Does extinction of responses to cigarette cues occur during smoking cessation?
Does extinction of responses to cigarette cues occur during smoking cessation?
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DOI：
10.1111/j.1360-0443.2010.03172.x
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发表时间：
2011-02-01
期刊：
影响因子：
6
通讯作者：
DeCarlo, Lawrence T.
中科院分区：
文献类型：
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作者：
O'Connell, Kathleen A.;Shiffman, Saul;DeCarlo, Lawrence T.
目的本研究通过确定在香烟线索存在下戒烟是否会导致失败概率降低以及这种效应是否由渴望介导来调查戒烟过程中是否会发生巴甫洛夫消退。观察设计。设置数据收集在吸烟者的自然环境中使用生态瞬时评估技术。1名和207名试图戒烟的吸烟者参加了研究，采用多水平路径模型研究了先前在有香烟的情况下戒烟的经验和其他人吸烟对随后的渴望强度和失败概率的影响。控制变量包括目前的香烟可用性，目前暴露于其他吸烟，先前的失误和时间在study.FindingsBoth目前可用的香烟[比值比（OR）= 36.60，11.59]和目前存在的其他吸烟（OR = 5.00，1.52）是吸烟失误的强有力的预测因素。重复暴露于可获得的香烟而不吸烟与在随后的事件中的失效概率显着降低（OR = 0.44，0.52）。然而，暴露于他人吸烟并不是一个可靠的预测因子，仅在较小的研究中具有显著性（OR = 0.30）。渴望作为一个中介之间的可用香烟和失效的灭绝，只有在较小的研究，并不是一个中介人的灭绝他人smoking in either study.ConclusionsThis研究表明，暴露于可用的香烟是一个很大的风险因素，失效，但这种风险也可以随着时间的推移减少反复暴露而不吸烟。戒烟干预措施应尝试减少香烟暴露（通过训练避免吸烟），但要认识到未经强化的香烟暴露的潜在优势。
AimsThis study investigated whether Pavlovian extinction occurs during smoking cessation by determining whether experience abstaining from smoking in the presence of cigarette cues leads to decreased probability of lapsing and whether this effect is mediated by craving.DesignSecondary analyses were carried out with data sets from two studies with correlational/observational designs.SettingData were collected in smokers' natural environments using ecological momentary assessment techniques.ParticipantsSixty-one and 207 smokers who were attempting cessation participated.MeasurementsMulti-level path models were used to examine effects of prior experience abstaining in the presence of available cigarettes and while others were smoking on subsequent craving intensity and the probability of lapsing. Control variables included current cigarette availability, current exposure to others smoking, number of prior lapses and time in the study.FindingsBoth currently available cigarettes [odds ratios (OR) = 36.60, 11.59] and the current presence of other smoking (OR = 5.00, 1.52) were powerful predictors of smoking lapse. Repeated exposure to available cigarettes without smoking was associated with a significantly lower probability of lapse in subsequent episodes (OR = 0.44, 0.52). However, exposure to others smoking was not a reliable predictor, being significant only in the smaller study (OR = 0.30). Craving functioned as a mediator between extinction of available cigarettes and lapsing only in the smaller study and was not a mediator for extinction of others smoking in either study.ConclusionsThis study showed that exposure to available cigarettes is a large risk factor for lapsing, but that this risk can also be reduced over time by repeated exposures without smoking. Smoking cessation interventions should attempt to reduce cigarette exposure (by training cigarette avoidance) but recognize the potential advantage of unreinforced exposure to available cigarettes.