Level of abstinence mediates heart-rate response to cue-elicited craving in smokers

The subjective and autonomic components of nicotine craving were examined in abstinent and non-abstinent smokers using a cue reactivity paradigm. A cigarette abstinent condition was used to examine how smoking deprivation mediates the activity of positive and negative reinforcement mechanisms. Levels of craving and physiologic responses were monitored during the presentation of videotaped neutral and smoking stimuli. Relative to the neutral material, smoking stimuli increased several indices of subjective craving in both abstinent and non-abstinent smokers. Autonomic responses to the smoking stimuli however, appeared to be mediated by the level of abstinence. Non-deprived smokers showed an increase in heart rate during the first minute of the smoking stimuli presentation relative to the first minute of the control video, while abstinent smokers showed no change. The autonomic responses of cigarette craving may be dependent on the perceived reinforcing value of cigarettes, which can be modulated by cigarette abstinence. These findings are consistent with the hypothesis that increased heart rate may be a marker for incentive motivation, but also strongly support a multi-dimensional model of nicotine craving. Furthermore, they stress the importance of recognising the condition of the smoker as a critical determinant in craving responses.