The Role of Viewer Orientation and Consumption Level in Smoking Cue Reactivity

Cherisse Yungblut Flanagan, Fielding's School of Psychology

The fact that individuals with substance addiction are highly reactive to drug cues that they have paired with drug use is well established. Vulnerability to continued drug use or relapse is thought to occur when addicted individuals are exposed to those contextual cues. Exposure to those cues evokes a reactivity that forms a paradigm, cue reactivity, which has been widely used in scientific research to explore affective responses involved in addictive processes. However, an overview of recent work indicates that the reactivity evoked by drug stimuli may not be fixed, but rather appears to be modulated by a variety of contextual cues. The impact of contextual cues on craving in research and cue-exposure treatment remains without careful examination. The present work advanced a thesis that the systematic study of cue factors would permit a more thorough standardization of test stimuli and thereby increase consistency across laboratories examining cue reactivity in the substance abuse literature. Specifically, subjective affective and arousal responses to smoking cues were investigated in 54 nicotine dependent individuals. Data were gathered on reactivity evoked by 24 pictures depicting smoking stimuli modulated by two types of contextual information (consumption level and orientation) using the computerized Self-Assessment Manikin (SAM).

Results suggested that first-person cues evoke more affective reactivity than third-person cues and provided new information on the pattern of reactivity based on orientation. Previous findings that beginning and end levels of cigarette consumption evoke a different pattern of reactivity in smokers were replicated. Further, results revealed an interaction between viewer orientation and consumption level such that smokers rated the first-person images of individuals beginning to smoke more pleasantly, and images of first-person terminal stimuli more aversively. These results underscore the importance of developing a universally available repository of addiction cues and suggest that addiction scientists need to be aware of these possible influences when choosing images in cue reactivity studies.

Key Words: Cue Reactivity, Addiction, Craving, Smoking, Nicotine, Orientation, Perspective, Consumption, Terminal, Stimuli, Drug Cues, Cue Exposure Treatment, Motivation, Emotion