Impulsivity and smoking relapse (original) (raw)
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Effect of impulsivity on craving and behavioral reactivity to smoking cues
Psychopharmacology, 2007
Introduction Nearly 25% of American adults remain regular smokers. Current smokers may be especially likely to possess characteristics that impair their ability to quit, such as impulsivity. Impulsive individuals may be overly prone to smoke because they are particularly drawn to rewarding stimuli and related cues. The aim of this study was to test the hypothesis that more impulsive smokers are more responsive to cigarette cues than other smokers. Materials and methods In a repeated measures design, 60 euthymic, adult smokers (50% female) were exposed to a smoking cue and a neutral cue in two experimental sessions. Cue reactivity was operationalized as changes in cigarette craving and preference for immediate vs delayed smoking after cue exposure. Results Impulsivity predicted a heightened craving response to both cues but particularly the smoking cue (t [161] = 3.21, p = 0.002). Smokers with high levels of impulsivity exhibited a greater preference for immediate rewards over larger, delayed rewards in terms of both hypothetical (t [58] = 5.99, p = 0.001) and actual (z = 3.02, p = 0.003) rewards. Conclusion These data suggest that increased reactivity to environmental smoking cues contributes to the link between impulsivity and smoking.
Impulsivity and cigarette craving: differences across subtypes
Psychopharmacology, 2009
Rationale Cigarette smoking has been linked to a number of personality characteristics, including impulsivity. Smokers tend to endorse high levels of impulsivity, and more impulsive smokers have greater difficulty quitting, but little is known about potential explanatory mechanisms. Although indirect evidence suggests craving as a candidate mechanism, direct evidence has been mixed. Materials and methods This study assessed whether specific aspects of impulsivity (sensation seeking, lack of premeditation, lack of perseverance, and urgency) were associated with cue-induced craving. Regular smokers (n = 60; 50% female) were exposed to a smoking cue and a neutral cue in a repeated measure counter-balanced design. Results Mixed effects regression models indicated that smokers who were high in sensation seeking reported greater increases in appetitive craving after smoking cue exposure, whereas, smokers who were high in urgency and lack of perseverance reported greater increases in negative affect craving. Conclusions Findings suggest a complex relationship between impulsivity and cue-induced craving that may be masked by single construct conceptualizations of impulsivity.
Impulsivity and the reinforcing value of cigarette smoking
Addictive Behaviors, 2007
The present study tested the hypothesis that impulsivity would predict perceptions of positive and negative reinforcement from smoking. The secondary hypothesis was that the relationship between impulsivity and smoking reinforcement expectations would be mediated by the character trait of self-directedness. College students (n = 202) who reported smoking cigarettes participated in the survey study. Hierarchical regression analyses confi rmed that impulsivity predicted expectations about positive (β = .22, p = .001) and negative (β = .25, p = .001) reinforcement from smoking. These relationships were also mediated by self-directedness. Results suggest that impulsive smokers in the early stages of dependence may smoke because they expect smoking to be extremely pleasurable as well as to help dispel bouts with negative affect. Furthermore, their elevated expectations about smoking may be related to diffi culties adapting to challenging environments and working toward long-term goals.
Effect of nicotine on negative affect among more impulsive smokers
Experimental and clinical psychopharmacology, 2006
In the present study, the authors tested the hypothesis that nicotine would provide greater relief from negative affect for more impulsive smokers than for less impulsive smokers. Euthymic adult smokers (N ϭ 70) participated in 2 laboratory sessions, during which they underwent a negative mood induction (music ϩ autobiographical memory), then smoked either a nicotinized or de-nicotinized cigarette. Mixed-effects regression yielded a significant Impulsivity ϫ Condition (nicotinized vs. de-nicotinized) ϫ Time interaction. Simple effects analyses showed that heightened impulsivity predicted greater negative affect relief after smoking a nicotinized cigarette but not after smoking a de-nicotinized cigarette. These data suggest that nicotine may be a disproportionately powerful negative reinforcer for highly impulsive smokers, promoting higher levels of nicotine dependence and inhibiting smoking cessation.
Experimental and Clinical Psychopharmacology, 2017
Impulsivity is associated with smoking, difficulties quitting smoking, and approach tendencies toward cigarette stimuli among adolescents. We examined the effects of impulsivity on (a) the association between approach tendencies and adolescents' smoking status and (b) the effectiveness of Cognitive Bias Modification (CBM), a smoking cessation intervention focused on changing approach tendencies, among adolescent smokers. We conducted a secondary analysis of evidence from 2 previous published studies: Study 1: a cross-sectional study comparing impulsivity and approach tendencies between adolescent smokers (n ϭ 67) and nonsmokers (n ϭ 58); Study 2: a treatment study that randomized 60 adolescent smokers to receive either CBM or sham training. Impulsivity was measured using the Barratt Impulsiveness Scale (BIS) and the Experiential Discounting Task (EDT). We found higher impulsivity, as determined by the BIS but not the EDT, increased adolescents' odds of being smokers. We observed that the interaction between EDT and approach tendencies also significantly predicted smoking status, however post hoc comparisons were not significant. Adolescents with higher BIS scores receiving CBM had increased odds of being abstinent at the end of treatment, but we found no association between EDT and treatment outcome. Our findings suggest that approach-bias modification (a form of CBM) may be more effective in impulsive adolescent smokers. Differences in findings for BIS and EDT highlight the complexity of the construct of impulsivity. Future studies with larger samples are needed to further disentangle the effects of different aspects of impulsivity on smoking behaviors and cessation outcomes among youth. Public Health Significance This study suggests that approach bias modification, a form of cognitive bias modification, may be a more effective treatment for impulsive adolescent smokers compared with nonimpulsive adolescent smokers. This finding supports the importance of considering the effects of impulsivity on adolescent smoking behavior in the research of smoking cessation treatments.
Effect of impulsivity on cardiovascular and subjective reactivity to smoking cues
Addictive behaviors, 2008
Individuals with high levels of impulsivity are more likely to smoke and may have greater difficulty quitting than other smokers. Although the specific mechanisms mediating this relationship are not explicitly known, one candidate is disproportionate cigarette craving in response to environmental smoking cues. We assessed the effect of impulsivity on three measures of cue reactivity. Regular smokers (n = 75) were exposed to a smoking cue and a neutral cue in 2 counterbalanced experimental sessions. Cigarette craving, heart rate (HR), and mean arterial pressure (MAP) were used to index cue reactivity. More impulsive smokers exhibited a disproportionate response to the smoking cue in terms of MAP ( p= .009) but not HR or craving. Impulsive smokers may experience disproportionate cigarette craving in response to environmental smoking cues that are not reflected in self-report measures due to a relative lack of conscious awareness of the urge to smoke.
The American Journal of Drug and Alcohol Abuse, 2017
Smoking remains one of the most preventable causes of morbidity and mortality in the United States (1). A number of factors contribute to the initiation and maintenance of smoking behavior, including psychosocial influences (2,3), neurobehavioral traits (4), and genetic susceptibility (5-7). Prevalence rates of tobacco dependence among individuals with mental health issues are strikingly high when compared to the general population, particularly among individuals with depression and anxiety disorders (8). There are well-established relationships between impulsivity, cue reactivity, and tobacco use in the literature (9). However, the interaction between these relationships remains unclear. The primary goal of this paper is to provide an overview of the existing literature across these domains and explore their interrelationship and subsequent impact on smoking initiation and tobacco dependence. Further, the clinical implications regarding the development of potential targeted smoking cessation strategies for this population are presented.
Addictive Behaviors, 2015
Young adults are at risk for initiation of tobacco use and progression to tobacco dependence. Not every person who smokes cigarettes becomes tobacco dependent, however, and non-daily smoking is becoming more prevalent among those who use tobacco. It is likely that individual differences in psychosocial and behavioral factors influence risk for engaging in non-daily and daily cigarette smoking. The objective of this study was to investigate the associations between impulsivity and smoking status in young adults who vary in frequency of cigarette smoking. Young adult first-year college students between the ages of 18-24 (512) were classified to one of three groups: nonsmokers, non-daily smokers, or daily smokers, and impulsivity was assessed using the UPPS-P(Negative and Positive Urgency, lack of Premeditation, lack of Perseverance, Sensation Seeking). When all impulsivity dimensions were used simultaneously to predict smoking status, negative urgency predicted increased risk of membership in the daily smoking group and lack of premeditation predicted increased risk of membership in the non-daily smoking group. These results suggest that dimensions of impulsivity may contribute differentially to forms of smoking behavior in young adults.
Cue-elicited negative affect in impulsive smokers
Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors, 2008
Impulsivity is associated with cigarette smoking, but the nature of this relationship and the mechanisms that maintain it are relatively unknown. The relationship has often been thought to reflect appetitive processes, but research suggests that an affective pathway exists as well. The present study tested the effect of impulsivity on affective responses to an environmental smoking cue. Adult smokers (N = 62) were exposed to a neutral cue and a smoking cue in separate experimental sessions in a repeated-measures design. Mixed-effects regression analyses showed that larger postexposure increases in negative affect were associated with high scores on 2 facets of impulsivity: urgency, t (179) = 6.16, p < .001, and sensation seeking, t(179) = 4.75, p < .001. Heightened impulsivity was associated with lower levels of positive affect generally but not with positive affective responses to cue exposure. Findings provide support for the existence of a negative affective pathway linking impulsivity and cigarette smoking, and they suggest that this pathway may be specific to the urgency and sensation-seeking components of impulsivity.