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Immediate hedonic response to smoking lapses: Relationship to smoking relapse, and effects of nicotine replacement therapy

Citation

Shiffman, S and Ferguson, SG and Gwaltney, CJ, Immediate hedonic response to smoking lapses: Relationship to smoking relapse, and effects of nicotine replacement therapy, Psychopharmacology (Berl), 184, (3-4) pp. 608-18. ISSN 0033-3158 (2006) [Refereed Article]


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The final publication is available at http://www.springerlink.com

Official URL: http://www.springerlink.com

DOI: doi:10.1007/s00213-005-0175-4

Abstract

Objective and rationale Smoking lapses represent an important juncture between smoking cessation and relapse. Nicotine replacement therapy (NRT) has been shown to decrease the risk of progression from lapse to relapse. We hypothesized that this effect might be mediated via decreases in reinforcement from smoking lapses. Method We assessed 169 subjects who lapsed during treatment in a double-blind placebo-controlled study of high-dose (35 mg) nicotine patch. Following their first lapse, using an electronic diary, subjects recorded the amount they smoked, and rated the pleasantness and satisfaction ("hedonic rating") and the aversiveness of smoking. Subjects were then followed and assessed for further lapses and relapses. Results Subjects who smoked more during the first lapse had greater risk of progression [second lapse: hazard ratio (HR)=1.16, confidence interval (CI)=1.01–1.32; relapse: HR=1.22, CI=0.97–1.54]. Subjects with higher hedonic ratings of the first lapse also had a greater risk of progression to the second lapse (HR=1.08, CI=1.02–1.14) and to relapse (HR=1.26, CI=1.11–1.41). Aversive ratings had no bearing on progression. As expected, active treatment reduced the risk of both a second lapse (HR=0.54, CI=0.39–0.78) and a relapse (HR=0.22, CI=0.11–0.45). Importantly, however, NRT had no effect on hedonic ratings, amount smoked during the first lapse, or aversive ratings. Conclusions Hedonic response to an initial lapse predicted progression to relapse, but this did not mediate the effect of NRT on progression.

Item Details

Item Type:Refereed Article
Keywords:smoking cessation
Research Division:Medical and Health Sciences
Research Group:Public Health and Health Services
Research Field:Preventive Medicine
Objective Division:Health
Objective Group:Public Health (excl. Specific Population Health)
Objective Field:Substance Abuse
Author:Ferguson, SG (Associate Professor Stuart Ferguson)
ID Code:57260
Year Published:2006
Web of Science® Times Cited:56
Deposited By:Pharmacy
Deposited On:2009-07-01
Last Modified:2011-05-05
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