Modulation of craving by cues having differential overlap with pharmacological effect: evidence for cue approach in smokers and social drinkers

Rationale: An increased risk of drug intake produced by drug cues may refle ct the fact that the cues are withdrawal-like or aversive, reflecting a con ditioned adaptation to the drug's acute effects. More recent work suggests that they may also be appetitive, signalling the goal characteristics of dr ug taking. Objective: These opposing mechanisms were tested in dependent sm okers and in social drinkers by examining the motivational nature of drug c ues that overlap differentially with the acute effects of the drug. Methods : Pictures of different phases of smoking or alcohol drinking were presente d to deprived and non-deprived smokers, to never smokers and non-deprived s mokers or to social drinkers. Desire for cigarettes or alcohol and momentar y pleasure and arousal were measured after viewing an experimental picture or a pleasant, neutral or unpleasant control scene. Results: High desire fo r smoking was evoked by pictures of preparation for and actual smoking but not by scenes of the end of smoking, although the latter were best correlat ed with acute drug effect. This pattern was not affected by overnight smoke deprivation, it was seen in different smokers but not in never-smokers and it was replicated in social drinkers using pictures of alcohol consumption . Moreover, scenes evoking high desire to consume did not evoke states of m omentary unpleasantness and they were seen as relaxing and not arousing. Co ntrol pictures had a minimal effect on desire to consume. Conclusions: In l ine with incentive models of drug cues, cues based on pictures of drug inta ke may be conditioned stimuli encoding cue approach and preparation for con sumption.