Examining the effects of initial smoking abstinence on response to smoking-related stimuli and response inhibition in a human laboratory model

Rationale Research is needed on initial smoking abstinence and relapse risk. Objective This study aims to investigate the effects of different durations of initial abstinence on sensitivity to smokingrelated stimuli and response inhibition in the context of a larger battery of outcome measures. Methods Smokers were randomly assigned to receive payment contingent on smoking abstinence across all 15 study days (15C) or just the final 2 days (2C). Smoking status and subject ratings were assessed daily. Participants completed fMRI sessions at baseline and day 14 during which they completed craving ratings after exposure to smoking-related and neutral stimuli and performed a response inhibition task. On day 15, participants completed a smoking preference session involving 20 exclusive choices between smoking and money. Results The payment contingencies were effective in producing greater smoking abstinence in the 15C vs. 2C conditions. Ratings of withdrawal decreased, while ratings of ease and confidence in abstaining increased in the 15C vs. 2C conditionsacrossthe15-daystudy.15Cparticipantswerelesslikely to choose the smoking option in the preference session. 15C participants reported greater reductions in craving compared to the 2C participants in the presence of smoking-related and neutral stimuli (i.e., decreases in generalized craving), but no differences were noted in cue reactivity per se or in response inhibition. Conclusions Results systematically replicate prior observations that a period 2 weeks of initial abstinence decreases the relative reinforcing effects of smoking and improves other outcomes associated with relapse risk compared to the initial day or two of a cessation effort, and extends them by underscoring the importance of generalized rather than cueinduced craving in relation to relapse risk during the initial weeks of smoking cessation.