Transcript Titre de la page

Tobacco
cue-reactivity
may
be
Réunion Ambulatoires SAS, 8.5.2006
more related to dependence in
adolescent than in adult smokers
Enrico Cancela1, Djamel Benguettat1, Riaz Khan1, Sonia Krenz2, Fabian Clays2, Yves Montagrin2,
Farfalle Ribordy2, Sophie Taparel2, Emmanuelle Frésard2, Yasser Khazaal2, Daniele Fabio Zullino1
1Division
of substance abuse, University Hospitals of Geneva, Switzerland
2Clinical Research Unit, University Department for Adult Psychiatry, Lausanne, Switzerland
Introduction
Results
A promising approach for understanding the irrationality in addictive behavior
is the view that automatic processes are important in maintaining the
addictive pattern. Drug-related stimuli, even in the absence of the drug,
independently may elicit cravings or urges to use (conditioned response),
and in real live situations are likely associated with relapse to drug use.
Adolescents
10
10
S (mean ± SD)
4
2
Repeated measures GLM were computed for adolescents and adults. Early
response (last 30 sec of the neutral phase vs first 30 sec of the tobacco
phase) and late response (last 30 sec vs first 30 sec of tobacco phase) were
defined through contrast calculations. A late response can be considered as a
lack of habituation.
Neutral images
0-30
sec
Baseline
90-120
sec
0-30
sec
90-120
sec
While in adolescents a habituation could be observed within the 2 minutes
exposition period, this was not the case in adults
Adults
Adolescents
All 42 volunteers (smoking at least 10 cigarettes/day) (15 adolescents [age
15-17], 27 adults [age18-65]) were recruited during a 7-day scientific
exposition for the general public.

2

Methods
Skin conductance data was collected via a ProComp+/Biograph system
(Thought Technology).
4
Both adolescents and adults showed an early response to smoking related
cues
Factor

6

The objective of the present study was to measure the skin conductance
reactivity in smokers exposed to smoking related pictures.
Three-minute laboratory session. Participants were first submitted to a 60second presentation of “neutral” pictures (landscapes), which was followed
by a 120-sec presentation of smoking related slides.
**
0
0
While skin conductance reactivity to substance-related visual stimuli has
previously been tested in cocaine abusers 1-4, studies on tobacco smokers
have focused until now only on cardiovascular reactivity 5-9.

***
8
6
Baseline

ns
**
8
Besides being measurable through behavior and self-report in humans,
stimulus-response associations can also be seen by means of physiological
changes. This may be especially interesting in the light of the automatic
characteristics of addictive behavior.
Skin conductance activity is a sensitive measure of autonomic nervous
system activity that correlates well with other physiologic measures and the
subject arousal associated with drug craving. This is due to ability of skin
conductance to abruptly rise and fall in response to stimuli (within two
seconds delayed peaking in five seconds after presentation of stimulus) and
to delayed habituation of skin conductance response to arousal.
Adults
S (mean ± SD)
Presented at the
Annual Meeting of the
EAAT
London,
6th-8th July 2006

Early response
Late response
Early response
Late response
Within-subjects contrast
[baseline - first 30 sec of
exposition]
Within-subjects contrast
[first - last 30 sec
exposition]
Within-subjects contrast
[baseline - first 30 sec of
exposition]
Within-subjects contrast
[first - last 30 sec
exposition]
F
p
F
p
Sex
0.040
0.845
0.027
0.873
Fagerstrom
score
0.295
0.599
7.991
Cigarettes
smoked
today
0.016
0.901
Time since
last
cigarette
0.416
0.534
Factor
F
p
F
p
Sex
0.478
0.496
0.105
0.749
0.018
Fagerstrom
score
0.663
0.424
0.148
0.704
10.882
0.008
Cigarettes
smoked
today
1.094
0.307
0.261
0.615
8.506
0.015
Time since
last
cigarette
2.977
0.098
0.042
0.839
Lack of habituation was dependent in adolescents but not in adults from
Fagerstrom score, number of cigarettes smoked prior to the experiment
and time elapsed since last cigarette smoked
Conclusions

While adolescent smokers seem rapidly to habituate within 2 minutes
during smoking cues exposition, this is no more the case in adult smokers

Lack of habituation is dependent in adolescent (but not in adult) smokers
from nicotine dependence

One can therefore formulate the hypothesis that with aging the importance
of automated stimulus-response associations becomes increasingly more
important compared to dendence(≈withdrawal)-associated cue reactivity

The following therapeutic inferences can be put forward:
Smoking related images

Treatment of dependence symptoms (withdrawal) in adolescents
can have an impact on their capacity to control smoking related
cues, leading to better habituation

In adults, in whom the cue reactivity seems to have a more ballistic
quality, the treatment of dependence symptoms may not be
sufficient to control smoking related cue reactivity, treatment should
rather focus on conditioned response
References
1.
Ehrman RN, Robbins SJ, Childress AR, O'Brien CP. Conditioned responses to cocaine-related stimuli in cocaine abuse patients. Psychopharmacology (Berl)
1992;107(4):523 - 9.
2.
Negrete JC, Emil S. Cue-evoked arousal in cocaine users: a study of variance and predictive value. Drug and Alcohol Dependence 1992;30(2):187 - 92.
3.
Robbins SJ, Ehrman RN, Childress AR, O'Brien CP. Relationships among physiological and self-report responses produced by cocaine-related cues. Addict
Behav 1997;22(2):157 - 67.
4.
Killeen TK, Brady KT. Skin conductance hypo-responding in recently abstinent cocaine dependent inpatients. Am J Addict 2000;9(2):154 - 62.
5.
Saumet JL, Dittmar A. Heat loss and anticipatory finger vasoconstriction induced by a smoking of a single cigarette. Physiol Behav 1985;35(2):229 - 32.
6.
Rickard-Figueroa K, Zeichner A. Assessment of smoking urge and its concomitants under an environmental smoking cue manipulation. Addictive Behaviors
1985;10(3):249 - 56.
7.
Abrams DB, Monti PM, Pinto RP, Elder JP, Brown RA, Jacobus SI. Psychosocial stress and coping in smokers who relapse or quit. Health Psychol 1987;6(4):289 303.
8.
Abrams DB, Monti PM, Carey KB, Pinto RP, Jacobus SI. Reactivity to smoking cues and relapse: two studies of discriminant validity. BehavResTher
1988;26(3):225 - 33.
9.
McDermut W, Haaga DAF. Effect of Stage of Change on Cue Reactivity in Continuing Smokers. Experimental & Clinical Psychopharmacology 1998;6(3):316 - 24.
Service d’abus de substances - Département de Psychiatrie