Cue reactivity in converted and native intermittent smokers

Introduction: Nondaily, or intermittent smokers (ITS), who constitute a substantial fraction of U.S. smokers, are thought to smoke in response to cues. Previous cue reactivity research showed no difference between ITS and daily smokers in response to cues. This report examines whether "converted" ITS (CITS) with a history of past daily smoking differ from "native" ITS (NITS) in craving and smoking in response to cues.

Methods: A total of 146 CITS (who previously smoked daily for at least 6 months) and 73 NITS participated. Participants were exposed to 5 active cues (smoking, alcohol, negative affect, positive affect, and smoking prohibitions) and a control neutral cue, in separate sessions. Changes in craving were assessed pre-post cue exposure. Smoking behavior (smoking [y/n], smoking latency, number of cigarettes, number of puffs, and increase in carbon monoxide [CO]) was observed. Analyses contrasted response to each active cue compared to the neutral cue and controlled for order effects and for time since last cigarette, which differed between groups.

Results: Regardless of cues, CITS reported higher craving and greater change in craving, were more likely to smoke, tended to progress faster to smoking, and showed greater increases in CO when they did smoke. NITS and CITS showed similar cue reactivity on most measures, though NITS took more puffs after viewing smoking cues (compared to neutral) than did CITS.

Conclusions: Though CITS show some remnants of their history of daily smoking, CITS and NITS demonstrate similar cue reactivity, suggesting that they would not require different behavioral approaches to help them quit.