, Volume 218, Issue 2, pp 391–403 | Cite as

Varenicline effects on craving, cue reactivity, and smoking reward

  • Thomas H. BrandonEmail author
  • David J. Drobes
  • Marina Unrod
  • Bryan W. Heckman
  • Jason A. Oliver
  • Richard C. Roetzheim
  • Sloan Beth Karver
  • Brent J. Small
Original Investigation



Varenicline is an α4β2 nicotinic acetylcholine receptor partial agonist that has been found to be effective for treating tobacco dependence. However, the subjective and behavioral mediators of its efficacy are not known.


Using multiple sessions of laboratory-based assessment, this double-blind, placebo-controlled experiment was designed to test if varenicline reduced both tonic and cue-provoked tobacco cravings, and if it attenuated perceived reward from smoking.


Participants in the present analysis include 100 smokers who were scheduled for three assessment sessions: at baseline, before receiving medication; at mid-run-in, 5–7 days after beginning medication; and after full dosage was reached, 12–15 days. Following overnight abstinence, each session included assessment of tonic craving, reactivity (including craving) to smoking cues, expected value of a cigarette, smoking behavior, and self-reported reward following smoking.


Varenicline, compared to placebo, reduced tonic craving, cue-provoked craving by the final assessment, the expected value of cigarettes, number of puffs and time spent smoking, and self-reported reward (i.e., satisfaction) from smoking.


Results showing that varenicline reduced tonic craving levels and perceived reward from smoking are consistent with reports from clinical trials, strengthening the evidence in support of these subjective mechanisms of action. This is the first placebo-controlled study to demonstrate that varenicline reduced cue-provoked cravings, thereby offering another potential mediator of its therapeutic effects. Findings may aid in the development of more targeted interventions for tobacco dependence.


Tobacco Nicotine Smoking Reward Reinforcement Craving Cues Conditioned stimuli 



This study was funded by Pfizer, Inc. via Investigator Initiated Research Grant #GA3051LP. The authors thank Kristen M. Sismilich, Monica S. Carrington, and Brittany Weisenthal for their work on the project.

Conflicts of interest

Dr. Brandon has served on the Varenicline Advisory Board for Pfizer and consulted on the development of the online behavioral adjuvant for varenicline users.


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Thomas H. Brandon
    • 1
    • 2
    • 4
    Email author
  • David J. Drobes
    • 2
    • 3
  • Marina Unrod
    • 2
    • 3
  • Bryan W. Heckman
    • 2
    • 3
  • Jason A. Oliver
    • 2
    • 3
  • Richard C. Roetzheim
    • 2
    • 3
  • Sloan Beth Karver
    • 2
    • 3
  • Brent J. Small
    • 2
    • 3
  1. 1.Department of PsychologyUniversity of South FloridaTampaUSA
  2. 2.University of South FloridaTampaUSA
  3. 3.Moffitt Cancer CenterTampaUSA
  4. 4.Tobacco Research and Intervention ProgramH. Lee Moffitt Cancer Center and Research InstituteTampaUSA

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