title: Stress decreases the ability to resist smoking and potentiates smoking intensity and reward.
abstract: 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 (n = 37) 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.
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, USA. sherry.mckee@yale.edu
authors.forename: Sherry A
authors.initials: SA
authors.lastname: McKee
authors.forename: Rajita
authors.initials: R
authors.lastname: Sinha
authors.forename: Andrea H
authors.initials: AH
authors.lastname: Weinberger
authors.forename: Mehmet
authors.initials: M
authors.lastname: Sofuoglu
authors.forename: Emily L R
authors.initials: EL
authors.lastname: Harrison
authors.forename: Meaghan
authors.initials: M
authors.lastname: Lavery
authors.forename: Jesse
authors.initials: J
authors.lastname: Wanzer
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000096:biosynthesis; D000328:Adult; D016739:Behavior, Addictive; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000096:biosynthesis; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects; D019018:Imagery, Psychotherapy; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009538:Nicotine / Q000494:pharmacology; D010913:Pituitary-Adrenal System / Q000187:drug effects; D012054:Reinforcement, Psychology; D012201:Reward; D012907:Smoking / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology; D013315:Stress, Psychological / Q000473:pathology / Q000523:psychology*; D055815:Young Adult
chemical_list: D009538:Nicotine; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone
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