Effects of Smoking Cues on Tobacco Craving Responses and the Reinforcing Efficacy of Cigarettes in Smokers With and Without Schizophrenia

In this study, we will compare cue-reactivity in smokers with and without schizophrenia and
the influence of smoking cues on responding for cigarette puffs under a PR schedule of
reinforcement. Given the high prevalence of smoking among individuals with schizophrenia,
understanding some of the environmental factors that serve to maintain nicotine dependence
is a critical step in improving smoking cessation treatment outcomes. Establishing and
validating a laboratory model of cue-elicited responsivity and cigarette self-
administration will allow the investigation of the efficacy of anti-craving medications in
people with schizophrenia.

Specific Aims 1) To compare the effects of smoking versus neutral cues on craving, mood, and
autonomic responsivity in smokers with schizophrenia and smokers without schizophrenia. 2)
To compare the effects of smoking versus neutral cues on the reinforcing efficacy of tobacco
cigarettes in smokers with schizophrenia and smokers without schizophrenia.

Outcome Measures During cue trials, primary measures include craving (TCQ-SF, VAS), mood
(mood form, VAS), and autonomic (heart rate, blood pressure, skin conductance and
temperature) responsivity. During self-administration trials, primary measures include
breakpoint (final ratio completed), total number of responses, and number of cigarette puffs
earned and taken. Secondary measures include baseline smoking history, mood form, TCQ-SF,
CO, FTND, and urinary cotinine and 3-hydroxycotinine (3-HC).

The ratio of 3-HC/cotinine is a phenotypic biomarker of the rate of nicotine metabolism,
which has been shown to be associated with level of nicotine dependence, various smoking
behaviors, and treatment outcome (Ho & Tyndale, 2007). We will correlate the primary
measures with the 3-HC/cotinine ratio to explore possible relationships for future study.