Maggie M. Sweitzer

Introduction: Understanding factors that render some individuals more vulnerable to smoking relapse during the early stages of a quit attempt is critical to tailoring treatment efforts. Development of laboratory models of relapse can provide a framework for identifying underlying mechanisms that may contribute to vulnerability. Here, we explored predictors of abstinence in a novel incentive-based model of relapse. Methods: Fifty-six nontreatment seeking daily smokers completed several nicotine dependence measures prior to participating in a 1-week abstinence incentive test. During the abstinence procedure, participants earned monetary reinforcement for each biochemically verified day of abstinence according to a descending schedule of reinforcement. Results: Compliance with the procedure was excellent. All but 3 participants were able to initiate abstinence; nearly 70% lapsed as incentives were reduced. Scores on the Fagerström Test for Nicotine Dependence (FTND), number of cigarettes smoked per day, and self-reported craving on the first day of abstinence each independently predicted time to lapse. The single item of time to first cigarette in the morning on the FTND significantly predicted time to lapse, even when controlling for other significant predictors just listed. The Nicotine Dependence Syndrome Scale (NDSS) and Wisconsin Inventory of Smoking Dependence Motives did not predict lapse, but the NDSS did predict reinitiation of abstinence among those experiencing an initial lapse. Conclusions: These findings partially replicate those of previous full-scale clinical trials and support the feasibility and validity of an incentive-based model of relapse. The time-limited and laboratory-based nature of this model has the potential to further investigations of underlying mechanisms contributing to relapse.

Impulsivity has been identified as a behavioral precursor to addiction, and may be the manifestation of a neurological vulnerability. The present study investigated whether individual differences in impulsivity were associated with performance on the Iowa Gambling Task (IGT, a test of emotional decision making thought to be associated in part with ventromedial prefrontal cortex function) and the Wisconsin Card Sorting Task (WCST, a set-shifting thought to be associated in part with dorsolateral prefrontal cortex function). Subjects were screened for impulsivity using the BIS-11 (self-report) and a delay discounting questionnaire (a behavioral measure of impulsivity). High impulsivity was associated with poorer performance on the final block of trials of the IGT but was not significantly related to WCST performance. Both measures were significantly correlated with scores on the BIS. These results provide support for hypothesis that, in a nonclinical sample, impulsivity may vary systematically with performance on neuropsychological indicators of prefrontal function. (JINS, 2008, 14, 878–882.)