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


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


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)=1.011.32; relapse: HR=1.22, CI=0.971.54]. Subjects with higher hedonic ratings of the first lapse also had a greater risk of progression to the second lapse (HR=1.08, CI=1.021.14) and to relapse (HR=1.26, CI=1.111.41). Aversive ratings had no bearing on progression. As expected, active treatment reduced the risk of both a second lapse (HR=0.54, CI=0.390.78) and a relapse (HR=0.22, CI=0.110.45). 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:Health Sciences
Research Group:Public health
Research Field:Preventative health care
Objective Division:Health
Objective Group:Public health (excl. specific population health)
Objective Field:Public health (excl. specific population health) not elsewhere classified
UTAS Author:Ferguson, SG (Professor Stuart Ferguson)
ID Code:57260
Year Published:2006
Web of Science® Times Cited:123
Deposited By:Pharmacy
Deposited On:2009-07-01
Last Modified:2011-05-05
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