References

1. Tobacco cue-reactivity may be more related to dependence in adolescent than in adult smokers Adults Adolescents 10 10 8 8 6 S (mean ± SD) 6 4 S (mean ± SD) 4 2 2 0 Baseline 0-30 sec 90-120 sec 0 Baseline 0-30 sec 90-120 sec Presented at theAnnual Meeting of the EAAT London, 6th-8th July 2006 *** ** ** ns • Both adolescents and adults showed an early response to smoking related cues • While in adolescents a habituation could be observed within the 2 minutes exposition period, this was not the case in adults Adults Adolescents Early response Early response Late response Late response Within-subjects contrast [baseline - first 30 sec of exposition] Within-subjects contrast [baseline - first 30 sec of exposition] Within-subjects contrast [first - last 30 sec exposition] Within-subjects contrast [first - last 30 sec exposition] Factor Factor F F p p F F p p Sex Sex 0.478 0.040 0.845 0.496 0.105 0.027 0.749 0.873 Fagerstrom score Fagerstrom score 0.663 0.295 0.424 0.599 7.991 0.148 0.018 0.704 Cigarettes smoked today Cigarettes smoked today 0.016 1.094 0.307 0.901 10.882 0.261 0.615 0.008 Time since last cigarette Time since last cigarette 2.977 0.416 0.098 0.534 8.506 0.042 0.015 0.839 • Lack of habituation was dependent in adolescents but not in adults from Fagerstrom score, number of cigarettes smoked prior to the experiment and time elapsed since last cigarette smoked Smoking related images Neutral images Enrico Cancela1, Djamel Benguettat1, Riaz Khan1, Sonia Krenz2, Fabian Clays2, Yves Montagrin2, Farfalle Ribordy2, Sophie Taparel2, Emmanuelle Frésard2, Yasser Khazaal2,Daniele Fabio Zullino1 1Division of substance abuse, University Hospitals of Geneva, Switzerland 2Clinical Research Unit, University Department for Adult Psychiatry, Lausanne, Switzerland Introduction A promising approach for understanding the irrationality in addictive behavior is the view that automatic processes are important in maintaining the addictive pattern. Drug-related stimuli, even in the absence of the drug, independently may elicit cravings or urges to use (conditioned response), and in real live situations are likely associated with relapse to drug use. Besides being measurable through behavior and self-report in humans, stimulus-response associations can also be seen by means of physiological changes. This may be especially interesting in the light of the automatic characteristics of addictive behavior. Skin conductance activity is a sensitive measure of autonomic nervous system activity that correlates well with other physiologic measures and the subject arousal associated with drug craving. This is due to ability of skin conductance to abruptly rise and fall in response to stimuli (within two seconds delayed peaking in five seconds after presentation of stimulus) and to delayed habituation of skin conductance response to arousal. While skin conductance reactivity to substance-related visual stimuli has previously been tested in cocaine abusers 1-4, studies on tobacco smokers have focused until now only on cardiovascular reactivity 5-9. The objective of the present study was to measure the skin conductance reactivity in smokers exposed to smoking related pictures. Results • Methods • All 42 volunteers (smoking at least 10 cigarettes/day) (15 adolescents [age 15-17], 27 adults [age18-65]) were recruited during a 7-day scientific exposition for the general public. • Three-minute laboratory session. Participants were first submitted to a 60-second presentation of “neutral” pictures (landscapes), which was followed by a 120-sec presentation of smoking related slides. • Skin conductance data was collected via a ProComp+/Biograph system (Thought Technology). • Repeated measures GLM were computed for adolescents and adults. Early response (last 30 sec of the neutral phase vs first 30 sec of the tobacco phase) and late response (last 30 sec vs first 30 sec of tobacco phase) were defined through contrast calculations. A late response can be considered as a lack of habituation. • Conclusions • While adolescent smokers seem rapidly to habituate within 2 minutes during smoking cues exposition, this is no more the case in adult smokers • Lack of habituation is dependent in adolescent (but not in adult) smokers from nicotine dependence • One can therefore formulate the hypothesis that with aging the importance of automated stimulus-response associations becomes increasingly more important compared to dendence(≈withdrawal)-associated cue reactivity • The following therapeutic inferences can be put forward: • Treatment of dependence symptoms (withdrawal) in adolescents can have an impact on their capacity to control smoking related cues, leading to better habituation • In adults, in whom the cue reactivity seems to have a more ballistic quality, the treatment of dependence symptoms may not be sufficient to control smoking related cue reactivity, treatment should rather focus on conditioned response References Ehrman RN, Robbins SJ, Childress AR, O'Brien CP. 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Psychosocial stress and coping in smokers who relapse or quit. Health Psychol 1987;6(4):289 - 303. Abrams DB, Monti PM, Carey KB, Pinto RP, Jacobus SI. Reactivity to smoking cues and relapse: two studies of discriminant validity. BehavResTher 1988;26(3):225 - 33. McDermut W, Haaga DAF. Effect of Stage of Change on Cue Reactivity in Continuing Smokers. Experimental & Clinical Psychopharmacology 1998;6(3):316 - 24. Service d’abus de substances - Département de Psychiatrie