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Early life adversity influences stress response association with smoking relapse

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Abstract

Rationale

We examined the hypothesis that stress-related blunting of cortisol in smokers is particularly pronounced in those with a history of severe life adversity.

Objectives

The two aims of this study were first to examine hormonal, craving, and withdrawal symptoms during ad libitum smoking and after the first 24 h of abstinence in smokers who experienced high or low levels of adversity. Second, we sought to examine the relationship between adversity and hypothalamic-pituitary-adrenal (HPA) hormones to predict relapse during the first month of a smoking cessation attempt.

Methods

Hormonal and self-report measures were collected from 103 smokers (49 women) during ad libitum smoking and after the first 24 h of abstinence. HPA hormones were measured during baseline rest and in response to acute stress in both conditions. All smokers were interested in smoking cessation, and we prospectively used stress response measures to predict relapse during the first 4 weeks of the smoking cessation attempt.

Results

The results showed that high adversity was associated with higher distress and smoking withdrawal symptoms. High level of early life adversity was associated with elevated HPA activity, which was found in both salivary and plasma cortisol. Enhanced adrenocorticotropic hormone (ACTH) stress response was evident in high-adversity but not in low-adversity relapsers.

Conclusions

This study demonstrated that early life adversity is associated with stress-related HPA responses. The study also demonstrated that, among smokers who experienced a high level of life adversity, heightened ACTH and cortisol responses were linked with increased risk for smoking relapse.

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Acknowledgements

We would like to thank the following individuals for their help with collecting (Barbara Gay, Elizabeth Ford, Dayna Schleppenbach, Soni Rraklli, Angie Forsberg) and managing (Motohiro Nakajima and Jie Gooder) the data for this study. Nikki Neumann, Christopher Schweiger, and Dan Vuicich helped with the conducting the assays. We also would like to thank Dr. Susan Raatz for providing nutritional guidance and Briana DeAngelis for her editorial help with this manuscript.

Funding

This research was supported in part by grants to the first author from the National Institute of Health (R01DA016351 and R01DA027232).

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Authors and Affiliations

  1. Department of Biobehavioral Health and Population Sciences, University of Minnesota Medical School, Duluth, MN, 55812, USA

    Mustafa al’Absi & Andrine Lemieux

  2. Department of Family Medicine and Community Health, University of Minnesota Medical School, Duluth, MN, USA

    Mustafa al’Absi, Ruth Westra & Sharon Allen

  3. Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA

    Mustafa al’Absi

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  1. Mustafa al’Absi
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  2. Andrine Lemieux
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Correspondence to Mustafa al’Absi.

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al’Absi, M., Lemieux, A., Westra, R. et al. Early life adversity influences stress response association with smoking relapse. Psychopharmacology 234, 3375–3384 (2017). https://doi.org/10.1007/s00213-017-4724-4

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