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Implicit attitudes towards smoking predict long-term relapse in abstinent smokers

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Abstract

Rationale

It has previously been argued that implicit attitudes toward substance-related cues drive addictive behavior. Nevertheless, it remains an open question whether behavioral markers of implicit attitude activation can be used to predict long-term relapse.

Objectives

The main objective of this study was to examine the relationship between implicit attitudes toward smoking-related cues and long-term relapse in abstaining smokers.

Methods

Implicit attitudes toward smoking-related cues were assessed by means of the Implicit Association Test (IAT) and the evaluative priming task (EPT). Both measures were completed by a group of smokers who volunteered to quit smoking (patient group) and a group of nonsmokers (control group). Participants in the patient group completed these measures twice: once prior to smoking cessation and once after smoking cessation. Relapse was assessed by means of short telephone survey, 6 months after completion of the second test session.

Results

EPT scores obtained prior to smoking cessation were related to long-term relapse and correlated with self-reported nicotine dependence as well as daily cigarette consumption. In contrast, none of the behavioral outcome measures were found to correlate with the IAT scores.

Conclusions

These findings corroborate the idea that implicit attitudes toward substance-related cues are critically involved in long-term relapse. A potential explanation for the divergent findings obtained with the IAT and EPT is provided.

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Notes

  1. The Welch-Satterthwaite approximation method was used to compensate for the violation of the equality-of-variances assumption.

  2. For the IAT, Cronbach α’s were computed on the basis of five different IAT scores. In line with earlier work by Teige-Mocigemba et al. (2008), each test block was divided into five sequential subblocks, and an IAT score was computed for each pair of subblocks. Cronbach α’s for the EPT were also computed on the basis of five different EPT scores, one for each smoke-related prime stimulus. Each of these EPT scores was computed as described in the “Data reduction” section, with the exception that we only included smoke-related trials on which a specific smoke-related stimulus was presented.

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Acknowledgments

Preparation of this paper was supported by Grant BOF/GOA2006/001 and Methusalem Grant BOF09/01M00209 of Ghent University. Bram Van Bockstaele is funded by a FMG-UvA Research Priority Grant on Affect Regulation. Adriaan Spruyt is Postdoctoral Fellow of the Flemish Research Foundation (FWO-Vlaanderen). The authors would like to thank Diederik Derijcke, Lene Rutten, and Jeffrey De Winne for their help in collecting the data.

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Correspondence to Adriaan Spruyt.

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Spruyt, A., Lemaigre, V., Salhi, B. et al. Implicit attitudes towards smoking predict long-term relapse in abstinent smokers. Psychopharmacology 232, 2551–2561 (2015). https://doi.org/10.1007/s00213-015-3893-2

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  • DOI: https://doi.org/10.1007/s00213-015-3893-2

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