Using your required reading, review the article “Olfactory Cue Reactivity in Nicotine-Dependent Adult Smokers.” Please see the article that is attached.
Your article review should include the following:
··introduction of the topic,
··author’s main point,
··comparison of the effects of olfactory and gustatory perception as it relates to this article, and
··personal analysis.
You should not directly quote the article. Instead, paraphrase the article. Tip: When paraphrasing, read a paragraph a few times, then cover the article so you cannot see it; then, write down what you remember in your own words.
Your response must be a minimum length of two double-spaced pages. All sources used, must be referenced; paraphrased and quoted material must have accompanying citations and be cited per APA guidelines.
BRIEF REPORT Olfactory Cue Reactivity in Nicotine-Dependent Adult Smokers Bernadette M. Cortese and Thomas W. Uhde Medical University of South Carolina Steven D. LaRowe Medical University of South Carolina and Ralph H. Johnson VAMC, Charleston, South Carolina Sarah V. Stein and W. Connor Freeman Medical University of South Carolina F. Joseph McClernon Duke University Medical Center Kathleen T. Brady and Karen J. Hartwell Medical University of South Carolina and Ralph H. Johnson VAMC, Charleston, South Carolina Cue-elicited reactivity is a significant factor in relapse during smoking quit attempts. Previous research has focused primarily on visual smoking cues, with very limited research examining reactivity to olfactory triggers. Twenty-six adult non-treatment-seeking, nicotine-dependent smokers were exposed to 7 odorants during a cue-reactivity session measuring heart rate, skin conductance, and subjective craving. Cues included 2 cigarette odors (fresh tobacco and cigarette smoke), 2 odors previously identified as smoking-related (freshly mowed grass and coffee), 2 odors previously identified as unrelated to smoking (lavender and burned rubber), and 1 odorless control (propylene glycol). Pairwise comparisons demon- strated that subjective intensity of craving was significantly higher following exposure to the fresh tobacco odor compared with the odorless control (p � .01). A significant main effect for cue type on a physiological measure of arousal was also revealed, with a fresh tobacco odor-elicited significant increase in skin conductance level compared with the odorless control. However, no main effect of cue type on heart rate was found (p � .25). The results of the present study indicate that cigarette odor is an effective olfactory cue that heightens both subjective craving and increases skin conductance in smokers. Future research is needed to evaluate whether avoidance of these odors, or extinction of responses to them, can reduce relapse risk during smoking quit attempts. Keywords: smoking, odor cues, craving, tobacco dependence, cue reactivity Cue reactivity—the array of psychological, physiological, and behavioral effects elicited by drug-related stimuli— is a well- established paradigm for investigating craving that generally de- scribes a greater response to drug-related, compared with neutral, cues in drug-dependent individuals (Carter & Tiffany, 1999; Drobes & Tiffany, 1997). Although visual cues (e.g., a picture of a lit cigarette) have been utilized most often in smoking cue- reactivity studies, a range of cues, across multiple modalities, have been shown to elicit conditioned reactions including handling a cigarette, the sound and feel of the flick of the lighter, being in close proximity to a person smoking, as well as script-guided imagery (Carter & Tiffany, 1999; Erblich & Bovbjerg, 2004; McRobbie, Hajek, & Locker, 2008). Contextual cues related to where people smoke, as well as behaviors that may coincide with smoking (e.g., drinking coffee/alcohol, driving a car), may also be effective conditioned stimuli (Conklin, Perkins, Robin, McCler- non, & Salkeld, 2010; Paris et al., 2011; Van Gucht, Van den Bergh, Beckers, & Vansteenwegen, 2010). Odors are among the most salient conditioning cues in the laboratory and natural environment (Gagliardo, 2013; Paschall & This article was published Online First September 1, 2014. Bernadette M. Cortese and Thomas W. Uhde, Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina; Steven D. LaRowe, Department of Psychiatry & Behavioral Sciences, Medical Uni- versity of South Carolina, and Ralph H. Johnson VAMC, Charleston, South Carolina; Sarah V. Stein and W. Connor Freeman, Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina; F. Joseph McClernon, Department of Psychiatry & Behavioral Sciences, Duke University Medical Center; Kathleen T. Brady and Karen J. Hartwell, Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, and Ralph H. Johnson VAMC. This research was supported by the Medical University of South Caro- lina’s South Carolina Clinical and Translational Research Institute (SCTR) Grant UL1 RR029882 (Karen J. Hartwell) and by NIMH Grant K01MH090548 (Bernadette M. Cortese). We thank Max Owens and Todd LeMatty for their assistance during data acquisition and the preparation of this article. We also thank ScentAir Corporation, Charlotte, NC for pro- viding the odorants. Correspondence concerning this article should be addressed to Berna- dette M. Cortese, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, MSC 861, Charleston, SC 29425. E-mail:
[email protected] T hi s do cu m en t is co py ri gh te d by th e A m er ic an Ps yc ho lo gi ca l A ss oc ia tio n or on e of its al lie d pu bl is he rs . T hi s ar tic le is in te nd ed so le ly fo r th e pe rs on al us e of th e in di vi du al us er an d is no t to be di ss em in at ed br oa dl y. Psychology of Addictive Behaviors © 2014 American Psychological Association 2015, Vol. 29, No. 1, 91–96 0893-164X/15/$12.00 http://dx.doi.org/10.1037/adb0000018 91 mailto:
[email protected] http://dx.doi.org/10.1037/adb0000018 Davis, 2002), possessing the ability to overshadow cues presented to other sensory modalities (Taukulis & St. George, 1982). It is therefore quite surprising that very few investigations have spe- cifically focused on the role of odors in drug cue reactivity. However, a small, but consistent, literature has emerged from the alcohol field revealing that odor cues readily elicit craving and the associated physiological responses (Bordnick et al., 2008; Kareken et al., 2004), including increases in urge to consume alcohol, heart rate (HR), and skin conductance level (SCL) in alcohol-dependent, but not nonproblem, drinkers (Kaplan et al., 1985; Rubonis et al., 1994; Stormark, Laberg, Bjerland, Nordby, & Hugdahl, 1995). Although numerous in vivo smoking cue-reactivity studies (Car- penter et al., 2014; LaRowe, Saladin, Carpenter, & Upadhyaya 2007; Niaura et al., 1998) have utilized smoking odors as a component of their multisensory drug cues, none have been able to isolate the sole impact of the odor component in their analyses. In fact, only two studies have attempted to specifically test whether cigarette odors are a relevant factor in smoking cue reactivity, and both of those studies utilized just one odor—that of cigarette smoke (Grüsser, Heinz, & Flor, 2000; Ordonana, Gonzalez-Javier, & Gomez-Amor, 2012). There were additional limitations as well, including not providing a pure unisensory odor cue (Ordonana et al., 2012) and reporting subjective craving alone, with no objective measure of cue reactivity (Grüsser et al., 2000). Given that the role of odor cues in addiction, and in nicotine dependence in particular, is relatively less explored and understood compared with the impact of other cues (visual, multisensory “in vivo”), both subjec- tive and objective measures of craving are warranted. Targeting the olfactory system with the use of odor cues may contribute more real-world factors during studies of drug cue reactivity, and our methods could help to identify individual smok- ers who react to the smell of cigarettes, as well as other odors that have been conditioned to their smoking behavior. Ultimately, this line of investigation may help to develop specific strategies to address during a smoking quit attempt. Therefore, the present study utilized cigarette odors, as well as smoking-related and neutral odors previously identified by our laboratory (Hartwell et al., 2012), to evaluate odor cue reactivity in nicotine-dependent adult smokers. Based upon previous findings in both nicotine and alcohol dependence (Grüsser et al., 2000; Kaplan et al., 1985; Ordonana et al., 2012; Rubonis et al., 1994; Stormark et al., 1995), we hypothesized that cigarette and smoking-related, but not neu- tral, odor cues would elicit increases in SCL, HR, and subjective craving to smoke. Method Participants Adult smokers (n � 26) between the ages of 18 and 59 years were recruited through local advertisement. Study eligibility re- quired potential participants to (a) smoke at least 10 cigarettes per day (menthol were included but other tobacco products were excluded); (b) be non-treatment-seeking or not in active smoking cessation treatment; (c) report no current or lifetime substance dependence, or past 30-day abuse, of drugs other than caffeine and nicotine; (d) be daily coffee drinkers who reported commonly smoking cigarettes while drinking their morning coffee (i.e., as- sociated coffee and cigarettes); (e) have no current or past history of significant psychiatric illness; and (f) have no major medical problems, including no known problems with sense of smell. A confidential phone screen provided initial eligibility. Once insti- tutional review board-approved informed consent was obtained, study eligibility was confirmed with (a) a detailed tobacco history, the Fagerström Test for Nicotine Dependence (FTND; Fagerström, 1978; Heatherton, Kozlowski, Frecker, & Fagerström, 1991), and a breath carbon monoxide (CO) level �10 ppm (Bedfont Scientific Ltd., Kent, England); (b) urine drug (Wan Han Pu Man Inc., Irwindale, CA) and breath alcohol (Intoximeters, Inc., St. Louis, MO) screens; (c) a Mini International Neuropsychiatric Interview (Sheehan et al., 1998); and (d) a medical examination and the University of Pennsylvania Smell Identification Test (UPSIT; Doty, Shaman, Kimmelman, & Dann, 1984), a self-administered, 40-item scratch-and-sniff test used to confirm normosmia, a nor- mal sense of smell. Those that met all study criteria were sched- uled for the laboratory study and instructed to remain abstinent from cigarettes for 12 hr before that scheduled time. Laboratory Olfactory Cue Reactivity Paradigm Odor cues. A total of seven odor cues, including two cigarette odors, two smoking-related odors, two odors unrelated to smoking, and one odorless control, were utilized in the cue-reactivity ses- sion. The odor cues were previously identified through a series of focus groups conducted prior to the start of the present study (Hartwell et al., 2012). Fresh tobacco (TOB) and cigarette smoke (CIG) served as the cigarette odors, and two odors identified as commonly associated with smoking—freshly mowed grass (GR) and coffee (COF)—served as the “smoking-related” cues. The two “unrelated” odors, identified as odors not related to smoking, included lavender (LAV), a pleasant odor, and burned rubber (BR), a relatively unpleasant odor. Propylene glycol (PG) was utilized as the odorless control, as well as the base oil for preparing other odor cues. Nature slideshows. All slideshows consisted of high- resolution, colored nature scenes, each presented at 5-s intervals. A 10-min slideshow was presented during the initial habituation period, and six 3-min slideshows were presented between odor cues to reduce carryover effects from the previous cue. Craving measures. Subjective reports for craving were as- sessed on 11-point analog scales measuring three aspects of crav- ing: Analog Scale #1 measured craving amount (0