Circadian and ultradian rhythms in heart rate and motor activity of smokers, abstinent smokers, and nonsmokers

A virtual reality craving study in tobacco addiction: The role of non-pharmacological support in tobacco detox therapy

Nicotine addiction is a widespread, worldwide epidemic, causing six million deaths per year. A large variety of treatments for smoking cessation are currently available, including Cytisine, which is a promising drug due to its low cost and high safety levels. Notwithstanding the important amount of research on tobacco addiction treatments, smoking remains one of the most difficult substance use disorders to treat, probably also due to the fact that pharmacological treatment often overlooks other maintaining factors in this addiction, such as sensory impact and cue reactivity. To address this gap in both treatment protocols and scientific literature, we propose a study protocol in which we will compare the effects of combining Cytisine with Nirdosh, a herbal tobacco substitute, to Cytisine only in two groups of patients (C + N and C) who will also undergo exposure to four different virtual reality settings that will assess the importance of environmental cues. We will further assess mood and craving in the two samples, and include a control group taken from the general population. We expect the C + N group to report a more positive mood and a lower sensitivity to tobacco-related environmental cues.

Smoking and atherosclerotic cardiovascular disease: part III: functional biomarkers influenced by smoking

Smoking cigarettes induces rapidly occurring and reversible functional changes in the cardiovascular system, which precede morphologic changes. These functional changes are also related to atherosclerotic disease development and thus may qualify as prognostic parameters in chronic smokers. As opposed to smoking-induced morphologic changes functional alterations occur and revert within minutes, thus, allowing for the detection of smoking-induced effects on the cardiovascular system within minutes following exposure to mainstream smoke. Some alterations represent 'direct' changes (e.g., endothelial function), others reflect changes in a different organ system (e.g., the autonomous nervous system influencing heart rate variability), while some represent the sum of alterations in many organs and systems (e.g., exercise performance influenced by the autonomous nervous and by endothelial and cardiac function). Since a specific functional parameter usually changes with at least one or several others, caution should be exercised when trying to establish a direct cause relationship between the alteration of a single parameter and a clinical outcome.

Fentanyl, but not haloperidol, entrains persisting circadian activity episodes when administered at 24- and 31-h intervals

Administration of several drugs of abuse on a 24-h schedule has been shown to entrain both pre-drug (anticipatory) and post-drug (evoked) circadian activity episodes that persist for several days when the drug is withheld. The present study tested the entrainment effects of fentanyl, an opioid agonist with a noted abuse liability, and haloperidol, an anti-psychotic dopamine antagonist without apparent abuse liability. Adult female Sprague-Dawley rats housed under constant light in cages with attached running wheels received repeated low, medium, or high doses of either fentanyl or haloperidol on a 24-h administration schedule followed by a 31-h schedule (Experiment 1) or solely on a 31-h schedule (Experiment 2). The results showed that all three doses of fentanyl entrained both pre-drug and post-drug episodes of wheel running when administered every 24h, and the combined pre- and post-fentanyl activity episodes persisted for at least 3 days when the drug was withheld during test days. On the 31-h schedule, fentanyl produced an "ensuing" activity episode approximately 24h post-administration, but failed to produce an anticipatory episode 29-31h post-administration. In contrast, haloperidol injections failed to produce both pre-drug episodes on the 24-h schedule and circadian ensuing episodes on the 31-h schedule, and post-haloperidol suppression of activity appeared to mask the free-running activity rhythm. Taken together, these results provide additional evidence that drugs of abuse share a common ability to entrain circadian activity episodes.

Pre- and post-nicotine circadian activity rhythms can be differentiated by a paired environmental cue

Previous studies have shown that addictive drugs presented daily at fixed times produce circadian (oscillator-driven) anticipatory and evoked activity rhythms in rats. Other studies have shown that environmental cues paired with addictive drugs produce tolerance to drug effects and elicit craving behavior when presented without the drug. The present study tested these circadian entrainment and paired-cue conditioning effects together. This study compared the ability of daily nicotine and saline injections at different fixed times to entrain pre-injection (anticipatory) and post-injection (evoked) circadian activity rhythms in two groups of female Sprague-Dawley rats. One group (Paired) had an environmental cue (a tone) paired with the effects of the nicotine injection, and the second group (Unpaired) had the tone paired with the effects of the saline injection. The rats were housed singly for 56 days in chambers with attached wheels under constant dim light and rate-limited food access. During three separate injection phases, nicotine and saline were administered daily at different fixed times, and the tone was presented at the second injection time. Three multi-day test phases examined circadian activity (a) without injections or tone, (b) with the tone alone at normal and novel times, and (c) with the tone absent and with injections occurring at normal and at novel times. The results showed that nicotine entrained both pre- and post-injection circadian oscillators, and the nicotine-paired tone interfered with pre-injection anticipatory activity.

Influence of smoking and gender on diurnal variations of heart rate reactivity in humans

We evaluated the influence of smoking and gender on diurnal variations of heart rate reactivity during performance of two vigilance tasks (auditory and visual) and a working memory task. Heart rate was measured hourly (08:00-21:00 h) at rest and during performance tasks in 20 smokers (ten men, ten women) and 20 non-smokers (ten men, ten women). Smoking and gender influenced reactivity only at certain times, especially at the earliest and latest hours and during the post-lunch period. Smokers displayed major post-lunch interference and a pattern of lowered stress in the second half of the day. Women showed greater reactivity at the first daily recording, although their levels later became similar to the men's and were even lower. The statement that women are myocardial hyperreactors must be further investigated, as it seems women may take longer than men to adapt to a task.

Nicotine and nicotinic receptors in the circadian system

Considerable data support a role for cholinergic influences on the circadian system. The extent to which these influences are mediated by nicotinic acetylcholine receptors (nAChRs) has been controversial, as have the specific actions of nicotine and acetylcholine in the suprachiasmatic nucleus (SCN) of the hypothalamus. In this article we review the existing literature and present new data supporting an important role for nAChRs in both the developing and adult SCN. Specifically, we present data showing that nicotine is capable of causing phase shifts in the circadian rhythms of rats. Like light and carbachol, nicotine appears to cause phase delays in the early subjective night and phase advances in the late subjective night. In the isolated SCN slice, however, only phase advances are seen, and, surprisingly, nicotine appears to cause the inhibition rather than the excitation of neurons. Among nAChR subunit mRNAs, alpha 7 appears to be the most abundant subunit in the adult SCN, whereas in the perinatal period, the more typical nAChRs with higher affinity for nicotine predominate in the SCN. This developmental change in subunit expression may explain the dramatic sensitivity of the perinatal SCN to nicotine that we have previously observed. The effects of nicotine on the SCN may contribute to alterations caused by nicotine in other physiological systems. These effects might also contribute to the dependence properties of nicotine through influences on arousal.

Smoking effects on diurnal variations of cardiovascular parameters

Previous studies have reported that nicotine increases heart rate and blood pressure, showing a peak 10 min after intake. But most of the work has focused on the period of maximum effect on cardiovascular parameters and has been limited to morning measurements. The aim of this study is to evaluate the effects of smoking in diurnal variations of heart rate and blood pressure, when no restrictions are placed on the pattern of consumption and activity is controlled. The sample consisted of healthy subjects, 21 smokers and 21 non-smokers, from 18 to 26 years. The recordings were carried out hourly from 8:00 to 21:00 h in resting conditions. Heart rate was measured beat-to-beat for 2 min, and blood pressure was assessed by conventional electronic monitor. Smokers and non-smokers did not differ in diurnal levels of heart rate nor blood pressure when time of day was not considered. However, when time of day was taken into account, the groups differed significantly for heart rate and systolic blood pressure, while diastolic blood pressure only showed differences for post-lunch period. The influence of nicotine on the cardiovascular system of young and healthy smokers is more apparent in the diurnal variations than in the mean level of heart rate and blood pressure. The results emphasize the importance of a chronobiological approach in the study of the early stages of smoking on cardiovascular parameters.