Smoking Cues Increase Craving As Abstinence Lengthens

Study suggests powerful cue-induced smoking urges persist after background craving subsides
By Jeff Muise
HealthDay Reporter

FRIDAY, Sept. 17 (HealthDay News) -- People who give up smoking experience greater craving in response to smoking cues as the duration of abstinence increases, according to a study published online Sept. 6 in Biological Psychiatry.

Gillinder Bedi, of the University of Chicago, and colleagues paid 86 adult smokers to abstain from smoking for either seven, 14, or 35 days. The seven-, 14-, and a subgroup of the 35-day abstainers were variably exposed on the last day of abstention to smoking or neutral cues, while another subgroup of the 35-day abstainers also were exposed to cues on days seven and 14. Smoking cues included viewing smoking-related photographs and holding a lit cigarette, while neutral cues included viewing neutral pictures and holding a pencil as a scented candle burned. The reviewers gauged craving by monitoring blood pressure and salivary cortisol, and administering the Tobacco Craving Questionnaire-Short Form (TCQ-SF).

As measured on the TCQ-SF, the researchers found that craving induced by the smoking cues increased with duration of abstinence, with the smokers who abstained for 35 days having greater cue-induced craving than the seven-day abstainers. Among the 35-day abstainers, cue-induced craving was greater at 35 days than at 14 days. Indeed, no measure showed a decrease in cue-induced craving as abstinence duration increased.

"We present initial evidence of incubation of cue-induced craving in humans. The observation that cue-induced craving increases with abstinence, even as 'background' craving and withdrawal symptoms subside, might have treatment implications," the authors write.

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