Exposure to Attachment Figure Cue Reduces Cigarette Craving

• Published in: Experimental and clinical psychopharmacology 2020-02, Vol.28 (1), p.81-86
• Main Authors: Le, Thao Lan, Conklin, Cynthia A, George, Tony P, Levitan, Robert D, Mann, Robert E, Maunder, Robert G
• Format: Article
• Language: English
• Subjects: Adult; Attachment Theory; Cigarette Smoking - psychology; Craving; Cues; Emotional Regulation; Female; Human; Humans; Male; Middle Aged; Object Attachment; Smokers; Test Construction; Tobacco Products; Tobacco Smoking; Tobacco Use Disorder - psychology; Young Adult
• ISSN: 1064-1297; 1936-2293
• DOI: 10.1037/pha0000284

Cue-induced craving among smokers is a well-documented phenomenon. Conditioning theory is used to explain how stimuli elicit cravings. Attachment theory may explain additional influences on cue-induced craving. This study tested the effects of cigarette cues and attachment figure cues on craving and affect. Cue-reactivity as a function of cue type was examined to explore the magnitude of craving effect sizes for each cue type. Thirty-six smokers (27 men) were exposed to cigarette cues (i.e., cigarette) and attachment figure cues (i.e., digital photos of people identified as attachment figures). Neutral to cue exposure differences in craving and affect were assessed. Sixty-one percent of participants reported increased craving to the cigarette cue (M = 61.1, SD = 29.4) compared to the neutral cue (M = 46.6, SD = 28.8), Mdiff = 20.7 (10.60, 30.73), Yt (23) = 4.24, p = .0003. When exposed to an attachment figure photo, 56% participants reported decreased craving (M = 38.2, SD = 31.6) compared to the neutral photo (M = 50.9, SD = 29.8), Mdiff = −15.73 (−30.83, −0.63), Yt (21) = −2.17, p = .042. There was a significant difference in the craving for cigarette cues (M = 14.5, SD = 22.8 (CI: 6.94, 22.39)), and attachment figure photos (M = −12.7, SD = 28.6 (CI: −22.38, −3.01); t(35) = 4.3, p < .001). The effect sizes for cigarette cues and attachment figure photos were d = .50, d = .42, respectively. Participants' responses to attachment cues were not influenced by their reactivity to cigarette cues or their attachment figure's smoking status. Findings support a plausible model in which an attachment figure photo decreases craving via affect regulation. Further research on cues that have an inhibitory effect on craving may inform new cessation strategies. Public Health Significance This study suggests that a novel cue, a photograph of an attachment figure (typically a romantic partner) may decrease craving in smokers. This work extends cue reactivity research on the influence of people as cues, to show the specific impact of attachment figures on craving to smoke. These findings provide new insight to understanding craving and identify potential novel and personalized treatment approaches to reduce smoking.