Automatic affective responses to smoking cues.

The authors examined automatic emotional reactions to smoking cues among 35 smokers and 25 nonsmokers (32 women and 28 men), using a novel implicit measure, the Affect Misattribution Procedure. Associative-learning theories of addiction suggest that smokers develop positive responses to cues linked to the rewarding effects of nicotine. Prior research, however, has yielded mixed evidence for whether smokers have favorable or unfavorable automatic responses to smoking cues. These findings may depend on the methods used to measure implicit responses. Using the Affect Misattribution Procedure, the authors found that nonsmokers responded to smoking cues with clear negative affect, whereas smokers' responses depended on individual differences in current smoking withdrawal. Smokers having withdrawal symptoms and those most motivated to smoke showed favorable emotional responses to smoking cues, but those with no withdrawal or low motivation to smoke showed negative responses. These results help integrate previous studies finding that smokers have negative automatic responses to cigarettes with those studies finding that smokers' responses were relatively positive. The results are important for theories that emphasize the role of cue conditioning in maintaining addiction because these theories assume, consistent with the current findings, that smoking cues can take on positive reward value. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Subliminal processing of smoking-related and affective stimuli in tobacco addiction.

Cognitive processing biases toward smoking-related and affective cues may play a role in tobacco dependence. Because processing biases may occur outside conscious awareness, the current study examined processing of smoking-related and affective stimuli presented at subliminal conditions. A pictorial subliminal repetition priming task was administered to three groups: (1) Nonsmokers (n = 56); (2) Smokers (≥10 cigarettes/day) who had been deprived from smoking for 12 h (n = 47); and (3) Nondeprived smokers (n = 66). Prime stimuli were presented briefly (17 ms) and were followed by a mask (to render them unavailable to conscious awareness) and then a target. Participants were required to make a speeded classification to the target. A posttask awareness check was administered to ensure that participants could not consciously perceive the briefly presented primes (i.e., smoking paraphernalia, neutral office supplies, and happy, angry, and neutral facial expressions). The groups differed in the degree to which they exhibited a processing bias for smoking-related stimuli, F(2, 166) = 4.99, p = .008. Deprived smokers exhibited a bias toward processing smoking (vs. neutral office supply) stimuli, F(1, 46) = 5.67, p = .02, whereas nondeprived smokers and nonsmokers did not (ps > .22). The three groups did not differ in the degree to which they exhibited a subliminal processing bias for affective stimuli. Tobacco deprivation appears to increase smokers' subliminal processing of smoking-related (vs. neutral) stimuli but does not influence subliminal processing of affective stimuli. Future research should investigate whether subliminal biases toward smoking-related stimuli influence relapse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attentional bias in drug dependence: Vigilance for cigarette-related cues in smokers.

Two experiments investigated attentional biases for smoking-related cues in smokers and nonsmokers, using the visual probe task. In Experiment 1, when pictures were displayed for 500 ms, smokers who had made repeated quit attempts showed an attentional bias for smoking-related scenes. Experiment 2 replicated this finding and revealed that when pictures were presented for 2,000 ms, the smoker group as a whole showed vigilance for smoking-related cues, but nonsmokers did not. The findings from the 500-ms exposure condition suggest that initial orienting of attention to smoking cues was associated with repeated unsuccessful attempts at abstinence in smokers. Results are discussed with reference to incentive-sensitization theories of addiction and to component processes of selective attention, such as initial orienting versus maintenance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of Cue Exposure, Urge to Smoke, and Nicotine Deprivation on Cognitive Performance in Smokers.

The primary aim of this investigation was to test the hypothesis that the urge to smoke interferes directly with cognitive performance. Fifty-four smokers were randomly assigned to 1 of 3 groups: (a) ad lib, (b) deprived, or (c) nicotine patch. Participants rated their urge to smoke on continuous visual analogue scales. Cognitive performance was determined by measuring reaction times (RTs) on a Sternberg task. The deprived group reported a higher urge and had longer RTs than the ad lib group when exposed to smoking-related cues. However, the nicotine patch group reported a higher urge in the absence of longer RTs. The results indicated that nicotine deprivation affects cognitive performance and that the urge to smoke only partially mediated RTs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of Transdermal Nicotine During Imaginal Exposure to Anxiety and Smoking Cues in College Smokers.

In a 2 (patch) × 2 (smoking) × 2 (anxiety) mixed design, 52 undergraduate smokers randomly received a nicotine (21 mg) or placebo patch. After a 4-hr nicotine absorption/deprivation period, participants imagined several scenarios varying in cue content: (a) anxiety plus smoking, (b) anxiety, (c) smoking, and (d) neutral. Although smoking urge increased in both the nicotine and placebo conditions after the absorption/deprivation period, those who received the placebo reported significantly greater urge. During the cue reactivity trials, a significant Patch × Smoking × Anxiety interaction effect was observed for urge. However, participants who received nicotine still experienced moderate urges, indicating that nicotine did not attenuate cue-elicited urge. Transdermal nicotine did not diminish anxiety during the absorption/deprivation period or in response to the cues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Testing the influence of external and internal cues on smoking motivation using a community sample.

Exposing smokers to either external cues (e.g., pictures of cigarettes) or internal cues (e.g., negative affect induction) can induce urge to smoke and other behavioral and physiological responses. However, little is known about whether the two types of cues interact when presented in close proximity, as is likely the case in the real word. Additionally, potential moderators of cue reactivity have rarely been examined. Finally, few cue-reactivity studies have used representative samples of smokers. In a randomized 2 × 2 crossed factorial between-subjects design, the current study tested the effects of a negative affect cue intended to produce anxiety (speech preparation task) and an external smoking cue on urge and behavioral reactivity in a community sample of adult smokers (N = 175), and whether trait impulsivity moderated the effects. Both types of cues produced main effects on urges to smoke, despite the speech task failing to increase anxiety significantly. The speech task increased smoking urge related to anticipation of negative affect relief, whereas the external smoking cues increased urges related to anticipation of pleasure; however, the cues did not interact. Impulsivity measures predicted urge and other smoking-related variables, but did not moderate cue-reactivity. Results suggest independent rather than synergistic effects of these contributors to smoking motivation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attentional bias predicts outcome in smoking cessation.

Most attempts to quit smoking end in failure, with many quitters relapsing in the first few days. Responses to smoking-related cues may precipitate relapse. A modified emotional Stroop task-which measures the extent to which smoking-related words disrupt performance on a reaction time (RT) task-was used to index the distracting effects of smoking-related cues. Smokers (N=158) randomized to a high-dose nicotine patch (35 mg) or placebo patch completed the Stroop task on the 1st day of a quit attempt. Smokers using an active patch exhibited less attentional bias, making fewer errors on smoking related words. Smokers who showed greater attentional bias (slowed RT on the first block of smoking words) were significantly more likely to lapse in the short-term, even when controlling for self-reported urges at the test session. Attentional bias measures may tap an important component of dependence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of night smoking, sleep disturbance, and their co-occurrence on smoking outcomes.

Recent evidence suggests that smoking during the night is an indicator of nicotine dependence and predicts smoking cessation failure. Night smokers are likely to experience disturbance to their sleep cycle when they wake to smoke, but we are not aware of the prevalence of night smokers' self-reported sleep disturbance. Because sleep disturbance also predicts smoking cessation failure, we examined how the pre-cessation risk factors of night smoking and sleep disturbance, and their co-occurrence, predict smoking cessation failure in a 6-week double-blind randomized controlled trial examining whether naltrexone augments the efficacy of the nicotine patch (O'Malley et al., 2006). Smokers (N = 385) completed the Pittsburgh Sleep Quality Index (Buysse, Reynolds, Monk, Berman, & Kupfer, 1989) and a single item of waking at night to smoke pre-cessation. Smoking status was determined at weeks 1, 6, 24, and 48 weeks after quitting. The two main findings were: (a) night smokers reported significantly greater sleep disturbance than nonnight smokers; and (b) smokers with co-occurring night smoking and sleep disturbance experienced significantly greater risk for smoking than smokers with neither risk factor. Results suggest that individuals who both wake during the night to smoke and report clinically-significant sleep disturbance represent a high-risk group of smokers. Future smoking cessation treatment might incorporate strategies related to managing these smokers' sleep habits and physiological dependence on nicotine in order to bolster their cessation outcomes. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Effects of smoking opportunity on attentional bias in smokers.

The emotional Stroop task was used to examine the influence of opportunity to smoke on attentionall bias to smoking-related stimuli. At the outset of the study, 92 nicotine-deprived smokers were told that they (a) would, (b) would not, or (c) might be able to smoke during the experiment. Next, participants completed an emotional Stroop task, in which they were presented with smoking-related or -unrelated words in an unblocked format. Smokers demonstrated interference to the smoking words, relative to matched neutral words, F(1, 87)?=?18.0, p?F(2, 87)?=?4.35, p?     

Evaluating social-cognitive mechanisms that regulate self-efficacy in response to provocative smoking cues: An experimental investigation.

Smokers' self-efficacy appraisals strongly predict smoking outcomes. However, the cognitive structures that regulate smokers' self-efficacy appraisals have not yet been identified. Knowledge of such structures could assist in designing treatments that target self-efficacy appraisals to improve smoking outcomes. This study evaluated whether 2 abstinence-related self-schemas, the abstainer ideal- and abstainer ought-possible selves, regulated self-efficacy to resist smoking when smokers were exposed to provocative smoking cues. Craving responses to the cues were a secondary outcome. Cognitively priming both of these abstainer selves increased self-efficacy and decreased craving compared with when a smoking-related self-schema was cognitively primed under the same provocative cue conditions. Higher levels of self-efficacy were consistently associated with decreased craving. These results have both theoretical and clinical implications for smoking cessation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cigarette smoking, nicotine addiction, and relaxation.

Shock endurance was used to measure the amount of anxiety experienced in a stressful situation by nonsmokers, smokers allowed to smoke cigarettes containing low levels or moderately high levels of nicotine, and smokers not allowed to smoke. Ss were 51 university students. Smokers deprived of cigarettes and those who smoked cigarettes containing low levels of nicotine behaved more anxiously than nonsmokers and Ss allowed to smoke high-nicotine cigarettes, but the high-nicotine smokers behaved no less anxiously than nonsmokers. Results support the hypothesis that the calming effect of smoking is due to the action of nicotine in ending withdrawal symptoms in addicted smokers rather than to a sedative property of cigarette smoking. (12 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of olfactory stimuli on urge reduction in smokers.

This study examined the possibility that exposure to olfactory stimuli can reduce self-reported urge to smoke. After an initial assessment of self-reported urge, nicotine-deprived smokers evaluated the pleasantness of a series of 8 odors. Facial expressions during odor presentations were coded with P. Ekman and W. V. Friesen's (1978) Facial Action Coding System. After odor administration, participants were exposed to smoking cues. Next, participants were administered their most pleasant, least pleasant, or a control odor (water) and reported their urge to smoke. Results indicated that sniffing either a pleasant or unpleasant odor reduced reported urge to smoke relative to the control odor. Reported pleasantness of the odors did not differentially affect urge reduction. Odors eliciting negative-affect-related expressions, however, were less effective than odors that did not elicit negative-affect-related expressions in reducing reported urge. Results of this preliminary investigation provide support for the consideration of odor stimuli as an approach to craving reduction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attentional bias for smoking and affective stimuli: A Stroop task study.

Prior research has demonstrated attentional biases to smoking-related cues among smokers, and several lines of research suggest strong ties between smoking and negative affect. The authors tested attentional biases to both smoking and affective cues in 27 smokers using an emotional Stroop paradigm, and examined the relationship between these forms of attentional bias. Findings indicated significant attentional biases to smoking-related and negative-affect words, but not positive-affect words. In addition, there was a significant correlation between the degree of attentional bias to smoking and negative-affect words. These data provide evidence of a close association between smoking-related and affective cue processing from a cognitive perspective. Potential theoretical and clinical implications for these findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nicotine and smoking: A review of effects on human performance.

Examined the effects of nicotine administration and cigarette smoking on human performance to clarify the role of such effects in controlling smoking. The results of 101 studies (129 experiments) published in scientific journals from 1970 to 1993 were reviewed. In nonabstinent smokers and nonsmokers, nicotine enhanced finger tapping and motor responses in tests of attention; cognitive functioning was not reliably enhanced. It is unlikely that these limited performance-enhancing effects of nicotine play an important role in the initiation of cigarette smoking. In contrast, data from abstinent smokers support the conclusion that nicotine deprivation functions to maintain smoking in nicotine-dependent persons, in part, because nicotine can reverse withdrawal-induced deficits in several areas of performance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Time of conditioning selectively influences contextual fear conditioning: further support for a multiple-memory systems view of fear conditioning

Three classical conditioning models (the conditioned compensatory response, conditioned withdrawal, and conditioned appetitive motivational models) postulate that drug cues evoke physiological and emotional responses associated with motivational states that prompt drug use. There is accumulating evidence to suggest that factors other than classical conditioning can influence emotional and physiological reactivity to drug stimuli. This study tested whether stage of change affects the nature of reactivity to smoking cues among continuing smokers. Precontemplators (smokers not considering quitting) and contemplators (smokers considering quitting in the near future) watched videotapes containing smoking cues. Emotional and physiological responses to the smoking video were contrasted with responses to a neutral videotape. Precontemplators had lower heart rates than did contemplators in response to the smoking videotape. Both contemplators and precontemplators evinced increased positive affect in response to the smoking cue. A comparison sample of nonsmokers did not show any reactivity to the smoking cue. Implications of these findings for conditioning theories of smoking are discussed.     

Effects of nicotine deprivation on craving response covariation in smokers.

Most models of craving propose that when cravings are strong, diverse responses--thought to index an underlying craving state--covary. Previous studies provided weak support for this hypothesis. The authors tested whether nicotine deprivation affects degree of covariation across multiple measures related to craving. Heavy and light smokers (N=127) were exposed to smoking cues while either nicotine deprived or nondeprived. Measures included urge ratings, affective valence, a behavioral choice task assessing perceived reinforcement value of smoking, and smoking-related judgment tasks. Results indicated higher correlations in the nicotine-deprived than in nondeprived group. The measures principally responsible for this effect loaded onto a single common Craving factor for nicotine-deprived but not nondeprived smokers. These findings suggest that, under certain conditions, measures of craving-related processes covary. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A case of Sj?gren''s syndrome associated with advanced hemolytic anemia caused by worsening autoimmune cholangiopathy

AIMS: Recent research suggests that people who become smokers may be more sensitive to the positive effects of nicotine than those who do not take up smoking. DESIGN AND SETTING: The present study was designed to investigate this hypothesis by querying initial experiences with cigarette smoking in smokers, ex-smokers and never-smokers recruited from the local community. PARTICIPANTS: Subjects were 80 women (23 highly-dependent smokers (Fagerstrom Tolerance Questionnaire score > or = 7), 30 less-dependent smokers (FTQ < or = 6), 12 ex-smokers and 15 never-smokers). MEASUREMENTS: Subjects were asked to rate pleasurable sensations and displeasurable sensations on a scale of 1 = none to 4 = intense, and to indicate the presence or absence of pleasurable rush or buzz, relaxation, dizziness, nausea and cough; social context was also queried. Pleasurable rush or buzz, relaxation, dizziness, nausea and cough were related to ratings of pleasurable and unpleasant sensations to establish their affective valence. FINDINGS: Pleasurable sensations, pleasurable rush or buzz and relaxation (pleasant effects) were significantly more likely to occur in the smoker categories than in never-smokers. The ratio of pleasurable to unpleasant sensations, computed as an index of overall hedonic impact of initial exposure, also significantly favored the smoker categories. By contrast, unpleasant sensations, nausea and cough (unpleasant effects) did not differ significantly among groups. Dizziness, which did not definitely emerge as either pleasurable or unpleasant, was significantly more likely to be reported among the smoker groups than among never-smokers. CONCLUSIONS: People who become highly dependent cigarette smokers appear to have more pleasurable sensations at their initial exposure to tobacco; unpleasant reactions to the first cigarette do not seem to protect against subsequent smoking.     

Effect of stage of change on cue reactivity in continuing smokers.

Three classical conditioning models (the conditioned compensatory response, conditioned withdrawal, and conditioned appetitive motivational models) postulate that drug cues evoke physiological and emotional responses associated with motivational states that prompt drug use. There is accumulating evidence to suggest that factors other than classical conditioning can influence emotional and physiological reactivity to drug stimuli. This study tested whether stage of change affects the nature of reactivity to smoking cues among continuing smokers. Precontemplators (smokers not considering quitting) and contemplators (smokers considering quitting in the near future) watched videotapes containing smoking cues. Emotional and physiological responses to the smoking video were contrasted with responses to a neutral videotape. Precontemplators had lower heart rates than did contemplators in response to the smoking videotape. Both contemplators and precontemplators evinced increased positive affect in response to the smoking cue. A comparison sample of nonsmokers did not show any reactivity to the smoking cue. Implications of these findings for conditioning theories of smoking are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of cigarette smoking and smoking deprivation on Wisconsin Card Sorting Test performance.

Wisconsin Card Sorting Test (WCST) performance was assessed in 24 heavy smokers and 12 nonsmokers recruited from universities in the US and Japan. Half of the smokers performed the WCST after abstaining from tobacco for 12 hrs, whereas the remaining smokers smoked a cigarette of their preferred brand immediately before the test. Nonsmokers did not smoke. The WCST was administered by computer, first with standard instructions and then a 2nd time with abbreviated instructions that specified the 3 sorting criteria. Results from the 2nd run indicated that abstinent smokers made significantly more perseverative responses and errors than did nonsmokers or smoking smokers. Results expand on previous findings of effects of smoking deprivation on human cognitive performance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mood-induced shifts in attentional bias to emotional information predict ill- and well-being.

Previous research has suggested that biased attention toward emotional (typically threatening) stimuli contributes to ill-being (e.g., high levels of anxiety), but its contribution to well-being is less clear. The researchers assessed naturalistic shifts in attentional bias toward threatening and pleasant schematic face cues in response to five induced mood states in college students. They also assessed state anxiety and satisfaction with life concurrently and 3 weeks later. Controlling for concurrent anxiety, a fear-induced shift in attention to threatening cues was associated with increased levels of later anxiety. Controlling for concurrent life satisfaction, a happiness-induced shift in attention to emotional cues (both threatening and pleasant) was associated with increased levels of later life satisfaction. These results suggest that mood-induced changes in deployment of attention to emotional information may accumulate in ways that impact psychological functioning, yet these effects depend on mood state and the emotional cues afforded by the context. (PsycINFO Database Record (c) 2011 APA, all rights reserved)