Cigarette abstinence impairs memory and metacognition despite administration of 2 mg nicotine gum.

The authors assessed the effects of cigarette abstinence (nonabstinent vs. minimum 8 hours abstinent) and nicotine gum (0 mg vs. 2 mg nicotine) on sustained attention, free recall, and metacognition using a within-subjects design. Moderate smokers (10 women and 22 men) received one training session followed by four test sessions on consecutive days. Nicotine gum improved sustained attention in both abstinent and nonabstinent states, but had no significant effect on predicted or actual recall levels. Cigarette abstinence significantly impaired free recall and reduced the magnitude of participants' predictions of their own performance. In addition, participants were significantly more overconfident about their future memory when abstinent. Thus, nicotine gum can improve smokers' performance in basic aspects of cognition (e.g., sustained attention) but may not alleviate the detrimental effects of cigarette abstinence on higher-level processes such memory and metacognition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Experimental analysis of the role of expectancy in nicotine withdrawal.

Manipulated the withdrawal symptoms experienced by 62 cigarette smokers during a 48-hr smoking abstinence period. Ss were randomly assigned to 1 of 4 expectancy manipulation groups (psychological complaints, somatic complaints, no complaints, and no-expectancy control), and withdrawal symptoms were measured during 48 hrs of ad libitum smoking and 48 hrs of abstinence. The expectancy manipulation consisted of placebo nicotine gum and specific instructions as to the type of withdrawal symptoms to expect during smoking abstinence. Ss instructed to expect no complaints during abstinence reported fewer somatic complaints and less mood disturbance than the no-expectancy controls. Ss instructed to expect somatic, but not psychological, complaints reported more numerous and severe somatic withdrawal symptoms than did Ss instructed not to expect such symptoms. Results suggest expectancy may play a role in nicotine withdrawal experiences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The influence of smoking on reward responsiveness and cognitive functions: a natural experiment

AIMS: To investigate the effects of (a) nicotine abstinence and (b) cigarette smoking after abstinence, on reward responsiveness and cognitive functions which are putatively dependent on activity in the dopaminergic system implicated in smoking. DESIGN: During Ramadhan, Muslim smokers elected to abstain from smoking either for the whole month (RAMQUIT) or during daylight hours (DAYQUIT). These groups, and non-smokers (NOSMOKE), were assessed on two occasions 6 hours apart (TEST1 and TEST2). DAYQUIT participants had abstained for 6 hours at TEST1 and smoked a single cigarette immediately prior to TEST2. RAMQUIT participants had abstained for at least 10 days prior to TEST1 and remained abstinent at TEST2. NOSMOKE and RAMQUIT participants are a small snack prior to TEST2 to control for non-specific consummatory effects. SETTING: TEST1 was conducted at the mosque and TEST2 in participants' homes. PARTICIPANTS: All were male; mean age was 26.7 years. Modal cigarette consumption prior to Ramadhan by both the 13 DAYQUIT and the 11 RAMQUIT smokers was 21-30 per day. DAYQUIT subjects rated themselves as more dependent. MEASUREMENTS: The Card Arranging Reward Responsivity Objective Test (CARROT), testing behavioural responsiveness to small financial incentive; digit span, measuring attention; verbal fluency, indexing frontal lobe function; and the two-choice guessing test (2CGT; at TEST1 only), measuring response stereotypy. FINDINGS: At TEST1, compared with non-smokers, both smoking groups showed greater stereotypy (2CG) and lower reward responsiveness (CARROT). DAYQUIT participants improved on all measures after smoking a single cigarette. No marked changes were seen in the other groups. CONCLUSION: These data suggest that (i) abstaining smokers have impaired dopaminergic function and (ii) nicotine consumption may boost their dopaminergic activity.     

Characterizing nicotine withdrawal in pregnant cigarette smokers.

Maternal smoking is a leading preventable cause of poor pregnancy outcomes and infant morbidity and mortality. Whereas pregnancy has been thought of as a "window of opportunity" when women are more motivated to change health behaviors such as smoking, only 20% of pregnant women quit smoking upon learning they are pregnant and remain abstinent at the end of the pregnancy. Greater understanding of possible obstacles to smoking during pregnancy, such as nicotine withdrawal, is needed. The symptoms of nicotine withdrawal have been well characterized in nonpregnant smokers, but there has been only 1 report conducted during pregnancy, and that was a retrospective study. The aim of the present study was to characterize nicotine withdrawal and craving in pregnant cigarette smokers. These data were collected as part of prospective clinical trials assessing the efficacy of voucher-based incentives to promote abstinence from cigarette smoking during pregnancy and postpartum. The authors examined results from the Minnesota Nicotine Withdrawal Scale (J. R. Hughes & D. K. Hatsukami, 1998) in 27 abstainers (reported no or very low levels of smoking, which was confirmed biochemically) and 21 smokers (smoked at >80% of their baseline smoking level) during the first 5 days of a cessation attempt. Abstainers reported more impatience, anger, and difficulty concentrating than did smokers. The results also suggest that pregnant smokers generally may have elevated baseline levels of withdrawal, which need to be considered in the design and analysis of future studies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Smokers’ expectancies for abstinence: Preliminary results from focus groups.

Smokers’ expectancies regarding the effects of cigarette use are powerful predictors of smoking motivation and behavior. However, studies have not investigated the consequences that smokers expect when they attempt to quit smoking: abstinence-related expectancies. The primary goal of this qualitative study was to gain initial insight into smokers’ expectancies for abstinence. Eight focus groups were conducted with 30 smokers diverse with respect to age, gender, and ethnoracial background. Content analyses indicated that smokers anticipate a variety of outcomes from abstinence. The most frequently reported expectancies included pharmacologic withdrawal symptoms, behavioral withdrawal symptoms, decreased monetary expense, and immediate improvement of certain aspects of physical functioning and health. Additional expectancies concerned weight gain, improved attractiveness, enhanced social functioning/self-esteem, long-term health outcomes, and loss of relationships. Finally, a number of relatively unheralded expectancies were revealed. These involved nicotine replacement therapy effectiveness, alcohol and other drug use, cue reactivity, cessation-related social support, aversion to smoking, and “political process” implications. This study provides a preliminary step in understanding smokers’ expectancies for abstinence from cigarettes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of nicotine on negative affect among more impulsive smokers.

In the present study, the authors tested the hypothesis that nicotine would provide greater relief from negative affect for more impulsive smokers than for less impulsive smokers. Euthymic adult smokers (N=70) participated in 2 laboratory sessions, during which they underwent a negative mood induction (music + autobiographical memory), then smoked either a nicotinized or de-nicotinized cigarette. Mixed-effects regression yielded a significant Impulsivity × Condition (nicotinized vs. de-nicotinized) × Time interaction. Simple effects analyses showed that heightened impulsivity predicted greater negative affect relief after smoking a nicotinized cigarette but not after smoking a de-nicotinized cigarette. These data suggest that nicotine may be a disproportionately powerful negative reinforcer for highly impulsive smokers, promoting higher levels of nicotine dependence and inhibiting smoking cessation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ever Users Versus Never Users of a "Less Risky" Cigarette.

The authors surveyed 173 smokers who purchased and 114 smokers who knew about but did not purchase Eclipse--a tobacco industry product that is advertised as a reduced risk cigarette. Most low-tar/nicotine cigarette users who purchased Eclipse believed Eclipse was safer than low-tar/nicotine cigarettes both for their own health (73%) and for the health of others around them (86%). Additionally, many viewed Eclipse as a step toward quitting (53%). The authors did not identify robust predictors of Eclipse use. At 6 months follow-up, Eclipse users were as likely to have tried to quit as nonusers; however, the small sample size does not rule out the possibility that Eclipse use undermines quit attempts. The authors conclude that almost all users believe Eclipse is safer than low-tar cigarettes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of cigarette smoking on perception of thermal pain.

The effects of cigarette smoking on pain perception were evaluated in 18 healthy smokers. Thermal pain stimuli were used to assess pain detection threshold and tolerance and to collect subjective ratings of the intensity and unpleasantness of painful stimuli. After overnight abstinence, pain perception was evaluated before and after 3 experimental treatments. Participants smoked normal cigarettes, smoked denicotinized cigarettes, or remained abstinent. Smoking normal cigarettes produced relative increases in pain tolerance compared with abstinence. Smoking denicotinized cigarettes produced intermediate effects on tolerance not different from the other 2 treatments. Effects were not detected for pain threshold or subjective pain ratings. Results suggest that cigarette smoking can have antinociceptive effects, which may depend both on nicotine and on other factors associated with smoking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The acute effects of nicotine on positive and negative affect in adolescent smokers.

Although adolescent cigarette smoking remains a critical public health concern, little is known about the reinforcing mechanisms governing smoking in this vulnerable population. To assess predictions derived from both positive and negative reinforcement models of drug use, the authors measured the acute effects of nicotine, as administered via tobacco cigarettes, on both positive and negative affect in a group of 15- to 18-year-old smokers. A matched group of nonsmokers served as a comparison group. Findings revealed that whereas adolescents who smoked a cigarette experienced reductions in both positive and negative affect, the observed reductions in negative affect were moderated by nicotine content of the cigarette (high yield vs. denicotinized), level of nicotine dependence, level of baseline craving, and smoking expectancies pertinent to negative affect regulation. Nonsmokers experienced no change in affect over the 10-min assessment period, and no interaction effects were observed for positive affect. Overall, the findings conform to a negative reinforcement model of nicotine effects and strongly suggest that, even among young light smokers, nicotine dependence and resultant withdrawal symptomatology may serve as motivating factors governing smoking behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Smoking and nicotine addiction: a pediatric epidemic with sequelae in adulthood

Pediatric addiction to nicotine from cigarette smoking is a major public health problem, extracting a tremendous societal toll in terms of human suffering, a loss of future productivity, and the consumption of scarce health care resources. Teenagers smoke 1.1 billion packs of cigarettes yearly and will account for more than $200 billion in future health care costs. Recent behavioral studies confirm nicotine's ability to induce in adolescents both the tolerance and abstinence phenomena typical of other addicting substances. A range of adverse health effects, first detectable in adolescent cigarette smokers, extend into adulthood. Through the effects of environmental smoke or smoking during pregnancy, adolescent smokers affect not only their own health, but that of friends, family members, and even their own fetuses and children. Additional research into effective prevention and smoking cessation programs is urgently needed to forestall the ravaging of yet another generation by this preventable and deadly habit.     

Serotonin transporter genotype and depressive symptoms moderate effects of nicotine on spatial working memory.

Smokers may use nicotine to self-medicate for situation-specific or person-specific cognitive or affective deficits. Although evidence suggests that nicotine replacement therapy (NRT), relative to placebo, enhances spatial working memory (SWM) in smoking-abstinent smokers with schizophrenia, the extent to which NRT may be helpful in attenuating abstinence-related SWM in other groups with deficits in SWM is unknown. Depressive symptoms are associated with both tobacco smoking and deficits in SWM. Previous studies have found that smoking abstinence increases depressive affect and depression-related hemispheric asymmetries in brain activation. Although the serotonin neurotransmitter system is closely associated with depression and the effects of nicotine, the authors are not aware of any studies that have evaluated the possible role of individual differences in serotonin transporter (5-HTT) genotype and depressive symptoms as moderators of the effects of NRT on SWM. Thus, the current study assessed the effects of NRT (nicotine patch) on SWM in relation to: (1) depressive traits and (2) 5-HTT genotype. Smoking-deprived habitual smokers (N = 64) completed the dot recall test of SWM during counterbalanced and double-blind nicotine and placebo testing sessions. There was a marginal overall effect of NRT on SWM. More importantly, NRT enhanced SWM in 5-HTT short allele carriers, relative to those with two long alleles, and this enhancement in short-allele carriers was greater for individuals with higher levels of depressive symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Smoking behavior and smoking history of tobacco chippers.

Nicotine produces dependence in almost all cigarette smokers. 65 chippers (anomalous smokers who smoke regularly but at very low levels [1–5 cigarettes/day]) were compared with 72 matched regular smokers (20–40 cigarettes/day). Despite having smoked an average of 46,000 cigarettes in 19 yrs of smoking, chippers demonstrated little sign of nicotine dependence. They reported frequent casual abstinence from smoking without withdrawal symptoms, smoked their 1st cigarette of the day hours after waking, and scored low on a modified Fagerstrom Tolerance Questionnaire, a measure of tobacco dependence. Although most chippers had never smoked heavily, a small subgroup of chippers reported previous extended periods of heavy smoking, which suggests that some people may be able to overcome dependence while continuing to smoke. These "converted chippers" could not be distinguished from "native chippers" on the basis of their current smoking behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of d-amphetamine and smoking abstinence on cue-induced cigarette craving.

In this study, the authors investigated the effects of the indirect dopamine agonist d-amphetamine (AMPH) on cue-induced cigarette craving in smokers. Abstinent or nonabstinent cigarette smokers (N=21) rated their cravings for cigarettes and for food (control) after pretreatment with AMPH (15 mg) or placebo and before and after viewing blocks of smoking-related, food-related, and neutral pictures. Before the cues were presented, AMPH increased cigarette craving and decreased food craving. Smoking and food cues increased craving for cigarettes and for food, respectively. AMPH also further increased cigarette craving (and decreased food craving) after cue presentation, but it did so regardless of cue type (food or smoking). Smoking abstinence markedly increased craving regardless of cue presentation or drug condition. These results suggest that both AMPH and smoking abstinence can increase cigarette craving, but they do not appear to specifically affect responses to conditioned smoking-related cues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mood influences on acute smoking responses are independent of nicotine intake and dose expectancy.

Acute responses to smoking are influenced by nicotine and by nonpharmacological factors such as nicotine dose expectancy and sensory effects of smoke inhalation. Because negative mood increases smoking reinforcement, the authors examined whether these effects may be altered by mood context. Smokers (n=200) participated in 2 sessions, negative or positive mood induction, and were randomized to 1 of 5 groups. Four groups comprised the 2×2 balanced placebo design, varying actual (0.6 mg vs. 0.05 mg yield) and expected nicotine dose (expected nicotine vs. denicotinized [denic]) of cigarettes. A fifth group was a no-smoking control. Smoking, versus not smoking, attenuated negative affect, as well as withdrawal and craving. Negative mood increased smoking reinforcement. However, neither actual nor expected nicotine dose had much influence on these responses; even those smokers receiving and expecting a denic cigarette reported attenuated negative affect. A follow-up comparison suggested that the sensory effects of smoke inhalation, but not the simple motor effects of smoking behavior, were responsible. Thus, sensory effects of smoke inhalation had a greater influence on relieving negative affect than actual or expected nicotine intake. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

High-dose transdermal nicotine and naltrexone: Effects on nicotine withdrawal, urges, smoking, and effects of smoking.

Although treatment with transdermal nicotine replacement (TNR) has improved smoking abstinence rates, higher doses of TNR could improve effects on urge to smoke, nicotine withdrawal, and reinforcement from smoking, and naltrexone might further reduce reinforcement and urges. A laboratory investigation with 134 smokers using a 3 × 2 parallel-group design evaluated the effects of TNR (42-mg, 21-mg, or 0-mg patch) as crossed with a single dose of naltrexone (50 mg) versus placebo on urge to smoke, withdrawal, and responses to an opportunity to smoke (intake, subjective effects) after 10 hr of deprivation. Urge and withdrawal were assessed both prior to and after cigarette cue exposure. Only 42 mg TNR, not 21 mg, prevented urge to smoke, heart rate change, and cue-elicited increase in withdrawal. Both 21 and 42 mg TNR blocked cue-elicited drop in heart rate and arterial pressure. Naltrexone reduced cue-elicited withdrawal symptoms but not urges to smoke or deprivation-induced withdrawal prior to cue exposure. Neither medication significantly affected carbon monoxide intake or subjective effects of smoking except that 42 mg TNR resulted in lower subjective physiological activation. No interaction effects were found, and no results differed by gender. Results suggest that starting smokers with 42 mg TNR may increase comfort during initial abstinence, but limited support is seen for naltrexone during smoking abstinence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The influence of transdermal nicotine on tobacco/nicotine abstinence and the effects of a concurrently administered cigarette in women and men.

Transdermal nicotine (TN) is an efficacious smoking cessation pharmacotherapy thought to work, in part, by attenuating the effects of tobacco/nicotine abstinence and the effects of concurrently smoked cigarettes. Clinical trials suggest that TN may be less efficacious for women. This study explored the possibility of TN-related gender differences in ≥8 hour abstinent smokers (54 women, 70 men) who completed four within-subject, double-blind, placebo-controlled sessions corresponding to 0, 7, 14, and 21 mg TN. In each approximately 6.5-hr long session participants smoked an own-brand cigarette 4 hours after TN administration and physiological and subjective outcomes were examined throughout each session. Results revealed that TN suppressed some signs and symptoms of tobacco abstinence and attenuated some effects of smoking, and these effects were not dependent on gender. Women were more sensitive to the direct effects of nicotine (e.g., ratings of Nauseous) and, independent of TN dose, self-administered less nicotine when smoking and rated smoking as less rewarding. Thus, although this study does not shed light on clinical observations that TN is less effective for women, results suggest that TN might need to be combined with other interventions to supplement its effects on tobacco/nicotine abstinence and concurrent smoking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A room with a cue: Personality judgments based on offices and bedrooms.

The authors articulate a model specifying links between (a) individuals and the physical environments they occupy and (b) the environments and observers' impressions of the occupants. Two studies examined the basic phenomena underlying this model: Interobserver consensus, observer accuracy, cue utilization, and cue validity. Observer ratings based purely on offices or bedrooms were compared with self- and peer ratings of occupants and with physical features of the environments. Findings, which varied slightly across contexts and traits, suggest that (a) personal environments elicit similar impressions from independent observers, (b) observer impressions show some accuracy, (c) observers rely on valid cues in the rooms to form impressions of occupants, and (d) sex and race stereotypes partially mediate observer consensus and accuracy. Consensus and accuracy correlations were generally stronger than those found in zero-acquaintance research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of nicotine fading and relapse prevention on smoking cessation.

In a pilot study, a combined nicotine-fading/relapse-prevention program for 24 smokers (mean age 38.6 yrs) achieved a 46% abstinence rate at 6-mo follow-up. The combined program was then compared to conditions in which 46 smokers (mean age 34.8 yrs) received nicotine fading or relapse prevention only or combination treatment. There was no difference among groups in abstinence or rate at any follow-up point, and overall abstinence levels were only 15% and 9% at 6-mo and 1-yr follow-ups, respectively. Groups receiving nicotine fading tended to retain lower estimated nicotine intake levels. (3 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Transdermal nicotine: The long and the short of it.

Cigarette smokers with a mean history of 35 smoking years (N?=?98) were randomly assigned to receive either 3 weeks or 12 weeks of transdermal nicotine treatment combined with a 5-session behavioral management program. Participants were followed for 20 weeks. At the conclusion of the study, 26% of the 3-week participants and 29% of the 12-week participants were abstinent. The number of abstinent participants and duration of abstinence were not significantly different between the 2 groups, although statistical power constraints do not rule out the possibility of small undetected differences in outcome. Most participants (68%) smoked at least once during their nicotine patch regimen. Smoking on the patch was associated with poor outcome. Those who smoked while using the patch reported more restlessness and cigarette cravings and lower confidence and intention to quit smoking than did participants who did not smoke during the drug regimen. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of cigarette smoking on electrodermal orienting reflexes to stimulus change and stimulus significance

Skin conductance responses (SCRs) evoked by novel, signal, and frequent tone stimuli were measured in 20 male heavy smokers and 10 male nonsmokers over two sessions. All smokers abstained from smoking for 12 hr prior to each session. Half of the smokers smoked a cigarette of their preferred brand prior to SCR measurement in the first session, whereas the remaining smokers smoked in the second session. Nonsmokers did not smoke. Results combined across the two sessions indicated that abstinence was associated with selective depression of SCRs to the novel tone. Separate analyses of results from each session revealed that, in the second session, SCRs to both novel and signal tones were depressed in abstinent smokers, partially replicating previous findings. By contrast, first session results showed no significant effects of smoking or abstinence. Results were interpreted in terms of nicotine's effects on nonspecific arousal, with some reservations.