Bradstreet Matthew P, Higgins Stephen T, McClernon F Joseph, Kozink Rachel V, Skelly Joan M, Washio Yukiko, Lopez Alexa A, Parry Marie A
Department of Psychiatry, University of Vermont, Burlington, VT, USA.
Psychopharmacology (Berl). 2014 May;231(10):2145-58. doi: 10.1007/s00213-013-3360-x. Epub 2013 Dec 15.
Research is needed on initial smoking abstinence and relapse risk.
This study aims to investigate the effects of different durations of initial abstinence on sensitivity to smoking-related stimuli and response inhibition in the context of a larger battery of outcome measures.
Smokers were randomly assigned to receive payment contingent on smoking abstinence across all 15 study days (15C) or just the final 2 days (2C). Smoking status and subject ratings were assessed daily. Participants completed fMRI sessions at baseline and day 14 during which they completed craving ratings after exposure to smoking-related and neutral stimuli and performed a response inhibition task. On day 15, participants completed a smoking preference session involving 20 exclusive choices between smoking and money.
The payment contingencies were effective in producing greater smoking abstinence in the 15C vs. 2C conditions. Ratings of withdrawal decreased, while ratings of ease and confidence in abstaining increased in the 15C vs. 2C conditions across the 15-day study. 15C participants were less likely to choose the smoking option in the preference session. 15C participants reported greater reductions in craving compared to the 2C participants in the presence of smoking-related and neutral stimuli (i.e., decreases in generalized craving), but no differences were noted in cue reactivity per se or in response inhibition.
Results systematically replicate prior observations that a period 2 weeks of initial abstinence decreases the relative reinforcing effects of smoking and improves other outcomes associated with relapse risk compared to the initial day or two of a cessation effort, and extends them by underscoring the importance of generalized rather than cue-induced craving in relation to relapse risk during the initial weeks of smoking cessation.
需要对初次戒烟及复吸风险进行研究。
本研究旨在探讨在一系列更广泛的结果测量背景下，不同时长的初次戒烟对与吸烟相关刺激的敏感性及反应抑制的影响。
吸烟者被随机分配，在全部15个研究日（15C组）或仅在最后2天（2C组）接受基于戒烟的报酬。每日评估吸烟状态及受试者评分。参与者在基线期和第14天完成功能磁共振成像（fMRI）检查，在此期间，他们在接触吸烟相关和中性刺激后完成渴求评分，并执行反应抑制任务。在第15天，参与者完成一个吸烟偏好环节，涉及在吸烟和金钱之间进行20次排他性选择。
在15C组与2C组的条件下，报酬应急措施在促使更高水平的戒烟方面有效。在为期15天的研究中，与2C组相比，15C组的戒断评分降低，而戒烟的轻松感和信心评分增加。在偏好环节中，15C组参与者选择吸烟选项的可能性更小。与2C组参与者相比，在存在吸烟相关和中性刺激的情况下（即一般性渴求降低），15C组参与者报告的渴求降低幅度更大，但在提示反应性本身或反应抑制方面未观察到差异。
结果系统地重复了先前的观察结果，即与戒烟努力的最初一两天相比，两周的初次戒烟期会降低吸烟的相对强化作用，并改善与复吸风险相关的其他结果，并且通过强调在戒烟最初几周内，与复吸风险相关的是一般性渴求而非提示诱发的渴求，从而扩展了这些观察结果。
