Blunted vagal reactivity predicts stress-precipitated tobacco smoking

Abstract

Rationale Long-term smoking can lead to changes in autonomic function, including decreased vagal tone and altered stress responses. One index of the inability to adapt to stress may be blunted vagal reactivity. Stress is a primary mechanism involved in relapse to smoking, but mechanisms leading to stress-precipitated relapse are not well understood. Objectives Using an experimental paradigm of stress-precipitated smoking behavior, we examined whether autonomic reactivity mediates the relationship between stress and smoking. High-frequency heart rate variability (HF-HRV), a putative measure of vagal tone and the ratio of low-to-high frequency HRV (LF/HF), a measure of sympathovagal balance were assessed. Methods Using a within-subjects design, 32 nicotine dependent 15-hour abstinent smokers (a subgroup from McKee et al. (2011)) were exposed to individualized script-driven imagery of stressful and relaxing scenarios and assessed on the ability to resist smoking and subsequent ad-lib smoking. HRV was monitored throughout each laboratory session (maximum 60 min following imagery). Results As expected, stress and ad-lib smoking additively decreased HF-HRV and increased LF/HF. Blunted stress-induced HF-HRV responses reflecting decreased vagal reactivity were associated with less time to initiate smoking and increased craving relief and reinforcement from smoking. These relationships were specific to HF-HRV following stress as neither baseline HF-HRV, HF-HRV following relaxing imagery, or LF/HF predicted smoking behavior. Conclusions The current findings are the first to experimentally demonstrate that stress-precipitated decreased vagal reactivity predicts the ability to resist smoking. Findings suggest that strategies that normalize vagal reactivity in early abstinent smokers may lead to improved smoking cessation outcomes.

Altered cardiorespiratory coupling in young male adults with excessive online gaming

“…While parasympathetic inputs facilitate humans to respond flexibly to stressors, sympathetic dominance is associated with maladaptive behaviors (Cyranowski et al, 2011). For instance, blunted vagal reactivity may predict the ability to resist smoking in abstinent smokers (Ashare et al, 2012).…”

The acute effects of yogic breathing exercises on craving and withdrawal symptoms in abstaining smokers

“…Second, breathing may help to relax smokers and thus counteract common withdrawal symptoms. For instance, acute alterations in sympathovagal activity and blunted vagal reactivity are linked to cessation (Ashare et al 2012), and drugs inhibiting sympathetic activity have been shown to decrease withdrawal symptoms (Sofuoglu et al 2003). It has been hypothesized that voluntary slow deep breathing functionally resets the autonomic nervous system through stretch induced inhibitory signals and hyperpolarization currents in both neural and nonneural tissue which synchronizes neural elements in the heart, lungs, limbic system and cortex (Jerath et al 2006).…”

Auriculotherapy for Smoking Cessation: An Observational Study of Outcomes

“…23 It seems that stress-precipitated, decreased vagal reactivity predicts the ability to resist smoking; findings suggest that strategies, which normalize vagal reactivity in early abstinent smokers, may lead to improved smoking-cessation outcomes. 24 The balancing effectiveness of auriculotherapy on vagal regulation has been shown in some studies. 25 Therefore, there is a neurophysiologic basis for using auriculotherapy to achieve smoking cessation and to sustain smoking remission.…”