Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA.
Nicotine Tob Res. 2019 May 21;21(6):778-783. doi: 10.1093/ntr/nty038.
Confirming preclinical findings, nicotine in humans (via smoking) enhances reinforcement from nondrug rewards. Recent demonstration of similar effects with nicotine via e-cigarettes suggests they may also occur when using nicotine replacement therapies (NRT).
Effects of nicotine via NRT patch or nasal spray were assessed on responding reinforced by music, video, or monetary rewards, or for no reward (control). Nontreatment seeking smokers (N = 31) participated in three virtually identical experimental sessions, each following overnight abstinence (CO ≤ 10 ppm). In a fully within-subjects design using a double-dummy procedure, these sessions involved: (1) nicotine patch (Nicoderm 14 mg) plus placebo spray, (2) placebo patch plus nicotine spray (Nicotrol, 2 × 1 mg/trial), or (3) placebo patch plus placebo spray. Session order was counter-balanced.
Relative to placebo, reinforced responding due to nicotine via spray or patch was greater for video reward (both p < .01) but not for music reward (both p > .10). Similar results for NRT spray and patch confirms preclinical findings indicating no difference between fast and slow nicotine delivery, respectively, on reinforcement enhancing effects. Withdrawal relief was unrelated to these effects of nicotine via NRT on nondrug reinforcement.
Nicotine from NRT has some reinforcement enhancing effects in humans, possibly in a manner consistent with nicotine via e-cigarettes but not tobacco smoking. Our findings could suggest differential dose-dependency of available rewards to enhanced reinforcement by nicotine. Such effects may help contribute to the efficacy of NRT for aiding smoking cessation, but more research focusing on dose-dependency of these nicotine actions is needed.
Acute nicotine from smoking enhances reinforced responding for nondrug sensory rewards. Yet, nonsmoked nicotine, including from NRT medications of patch and nasal spray, may act more selectively across rewards, perhaps due to lower dosing exposure. Our results suggest that nicotine via NRT enhances responding for visual (video) reward, but not from auditory (music) reward, just as in prior results using e-cigarettes. Withdrawal relief from NRT was unrelated to reinforced responding, consistent with positive (and not negative) reinforcement from this nicotine. Further research evaluating the dose-response effects of nicotine may clarify differences in enhanced reinforcement depending on the type of available reward.
临床前研究发现,尼古丁(通过吸烟)可增强非药物奖赏的强化作用。最近通过电子烟证明了类似的尼古丁作用,这表明在使用尼古丁替代疗法(NRT)时也可能发生这种作用。
使用尼古丁贴片或鼻喷剂评估 NRT 对音乐、视频或金钱奖励强化的反应,或无奖励(对照)的反应。非治疗性吸烟的吸烟者(N = 31)参加了三个完全相同的实验,每个实验均在一夜的禁欲(CO ≤ 10 ppm)后进行。在使用双盲程序的完全内被试设计中,这些实验涉及:(1)尼古丁贴片(Nicoderm 14 mg)加安慰剂喷雾,(2)安慰剂贴片加尼古丁喷雾(Nicotrol,2 × 1 mg/次),或(3)安慰剂贴片加安慰剂喷雾。实验顺序是平衡的。
与安慰剂相比,喷雾或贴片中的尼古丁增强了对视频奖励的反应(均 p <.01),但对音乐奖励的反应没有增强(均 p >.10)。NRT 喷雾和贴片的相似结果证实了临床前研究的发现,即快速和慢速尼古丁输送在增强强化作用方面没有差异。戒烟缓解与 NRT 对非药物强化的尼古丁作用无关。
NRT 中的尼古丁在人类中具有一些增强强化的作用,可能与电子烟中的尼古丁相似,但与吸烟中的尼古丁不同。我们的发现可能表明,可用奖励对尼古丁增强强化作用的依赖性不同。这些作用可能有助于解释 NRT 戒烟的疗效,但需要更多关注这些尼古丁作用的剂量依赖性的研究。
吸烟中的急性尼古丁增强了对非药物感觉奖励的强化反应。然而,非吸烟的尼古丁,包括贴片和鼻喷剂等 NRT 药物中的尼古丁,可能在奖励方面更具选择性,这可能是由于剂量暴露较低。我们的结果表明,NRT 中的尼古丁增强了对视觉(视频)奖励的反应,但对听觉(音乐)奖励的反应没有增强,这与之前使用电子烟的结果一致。NRT 的戒烟缓解与强化反应无关,这与这种尼古丁的正强化(而不是负强化)一致。进一步评估尼古丁剂量反应作用的研究可能会阐明根据可用奖励类型增强强化的差异。