Effects of Smoking Cues on Tobacco Craving Responses and the Reinforcing Efficacy of Cigarettes in Smokers With and Without Schizophrenia
Condition: Schizophrenia; Nicotine Dependence
MeSH terms: Tobacco Use Disorder; Schizophrenia
Study type: Interventional

Summary: 
      In this study, we will compare cue-reactivity in smokers with and without schizophrenia and
      the influence of smoking cues on responding for cigarette puffs under a PR schedule of
      reinforcement. Given the high prevalence of smoking among individuals with schizophrenia,
      understanding some of the environmental factors that serve to maintain nicotine dependence is
      a critical step in improving smoking cessation treatment outcomes. Establishing and
      validating a laboratory model of cue-elicited responsivity and cigarette self- administration
      will allow the investigation of the efficacy of anti-craving medications in people with
      schizophrenia.

      Specific Aims 1) To compare the effects of smoking versus neutral cues on craving, mood, and
      autonomic responsivity in smokers with schizophrenia and smokers without schizophrenia. 2) To
      compare the effects of smoking versus neutral cues on the reinforcing efficacy of tobacco
      cigarettes in smokers with schizophrenia and smokers without schizophrenia.

      Outcome Measures During cue trials, primary measures include craving (TCQ-SF, VAS), mood
      (mood form, VAS), and autonomic (heart rate, blood pressure, skin conductance and
      temperature) responsivity. During self-administration trials, primary measures include
      breakpoint (final ratio completed), total number of responses, and number of cigarette puffs
      earned and taken. Secondary measures include baseline smoking history, mood form, TCQ-SF, CO,
      FTND, and urinary cotinine and 3-hydroxycotinine (3-HC).

      The ratio of 3-HC/cotinine is a phenotypic biomarker of the rate of nicotine metabolism,
      which has been shown to be associated with level of nicotine dependence, various smoking
      behaviors, and treatment outcome (Ho & Tyndale, 2007). We will correlate the primary measures
      with the 3-HC/cotinine ratio to explore possible relationships for future study.
    


Intervention name(s): Smoking Cues; Neutral Cues
Intervention type(s): Behavioral; Behavioral
Intervention description(s): In the smoking cue condition, a pack of the participants preferred brand of cigarettes, a lighter, and an ashtray will be under the tray cover. In the neutral cue condition, a pack of unsharpened pencils, a pencil sharpener, and a small notepad will be under the cover. When instructed, the participant will lift the cover on the tray. In the smoking cue condition, participants will take one cigarette out of the pack, light it without puffing, hold it for 1 minute, extinguish the cigarette, and replace the cover on the tray.; In the neutral cue condition, participants will take one pencil out of the pack, sharpen it, hold it for 1 minute as if to write on the notepad, and then replace the cover. Participants will complete the VAS during cue exposure and the TCQ-SF, VAS, and mood form immediately and 15 minutes after cue presentation; physiological measures will be recorded continuously.
Intervention model: Crossover Assignment
Masking: Single (Participant)
Primary purpose: Diagnostic
Keywords: Smoking; Nicotine; Schizophrenia