Stress decreases the ability to resist smoking and potentiates smoking intensity and reward
Despite tobacco being responsible for 5.4 million deaths per year and well publicized as one of the most preventable causes of mortality in the developed world, many of us still reach for a cigarette at the first sign of stress. Using a novel human laboratory model this study examined stress as a causal factor in accounts of smoking relapse, identifying a clear link between stress and reduced ability to resist smoking. The findings of this research have implications for understanding motivation as well as the putative value of tobacco, and point to a potential mechanism underlying stress-precipitated relapse behavior.
We have developed a novel human laboratory model to examine two primary aspects of stress-precipitated tobacco relapse: (1) Does stress reduce the ability to resist the first cigarette? (2) Once the first cigarette is initiated, does stress facilitate subsequent smoking? Using a within-subject design, daily smokers (n¼37) who were nicotine deprived overnight received a personalized imagery induction (stress or neutral) on two separate days, and then had the option of initiating a tobacco self-administration session or delaying initiation for up to 50 min in exchange for three levels of monetary reinforcement. Subsequently, the tobacco self-administration session entailed a 1-hour period in which subjects could choose to smoke using a smoking topography system. Following the stress induction, subjects were less able to resist smoking, smoked more intensely (increased puffs, shorter inter-puff interval, and greater peak puff velocity), and perceived greater satisfaction and reward from smoking. Stress significantly increased hypothalamus– pituitary–adrenal (HPA) axis reactivity, tobacco craving, negative emotion, and physiologic reactivity relative to the neutral condition. In addition, increased cortisol, ACTH, and tobacco craving were associated with reduced ability to resist smoking following stress. These findings have implications for understanding the impact of stress on smoking relapse and model development to assess smoking lapse behavior.
McKee, S., Sinha, R., Weinberger, A., Sofuoglu, M., Harrison, E., Lavery, M., & Wanzer, J. (2010). Stress decreases the ability to resist smoking and potentiates smoking intensity and reward Journal of Psychopharmacology, 25 (4), 490-502 DOI: 10.1177/0269881110376694