Impulsivity and Relapse Prevention in Smoking

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DESCRIPTION (provided by applicant): Cigarette smoking is the largest preventable risk factor for morbidity and mortality in developed countries. There is growing evidence from questionnaire-based research that smokers are more impulsive than nonsmokers, suggesting that impulsivity could be one mechanism operating in the acquisition, maintenance, and relapse of cigarette smoking. However, the conditions that affect impulsivity in smokers are virtually unknown, and the relationship between questionnaire- and behavior-based measures of impulsivity remains unclear. In the proposed project, smokers will choose between immediate reinforcers and delayed reinforcers in a laboratory setting. This laboratory model nicely captures a central characteristic of relapse: An abstaining smoker relapses when an immediate smoke reinforcer is chosen over a delayed alternative reinforcer. The project will adapt powerful questionnaire- and behavior-based laboratory preparations and examine a treatment-relevant question: What conditions influence impulsive choice? Ongoing studies are showing that nicotine deprivation increases impulsive choices to smoke and impulsivity in general. The proposed study will examine the effects of a pharmacological intervention on impulsivity. The intervention, a nicotine patch, is expected to return impulsive choice to non-deprivation levels. The laboratory model may be enormously useful for initial testing of both pharmacological and behavioral interventions designed for relapse prevention. For instance, methods to decrease impulsive choice developed using animal models can be assessed in smokers and could lead to novel treatment strategies. More generally, the model could further our understanding about whether and how critical variables (e.g., cue exposure, contextual factors, nicotine deprivation, drugs of abuse, pharmacotherapies, stress, etc) affect the impulsive choices that lead to or prevent relapse.