Regulation of craving by cognitive strategies in cigarette smokers

Abstract

Cigarette craving is an important contributor to cigarette smoking, and clinical approaches that focus on regulation of craving are effective in reducing rates of relapse. However, a laboratory model that targets the use of cognitive strategies to regulate craving is lacking. To develop such a model, twenty heavy cigarette smokers (>12/day), twenty-two tobacco "chippers" (<6/day), and twenty non-smoking controls completed this outpatient study, during which they were presented with photographs of cigarettes and foods that have been previously shown to induce craving. During each trial, participants were instructed to think of the stimulus in one of two ways: by focusing either on the short-term consequences associated with consuming the item (e.g., it will taste good) or on the long-term consequences associated with regular consumption (e.g., I may get lung cancer). Participants reported significantly reduced food cravings when focusing on the long-term consequences associated with eating. For cigarette-smoking participants, cigarette craving was significantly reduced when focusing on the long-term consequences associated with smoking. This latter finding confirms clinical data and extends it by highlighting the importance of cognition in the modulation of craving. Future studies using this laboratory model could test the efficacy of different cognitive strategies and develop targeted interventions for smoking cessation based on the regulation of craving.

Figure 1

(A) Mean craving reported by smokers, chippers, and non-smokers, on trials in which images of food or cigarette were presented. The three experimental groups did not differ in their overall craving for food. A significant linear trend was found for cigarettes across groups. (B) Number of cigarettes smoked per week plotted against average cigarette craving reported (for smokers and chippers only). Regression analysis showed that the number of cigarettes smoked per week was a significant predictor of reported craving, and explained a significant portion of the variance in reported craving. (C) Mean craving reported in NOW compared to LATER trials across groups and stimuli; Overall, participants reported greater desire to consume food and cigarettes when engaging in the NOW strategy compared to the LATER strategy. (D) Mean craving reported by smokers, chippers, and non-smokers across all trial types. These data represent a significant three-way Group X Cue X Strategy interaction. As shown, the difference in craving for food reported in the NOW vs. LATER was similar across groups, while the difference in craving for cigarettes in NOW vs. LATER conditions varied across groups. Asterisks (*) indicate significant differences. * p<.05, ** p<.01, *** p<.001.