Soft Commitment as a Mechanism to Prevent Preference Reversals in Smokers

描述（由申请人提供）：吸烟与其他形式的药物依赖一样，在美国对健康构成重大威胁。公众意识运动扩大了公众对吸烟后果的认识，大多数吸烟者都表达了戒烟的愿望。然而，绝大多数吸烟者都未能成功戒烟；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，以促进对香烟和其他滥用药物依赖的综合治疗方案的发展。我们将在偏好逆转的背景下研究禁欲努力失败的现象，即当两种结果都在暂时的远端时，更大、更延迟的奖励比更小、更不延迟的奖励更受欢迎，但随着时间的推移，两种奖励都变得更近，就会切换到更小的奖励。这些偏好逆转可以为理解为什么吸烟者计划戒烟，但未能开始或维持戒烟尝试提供一个框架。人们提出了一种名为“软承诺”的机制来防止这些偏好逆转，即当奖励在远端时，反复选择更大、更延迟的奖励，会产生对该选择的反应持久性，即使奖励变得更近端，这种反应持久性也会保持下去。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对预测偏好逆转的时间位置的能力。在具体目标3中，我们将研究软承诺程序在防止吸烟者和非吸烟者偏好逆转方面的功效。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有效性。如果软承诺确实可以防止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，这些程序可能会被修改以防止偏好逆转。

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.