BACKGROUND: Alcohol and tobacco misuse and dependence are highly comorbid disorders. Varenicline alleviates symptoms of cigarette craving while preventing nicotine from binding to nicotinic acetylcholine receptors, thereby reducing nicotine’s reinforcing effects. Recent studies have shown that varenicline decreased alcohol self-administration in animal models and in one human study of heavy-drinking smokers. AIMS: To assess the effect of two-week varenicline (0.5-2mg) vs. placebo administration on cue-induced craving for tobacco and alcohol in smokers with heavy alcohol use (n = 24). METHODS: Subjects participated in two study visits where nicotine and alcohol craving and withdrawal were assessed with self-report questionnaires under four conditions (abstinence/one cigarette/neutral cues/tobacco-alcohol cues). RESULTS: Two-week administration of varenicline reduced tobacco-alcohol cue-induced cigarette cravings and reduced emotionality aspects of alcohol craving after smoking a cigarette compared to abstinence in heavy-drinking smokers. CONCLUSION: It is possible that varenicline may have particular advantages as a smoking cessation aid in heavy drinkers.

BACKGROUND: Alcohol and tobacco misuse and dependence are highly comorbid disorders. Varenicline alleviates symptoms of cigarette craving while preventing nicotine from binding to nicotinic acetylcholine receptors, thereby reducing nicotine’s reinforcing effects. Recent studies have shown that varenicline decreased alcohol self-administration in animal models and in one human study of heavy-drinking smokers. AIMS: To assess the effect of two-week varenicline (0.5-2mg) vs. placebo administration on cue-induced craving for tobacco and alcohol in smokers with heavy alcohol use (n = 24). METHODS: Subjects participated in two study visits where nicotine and alcohol craving and withdrawal were assessed with self-report questionnaires under four conditions (abstinence/one cigarette/neutral cues/tobacco-alcohol cues). RESULTS: Two-week administration of varenicline reduced tobacco-alcohol cue-induced cigarette cravings and reduced emotionality aspects of alcohol craving after smoking a cigarette compared to abstinence in heavy-drinking smokers. CONCLUSION: It is possible that varenicline may have particular advantages as a smoking cessation aid in heavy drinkers.

The use of Virtual Reality (VR) and Imagery have been utilized in psychological practices and treatment. VR has recently been the focus of research with treatments for post traumatic stress disorder, substance abuse, and phobias, among other social and behavioral issues. VR allows the researcher to create realistic controlled environments in which they are able to manipulate the experiment. Imagery permits the individual to imagine and recall scenarios from their past in order to create a more personal environment. This experiment aimed to expand upon VR practices and treatment in regards to alcohol research. In this experiment, 70 participants, 39 females and 31 males, were exposed to two VR alcohol and two Imagery alcohol cue environments. Subject craving and psychophysiological measures were taken across all four scenes and all baselines. Overall, craving measures demonstrated that female nondrinkers developed higher cravings during Imagery. Conversely, male social drinkers demonstrated higher cravings during VR. This study supports the use of VR environments in the study of alcohol cue reactivity.

This study examined the motivational state associated with smoking craving specifically among women and the effect of deprivation and smoking status on the relationship between responses to appetitive cues. Utilizing both psychophysiological (startle EMG, skin conductance) and self-report measures, we compared cue reactivity to positive, neutral, aversive, smoking, and chocolate pictures among groups of 10 hr. smoking deprived smokers, non-deprived smokers, and non-smokers. Smokers responded to smoking cues similar to pleasant affect cues with more inhibited startle and high arousal, while responses from non-smoking females indicated a neutral state. However, deprivation also significantly increased startle responses to smoking cues when compared to non-deprived smokers. Furthermore, a closer look at skin conductance responses to aversive cues suggest that smoking status (deprived and non-deprived groups) significantly inhibited one?s ability to habituate to negative affect stimuli. When responses to chocolate cues were examined, psychophysiological and self-report data seemed to indicate that smoking deprivation influenced one's ability to attend to other appetitive/rewarding cues. Implications of these results on female smoking craving and sensitivity to appetitive cues are discussed.

A number of theories have attempted to explicate mechanisms underpinning the transition from recreational drug use to substance dependence. A highly reliable correlate of dependence is the value ascribed to the drug. However, supernormal drug valuation may be insufficient to fully account for a subgroup of dependent individuals for whom the course of dependence is chronic and relapsing and who persist in drug use in the face of devastating costs. Three candidate secondary mechanisms for dependence are considered in this thesis: cue reactivity, cost discounting, and sensitivity to negative affect. Neither cue reactivity nor cost discounting were found to be significantly associated with severity of alcohol dependence in samples of young adult drinkers. By contrast, induced negative affect was found to be reliably associated with augmented alcohol motivation, and sensitivity to this effect was related to symptoms of depression and self-reported drinking to cope with negative affect: both risk factors for the development of dependence. These findings delineate a particular subset of dependent individuals for whom negative affect may represent a substantial trigger to continued drug use. There are a lack of brief interventions to abolish or limit negative affect driven drug motivation. This thesis trialled three potential interventions. A natural walk intervention in hazardous drinkers showed no evidence of limiting this effect in two experiments. Brief instruction in acceptance-based coping showed no evidence of limiting annoyance in response to an aversive noise induction procedure in an alcohol dependent population, and was therefore also eliminated as a potential intervention. However, engagement with pleasant environmental images, as a proxy for environmental enrichment, significantly reduced negative affect driven alcohol choice in student drinkers who reported a desire to visit the locations shown (high liking), compared to low-liking individuals and controls. This provides preliminary evidence for the efficacy of environmental enrichment type interventions, justifying further trials. In treatment of dependence more generally, interventions to increase access to healthy, non-drug sources of positive reinforcement may prove effective.

Smoking is now the leading cause of preventable death and disease in women. Understanding women's motivations to smoke is important in developing effective cessation and relapse prevention programs. Previous descriptive, correlational, and quasi-experimental research has established that weight concerns and negative body image are associated with tobacco smoking, cessation, and relapse, particularly among young women. This study, building upon a previous experimental study (Lopez, Drobes, Thompson, & Brandon, 2008), examined whether activation of negative body image cognitions would produce greater urges to smoke and would affect actual smoking behavior. A randomized 2 X 2 crossed factorial, between-subjects design (body image manipulation X smoking cue manipulation) was conducted with 133 female college smokers. The body image manipulation involved trying on a one-piece bathing suit or evaluating a purse, and the smoking cue manipulation included the presentation of their pack of cigarettes or a stapler. Participants completed pre-intervention measures assessing smoking history, trait body dissatisfaction, trait self-objectification, and trait affect. State levels of urge to smoke, mood, and body dissatisfaction were assessed after the manipulations. It was hypothesized that main effects on the measures of smoking motivation (i.e., self-reported urges to smoke and topographical measures of smoking behavior) would be found for the body image manipulation, with trait body dissatisfaction and/or trait self-objectification moderating the body image manipulation and state negative affect serving as a mediator. Results indicated that trying on a bathing suit, which increased body dissatisfaction, did increase reported urges to smoke, particularly those urges related to reducing negative affect. Women assigned to the bathing suit condition also subsequently took a greater number of puffs from their cigarette than those who evaluated the purse. (No main effects were found for the smoking cue manipulation). No moderation effects were found, but the effect on smoking urges by the body image manipulation was mediated by state negative affect. This study provides additional support, through an experimental design, that situational challenges to body image influence smoking motivation, and that this effect occurs, at least in part, via increases in negative affect. Theoretical and applied implications are discussed.

Obesity is a growing problem in the United States. Research into the causes, treatment, and prevention of obesity is vital. One past study examined four eating behaviors in relation to obesity: eating beyond satiety, snacking, night eating, and feeling hungry within three hours of eating. Only eating beyond satiety was associated with obesity. The present study examined these same eating behaviors while correcting some of the flaws of the previous study. Using a cross-sectional design, university undergraduates reported on the frequency of the above-named eating behaviors. Current weight and height were collected. Multiple regression analyses determined that eating beyond satiety and hunger predicted body mass index (BMI). Race/ethnicity moderated the relationship between hunger and BMI. These findings have important implications for obesity treatment as well as suggesting important avenues for future research.

Smoking is now the leading cause of preventable death and disease in women. Understanding women's motivations to smoke is important in developing effective cessation and relapse prevention programs. Women, more so than men, appear to associate their smoking behavior to issues of weight. Although a general relationship between weight concerns and smoking has been found among women, a causal relationship had not been demonstrated. This study tested whether activation of negative body image cognitions would produce greater urges to smoke and whether the relationship would be moderated by trait body dissatisfaction and mediated by state body dissatisfaction. A randomized 2 X 2 crossed factorial, within-subjects design (body image cues X smoking cues) was conducted with 62 female college smokers. The body image manipulation comprised an image of either a thin model or a neutral object, and the smoking manipulation comprised an image of either a smoking cue or a neutral object. Participants completed pre-intervention measures assessing smoking history and body image dissatisfaction. Urge to smoke, mood state, and weight and appearance satisfaction were assessed during the experiment. It was hypothesized that main effects on reported urge to smoke would be found for both manipulations, with body dissatisfaction moderating the body image manipulation. Results indicated that both smoking cues and thin model images increased reported urges to smoke. Additionally, in the absence of smoking cues, the effect of the body image manipulation was moderated by baseline body dissatisfaction, with those women with greater body dissatisfaction reacting more strongly to the thin model image. The effect on smoking urges by the body image manipulation was partially mediated by both state measures of affect and body satisfaction. Thus,this study is the first to demonstrate through an experimental design that the presentation of images portraying thin women increased smoking urge, which is consistent with a causal influence of body image affecting their smoking motivation.

Expectancy theory provides a useful framework within which to examine the link between cognitive representations of anticipated alcohol related outcomes and affective processes that ought to shape behavior at the level of implicit, or automatic, processing. The role of affect in alcohol expectancies is an important one as it reflects the approach-avoid contingency associated with reward learning presumed to underlie addictive processes. This study examined the relationship between affect and expectancy operation by using suboptimally presented alcohol related cues to prime affectively congruent evaluations of otherwise unrelated targets. Hypotheses predicted that drinkers who reported higher positive and arousing expectancies for alcohol outcomes would make affective evaluations (but not semantic categorizations) more accurately when target stimuli were preceded with an alcohol picture or word prime. Analysis of drinking and expectancy variables revealed positive relationships between drinking frequency and social/physical pleasure expectancies, as well as tension reduction expectancies. No relationships were found between drinking quantity and expectancies. Evaluation response accuracy was not related to alcohol expectancies. Discussion centers on potential reasons for lack of findings, including experimenter error and design limitations.

Tobacco smoking has been associated with the development, protraction, and exacerbation of chronically painful conditions. Conversely, there is reason to believe that smokers may be motivated to use tobacco as a means of coping with their pain. To date, no controlled, experimental studies have tested for a causal relationship between pain and smoking motivation. The primary aim of the current study was to test the hypothesis that laboratory-induced cold-pressor pain would enhance smoking motivation, as measured by self-reported urge to smoke and observation of immediate smoking behavior. The effect of a smoking cue was also tested. Smokers (n = 132) were randomly assigned to one of four conditions in this 2 (Pain Manipulation) X 2 (Smoking Cue Manipulation) crossed factorial between-subjects design. Results indicated that both pain induction and the presence of smoking cues increased urge ratings, and pain induction also produced a shorter latency to smoke. The relationship between pain and increased urge to smoke was partially mediated by pain-induced negative affect. This study provides the first experimental evidence that situational pain can be a potent motivator of smoking.