|Factors Involved in the Maintenance and Cessation of Cigarette Smoking
|Sunday, May 30, 2010
|4:30 PM–5:50 PM
|Travis C/D (Grand Hyatt)
|Area: BPH/CBM; Domain: Experimental Analysis
|Chair: Rachelle L. Yankelevitz (Oregon Health and Sciences University)
|Abstract: This symposium highlights how smoking can be studied through a combination of approaches based on both individual differences and group-level effects. The projects investigated factors involved in the maintenance of smoking, the experience of withdrawal and relapse, and the design of effective treatment programs. The first presentation utilizes ecological momentary assessment to identify antecedents and consequences of smoking, showing that this method could suggest treatments for individual smokers. The second presentation examines the relation between impulsivity and dimensions of withdrawal using within-subjects comparisons of smokers abstaining and not abstaining from smoking. The third experimentally analyzes the impact of an initial period of abstinence on relapse risk and shows that the initial abstinence period causes changes that are important in lowering this risk. The fourth compares two contingency management programs for smoking cessation in opioid-dependent patients: an intensive 2-week intervention versus an intensive 2-week intervention followed by a less-intense 10-week intervention.
|A Descriptive Assessment of Smoking Using Ecological Momentary Assessment
|ALANA M. ROJEWSKI (University of Florida), Jesse Dallery (University of Florida)
|Abstract: Descriptive assessment measures can identify antecedent and consequent events that may control behavior, but few such measures have been utilized to assess smoking. The purpose of the current study was to employ a real-time, computer-based method, ecological momentary assessment (EMA), to identify individual differences in the variables associated with smoking (e.g., direct drug effects, social reinforcers, presence of antecedent stimuli such as coffee, alcohol, etc.). Eight participants indicated the presence of various antecedent and consequent events on a PocketPC before and after each cigarette smoked. Frequency counts of reported variables were obtained to assess the number of times each item was associated with an instance of smoking. Participants also completed assessments independent of smoking occasions to determine the frequency of the events when smoking did not occur.
Individual differences in the events associated with smoking were apparent. Results suggest a descriptive assessment of smoking is feasible using the proposed methods.
|Impulsivity, Withdrawal From Cigarette Smoking, and Release From Withdrawal
|RACHELLE L. YANKELEVITZ (Oregon Health and Sciences University), Vanessa B. Wilson (Oregon Health and Science University), Suzanne H. Mitchell (Oregon Health and Science University)
|Abstract: Identifying factors that mediate the subjective effects of nicotine withdrawal and the subsequent reinforcing efficacy of smoking could illuminate some potential causes of relapse in smokers trying to quit. The current study asks whether impulsivity (delay discounting) is one factor related to the subjective and objective dimensions of withdrawal and release from withdrawal, as impulsive responders are, by definition, more sensitive to temporally local outcomes than to remote outcomes. Twenty-nine nontreatment-seeking smokers completed two sessions on which their smoking topography and the subjective effects of smoking (including relief from withdrawal) were assessed. Prior to one session, smokers smoked as normal. Prior to the other session, they abstained from smoking for 48 hours. Subjects reported typical subjective effects of nicotine withdrawal, which were related to smoking indices when subjects smoked following abstinence. However, neither the various smoking indices nor subjective withdrawal were related to measures of impulsivity. These results suggest that basal levels of impulsivity do not mediate the relationship between withdrawal effects and later smoking, though it is possible that impulsivity is associated with other processes that influence the probability of smoking relapse during a quit attempt.
|Experimental Laboratory Studies Examining Relationships Between Initial Smoking Abstinence and Relapse Risk
|MATTHEW P. BRADSTREET (University of Vermont), Stephen T. Higgins (University of Vermont)
|Abstract: Cigarette smoking remains the leading preventable cause of morbidity and mortality in the United States. Millions of individuals attempt to quit smoking each year, yet over half fail within the first few days or weeks of a quit attempt. There is an emerging literature suggesting that the initial two weeks of a smoking cessation effort are crucial to successful longer-term abstinence. Our group has been using contingency-management to experimentally manipulate duration of initial smoking abstinence to investigate how it might directly affect relapse risk. The aim of this presentation will be to summarize four experiments from our laboratory in chronological order, following the research line and outlining the cumulative knowledge gained. Included will be information from an ongoing experiment. Overall, these studies provide evidence that sustaining initial abstinence results in several changes important to lowering relapse risk, including decreases in the relative reinforcing effects of smoking.
|A Behavioral Approach to Smoking Cessation Among Opioid-Maintained Patients
|KATHRYN A. SAULSGIVER (University of Vermont), Kelly Dunn (University of Vermont), Mollie Patrick (University of Vermont), Stacey C. Sigmon (University of Vermont), Ed Reimann (University of Vermont), Alison Necheles (University of Vermont), Sarah H. Heil (University of Vermont), Stephen T. Higgins (University of Vermont)
|Abstract: Cigarette smoking is one of the leading causes of preventable death among the substance abusing population. In the methadone-maintained population, 80-100% of patients endorse smoking cigarettes. There has been limited scientific efforts thus far to develop and test smoking-cessation interventions in opioid-maintained patients. Behavioral approaches represent the most promising efforts thus far. We examined the efficacy of a CM intervention to promote smoking abstinence in a sample of opioid-maintained smokers across two studies. Study 1 examined the efficacy of an intensive 2-week CM intervention to promote smoking abstinence in this population and found that participants receiving vouchers contingent on smoking abstinence provided significantly greater percentage smoking-negative samples (55% vs. 17% respectively; p < 0.01) and had longer durations of continuous abstinence (7.7 vs. 2.4 days respectively; p = 0.01) than noncontingent participants. These results demonstrated the efficacy of a brief, voucher-based CM intervention in promoting initial smoking abstinence among opioid-maintained patients. study 2 examined the efficacy of an intensive 2-week intervention, followed by a less-intensive 10-week intervention, with the aim of promoting and maintaining the smoking abstinence achieved initially. Extended contingent participants appear to be maintaining more smoking abstinence than extended noncontingent participants during weeks 3-12.