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Investigating Attentional Bias to Smoking-Related Cues Among Individuals Who Use E-Cigarettes

Taylor Palechuk1,2, Noreen Rahmani1,2, Laurie Zawertailo1,2

1Department of Pharmacology & Toxicology, University of Toronto, Toronto, Canada;

2Centre for Addiction and Mental Health, Toronto, Canada

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Dr. Zawertailo and the Zawertailo lab members: Dr. Sophia Attwells, Helena Zhang, Noreen Rahmani, Kanwar Boparai, and Marium Ali

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Results

Acknowledgements

Conclusions

References

Results (Cont’d)

Aim

Methods

1. To characterize attentional bias to smoking-related cues in e-cigarette users

2. To explore to what effect switching to an e-cigarette from cigarette smoking has on attentional bias to smoking-related cues

Background

[1] Statistics Canada. Canadian Nicotine and Tobacco Survey, 2020, https://www.canada.ca/en/health-canada/services/canadian-tobacco-nicotine-survey/2020-summary.html.

[2] Franken IH. Drug craving and addiction: integrating psychological and neuropsychopharmacological approaches. Prog Neuropsychopharmacol Biol Psychiatry. 2003 Jun;27(4):563-79. doi: 10.1016/S0278-5846(03)00081-2. PMID: 12787841.

[3] Field M, Cox WM. Attentional bias in addictive behaviors: a review of its development, causes, and consequences. Drug Alcohol Depend. 2008;97(1-2):1-20.

[4] Masiero M, Lucchiari C, Maisonneuve P, Pravettoni G, Veronesi G, Mazzocco K. The Attentional Bias in Current and Former Smokers. Front Behav Neurosci. 2019 Jul 10;13:154. doi: 10.3389/fnbeh.2019.00154. PMID: 31354446; PMCID: PMC6637300.

  • 1.5 million Canadians report past-30 day vaping and 70% identify as past or current smokers1
  • Nicotine acts on the brain reward system triggering dopamine release causing associative learning to smoking cues through incentive salience making cues more attractive than other stimuli and demanding attention2
  • Craving and urges to smoke can be triggered by cues3
  • Attentional bias (AB) is the propensity to allocate attention automatically and is a proxy measure for incentive salience4
  • The purpose of this study is to assess AB to smoking cues in former smokers have switched completely or partially to e-cigarettes
  • We hypothesize smokers who have fully switched to e-cigarettes have less AB to smoking cues than those who partially switched

Table 1. Baseline Characteristics. Values reported as n (%) or mean (SD).

  • E-cigarette use reduces AB to smoking cues in former smokers
  • Full switchers have less AB to smoking cues than dual users (p=0.09)
  • Pre-assessment craving is significantly moderately associated with AB to smoking cues (p<0.01)
  • E-cigarette use may interfere with incentive salience processing of smoking cues which may reduce craving, motivation to smoke and decrease risk of relapse
  • Participants (n=34): former regular smokers who have switched completely (“full switchers” n=19) or partially (“dual users” n=15) to vaping
  • Tasks: self-report questionnaires, passive viewing eye-tracking of multiple competing smoking, social, or neutral cues
  • Measures: mean relative fixation time (mRFT) to smoking and neutral cues

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Full Switchers

Dual Users

Total

19 (55.9%)

15 (44.1%)

34 (100.0%)

Age

28.4 (7.1)

32.9 (13.9)

30.4 (10.9)

Gender

Male

12 (63.2%)

10 (66.7%)

22 (64.8%)

Female

6 (31.5%)

5 (33.3%)

11 (32.3%)

Other

1 (5.3%)

0 (0.0%)

1 (2.9%)

Mean Cigarettes Per Day (mCPD)

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1.74 (2.4)

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Questionnaire of Smoking Urges (QSU) (n=27)

22.4 (12.0)

30.9 (15.7)

26.4 (14.8)

a) Example of eye-tracking set-up

b) Example of test cues

Figure 2. Relationship of Dual User’s Average Cigarettes Per Day and Attentional Bias to Smoking-Related Cues

Pearson’s R=0.11, p=0.69. CPD: mean=1.74 (2.4), min=0.07, max=10.0

mCPD = (days smoked per month)x(cigarettes smoked per day)/30

Figure 3. Relationship of Pre-Eye-Tracking Self-Report Craving Scores and Attentional Bias to Smoking-Related Cues

Pearson correlation coefficient R=0.52, p<0.01 indicating significantly moderate positive correlation of pre-eye-tracking smoking craving and mRFT to smoking cues

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Figure 1. Attentional Bias to Smoking-Related Cues in Healthy Controls, E-Cigarette Users (Full Switchers, Dual Users), and Smokers

(HC = Healthy Controls, FS = Full Switchers, DU = Dual Users, SM = Smokers)

* p<0.05 using two-tailed independent t-tests. Other comparisons not statistically significant

*