Abstract
Background
Stimuli from the terminal phase of smoke or drug intake are paired with drug effect but have surprisingly low cue reactivity. Smoking terminal stimuli were compared to cues under conditions of different perceived smoke intake to probe whether (1) terminal stimuli are only weak cues, (2) any effect is an artifact of rigid test conditions, and (3) terminal stimuli have a unique function during the intake ritual.
Materials and methods
Nonabstinent, healthy smokers were tested in three experiments with one-session, within-subject cue reactivity tests. Smoking terminal stimuli and cues were compared using pictures depicting events after completion (END) and before start of smoke inhalation (BEGIN). Test pictures were presented alone and in combination with no-go symbols (from no-smoking signs) or with extra cues to decrease and to increase perceived smoke availability, respectively. Measured were subjective effects and affect modulation of the startle reflex.
Results
END stimuli relative to BEGIN stimuli evoked less subjective craving and pleasure but more arousal. A no-go stimulus, which reduced reports of intention to smoke, reduced the reactivity to BEGIN but only marginally affected responses to END stimuli. This was confirmed with different sets of test pictures and using tests with the startle response. An extra cue did not affect reactivity to a BEGIN stimulus but increased craving and pleasure to the END stimulus, although not to the level of BEGIN stimuli alone.
Conclusions
This first systematic study of terminal stimuli found their effects to be robust and have test generality. They are probably not weak cues but evoke reactivity, which may oppose reactivity of cues. They may signal poor availability of drug. Methodological, clinical, and theoretical implications were noted.
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Notes
The word “cues” specifically means those drug stimuli leading to craving for drug and/or its self-administration. This reflects a use in the drug abuse literature and is not to be confused with its common use as a synonym for conditioned or discriminative stimuli. Our labeling was necessary to set apart cues and cue reactivity from terminal stimuli and their effects. Like cues, terminal stimuli may also acquire their meaning through pairing with drug effect. Hence, we wanted to avoid any confusion arising from the fact that both cues and terminal stimuli may be drug-paired but have different effects on craving. Cues were modeled here by BEGIN and terminal stimuli by END smoking stimuli, respectively; these terms may be used interchangeably.
The END smoking stimuli in Experiment 1 were B6, B12, B16, B19, B22, B23, B28, and B31 from Experiment 1 of Mucha et al. (1999). The BEGIN stimuli we used were B1, B5, B10, B11, B18, and B20 from Experiment 1 of Mucha et al. (1999) and two pictures (C1 and C2) prepared during the generation of pictures for Experiment 2 of Mucha et al. (1999). They are pictures found in an unpublished battery of pictures (Mucha and Pauli unpublished).
The smoking pictures in Experiment 2 were the images A2, A4, A6, A10 A14, A16, A18, and A20 as END stimuli and A1, A3, A5, A9 A13, A15, A17, and A19 as BEGIN stimuli found in Mucha and Pauli (unpublished) and were used in Exp. 2 of Mucha et al. (1999).
The nonsmoking, emotional pictures were derived from the following individual images of the International Affective Picture System (Lang et al. 1996). They comprised neutral (2840, 5534, 6150, 7000, 7002, 7050, 7190, 7820), unpleasant (3170, 3530, 6230, 9410, 3000, 3150, 3010, 3102) and pleasant objects or scenes (4660, 8030, 8080, 8370, 8380, 5480, 4490, 4510, 4180, and 4290).
The smoking pictures in Experiment 3 were the images from Experiment 2 together with two additional BEGIN (A7, A11) and END images (A8, A12) generated at the same time; they are to be found in Mucha and Pauli (unpublished).
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Acknowledgements
The paper is dedicated to Harold Kalant on his 85th birthday, a pioneer in the research on the behavioral and psychological mechanisms of phenomena underlying drug dependence. The authors are grateful to E. Wahlen, V. Roeder, and S. Wenkel for technical and secretarial assistance. Dr. J. Hogan was helpful in dealing with the ideas behind behavior systems and Dr. H. Kalant in commenting on the manuscript. Some of the data were submitted by M. Weber to the University of Tübingen as partial fulfillment of a thesis supervised by M. Hautzinger and R. Mucha. The experimental work was supported in part by the Deutsche Forschungsgemeinschaft (DFG). Support for M. Winkler came from the Würzburg DFG Research Group FOR605 “Emotion and behavior: reflective and impulsive processes.” The present study was conceived and implemented without any conflict of interest. The principal author (RFM) acknowledges that since then he has invested in a venture to market pictures of the end of smoking to symbolize smoking with little craving.
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Mucha, R.F., Pauli, P., Weber, M. et al. Smoking stimuli from the terminal phase of cigarette consumption may not be cues for smoking in healthy smokers. Psychopharmacology 201, 81–95 (2008). https://doi.org/10.1007/s00213-008-1249-x
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DOI: https://doi.org/10.1007/s00213-008-1249-x