Investigation of Cigarette Cravings in Smokers

Study Overview
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Brief Summary
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Interventions to disrupt memory reconsolidation have held promise for the treatment of stress- and anxiety-related disorders. In the present study, the investigators will examine whether an intervention based on these principles, called memory updating, could be adapted for reward-seeking behaviors. To test this, non-treatment seeking tobacco smokers will be exposed to smoking cues and/or stress, two stimuli known to trigger smoking. It is predicted that exposure to a stress task will enhance the cues' motivational salience and yield greater susceptibility to the memory updating procedure. As an add-on, the investigators will examine COVID-associated changes in substance use and whether participants in the memory updating groups might be more resilient to these effects. It is predicted that the changes in substance use will depend on whether the substances are used primarily in social settings.

Detailed Description
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Non-treatment seeking cigarette dependent smokers will be randomized to one of four testing conditions: 1) a non-stressful task followed by neutral cues, 2) the non-stressful task followed by smoking cues, 3) a stressful task followed by neutral cues, or 4) the stressful task followed by smoking cues. Ten minutes after the intervention, participants will undergo a 60-minute extinction procedure consisting of smoking-related videos, images and smoking paraphernalia. Cue reactivity test sessions will take place 24 hours, 2 weeks and 6 weeks following the intervention. COVID-associated changes in substance use will be quantified over three telephone interviews: one at the end of March / beginning of April 2020 (at the start of the pandemic), one at the end of April / beginning of May, and a final one which will be instituted if feasible once the infection rates and social distancing policies have decreased.

Official Title
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Investigating Stress-Potentiated Memory Updating as a Novel Intervention for Non-Treatment Seeking Smokers

Conditions
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Tobacco Use, Cigarette Smoking, Addiction Nicotine

Intervention / Treatment
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* Behavioral: Stress induction
* Behavioral: Control stress exposure
* Behavioral: Cue induction
* Behavioral: Neutral cue exposure


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Scoring 5 or higher on the Fagerström Test for Cigarette Dependence Willingness to abstain from smoking for 4 hours prior to each laboratory visit Exclusion Criteria: Currently using cigarette cessation products Endocrinological problems Significant mental or physical health conditions Pregnancy

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Stress task and smoking cue<br>Exposure to a psychosocial stress task followed by smoking video cues | Behavioral: Stress induction<br>* Exposure to a psychosocial stressor<br>Behavioral: Cue induction<br>* Exposure to a smoking-related task<br>|
| Experimental: Stress task and neutral cue<br>Exposure to a psychosocial stress task followed by neutral video cues | Behavioral: Stress induction<br>* Exposure to a psychosocial stressor<br>Behavioral: Neutral cue exposure<br>* Exposure to neutral cues<br>|
| Active Comparator: Control task and smoking cue<br>Exposure to a control task followed by smoking video cues | Behavioral: Control stress exposure<br>* Exposure to a control task (no stress)<br>Behavioral: Cue induction<br>* Exposure to a smoking-related task<br>|
| Active Comparator: Control task and neutral cue<br>Exposure to a control task followed by neutral video cues | Behavioral: Control stress exposure<br>* Exposure to a control task (no stress)<br>Behavioral: Neutral cue exposure<br>* Exposure to neutral cues<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in cigarettes smoked per day from the pre-intervention baseline to test sessions 2 and 3 given two and six weeks post-intervention | A journal is given to participants to record their cigarette use behaviour every day for a month and a half | At the end of test session 1 (24 hours post-intervention), participants will receive a journal to record their daily smoking behaviour. They are asked to keep this journal until test session 3 (6 weeks post-intervention). | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in smoking cue-induced cigarette cravings from the pre-intervention baseline to test session 2 | Participants will be asked to complete craving and urge to smoke questionnaires at several time points throughout the study sessions | Multiple times points during the baseline, intervention and test sessions at 24 hours, 2 weeks and 6 weeks post-intervention. | 
| Change in smoking cue-induced cigarette cravings from the pre-intervention baseline to test session 3 | Participants will be asked to complete craving and urge to smoke questionnaires at several time points throughout the study sessions | Multiple times points during the baseline, intervention and test sessions at 24 hours, 2 weeks and 6 weeks post-intervention. | 
| Change in smoking cue-induced heart rate responses from the pre-intervention baseline to test session 2 | Participants' heart rate will be measured through the use of a polar belt at several time points during the study sessions | Multiple time points during the baseline, intervention and test sessions at 24 hours, 2 weeks and 6 weeks post-intervention | 
| Change in smoking cue-induced heart rate responses from the pre-intervention baseline to test session 3 | Participants' heart rate will be measured through the use of a polar belt at several time points during the study sessions | Multiple time points during the baseline, intervention and test sessions at 24 hours, 2 weeks and 6 weeks post-intervention | 
| Change in smoking cue-induced skin conductance responses from the pre-intervention baseline to test session 2 | Participants' skin conductance will be measured through the use of electrodes on their index and middle fingers at several time points during the study sessions | Multiple time points during the baseline, intervention and test sessions at 24 hours, 2 weeks and 6 weeks post-intervention | 
| Change in smoking cue-induced skin conductance responses from the pre-intervention baseline to test session 3 | Participants' skin conductance will be measured through the use of electrodes on their index and middle fingers at several time points during the study sessions | Multiple time points during the baseline, intervention and test sessions at 24 hours, 2 weeks and 6 weeks post-intervention | 
| Change in tobacco and other substance use patterns from the pre-COVID-19 baseline to during COVID-19 | Participants will be asked to report the quantity of cigarettes and/or other substances they have consumed recently | Multiple time points at baseline (before the pandemic), at the start of the pandemic, and during the pandemic | 
| Change in tobacco and other substance use patterns from the pre-COVID-19 baseline to post-COVID-19 | Participants will be asked to report the quantity of cigarettes and/or other substances they have consumed recently | At baseline (before the pandemic) and through study completion, an average of 1 year | 
| Change in tobacco and other substance use patterns during the COVID-19 pandemic to post-COVID-19 | Participants will be asked to report the quantity of cigarettes and/or other substances they have consumed recently | Multiple time points during the pandemic and through study completion, an average of 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Memory updating, Reconsolidation