Tobacco smoking is the leading preventable cause of morbidity and mortality in the world, yet despite decades of public awareness campaigns on the adverse health consequences of smoking, 21.5% of adults in the U.S. are daily smokers. In contrast with the general population, people with schizophrenia have a much higher prevalence of smoking with reported rates of 70-90%. Environmental smoking cues have been shown to play an important role in the maintenance of nicotine addiction and in relapse to smoking. Few studies, however, have investigated whether smokers with schizophrenia show an exaggerated attentional bias or cue reactivity response to enviornmental smoking cues. Another biobehavioral factor central to addiction is the rewarding or reinforcing effect of pychoactive drugs. If initial drug use leads to increased frequency of use, then the drug is referred to, in operant conditioning terms, as a reinforcing stimulus. One defining characteristic of an addictive drug is that it positively reinforces drug-seeking and drug-taking behavior. The purpose of this study is to determine the effects of smoking versus neutral cues on schizophrenia patients who smoke on 1) craving, mood, and autonomic responsivity and 2) the relative reinforcing efficacy of tobacco cigarettes. We will test 22 patients with schizophrenia who smoke and 22 smokers without schizophrenia. During cue trials, primary measures include craving (TCQ-SF, VAS), mood (mood form, VAS), and autonomic (heart rate, blood pressure, skin conductance) 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, tobacco craving, nicotine dependence, and urinary cotinine and 3-hydroxycotinine. During the past year, we have initiated the study and completed testing of 10 smokers without schizophrenia. Because study enrollment is ongoing, we have no findings to report at this time.
