Cue-Reactivity to Tobacco and E-Cigarette Pictorial Stimuli in Single and Dual E-Cigarette Users
Poster No:
1054
Submission Type:
Abstract Submission
Authors:
Nadja Grundinger1, Marike Andreas2, Valerie Lohner3, Ute Mons4, Sven Schneider2, Sabine Vollstädt-Klein1
Institutions:
1Central Institute of Mental Health, Mannheim, Baden-Wuerttemberg, 2Division of Public Health, Social and Preventive Medicine, Center for Preventive Medicine and Digita, Mannheim, Baden-Wuerttemberg, 3University of Cologne, Cologne, Germany, 4German Cancer Research Center, Heidelberg, Germany, Heidelberg, Baden-Wuerttemberg
First Author:
Co-Author(s):
Marike Andreas
Division of Public Health, Social and Preventive Medicine, Center for Preventive Medicine and Digita
Mannheim, Baden-Wuerttemberg
Division of Public Health, Social and Preventive Medicine, Center for Preventive Medicine and Digita
Mannheim, Baden-Wuerttemberg
Sven Schneider
Division of Public Health, Social and Preventive Medicine, Center for Preventive Medicine and Digita
Mannheim, Baden-Wuerttemberg
Division of Public Health, Social and Preventive Medicine, Center for Preventive Medicine and Digita
Mannheim, Baden-Wuerttemberg
Introduction:
Tobacco use disorder remains chronic for many individuals, with a heightened sensitivity to conditioned cues posing a risk of relapse even after prolonged abstinence (Courtney et al., 2016). As e-cigarettes have become a popular smoking cessation aid but are also discussed as a gateway addictive product for adolescents, understanding the mechanisms of cue-processing related to tobacco and e-cigarettes is crucial for developing effective strategies for primary prevention and relapse prevention.
Methods:
We studied 44 daily adult e-cigarette users: 30 single users, who used only e-cigarettes (M=35.4 ± 14.6 yrs, 24 men, 26 former tobacco smokers) and 14 dual users, who additionally consumed tobacco cigarettes (M=29.9 ± 8.0 yrs, 10 men), as well as 28 nicotine-naïve persons as a control group (M=28.0 ± 7.6 yrs, 10 men) (registration at Clinicaltrials.gov/ct2/show/NCT04772014, study protocol: Vollstädt-Klein et al., 2021). Using a cue-reactivity paradigm with pictorial stimuli (adapted from Vollstädt-Klein et al., 2011) and functional magnetic resonance imaging (fMRI) (3 Tesla whole-body-tomograph, 32-channel head coil, T2*-weighted echo-planar images, TR = 869ms, flip angle = 58°, number of slices = 60, slice thickness = 2.4mm, voxel dimensions = 3×3×3mm, field of view = 192×192mm², 88×88 in-plane resolution), we investigated the brain's stimulus responses to tobacco, e-cigarette, and neutral images. FMRI data was analyzed using SPM12 (Wellcome Department of Imaging Neuroscience, London, UK). Preprocessing consisted of realignment for motion correction, slice time correction, normalization to Montreal Neurological Institute space and segmentation, spatial smoothing with a Gaussian kernel of 8 mm full width at half-maximum. Statistical analysis of the pre-processed fMRI data on first level was performed by modelling the different conditions (boxcar functions convoluted with the hemodynamic response function) as explanatory variables within the context of the general linear model on a voxel-by-voxel basis. Subsequently, at the second-level analysis, the resulting contrast images were included in a full factorial model with condition as within-subject factor and group as between-subject factor.
Results:
For images of tobacco cigarettes, no significant differences in brain activation were found between single and dual users. Across all e-cigarette users, images of tobacco cigarettes elicited greater activation in limbic (nucleus accumbens, caudate, anterior cingulate cortex, cingulate gyrus) and frontal regions (medial frontal gyrus, medial orbitofrontal cortex) compared to neutral stimuli. In addition, e-cigarette stimuli also showed greater activation in limbic (cingulate gyrus), and frontal (medial and superior frontal gyrus) regions compared to neutral stimuli. Single users showed greater activation in frontal regions (orbitofrontal cortex, middle and medial frontal gyrus) in response to e-cigarette stimuli compared to dual users.
Conclusions:
The lack of significant differences in brain activation between single and dual users for tobacco cigarette cues may reflect their shared history of tobacco use. Both single and dual e-cigarette users maintain strong neural responses to tobacco stimuli in brain regions associated with reward processing indicating addiction memory even after shifting to e-cigarettes. The increased activation in single users in response to e-cigarette stimuli suggests a stronger cognitive/emotional engagement related to e-cigarettes, possibly due to their shift from tobacco cigarettes to e-cigarettes. Regarding e-cigarettes as nicotine replacement in smoking cessation treatment, given the importance of cue reactivity for relapse, additional interventions to reduce reactivity to tobacco stimuli are warranted.
Disorders of the Nervous System:
Psychiatric (eg. Depression, Anxiety, Schizophrenia)
Emotion, Motivation and Social Neuroscience:
Reward and Punishment 2
Modeling and Analysis Methods:
Activation (eg. BOLD task-fMRI) 1
Novel Imaging Acquisition Methods:
BOLD fMRI
Keywords:
Addictions
FUNCTIONAL MRI
Limbic Systems
Other - Cue Reactivity, Harm Reduction
1|2Indicates the priority used for review
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Was this research conducted in the United States?
Were any human subjects research approved by the relevant Institutional Review Board or ethics panel? NOTE: Any human subjects studies without IRB approval will be automatically rejected.
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Provide references using APA citation style.
Vollstädt-Klein, S., Grundinger, N., Görig, T., Szafran, D., Althaus, A., Mons, U., & Schneider, S. (2021). Study protocol: Evaluation of the addictive potential of e-cigarettes (EVAPE): Neurobiological, sociological, and epidemiological perspectives. BMC Psychology, 9(1), 181. https://doi.org/10.1186/s40359-021-00682-8
Vollstädt-Klein, S., Kobiella, A., Bühler, M., Graf, C., Fehr, C., Mann, K., & Smolka, M. N. (2011). Severity of dependence modulates smokers' neuronal cue reactivity and cigarette craving elicited by tobacco advertisement. Addiction Biology, 16(1), 166–175. https://doi.org/10.1111/j.1369-1600.2010.00207.x