Modulation of craving by cues having differential overlap with pharmacological effect: evidence for cue approach in smokers and social drinkers

Abstract 

Rationale: An increased risk of drug intake produced by drug cues may reflect the fact that the cues are withdrawal-like or aversive, reflecting a conditioned adaptation to the drug’s acute effects. More recent work suggests that they may also be appetitive, signalling the goal characteristics of drug taking. Objective: These opposing mechanisms were tested in dependent smokers and in social drinkers by examining the motivational nature of drug cues that overlap differentially with the acute effects of the drug. Methods: Pictures of different phases of smoking or alcohol drinking were presented to deprived and non-deprived smokers, to never smokers and non-deprived smokers or to social drinkers. Desire for cigarettes or alcohol and momentary pleasure and arousal were measured after viewing an experimental picture or a pleasant, neutral or unpleasant control scene. Results: High desire for smoking was evoked by pictures of preparation for and actual smoking but not by scenes of the end of smoking, although the latter were best correlated with acute drug effect. This pattern was not affected by overnight smoke deprivation, it was seen in different smokers but not in never-smokers and it was replicated in social drinkers using pictures of alcohol consumption. Moreover, scenes evoking high desire to consume did not evoke states of momentary unpleasantness and they were seen as relaxing and not arousing. Control pictures had a minimal effect on desire to consume. Conclusions: In line with incentive models of drug cues, cues based on pictures of drug intake may be conditioned stimuli encoding cue approach and preparation for consumption.