The relevance and treatment of cue-induced cravings in tobacco dependence.
Craving to smoke is often conceptualized and measured as a tonic, slowly changing state induced by abstinence. In this article, we review the literature on the existence, causes, and treatment of cue-induced cravings: intense, episodic cravings typically provoked by situational cues associated with drug use. In laboratory research, smokers exposed to smoking-related cues demonstrate increased craving as well as distinct patterns of brain activation. Observational field studies indicate that such cue-induced cravings are substantially responsible for relapse to smoking but that smoking can often be averted by coping responses. The effects of pharmacological interventions are mixed. Steady-state medications (bupropion, varenicline, nicotine patch) do not appear to protect smokers from cue-induced cravings. However, acutely administered nicotine medications (such as nicotine gum and lozenge), used after cue exposure as "rescue medications," can help a smoker's recovery from cue-induced cravings. Cue-induced craving plays an important role in smoking and relapse and likely in other addictions as well. Treatments to mitigate the effect of cue-induced craving are both important and needed.
Ferguson
Stuart G
SG
Pinney Associates, Pittsburgh, PA 15213, USA.
Shiffman
Saul
S
D000223:Adaptation, Psychological / Q000502:physiology; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D001552:Benzazepines / Q000627:therapeutic use; D016642:Bupropion / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy; D003463:Cues; D005108:Extinction, Psychological; D006801:Humans; D009538:Nicotine / Q000008:administration & dosage / Q000627:therapeutic use; D018722:Nicotinic Agonists / Q000008:administration & dosage / Q000627:therapeutic use; D011810:Quinoxalines / Q000627:therapeutic use; D016540:Smoking Cessation; D014029:Tobacco Use Disorder / Q000523:psychology*; D000068580:Varenicline
D018687:Antidepressive Agents, Second-Generation; D001552:Benzazepines; D018722:Nicotinic Agonists; D011810:Quinoxalines; D016642:Bupropion; D009538:Nicotine; D000068580:Varenicline