UVM Theses and Dissertations
Format:
Print
Author:
Bradstreet, Matthew
Dept./Program:
Psychology
Year:
2012
Degree:
Ph. D.
Abstract:
Abstinence during the initial two weeks of a quit attempt is a robust predictor of longer-term success in quitting smoking. We have been investigating whether initial abstinence may lower relapse risk. Our prior studies on this topic have shown decreases in nicotine withdrawal, craving, and the relative reinforcing effects of smoking versus money, and an increase in participant-rated ease of abstaining and confidence in ability to abstain following a sustained period of initial abstinence. The present study aims to systematically extend this model by examining the reliability of the prior observations and whether initial abstinence changes sensitivity to smoking-related-stimuli, response-inhibition, and their underpinning neurobiological correlates.
Participants were randomly assigned to one of two 15-day conditions in which payment was contingent on abstinence on all 15 days (15C) or just the final 2 days (2C). Participants reported to the lab daily for an assessment of smoking status during which they completed daily measures of nicotine withdrawal, craving, and ease and confidence in abstaining, among other questionnaires. Participants also completed fMRI sessions at baseline and on day 14 during which they were exposed to smoking-related and neutral visual stimuli and performed a response-inhibition (Go/NoGo) task. On day 15 all participants participated in a smoking preference session in which they made discrete trial choices between opportunities for smoke vs. earning money.
Ratings of nicotine withdrawal and expectations of positive outcomes from smoking decreased, while ratings of ease and confidence in abstaining increased in the 15C vs. the 2C conditions, and 15C participants were significantly less likely to ever choose the smoking option in the preference session demonstrating a decrease in the relative reinforcing effects of smoking. Craving ratings in response to smoking-related and neutral stimuli in the cue-reactivity task did not differ between the 15C and 2C conditions at baseline. However, they differed significantly on day 14, with participants in the I5C condition showing two-to three-fold reductions in craving intensity compared to the 2C condition across both smoking-related and neutral stimuli. Those changes were indicative of a reduction in generalized smoking craving among participants in the 15C condition. No significant differences between treatment conditions were noted in neural response to smoking-related or neutral stimuli nor were there significant behavioral or neural differences between conditions noted in response inhibition.
These results replicate our prior observations that abstinence during the initial two weeks of smoking cessation significantly reduces numerous outcomes associated with relapse risk and extends them by demonstrating that initial abstinence also produces robust reductions in the intensity of generalized smoking craving, a potentially substantive measure of relapse risk.
Participants were randomly assigned to one of two 15-day conditions in which payment was contingent on abstinence on all 15 days (15C) or just the final 2 days (2C). Participants reported to the lab daily for an assessment of smoking status during which they completed daily measures of nicotine withdrawal, craving, and ease and confidence in abstaining, among other questionnaires. Participants also completed fMRI sessions at baseline and on day 14 during which they were exposed to smoking-related and neutral visual stimuli and performed a response-inhibition (Go/NoGo) task. On day 15 all participants participated in a smoking preference session in which they made discrete trial choices between opportunities for smoke vs. earning money.
Ratings of nicotine withdrawal and expectations of positive outcomes from smoking decreased, while ratings of ease and confidence in abstaining increased in the 15C vs. the 2C conditions, and 15C participants were significantly less likely to ever choose the smoking option in the preference session demonstrating a decrease in the relative reinforcing effects of smoking. Craving ratings in response to smoking-related and neutral stimuli in the cue-reactivity task did not differ between the 15C and 2C conditions at baseline. However, they differed significantly on day 14, with participants in the I5C condition showing two-to three-fold reductions in craving intensity compared to the 2C condition across both smoking-related and neutral stimuli. Those changes were indicative of a reduction in generalized smoking craving among participants in the 15C condition. No significant differences between treatment conditions were noted in neural response to smoking-related or neutral stimuli nor were there significant behavioral or neural differences between conditions noted in response inhibition.
These results replicate our prior observations that abstinence during the initial two weeks of smoking cessation significantly reduces numerous outcomes associated with relapse risk and extends them by demonstrating that initial abstinence also produces robust reductions in the intensity of generalized smoking craving, a potentially substantive measure of relapse risk.