Out of Sight Out of Mind: Do Electrophysiological Markers Elicited by Nicotine Related Visual Cues Predict Relapse in a Sample of Adult Smokers? A Longitudinal Study

Nicotine dependence is a global health problem that continues to adversely affect millions of people. In order to better understand the effects of cigarette cue-reactivity, event-related potentials (ERP) were recorded while smoking-related and neutral pictures and words were presented to abstinent smokers (who were later classified as been successful abstainers or relapsers after 1 month) and never smokers (Studies 1 and 2 respectively). To assess the effects of top-down regulation in mitigating smoking cue reactivity, Study 1 also included “Suppress” and “Express” instructions that required participants to either regulate any experienced affect or react without restraint. Study 3 utilized discriminant function analyses to explore the predictive value of data acquired in Studies 1 and 2. For Study 1, greater craving was experienced after exposure to smoking-related pictures for both groups of smokers. An early frontal EAP response was also observed in both groups of abstinent smokers after cigarette cue exposure in the “Express” condition, but this cue-related response was not observed in the successful abstainer group during the “Suppress” condition. A later posterior LPP response was larger after smoking cue exposure in the “Express” and “Suppress” conditions for successful abstainers and relapsers respectively. For Study 2, reaction times to smoking-related words were significantly slower for abstinent smokers, and a significant P2a difference was seen over the anterior scalp when all abstinent smokers were compared to never smokers and when relapsers were compared to never smokers. Lastly, Study 3 found that data from Study 1 was particularly useful for predicting which of the smokers would relapse within a 1 month period, as a model that combined ERP and questionnaire data identified relapsers and successful abstainers with 86.5% accuracy. These findings have the potential to inform researchers, therapists, and cigarette smokers about the effects of cigarette cue-exposure, and may also help facilitate successful abstinence.