The relevance and treatment of cue-induced cravings in tobacco dependence

J Subst Abuse Treat. 2009 Apr;36(3):235-43. doi: 10.1016/j.jsat.2008.06.005. Epub 2008 Aug 20.

Abstract

Craving to smoke is often conceptualized and measured as a tonic, slowly changing state induced by abstinence. In this article, we review the literature on the existence, causes, and treatment of cue-induced cravings: intense, episodic cravings typically provoked by situational cues associated with drug use. In laboratory research, smokers exposed to smoking-related cues demonstrate increased craving as well as distinct patterns of brain activation. Observational field studies indicate that such cue-induced cravings are substantially responsible for relapse to smoking but that smoking can often be averted by coping responses. The effects of pharmacological interventions are mixed. Steady-state medications (bupropion, varenicline, nicotine patch) do not appear to protect smokers from cue-induced cravings. However, acutely administered nicotine medications (such as nicotine gum and lozenge), used after cue exposure as "rescue medications," can help a smoker's recovery from cue-induced cravings. Cue-induced craving plays an important role in smoking and relapse and likely in other addictions as well. Treatments to mitigate the effect of cue-induced craving are both important and needed.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adaptation, Psychological / physiology
  • Antidepressive Agents, Second-Generation / therapeutic use
  • Benzazepines / therapeutic use
  • Bupropion / therapeutic use
  • Cognitive Behavioral Therapy
  • Cues*
  • Extinction, Psychological
  • Humans
  • Nicotine / administration & dosage
  • Nicotine / therapeutic use
  • Nicotinic Agonists / administration & dosage
  • Nicotinic Agonists / therapeutic use
  • Quinoxalines / therapeutic use
  • Smoking Cessation*
  • Tobacco Use Disorder / psychology*
  • Varenicline

Substances

  • Antidepressive Agents, Second-Generation
  • Benzazepines
  • Nicotinic Agonists
  • Quinoxalines
  • Bupropion
  • Nicotine
  • Varenicline