title: Dissociable effect of acute varenicline on tonic versus cue-provoked craving in non-treatment-motivated heavy smokers.
abstract: BACKGROUND
  The effectiveness of varenicline for smoking cessation has been established, but little is known about the psychological processes that mediate this clinical outcome.
  
  
  OBJECTIVE
  This study evaluated the effect of a single dose of varenicline on tonic and cue-provoked changes in craving, withdrawal, and affect using a randomized, double-blind, placebo-controlled, cross-over design.
  
  
  METHODS
  Following overnight abstinence, 38 non-treatment-motivated smokers received either varenicline 2mg or matched placebo, then tonic measures of craving, withdrawal, and positive and negative affect were obtained at 30-min intervals. At 4-h post-administration, a cue exposure session obtained the same subjective measures at three time-points following the physical handling of a lit cigarette versus the sharpening and handling of a pencil.
  
  
  RESULTS
  At 4-h post-administration, varenicline reduced tonic craving as well as craving across the smoking and neutral cue conditions, relative to placebo. By contrast, the capacity of the smoking cue to enhance craving relative to the neutral cue was unaffected by varenicline. Measures of withdrawal and positive and negative affect produced mixed results.
  
  
  CONCLUSIONS
  Acute varenicline selectively attenuates tonic but not cue-provoked craving. This dissociation provides insight into the specific psychological processes that might mediate the effectiveness of varenicline, and highlights cue-provoked craving as a discrete target for advancing smoking cessation pharmacotherapy.
authors.affiliation: Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States. b-hitsman@northwestern.edu
authors.forename: Brian
authors.initials: B
authors.lastname: Hitsman
authors.forename: Lee
authors.initials: L
authors.lastname: Hogarth
authors.forename: Li-Jung
authors.initials: LJ
authors.lastname: Tseng
authors.forename: Jordan C
authors.initials: JC
authors.lastname: Teige
authors.forename: William G
authors.initials: WG
authors.lastname: Shadel
authors.forename: Dana Britt
authors.initials: DB
authors.lastname: DiBenedetti
authors.forename: Spencer
authors.initials: S
authors.lastname: Danto
authors.forename: Theodore C
authors.initials: TC
authors.lastname: Lee
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Price
authors.forename: Raymond
authors.initials: R
authors.lastname: Niaura
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016739:Behavior, Addictive / Q000188:drug therapy* / Q000523:psychology; D001552:Benzazepines / Q000008:administration & dosage*; D018592:Cross-Over Studies; D003463:Cues; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation / Q000187:drug effects* / Q000502:physiology; D011810:Quinoxalines / Q000008:administration & dosage*; D012907:Smoking / Q000188:drug therapy* / Q000523:psychology; D016896:Treatment Outcome; D000068580:Varenicline; D055815:Young Adult
chemical_list: D001552:Benzazepines; D011810:Quinoxalines; D000068580:Varenicline