Personalized Cues as Factors in Smoking Relapse

描述（由申请人提供）：当吸烟者面对与吸烟相关的显著线索、先前与吸烟行为配对的刺激时，他们在主观（如自我报告的渴望）和生理（如心率）冲动反应方面表现出强劲的增长。这一发现导致了基于线索的治疗，旨在消除对线索的反应，作为减少戒烟后复发的一种手段。然而，过去的线索暴露程序已经证明在治疗研究中的效用有限。其中一个原因可能是，他们主要关注吸烟的近端线索（如点燃的香烟），而忽略了吸烟的远端线索，如吸烟的环境、个人情绪状态和与吸烟有关的特定人群，这些都可能在很大程度上激发戒烟后的复发。在RFA #DA-03-010的R21申请中提出的研究旨在开发创新技术，通过将吸烟者的个人环境，情绪和人的线索带入实验室来评估反应性，从而更准确地捕捉日常生活中吸烟的真实体验。吸烟者会通过拍摄他们每天吸烟和不吸烟的特定环境来产生自己的图像刺激。研究1将关注吸烟者是否对他们自己的真实环境线索表现出比实验者产生的环境线索更多的主观和生理反应。研究2将评估个人和个人环境和情绪线索对吸烟者反应的综合影响。最后，研究3将确定每个吸烟者生活中的特定个体是否会增强或减弱对环境和情绪暗示的综合反应。这项工作将开发一种创新的、节省时间/成本的技术，以更全面地捕捉真实世界的吸烟体验。它将增强我们对远端线索的功能的理解，单独或联合，在介导和/或激发吸烟行为和复发。这些技术可直接转移到基于线索的吸烟治疗中，旨在消除冲动反应并减少戒烟后的复发。此外，这些程序可能具有更广泛的适用性，例如评估戒烟药物或行为干预是否通过减少线索反应性起作用，从而防止复发。

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.