between these and other brain regions is modulated by smoking withdrawal and may contribute to relapse vulnerability. In the present study, 37 smokers completed resting state fMRI scans during both satiated and 24-h abstinent conditions, prior to engaging in a 3-week quit attempt supported by contingency management. We examined the effects of abstinence condition and smoking outcome (lapse vs non-lapse) on whole-brain connectivity with ventral and dorsal striatum seed regions. Results indicated a significant condition by lapse outcome interaction for both right and left ventral striatum seeds. Robust abstinence-induced increases in connectivity with bilateral ventral striatum were observed across a network of regions implicated in addictive disorders, including insula, superior temporal gyrus, and anterior/mid-cingulate cortex among non-lapsers; the opposite pattern was observed for those who later lapsed. For dorsal striatum seeds, 24-h abstinence decreased connectivity across both groups with several regions, including medial prefrontal cortex, posterior cingulate cortex, hippocampus, and supplemental motor area. These findings suggest that modulation of striatal connectivity with the cingulo-insular network during early withdrawal may be associated with smoking cessation outcomes.
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Lemieux A, Olson L, Nakajima M, Schulberg L, al'Absi M. Life adversity is associated with smoking relapse after a quit attempt. Addict Behav 2016; 60:71-7. [PMID: 27100471 DOI: 10.1016/j.addbeh.2016.03.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 01/25/2016] [Accepted: 03/29/2016] [Indexed: 11/18/2022]
Abstract
Multiple cross-sectional studies have linked adverse childhood events and adult adversities to current smoking, lifetime smoking, and former smoking. To date, however, there have been no direct observational studies assessing the influence of adversities on smoking relapse. We prospectively followed 123 participants, 86 of whom were habitual smokers, from pre-quit ad libitum smoking to four weeks post-quit. Thirty-seven non-smokers were also tested in parallel as a comparison group. Subjects provided biological samples for confirmation of abstinence status and self-report history of adversities such as abuse, neglect, family dysfunction, incarceration, and child-parent separation. They also completed mood and smoking withdrawal symptom measures. The results indicated that within non-smokers and smokers who relapsed within the first month of a quit attempt, but not abstainers, females had significantly higher adversity scores than males. Cigarette craving, which was independent from depressive affect, increased for low adversity participants, but not those with no adversity nor high adversity. These results demonstrate that sex and relapse status interact to predict adversity and that craving for nicotine may be an important additional mediator of relapse. These results add further support to the previous cross-sectional evidence of an adversity and smoking relationship. Further studies to clarify how adversity complicates smoking cessation and impacts smoking behaviors are warranted.
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Affiliation(s)
- Andrine Lemieux
- University of Minnesota Medical School, Duluth, MN, United States
| | - Leif Olson
- University of Minnesota Medical School, Duluth, MN, United States
| | | | - Lauren Schulberg
- University of Minnesota Medical School, Duluth, MN, United States
| | - Mustafa al'Absi
- University of Minnesota Medical School, Duluth, MN, United States; Department of Psychiatry, University of Minnesota, Twin Cities, Minneapolis, MN, United States; Department of Family Medicine and Community Health, University of Minnesota, Twin Cities, Minneapolis, MN, United States.
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Falcone M, Bernardo L, Ashare RL, Hamilton R, Faseyitan O, McKee SA, Loughead J, Lerman C. Transcranial Direct Current Brain Stimulation Increases Ability to Resist Smoking. Brain Stimul 2016; 9:191-6. [PMID: 26572280 PMCID: PMC4789149 DOI: 10.1016/j.brs.2015.10.004] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 08/28/2015] [Accepted: 10/15/2015] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The ability to exert self-control over temptation is a fundamental component of smoking behavior change. Transcranial direct current stimulation (tDCS) of the dorsolateral prefrontal cortex (DLPFC) has been shown to modulate cognitive control circuits. Although prior studies show that stimulation reduces cigarette craving and self-reported smoking, effects on ability to resist smoking have not been investigated directly. OBJECTIVES We assessed effects of a single 20-minute session of 1.0 mA anodal stimulation over the left DLPFC with cathodal stimulation over the right supra-orbital area (vs. sham stimulation) on ability to resist smoking in a validated smoking lapse paradigm. METHODS Twenty-five participants completed two tDCS sessions (active and sham stimulation) in a within-subject, double-blind, randomized and counterbalanced order with a 2-week washout period. Following overnight abstinence, participants received tDCS in the presence of smoking related cues; they had the option to smoke at any time or receive $1 for every 5 minutes they abstained. After 50 minutes, they participated in a 1 hour ad libitum smoking session. Primary and secondary outcomes were time to first cigarette and cigarette consumption, respectively. RESULTS In multiple regression models, active tDCS (compared to sham) significantly increased latency to smoke (p = 0.02) and decreased the total number of cigarettes smoked (p = 0.014) during the session. CONCLUSION These findings suggest that acute anodal stimulation over the left DLPFC (with cathodal stimulation over the right supra-orbital area) can improve ability to resist smoking, supporting the therapeutic potential of tDCS for smoking cessation treatment.
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Affiliation(s)
- Mary Falcone
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
| | - Leah Bernardo
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Rebecca L Ashare
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Roy Hamilton
- Laboratory for Cognition and Neural Stimulation, University of Pennsylvania, Philadelphia, PA, USA
| | - Olufunsho Faseyitan
- Laboratory for Cognition and Neural Stimulation, University of Pennsylvania, Philadelphia, PA, USA
| | - Sherry A McKee
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - James Loughead
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Caryn Lerman
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
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