Relapse and maintenance issues for smoking cessation.

Ockene, Judith K.; Emmons, Karen M.; Mermelstein, Robin J.; Perkins, Kenneth A.; Bonollo, Debra; Voorhees, Carolyn C.; Hollis, Jack F.

doi:10.1037/0278-6133.19.suppl1.17

Cited by 308 publications

(289 citation statements)

References 146 publications

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“…Rewarding as well as aversive properties of nicotine may act synergistically to direct the behavior of smokers toward tobacco consumption (Koob, 1996). The magnitude of nicotine dependence, as well as the negative state and dysphoria associated with nicotine withdrawal, are good predictors of smoking relapse (Ockene et al, 2000). Indeed, ICSS studies in rats demonstrate reduced sensitivity to rewarding stimulation (anhedonia) following spontaneous withdrawal from nicotine minipump extraction (Skjei and Markou, 2003;Kenny et al, 2003a;Yamada et al, 2010;Epping-Jordan et al, 1998;Vlachou et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

Reward Sensitization: Effects of Repeated Nicotine Exposure and Withdrawal in Mice

Hilário

Turner

Blendy

2012

Neuropsychopharmacol

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Tobacco dependence is an addiction with high rates of relapse, resulting in multiple quit attempts in individuals who are trying to stop smoking. How these multiple cycles of smoking and withdrawal contribute to nicotine dependence, long-term alterations in brain reward systems, and nicotine receptor regulation is unknown. Therefore, to evaluate how multiple exposures of nicotine and withdrawal periods modulate rewarding properties of nicotine, we used intracranial self-stimulation to measure alterations in the threshold of brain stimulation reward. In addition, we employed the conditioned place preference (CPP) paradigm to evaluate positive context conditioning following each withdrawal period and measured levels of neuronal nicotinic receptors in cortex, striatum, and hippocampus. We found that repeated nicotine exposure and withdrawal enhanced brain stimulation reward and reward sensitivity to acute injections of nicotine. This increased reward was reflected by enhanced CPP to nicotine. Chronic nicotine is known to up-regulate nAChRs (nicotinic acetylcholine receptors) and we found that this up-regulation was maintained for up to 8 days of withdrawal in the striatum and in the hippocampus, but not in the cortex, of animals exposed to multiple nicotine exposure and withdrawal periods. These results demonstrate that repeated exposures to nicotine, followed by withdrawal, induce a persistent increase in both brain reward function and sensitivity to the hedonic value of nicotine and long-lasting up-regulation of neuronal nicotinic receptors. Together, these data suggest that a continuing increase in brain reward function and enhanced sensitivity to nicotine reward following repeated withdrawal periods may be one reason why smokers relapse frequently.

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Section: Discussionmentioning

confidence: 99%

Reward Sensitization: Effects of Repeated Nicotine Exposure and Withdrawal in Mice

Hilário

Turner

Blendy

2012

Neuropsychopharmacol

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“…Men in this study were more than twice as likely to have attempted smoking cessation than woman. Therefore, because a history of previous attempts at quitting has been found to be a predictor of smoking relapse, 16 men may require additional follow-up to improve their long-term abstinence from smoking.…”

Section: Discussionmentioning

confidence: 99%

Cigarette Smoking and the Desire to Quit Among Individuals Living with HIV

Mamary

Bahrs

Martinez

2002

AIDS Patient Care and STDs

138

135

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Among individuals living with human immunodeficiency virus (HIV), studies have found that smokers are at greater risk than nonsmokers to develop bacterial pneumonia, oral lesions and acquired immune deficiency syndrome (AIDS) dementia complex. Information is lacking re garding the prevalence of cigarette smoking among people living with HIV or about their in tentions to quit smoking. A survey was conducted with a sample of patients attending an HIV outpatient clinic at San Francisco General Hospital to assess the prevalence of cigarette smok ing and the level of interest in quitting. In total, 228 assessments were completed. Study re sults revealed a high percentage of smokers among our sample of individuals living with HIV compared to the percentage of smokers found in the general adult population. A total of 123 individuals (54%) reported that they smoked cigarettes. Men were more than twice as likely to have made previous attempts at smoking cessation than were woman. The majority of cig arette smokers (63%) reported that they were currently thinking about quitting. Respondents' preferences for types of smoking cessation methods are discussed, and recommendations are proposed for identifying and treating tobacco dependence in this population.

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“…Evidence suggests that older age and markers of lower cigarette dependence are predictive of success 2, 3, 4, 5, 6, although not all studies show these results 7. There is less consistent, conflicting or negative evidence on the effects of age of smoking onset 2, 3, substance use disorder 8, psychiatric disorder 6, 9, gender 4, 6, 10, geographical location 11, 12, body mass index (BMI) 2, 3, 10, 13, 14 and prior use of smoking cessation treatments 15. These covariates were assessed in the EAGLES trial.…”

Section: Introductionmentioning

confidence: 98%

Factors associated with the efficacy of smoking cessation treatments and predictors of smoking abstinence in EAGLES

et al. 2018

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AimsTo assess (1) how far the efficacies of front‐line smoking cessation pharmacotherapies vary as a function of smoker characteristics and (2) associations between these characteristics and success of smoking cessation attempts.DesignProspective correlational study in the context of a double‐blind randomized trial. The outcome was regressed individually onto each covariate after adjusting for treatment, and then a forward stepwise model constructed. Treatment moderator effects of covariates were tested by treatment × covariate interactions.SettingHealth service facilities in multiple countries.ParticipantsData came from 8120 smokers willing to make a quit attempt, randomized to varenicline, bupropion, nicotine replacement therapy (NRT) or placebo in Evaluating Adverse Events in a Global Smoking Cessation Study (EAGLES) between 30 November 2011 and 13 January 2015.MeasurementsSmoker characteristics measured at baseline were country, psychiatric history, sex, age, body mass index (BMI), ethnic group, life‐time suicidal ideation/behaviour, anxiety, depression, aggression, psychotropic medication, history of alcohol/substance use disorder, age of starting smoking, cigarette dependence [Fagerström Test for Cigarette Dependence (FTCD)] and prior use of study medicines. Outcome was biochemically confirmed continuous abstinence at weeks 9–24 from start of treatment.FindingsNo statistically significant treatment × covariate interactions were found. Odds of success were associated independently positively with age [odds ratio (OR) = 1.01; 95% confidence interval (CI) = 1.00, 1.01], BMI (1.01; 95% CI = 1.00, 1.02) and age of starting smoking (1.03; 95% CI = 1.02, 1.04). Odds were associated independently negatively with US (versus non‐US) study site (0.53; 95% CI = 0.46, 0.61), black (versus white) ethnic group (0.57; 95% CI = 0.45, 0.72), mood disorder (0.85; 95% CI = 0.73, 0.99), anxiety disorder (0.71; 95% CI = 0.55, 0.90) and psychotic disorder (0.73; 95% CI = 0.50, 1.07), taking psychotropic medication (0.81; 95% CI = 0.68, 0.95), FTCD (0.89; 95% CI = 0.87, 0.92) and previous use of NRT (0.78; 95% CI = 0.67, 0.91).ConclusionsWhile a range of smoker characteristics—including psychiatric history, cigarette dependence and prior use of nicotine replacement therapy (NRT)—are associated with lower cessation rates, they do not substantially influence the efficacy of varenicline, bupropion or NRT.

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Relapse and maintenance issues for smoking cessation.

Cited by 308 publications

References 146 publications

Reward Sensitization: Effects of Repeated Nicotine Exposure and Withdrawal in Mice

Reward Sensitization: Effects of Repeated Nicotine Exposure and Withdrawal in Mice

Cigarette Smoking and the Desire to Quit Among Individuals Living with HIV

Factors associated with the efficacy of smoking cessation treatments and predictors of smoking abstinence in EAGLES

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