Cigarette smoking remains a leading cause of preventable death in this country. As with all substance abuse disorders, the factors contributing to use and relapse following treatment remain central concerns. Two cognitive processes may be at the core of vulnerability to smoking behavior. First, cigarette smokers may focus excessive attention on smoking-related stimuli that in turn evoke responses such as craving, withdrawal, and memories of the positive consequences of smoking (e.g. stress relief). These cue-induced states may motivate further smoking. Furthermore, excessive attention to these events may reduce cognitive capacities necessary for employing abstinence oriented coping skills learned in therapy. Second, smokers may have positive attitudes toward smoking that undermine their attempts at abstinence. According to cognitive therapy models, a key component of successful treatment involves teaching individuals to focus more on the negative consequences of smoking (e.g. health risks) and less on the positive aspects (e.g. stress relief). Because individuals may be unaware of their attentional biases and unwilling to disclose attitudes that contradict societal views of smoking, these cognitive processes may be difficult to study through traditional self-report measures. Thus, the purpose of the present application is to study these cognitive biases through reaction-time computer tasks that minimize response biases and task demands. Pilot data demonstrate that the tasks proposed here successfully reveal the existence of attentional and attitudinal biases in smokers. The four studies proposed expand on our initial demonstrations in several ways. First, Study 1 is aimed at exploring whether attentional and attitudinal biases vary across individuals with different smoking histories (past smokers, current smokers seeking treatment, current smokers not seeking treatment and non-smokers). Second, Study 3 explores whether cognitive biases vary with local conditions that are known to promote smoking behavior, namely short-term abstinence (in this case, 24 hour deprivation) and exposure to smoking-related stimuli. Third, Study 2 will determine the stability of the cognitive biases over time and examines procedural variations to minimize artifactual variability. Finally, Study 4 examines whether cognitive biases diminish during successful treatment and whether changes in those biases are predictive of individual success. We hope both to establish the importance of cognitive biases in smoking and to validate novel, demand-free, non-self-report measures of those processes.
| Robbins, Steven J; Ehrman, Ronald N (2004) The role of attentional bias in substance abuse. Behav Cogn Neurosci Rev 3:243-60 |
