Advertisement

Psychopharmacology

, Volume 216, Issue 1, pp 91–99 | Cite as

Cigarette demand and delayed reward discounting in nicotine-dependent individuals with schizophrenia and controls: an initial study

  • James MacKillopEmail author
  • Jennifer W. Tidey
Original Investigation

Abstract

Rationale

The high prevalence of smoking and low cessation rates among individuals with schizophrenia and similar conditions are not well understood. Behavioral economics has been extensively applied to studying addictive behavior and may contribute to understanding smoking in this subpopulation.

Objectives

This study compared smokers with schizophrenia or schizoaffective disorder (SS) and control smokers (CS) on indices of cigarette demand and delayed reward discounting, a behavioral economic index of impulsivity.

Materials and methods

The SS (n = 25) and CS (n = 24) groups participated in two sessions approximately 1 week apart. During the first session, delay discounting was assessed using the Monetary Choice Questionnaire. During the second session, participants smoked their usual brand ad libitum through a smoking topography assessment device, after which cigarette demand was assessed using a cigarette purchase task. Primary comparisons were of the hyperbolic discounting function, k, and indices of cigarette demand.

Results

Compared to the CS group, the SS group exhibited significantly higher intensity of demand, and significantly greater consumption and expenditure across the inelastic portion of the demand curve, but no differences were evident on the other demand indices. No differences were evident for delay discounting. The SS group also exhibited heavier smoking topography and two indices of smoking topography were significantly correlated with demand.

Conclusions

These results provide further evidence of higher incentive value of cigarettes among SS individuals, but not greater impulsivity, as measured by discounting. Considerations include potentially important methodological factors and the role of satiation/withdrawal.

Keywords

Nicotine Tobacco Cigarette Schizophrenia Behavioral economics Demand Discounting 

Notes

Acknowledgments

Funding support from NIH grants K23AA016936 (JM), 5R01DA014002 (JT), and 1R21DA026829 (JT) is acknowledged. The authors are grateful for excellent technical assistance from Laura Dionne. The authors have no conflicts of interest with these findings.

References

  1. Baker F, Johnson MW, Bickel WK (2003) Delay discounting in current and never-before cigarette smokers: similarities and differences across commodity, sign, and magnitude. J Abnorm Psychol 112:382–392PubMedCrossRefGoogle Scholar
  2. Bickel WK, Marsch LA (2001) Toward a behavioral economic understanding of drug dependence: delay discounting processes. Addiction 96:73–86PubMedCrossRefGoogle Scholar
  3. Bickel WK, DeGrandpre RJ, Higgins ST (1995) The behavioral economics of concurrent drug reinforcers: a review and reanalysis of drug self-administration research. Psychopharmacol (Berl) 118:250–259CrossRefGoogle Scholar
  4. Bickel WK, Odum AL, Madden GJ (1999) Impulsivity and cigarette smoking: delay discounting in current, never, and ex-smokers. Psychopharmacol (Berl) 146:447–454CrossRefGoogle Scholar
  5. Bickel WK, Marsch LA, Carroll ME (2000) Deconstructing relative reinforcing efficacy and situating the measures of pharmacological reinforcement with behavioral economics: a theoretical proposal. Psychopharmacology 153:44–56PubMedCrossRefGoogle Scholar
  6. Bickel WK, Mueller ET, MacKillop J, Yi R (2011) Behavioral economic and neuroeconomic perspectives on addiction. In: Sher K (ed) Oxford handbook of substance use disorders. Oxford University Press, OxfordGoogle Scholar
  7. Chambers RA, Krystal JH, Self DW (2001) A neurobiological basis for substance abuse comorbidity in schizophrenia. Biol Psychiatry 50:71–83PubMedCrossRefGoogle Scholar
  8. Christensen CJ, Silberberg A, Hursh SR, Huntsberry ME, Riley AL (2008) Essential value of cocaine and food in rats: tests of the exponential model of demand. Psychopharmacol (Berl) 198:221–229CrossRefGoogle Scholar
  9. Cummings KM, Fong GT, Borland R (2009) Environmental influences on tobacco use: evidence from societal and community influences on tobacco use and dependence. Annu Rev Clin Psychol 5:433–458PubMedCrossRefGoogle Scholar
  10. de Leon J, Diaz FJ (2005) A meta-analysis of worldwide studies demonstrates an association between schizophrenia and tobacco smoking behaviors. Schizophr Res 76:135–157PubMedCrossRefGoogle Scholar
  11. Field M, Santarcangelo M, Sumnall H, Goudie A, Cole J (2006) Delay discounting and the behavioural economics of cigarette purchases in smokers: the effects of nicotine deprivation. Psychopharmacol (Berl) 186:255–263CrossRefGoogle Scholar
  12. First M, Gibbon M, Spitzer R, Williams J (1995) User’s guide for the structured clinical interview for DSM-IV axis I disorders (SCID-I, version 2.0.). New York State Psychiatric Institute, Biometrics Research Department, New YorkGoogle Scholar
  13. Granholm E, Loh C, Swendsen J (2008) Feasibility and validity of computerized ecological momentary assessment in schizophrenia. Schizophr Bull 34:507–514PubMedCrossRefGoogle Scholar
  14. Greenwald MK, Hursh SR (2006) Behavioral economic analysis of opioid consumption in heroin-dependent individuals: effects of unit price and pre-session drug supply. Drug Alcohol Depend 85:35–48PubMedCrossRefGoogle Scholar
  15. Heatherton TF, Kozlowski LT, Frecker RC, Fagerstrom KO (1991) The Fagerstrom test for nicotine dependence: a revision of the Fagerstrom tolerance questionnaire. Br J Addict 86:1119–1127PubMedCrossRefGoogle Scholar
  16. Heery EA, Robinson BM, McMahon RP, Gold JM (2007) Delay discounting in schizophrenia. Cogn Neuropsychiatry 12:213–221CrossRefGoogle Scholar
  17. Hitsman B, MacKillop J, Lingford-Hughes A, Williams TM, Ahmad F, Adams S, Nutt DJ, Munafo MR (2008) Effects of acute tyrosine/phenylalanine depletion on the selective processing of smoking-related cues and the relative value of cigarettes in smokers. Psychopharmacol (Berl) 196:611–621CrossRefGoogle Scholar
  18. Hodos W (1961) Progressive ratio as a measure of reward strength. Science 134:943–944PubMedCrossRefGoogle Scholar
  19. Hughes JR, Hatsukami DK, Mitchell JE, Dahlgren LA (1986) Prevalence of smoking among psychiatric outpatients. Am J Psychiatry 143:993–997PubMedGoogle Scholar
  20. Hursh SR, Silberberg A (2008) Economic demand and essential value. Psychol Rev 115:186–198PubMedCrossRefGoogle Scholar
  21. Jacobs EA, Bickel WK (1999) Modeling drug consumption in the clinic using simulation procedures: demand for heroin and cigarettes in opioid-dependent outpatients. Exp Clin Psychopharmacol 7:412–426PubMedCrossRefGoogle Scholar
  22. Johnson MW, Bickel WK (2003) The behavioral economics of cigarette smoking: the concurrent presence of a substitute and an independent reinforcer. Behav Pharmacol 14:137–144PubMedCrossRefGoogle Scholar
  23. Kay SR, Fiszbein A, Opler LA (1987) The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 13:261–276PubMedGoogle Scholar
  24. Kassel JD, Stroud LR, Paronis CA (2003) Smoking, stress, and negative affect: correlation, causation, and context across stages of smoking. Psychol Bull 129:270–304PubMedCrossRefGoogle Scholar
  25. Kirby KN, Petry NM, Bickel WK (1999) Heroin addicts have higher discount rates for delayed rewards than non-drug-using controls. J Exp Psychol Gen 128:78–87PubMedCrossRefGoogle Scholar
  26. Kumari V, Postma P (2005) Nicotine use in schizophrenia: the self medication hypotheses. Neurosci Biobehav Rev 29:1021–1034PubMedCrossRefGoogle Scholar
  27. Lasser K, Boyd JW, Woolhandler S, Himmelstein DU, McCormick D, Bor DH (2000) Smoking and mental illness: a population-based prevalence study. JAMA 284:2606–2610PubMedCrossRefGoogle Scholar
  28. MacKillop J, Kahler CW (2009) Delayed reward discounting predicts treatment response for heavy drinkers receiving smoking cessation treatment. Drug Alcohol Depend 104:197–203PubMedCrossRefGoogle Scholar
  29. MacKillop J, Murphy JG, Ray LA, Eisenberg DT, Lisman SA, Lum JK, Wilson DS (2008) Further validation of a cigarette purchase task for assessing the relative reinforcing efficacy of nicotine in college smokers. Exp Clin Psychopharmacol 16:57–65PubMedCrossRefGoogle Scholar
  30. MacKillop J, Murphy JG, Tidey JW, Kahler CW, Ray LA, Bickel WK (2009) Latent structure of facets of alcohol reinforcement from a behavioral economic demand curve. Psychopharmacol (Berl) 203:33–40CrossRefGoogle Scholar
  31. MacKillop J, Miranda JR, Monti PM, Ray LA, Tidey JW, Rohsenow DJ, Gwaltney GJ, McGeary JE, Swift RM (2010) Alcohol demand, delayed reward discounting, and craving in relation to drinking and alcohol use disorders. J Abnorm Psychol 119:115–125PubMedCrossRefGoogle Scholar
  32. Mitchell SH (2004) Effects of short-term nicotine deprivation on decision-making: delay, uncertainty and effort discounting. Nicotine Tob Res 6:819–828PubMedCrossRefGoogle Scholar
  33. Mobascher A, Winterer G (2008) The molecular and cellular neurobiology of nicotine abuse in schizophrenia. Pharmacopsychiatry 41(Suppl 1):S51–S59PubMedCrossRefGoogle Scholar
  34. Murphy JG, MacKillop J (2006) Relative reinforcing efficacy of alcohol among college student drinkers. Exp Clin Psychopharmacol 14:219–227PubMedCrossRefGoogle Scholar
  35. O’Grada C, Dinan T (2007) Executive function in schizophrenia: what impact do antipsychotics have? Hum Psychopharmacol 22:397–406PubMedCrossRefGoogle Scholar
  36. Odum AL, Madden GJ, Bickel WK (2002) Discounting of delayed health gains and losses by current, never- and ex-smokers of cigarettes. Nicotine Tob Res 4:295–303PubMedCrossRefGoogle Scholar
  37. Olincy A, Young DA, Freedman R (1997) Increased levels of the nicotine metabolite cotinine in schizophrenic smokers compared to other smokers. Biol Psychiatry 42:1–5PubMedCrossRefGoogle Scholar
  38. Perry JL, Carroll ME (2008) The role of impulsive behavior in drug abuse. Psychopharmacol (Berl) 200:1–26CrossRefGoogle Scholar
  39. Petry NM (2001) Delay discounting of money and alcohol in actively using alcoholics, currently abstinent alcoholics, and controls. Psychopharmacol (Berl) 154:243–250CrossRefGoogle Scholar
  40. Reynolds B (2006) The experiential discounting task is sensitive to cigarette-smoking status and correlates with a measure of delay discounting. Behav Pharmacol 17:133–142PubMedCrossRefGoogle Scholar
  41. Roick C, Fritz-Wieacker A, Matschinger H, Heider D, Schindler J, Riedel-Heller S, Angermeyer MC (2007) Health habits of patients with schizophrenia. Soc Psychiatry Psychiatr Epidemiol 42:268–276PubMedCrossRefGoogle Scholar
  42. Shiffman S, Paty JA, Gwaltney CJ, Dang Q (2004) Immediate antecedents of cigarette smoking: an analysis of unrestricted smoking patterns. J Abnorm Psychol 113:166–171CrossRefGoogle Scholar
  43. Shipley WC (1940) A self-administering scale for measuring intellectual impairment and deterioration. J Psychol 9:371–377CrossRefGoogle Scholar
  44. Spring B, Pingitore R, McChargue DE (2003) Reward value of cigarette smoking for comparably heavy smoking schizophrenic, depressed, and nonpatient smokers. Am J Psychiatry 160:316–322PubMedCrossRefGoogle Scholar
  45. Steinberg M, Williams J, Ziedonis D (2004) Financial implications of cigarette smoking among individuals with schizophrenia. Tob Control 13:206PubMedCrossRefGoogle Scholar
  46. Tabachnick BG, Fidell LS (2001) Using multivariate statistics, 4th edn. Allyn & Bacon. Needham Heights, MA, USAGoogle Scholar
  47. Tidey JW, O’Neill SC, Higgins ST (1999) Effects of abstinence on cigarette smoking among outpatients with schizophrenia. Exp Clin Psychopharmacol 7:347–353PubMedCrossRefGoogle Scholar
  48. Tidey JW, Rohsenow DJ, Kaplan GB, Swift RM (2005) Cigarette smoking topography in smokers with schizophrenia and matched non-psychiatric controls. Drug Alcohol Depend 80:259–265PubMedCrossRefGoogle Scholar
  49. Tidey JW, Rohsenow DJ, Kaplan GB, Swift RM, Adolfo AB (2008) Effects of smoking abstinence, smoking cues and nicotine replacement in smokers with schizophrenia and controls. Nicotine Tob Res 10:1047–1056PubMedCrossRefGoogle Scholar
  50. Vuchinich RE, Heather N (2003) Choice, behavioural economics and addiction. Pergamon/Elsevier Science, AmsterdamGoogle Scholar
  51. Weinberger AH, Reutenauer EL, Allen TM, Termine A, Vessicchio JC, Sacco KA, Easton CJ, McKee SA, George TP (2007) Reliability of the Fagerstrom test for nicotine dependence, Minnesota nicotine withdrawal scale, and Tiffany questionnaire for smoking urges in smokers with and without schizophrenia. Drug Alcohol Depend 86:278–282PubMedCrossRefGoogle Scholar
  52. Williams JM, Ziedonis DM, Abanyie F, Steinberg ML, Foulds J, Benowitz NL (2005) Increased nicotine and cotinine levels in smokers with schizophrenia and schizoaffective disorder is not a metabolic effect. Schizophr Res 79:323–335PubMedCrossRefGoogle Scholar
  53. Winger G, Galuska CM, Hursh SR (2007) Modification of ethanol’s reinforcing effectiveness in rhesus monkeys by cocaine, flunitrazepam, or gamma-hydroxybutyrate. Psychopharmacol (Berl) 193:587–598CrossRefGoogle Scholar
  54. Yang YK, McEvoy JP, Wilson WH, Levin ED, Rose JE (2003) Reliabilities and intercorrelations of reported and objective measures of smoking in patients with schizophrenia. Schizophr Res 60:9–12PubMedCrossRefGoogle Scholar
  55. Yoon JH, Higgins ST, Heil SH, Sugarbaker RJ, Thomas CS, Badger GJ (2007) Delay discounting predicts postpartum relapse to cigarette smoking among pregnant women. Exp Clin Psychopharmacol 15:176–186PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.Department of PsychologyUniversity of GeorgiaAthensUSA
  2. 2.Center for Alcohol and Addiction StudiesBrown UniversityProvidenceUSA

Personalised recommendations