Soft Commitment as a Mechanism to Prevent Preference Reversals in Smokers

描述(申请人提供)：吸烟，像其他形式的药物依赖一样，在美国构成严重的健康威胁。公众意识运动扩大了公众对吸烟后果的认识，大多数吸烟者表达了戒烟的愿望。然而，绝大多数吸烟者戒烟的尝试都失败了，这是自我控制的失败。我们的长期目标是进一步了解影响自我控制失败的变量，以努力促进对香烟和其他滥用药物依赖的综合治疗计划的发展。我们将在偏好反转的背景下考察戒酒努力失败的现象，即当两种结果在时间上都较远时，较大且延迟较长的奖励比较小但延迟较少的奖励更受青睐，但随着时间的推移，两种奖励都变得更接近时，会切换到较小的奖励。这些偏好逆转可能为理解为什么吸烟者计划戒烟，但未能发起或维持戒烟尝试提供一个框架。有人提出了一种名为软承诺的机制来防止这种偏好逆转，在这种机制下，重复选择更大、更延迟的奖励，而奖励是远端的，会发展出这种替代的反应持久性，即使在奖励变得更接近的时候也会保持这种反应的持久性。我们假设，软承诺机制可以防止或限制偏好逆转。在具体目标1中，我们将确定吸烟者是否比不吸烟者表现出更早的偏好逆转。在具体目标2中，我们将比较不同的延迟贴现模型预测偏好反转的时间位置的能力。在具体目标3中，我们将检验软承诺程序在防止吸烟者和非吸烟者偏好逆转方面的有效性。在具体目标4中，我们将确定当吸烟者经历尼古丁戒断时软承诺程序的效果。如果软承诺确实防止了人类吸烟者的偏好逆转，那么当偏好逆转导致戒烟尝试失败时，这种程序可能会被修改，以防止偏好逆转。 与公共健康相关：吸烟在美国是一个严重的问题，仍然是最可预防的死亡和发病原因。虽然许多吸烟者想要戒烟，但极少数人能够在任何相当长的时间内戒烟。这项研究可能会为影响自我控制失败的变量提供新的见解，这些变量的特征是戒烟失败的尝试和滥用药物的失败，导致针对个人易复发时间的新治疗模块。

DESCRIPTION (provided by applicant): Cigarette smoking, like other forms of drug dependence, poses a significant health threat in the United States. Public awareness campaigns have expanded the public's knowledge of the consequences of cigarette smoking, and the majority of smokers express a desire to quit. However, the vast majority of smokers fail in their attempts to abstain from cigarette smoking; a failure of self-control. Our long-term goal is to further knowledge about the variables that influence failures of self-control in an effort to facilitate the development of comprehensive treatment programs for dependence on cigarettes and other drugs of abuse. We will examine the phenomenon of failed abstinence efforts in the context of preference reversals, a phenomenon where a larger and more-delayed reward is preferred to a smaller but less-delayed when both outcomes are temporally distal, but switches to the smaller reward as time passes and both rewards become more proximal. These preference reversals may provide a framework for understanding why a cigarette smoker plans to quit smoking, but fails to initiate or maintain a quit attempt. A mechanism called soft commitment has been proposed to prevent these preference reversals, where repeated choice for the larger, more-delayed reward while the reward is distal develops response persistence for that alternative that is maintained even as the reward becomes more proximal. We hypothesize that a soft commitment mechanism can prevent or limit preference reversals. In Specific Aim 1, we will determine if cigarette smokers exhibit earlier preference reversals than nonsmokers. In Specific Aim 2, we will compare different models of delay discounting on their ability to predict the temporal location of preference reversal. In Specific Aim 3, we will examine the efficacy of a soft commitment procedure in preventing preference reversals in cigarette smokers and nonsmokers. In Specific Aim 4, we will determine the efficacy of soft commitment procedures when a cigarette smoker is experiencing nicotine withdrawal. If soft commitment does prevent preference reversals in human cigarette smokers, such procedures might be modified to prevent preference reversals when the preference reversal results in failures of abstinence attempts. PUBLIC HEALTH RELEVANCE: Cigarette smoking is a significant concern in the United States, continuing to be the most preventable cause of mortality and morbidity. Though many smokers want to quit, a very small minority are able to abstain from smoking for any substantial time period. This research may provide new insights into the variables that affect the failures of self-control that characterize failed attempts to abstain from cigarettes in particular and drugs of abuse in general, leading to new modules of treatment that target an individual's time of vulnerability to relapse.