Tobacco Craving and Triggers in Persons With Schizophrenia
Condition: Smoker; Schizophrenia Diagnosis
MeSH terms: Schizophrenia
Study type: Observational

Summary: 
      Investigators have recently completed a pilot study exploring the safety and efficacy of
      using a virtual-reality based cue platform to elicit craving in smokers with
      schizophrenia(SWS)(Wehring et al, unpublished). In this study, participants with
      schizophrenia (n=16) showed increased attention to cigarettes and changes in craving measures
      when participating in the VR craving platform. In addition, participants tolerated the VR
      environment without undue adverse effects or exacerbation of symptoms. Adverse effects from
      the VR environment did not differ from that in a non-mentally ill population, and included
      headache, nausea, and dizziness as most commonly occurring factors. Persons in this pilot
      also showed acceptable rates of Immersion and Presence in the VR environment, showing the
      potential use of this form of environment for this and other purposes.

      In this study, investigators will examine virtual reality cue-reactivity in smokers with
      schizophrenia, with a focus on the relationship of cue-reactivity with self-identified
      triggers/cues. Smokers with schizophrenia often identify specific cues that trigger craving.
      Many of these are environmental (scent, sight of smoking paraphernalia or cigarettes, related
      objects, or social situations), however, a significant amount of smokers describe
      emotionally-based factors (sadness, being upset, etc.) as primary cues and triggers. Most
      methods used to elicit craving in experimental studies are executed via using environmental
      cues like sight of cigarettes or smoking paraphernalia. It is not known if smokers with
      schizophrenia(SWS) who are strongly emotionally triggered will be responsive to environmental
      triggers in a cue-elicited craving platform. This is an important research question, as the
      testing of anti-craving interventions should be generalizable for use across SWS with
      differing triggers to smoking. The VR-based environmental program from our pilot study, which
      includes sight, scent, and social cues, will be used to test pre-identified environmental
      cues/triggers and their effects on cue-elicited craving in 30 SWS. Subjective reports, mood
      and emotion measures, and objective physiological measurements will be used to identify and
      quantify environmental craving responsivity as well as tonic craving.

      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 model of
      cue-elicited responsivity will allow future investigations of craving, and ultimately designs
      for studying the efficacy of anti-craving medications in people with schizophrenia.
    


Observational model: Other
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        This study will include: current smokers with a DSM-IV diagnosis of schizophrenia or
        schizoaffective disorder. Participants with schizophrenia will be considered on a stable
        medication regimen if they have received their current antipsychotic medication(s) for at
        least 6 weeks and the same dose for at least 30 days.