Smoker reactivity to cues: effects on craving and on smoking behavior

Abstract

We assessed craving and smoking in response to smoking-relevant cues. Two hundred seven daily smokers viewed images related to 1 of 6 cue sets (cigarettes, positive and negative affect, alcohol, smoking prohibitions, and neutral cues) in separate sessions. Compared with neutral cues, cigarette cues significantly increased craving, and positive affect cues significantly decreased craving. When subjects were then allowed to smoke during continuing cue exposure, cues did not affect the likelihood of smoking or the amount smoked (number of cigarettes, number of puffs, puff time, or increased carbon monoxide). However, craving intensity predicted likelihood of smoking, latency to smoke, and amount smoked, with craving increases after cue exposure making significant independent contributions. Some craving effects were curvilinear, suggesting that they are subject to thresholds and might not be observed under some circumstances.

2013 APA, all rights reserved

Figures

Figure 1

Timeline of procedure and assessments in cue reactivity sessions.

Figure 2

Change in appetitive craving (A) and distress-relief craving (B) after exposure to each cue. 1Data for alcohol cue are from subjects who were known to drink. *p < .05, †p < .10.

Figure 2

Change in appetitive craving (A) and distress-relief craving (B) after exposure to each cue. 1Data for alcohol cue are from subjects who were known to drink. *p < .05, †p < .10.

Figure 3

Survival graphs showing time to smoking after exposure to cues. No significant effect of cues on latency to smoke.

Figure 4

Survival graphs demonstrating the quadratic effects of appetitive craving (A) and distress-relief craving (B) on latency to smoke. Based on shared-frailty survival analysis with Gompertz function specification. Quadratic term for appetitive craving is non-significant.

Figure 5

The association between post-cue craving intensity and probability of smoking. Based on General Estimating Equation logit models with a significant quadratic term for appetitive craving, indicating significant curvature. Quadratic term for distress-relief craving is non-significant. Gray shaded bands represent 95% confidence bands.

Figure 6

The association of post-cue craving intensity with number of puffs (A) and total puff time (B). Based on mixed regression models with significant quadratic terms for both appetitive and distress-relief craving.