Personalized Cues as Factors in Smoking Relapse

描述（由申请人提供）：当吸烟者面对突出的吸烟相关线索时，先前与吸烟行为配对的刺激，他们表现出主观（例如，自我报告渴望）和生理（例如心率）冲动反应性。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在治疗研究中的效用有限。一个原因可能是他们主要关注近端线索（例如，点燃的香烟），并忽略吸烟的远端线索，例如吸烟发生的环境、个人情绪状态以及与吸烟相关的特定人，这可以实质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、情绪和人员线索带入实验室，在实验室中评估反应性，从而更准确地捕捉人们日常生活中的真实吸烟体验。吸烟者将通过拍摄他们每天吸烟和不吸烟的特定环境来产生他们自己的图片刺激。研究1将重点关注吸烟者是否对他们自己的真实世界环境线索表现出比实验者产生的环境线索更主观和生理反应。研究2将评估个人环境和情绪线索对吸烟者反应的个体和综合影响。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加或减弱对环境和情绪线索的反应。这项工作将开发一种创新的和时间/成本效率高的技术，用于捕捉真实世界吸烟体验的更完整的画面。它将增强我们对远端线索单独和组合在介导和/或激发吸烟行为和复吸中的功能的理解。这些技术可直接转移到基于线索的吸烟治疗中，旨在消除应激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而起作用，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.