strengthening instrumental extinction to prevent smoking relapse (vlnccue)

Conditions: Cigarette Smoking

Summary: the central objective of the project is to evaluate the effect of incorporating smoking related contexts into very low nicotine content (vlnc) cigarette extinction trials on clinically relevant, smoking-related outcomes. adult smokers interested in quitting smoking (n=80) will be interviewed and trained to take pictures where they smoke cigarettes. following taking these pictures, participants will then be switched to smoke vlncs while wearing a 21 mg/d nicotine patch (ext) for three weeks. during this 3-week treatment period, half of the sample (n=40) will be randomly assigned to undergo six, 60-minute sessions of multiple context extinction (mce+) during which they will view smoking-related environments and smoke their assigned cigarettes. the remaining 40 participants will undergo control mce (exposure to nature environments; mce-) and smoke their assigned cigarettes. at the end of the three weeks, participants will quit smoking and continue to wear the nicotine patch while being followed during a 10-week abstinence period. participants will also complete a follow-up phone call 6 months after their quit day.


Eligibility criteria:
inclusion criteria: * generally healthy (i.e. ambulatory, not currently sick) * interest in quitting smoking * smoking of at least 5 cig/day of a brand delivering ≥ 0.5 mg nicotine (ftc method) for \> 1 year * an expired carbon monoxide concentration of at least 10 ppm (to confirm inhalation) or urinary cotinine \> 1000 ng/ml to confirm daily smoking (nicalert=6) exclusion criteria: * inability to attend all required experimental sessions * desire to quit smoking prior to the study quit date * a quit attempt resulting in greater than 3 days of abstinence in the past 30 days * report of significant health problems including but not restricted to (e.g. chronic hypertension, emphysema, seizure disorder, history of significant heart problems) * unstable psychiatric conditions (any significant change in psychiatric symptoms during the past 3 months as determined by the study physician) * schizophrenia and schizoaffective disorder * psychiatric medication changes (e.g. new prescriptions, changes in dosages, or discontinuation of medications) in the past 3 months that was a result of negative changes in symptoms * use of other tobacco products or e-cigarettes more than 9 days in the past 30 days * current alcohol or drug abuse * use of illegal drugs (excluding marijuana) or drugs without a valid prescription as measured by urine drug screen * current use of nicotine replacement therapy or other smoking cessation treatment * use of theophylline for asthma * presence of conditions contraindicated for nicotine replacement therapy (e.g., skin allergies) * previous participation in a study within the past year involving use of spectrum cigarettes * systolic bp greater than or equal to 140 (participants failing for blood pressure will be allowed to rescreen once) * diastolic bp greater than or equal to 90 (participants failing for blood pressure will be allowed to rescreen once) * heart rate greater than or equal to 100 (participants failing for heart rate will be allowed to rescreen once) * blood alcohol level \>0.0 (participants failing the blood alcohol screen will be allowed to rescreen once) * pregnant, trying to become pregnant, or breastfeeding