Investigation of Cigarette Cravings in Smokers

Investigating Stress-Potentiated Memory Updating as a Novel Intervention for Non-Treatment Seeking Smokers

Interventions to disrupt memory reconsolidation have held promise for the treatment of stress- and anxiety-related disorders. In the present study, the investigators will examine whether an intervention based on these principles, called memory updating, could be adapted for reward-seeking behaviors. To test this, non-treatment seeking tobacco smokers will be exposed to smoking cues and/or stress, two stimuli known to trigger smoking. It is predicted that exposure to a stress task will enhance the cues' motivational salience and yield greater susceptibility to the memory updating procedure.

As an add-on, the investigators will examine COVID-associated changes in substance use and whether participants in the memory updating groups might be more resilient to these effects. It is predicted that the changes in substance use will depend on whether the substances are used primarily in social settings.

Study Overview

• Status: Active, not recruiting
• Conditions: Tobacco Use; Addiction Nicotine; Cigarette Smoking
• Intervention / Treatment: Behavioral: Stress induction; Behavioral: Cue induction; Behavioral: Neutral cue exposure; Behavioral: Control stress exposure

Detailed Description

Non-treatment seeking cigarette dependent smokers will be randomized to one of four testing conditions: 1) a non-stressful task followed by neutral cues, 2) the non-stressful task followed by smoking cues, 3) a stressful task followed by neutral cues, or 4) the stressful task followed by smoking cues. Ten minutes after the intervention, participants will undergo a 60-minute extinction procedure consisting of smoking-related videos, images and smoking paraphernalia. Cue reactivity test sessions will take place 24 hours, 2 weeks and 6 weeks following the intervention.

COVID-associated changes in substance use will be quantified over three telephone interviews: one at the end of March / beginning of April 2020 (at the start of the pandemic), one at the end of April / beginning of May, and a final one which will be instituted if feasible once the infection rates and social distancing policies have decreased.

• Study Type: Interventional
• Enrollment (Actual): 76
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Canada
  • Quebec
    • Montreal, Quebec, Canada, H3A 1A1
      • McGill University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Scoring 5 or higher on the Fagerström Test for Cigarette Dependence
• Willingness to abstain from smoking for 4 hours prior to each laboratory visit

Exclusion Criteria:

• Currently using cigarette cessation products
• Endocrinological problems
• Significant mental or physical health conditions
• Pregnancy

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Stress task and smoking cue; Exposure to a psychosocial stress task followed by smoking video cues	Behavioral: Stress induction; Exposure to a psychosocial stressor; Behavioral: Cue induction; Exposure to a smoking-related task
Experimental: Stress task and neutral cue; Exposure to a psychosocial stress task followed by neutral video cues	Behavioral: Stress induction; Exposure to a psychosocial stressor; Behavioral: Neutral cue exposure; Exposure to neutral cues
Active Comparator: Control task and smoking cue; Exposure to a control task followed by smoking video cues	Behavioral: Cue induction; Exposure to a smoking-related task; Behavioral: Control stress exposure; Exposure to a control task (no stress)
Active Comparator: Control task and neutral cue; Exposure to a control task followed by neutral video cues	Behavioral: Neutral cue exposure; Exposure to neutral cues; Behavioral: Control stress exposure; Exposure to a control task (no stress)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in cigarettes smoked per day from the pre-intervention baseline to test sessions 2 and 3 given two and six weeks post-intervention	A journal is given to participants to record their cigarette use behaviour every day for a month and a half	At the end of test session 1 (24 hours post-intervention), participants will receive a journal to record their daily smoking behaviour. They are asked to keep this journal until test session 3 (6 weeks post-intervention).

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in smoking cue-induced cigarette cravings from the pre-intervention baseline to test session 2	Participants will be asked to complete craving and urge to smoke questionnaires at several time points throughout the study sessions	Multiple times points during the baseline, intervention and test sessions at 24 hours, 2 weeks and 6 weeks post-intervention.
Change in smoking cue-induced cigarette cravings from the pre-intervention baseline to test session 3	Participants will be asked to complete craving and urge to smoke questionnaires at several time points throughout the study sessions	Multiple times points during the baseline, intervention and test sessions at 24 hours, 2 weeks and 6 weeks post-intervention.
Change in smoking cue-induced heart rate responses from the pre-intervention baseline to test session 2	Participants' heart rate will be measured through the use of a polar belt at several time points during the study sessions	Multiple time points during the baseline, intervention and test sessions at 24 hours, 2 weeks and 6 weeks post-intervention
Change in smoking cue-induced heart rate responses from the pre-intervention baseline to test session 3	Participants' heart rate will be measured through the use of a polar belt at several time points during the study sessions	Multiple time points during the baseline, intervention and test sessions at 24 hours, 2 weeks and 6 weeks post-intervention
Change in smoking cue-induced skin conductance responses from the pre-intervention baseline to test session 2	Participants' skin conductance will be measured through the use of electrodes on their index and middle fingers at several time points during the study sessions	Multiple time points during the baseline, intervention and test sessions at 24 hours, 2 weeks and 6 weeks post-intervention
Change in smoking cue-induced skin conductance responses from the pre-intervention baseline to test session 3	Participants' skin conductance will be measured through the use of electrodes on their index and middle fingers at several time points during the study sessions	Multiple time points during the baseline, intervention and test sessions at 24 hours, 2 weeks and 6 weeks post-intervention
Change in tobacco and other substance use patterns from the pre-COVID-19 baseline to during COVID-19	Participants will be asked to report the quantity of cigarettes and/or other substances they have consumed recently	Multiple time points at baseline (before the pandemic), at the start of the pandemic, and during the pandemic
Change in tobacco and other substance use patterns from the pre-COVID-19 baseline to post-COVID-19	Participants will be asked to report the quantity of cigarettes and/or other substances they have consumed recently	At baseline (before the pandemic) and through study completion, an average of 1 year
Change in tobacco and other substance use patterns during the COVID-19 pandemic to post-COVID-19	Participants will be asked to report the quantity of cigarettes and/or other substances they have consumed recently	Multiple time points during the pandemic and through study completion, an average of 1 year

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in stress- and/or cue-induced mood during the intervention and at test sessions 1, 2 and 3	Participants will be asked to complete a mood questionnaire at several time points during the intervention and at test sessions 1, 2 and 3	Multiple time points during the intervention and test sessions at 24 hours, 2 weeks and 6 weeks post-intervention
Change in cigarette use over the course of the procedure as a function of personality factors, childhood trauma, perceived stress, mood and/or cigarette withdrawal	Participants will be asked to complete self-report questionnaires about their personality traits, traumatic childhood experiences, perceived stress, current mood states and cigarette withdrawal symptoms	Multiple time points at baseline, during the intervention, at test sessions (24 hours, 2 weeks and 6 weeks post-intervention) and telephone follow-ups (6 months post-intervention)

Collaborators and Investigators

• Sponsor: Marco Leyton
• Investigators: Principal Investigator: Marco Leyton, PhD, McGill University

Publications and helpful links

General Publications

• Barnabe A, Gamache K, de Camargo JVP, Allen-Flanagan E, Rioux M, Pruessner J, Leyton M, Nader K. A novel stress-based intervention reduces cigarette use in non-treatment seeking smokers. Neuropsychopharmacology. 2023 Jan;48(2):308-316. doi: 10.1038/s41386-022-01455-6. Epub 2022 Sep 29.

Study record dates

Study Major Dates

• Study Start (Actual): February 20, 2018
• Primary Completion (Actual): May 1, 2020
• Study Completion (Anticipated): January 31, 2022

Study Registration Dates

• First Submitted: April 3, 2021
• First Submitted That Met QC Criteria: April 11, 2021
• First Posted (Actual): April 14, 2021

Study Record Updates

• Last Update Posted (Actual): April 14, 2021
• Last Update Submitted That Met QC Criteria: April 11, 2021
• Last Verified: April 1, 2021

More Information

Terms related to this study

• Keywords: Reconsolidation; Memory updating
• Additional Relevant MeSH Terms: Compulsive Behavior; Impulsive Behavior; Behavior, Addictive
• Other Study ID Numbers: 421-0318

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: We will share deidentified individual participant data that underlie any results reported in the article. This includes results reported in text, figures and appendices.
• IPD Sharing Time Frame: From 9 to 36 months following article publication.
• IPD Sharing Access Criteria: Investigators whose proposed use of the data has already been approved by an ethics committee.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No