Attenuated beta endorphin response to acute stress is associated with smoking relapse

Abstract

Stress has been cited as an important precipitator of smoking relapse. Dysregulation of neurobiological pathways related to stress might mediate effects of stress on smoking relapse. This study assessed the extent to which beta endorphin response to stress is associated with early smoking relapse. Forty-five smokers interested in smoking cessation were recruited and attended a laboratory session 24 h following the beginning of their abstinence period. During this session beta endorphin samples were collected before and after performing two acute stressors (public speaking and cognitive tasks). Participants also attended four weekly follow-up sessions to assess their smoking status. Results were compared between smokers who relapsed within the 4-week follow-up period and those who maintained abstinence over the same period. The acute stressors were associated with significant increases in measures of craving and withdrawal symptoms (ps<0.01). While baseline measures of beta endorphin did not differ between relapsers and successful abstainers (F<1), results demonstrated that smokers who relapsed exhibited attenuated beta endorphin response to the two stressors relative to those who maintained abstinence over the same period (ps<05). These results support recent evidence indicating that a dysregulated stress response is a key component in predicting smoking relapse.

Figure 1

Timeline protocol during the laboratory sessions (time in minutes)

Figure 2

Mean beta endorphin concentrations during the laboratory session. Bar lines represent standard error of the mean. Dark boxes indicate the acute psychological challenges. Sample by group interaction was significant (p < 0.05), due to attenuated responses by relapsers relative to successful abstainers.

Figure 3

Mean beta endorphin changes in response to the public speaking and cognitive stressors. Bar lines represent standard error of the mean. Relapsers exhibited smaller beta endorphin responses to both stressors than successful abstainers (ps < 0.05).