Personalized Cues as Factors in Smoking Relapse

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DESCRIPTION (provided by applicant): When smokers are confronted with salient smoking-related cues, stimuli previously paired with smoking behavior, they exhibit robust increases in subjective (e.g., self-report craving) and physiological (e.g. heart rate) urge-reactivity. This finding has led to cue-based treatments aimed at extinguishing reactivity to cues as a means of reducing relapse post-quit. However, past cue-exposure procedures have demonstrated somewhat limited utility in treatment research. One reason may be that they largely focus on proximal cues (e.g., lit cigarettes) and ignore distal cues for smoking, such as the environments in which smoking occurs, personal mood states, and specific people one associates with smoking, which can substantially motivate relapse postquit. The studies proposed in this R21 application for RFA #DA-03-010 are aimed at developing innovative techniques for more accurately capturing the real-world experience of smoking during one's daily life by bringing smokers' personal environment, mood, and people cues into the laboratory where reactivity can be assessed. Smokers will generate their own pictorial stimuli by taking pictures of the specific environments in which they do and do not engage in daily smoking. Study 1 will focus on whether or not smokers show more subjective and physiological reactivity to their own real-world environment cues compared to experimenter generated environment cues. Study 2 will evaluate the individual and combined impact of personal environment and mood cues on smokers' reactivity. Lastly, Study 3 will determine whether or not specific individuals in each smoker's life augment or attenuate reactivity to combined environment and mood cues. This work will develop an innovative and time/cost efficient technique for capturing a more complete picture of real-world smoking experiences. It will enhance our understanding of the function of distal cues, alone and in combination, in mediating and/or motivating smoking behavior and relapse. These techniques are directly transferable into cue-based smoking treatments aimed at extinguishing urge-responding and reducing relapse post-quit. Moreover, these procedures potentially have broader applicability, such as evaluating whether cessation medications or behavioral interventions work by reducing cue-reactivity, thereby preventing relapse.