Self-Control Improvement Intervention (SCII): Improving Abstinence in Smokers. More than 15 years of our translational research has shown that discounting (i.e., devaluing) future rewards in favor of immediate rewards (which we will refer to as self-control failure) is endemic among individuals addicted to cigarettes and other drugs. Indeed, we propose that individuals who excessively discount future rewards may be """"""""stimulus bound"""""""" and more susceptible to drug-related cues and negative consequences. Consistent with this view, treatment success among smokers is inversely correlated with their rates of discounting. Unfortunately, no research translating basic findings on excessive discounting among smokers into clinical treatments has been conducted. This proposed project is a systematic effort to translate basic research on self-control failure into effective interventons to normalize or improve self-control among smokers. In the first phase, a laboratory study will determine if smokers with less self-control are more stimulus bound. Within this phase, we will delineate the target for subsequent intervention, self-control failure (i.e., excessive discounting, and its functional relation to measures that could determine whether smokers are stimulus bound under cigarette available and deprivation conditions. Concurrently, we will examine the quantitative relation between smokers'discounting rates and responsiveness to those measures. In the second phase, we will conduct a proof-of-concept field study testing a novel Self-Control Improvement Intervention (SCII). This intervention is based on our prior work demonstrating that working memory training (hereafter, SCII) improves self-control in stimulant-dependent individuals. We will examine (1) whether SCII decreases the extent to which smokers are stimulus bound, and (2) if this decrease in being stimulus bound is dependent on baseline self- control level. In the third phase, we will seek to improve current smoking cessation treatments (i.e., combination cognitive behavioral therapy and nicotine replacement therapy) that have been shown to be efficacious, but still fail to produce abstinence in the vast majority o participants. This will be accomplished by incorporating SCII into the multi-modal smoking treatment program among those individuals who we demonstrated to be sensitive to the SCII in Phase 2.

Public Health Relevance

Despite smoking being the single largest preventable cause of mortality and morbidity in the U.S., even the most efficacious smoking cessation treatments fail to produce abstinence among the majority of smokers. As self-control failure is a major source of poor treatment outcomes among smokers, a greater understanding of self-control failure and its repair could lead to new and more refined approaches to smoking cessation treatment. We will attempt to improve treatment outcomes in three inter-related Aims: (1) a basic research study to characterize, in detail, self-control failure among smokers and its relationship to measures that suggest smokers are more sensitive to the immediate environment (stimulus bound), (2) a proof-of-concept study to characterize a novel Self-Control Improvement Intervention (SCII) on measures indicative of being stimulus bound among smokers, and (3) a pilot/feasibility study to address the role of our SCII in a multi-modal smoking cessation treatment regimen.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
1R01DA034755-01A1
Application #
8578800
Study Section
Risk, Prevention and Intervention for Addictions Study Section (RPIA)
Program Officer
Grossman, Debra
Project Start
2013-07-15
Project End
2018-06-30
Budget Start
2013-07-15
Budget End
2014-06-30
Support Year
1
Fiscal Year
2013
Total Cost
$573,078
Indirect Cost
$217,129
Name
Virginia Polytechnic Institute and State University
Department
Type
Organized Research Units
DUNS #
003137015
City
Blacksburg
State
VA
Country
United States
Zip Code
24061
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Bickel, Warren K; Moody, Lara; Higgins, Stephen T (2016) Some current dimensions of the behavioral economics of health-related behavior change. Prev Med 92:16-23
Snider, Sarah E; Quisenberry, Amanda J; Bickel, Warren K (2016) Order in the absence of an effect: Identifying rate-dependent relationships. Behav Processes 127:18-24
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Bickel, W K; Quisenberry, A J; Snider, S E (2016) Does impulsivity change rate dependently following stimulant administration? A translational selective review and re-analysis. Psychopharmacology (Berl) 233:1-18
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Bickel, Warren K; Quisenberry, Amanda J; Moody, Lara et al. (2015) Therapeutic Opportunities for Self-Control Repair in Addiction and Related Disorders: Change and the Limits of Change in Trans-Disease Processes. Clin Psychol Sci 3:140-153
Wilson, A George; Franck, Christopher T; Mueller, E Terry et al. (2015) Predictors of delay discounting among smokers: education level and a Utility Measure of Cigarette Reinforcement Efficacy are better predictors than demographics, smoking characteristics, executive functioning, impulsivity, or time perception. Addict Behav 45:124-33
Quisenberry, Amanda J; Eddy, Celia R; Patterson, David L et al. (2015) Regret Expression and Social Learning Increases Delay to Sexual Gratification. PLoS One 10:e0135977

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