In Brief

Exposing a smoker to a bar or other setting that they personally associate with smoking may provoke cigarette craving-even if the environment is completely devoid of any typical smoking cues, like cigarettes, ashtrays or even other smokers, according to an article in the February issue of Experimental and Clinical Psychopharmacology (Vol. 14, No. 1).

The findings add to a growing literature on how environments can become linked to drug use and may have implications for helping smokers quit, according to the study's researcher, Cynthia A. Conklin, PhD, of the University of Pittsburgh's Western Psychiatric Institute and Clinic.

"In treatment to help people quit smoking, smokers learn to guard against salient smoking cues," Conklin says. "My research suggests that smokers also have to guard themselves against the places in which their smoking typically occurred. They need to be prepared that those environments alone might bring about strong urges to smoke."

In an initial study, Conklin presented smokers with a set of photographs of common smoking-related settings, like a bar, as well as nonsmoking environments, like a shower, in addition to typical smoking and nonsmoking cues, like a lit cigarette or pad of paper, respectively.

Conklin found that when the participants viewed the smoking-related contexts they felt an intense craving to smoke, even though those contexts were devoid of cues like an ashtray or other smokers. The participants' levels of craving during exposure to smoking environments was similar, but somewhat less strong, than that reported while viewing typical smoking cues.

To test whether personalizing the smoking environments would enhance craving, Conklin interviewed 72 smokers to find the places they smoked and did not smoke most often and gave them a digital camera to take pictures of those locations. Conklin and her colleagues removed from the photos any smoking cues, like a lighter or ashtray, and then showed participants their personalized pictures, as well as photos of standard smoking and nonsmoking environments on a large screen. The participants then rated their urge to smoke.

Conklin found that the personalized smoking environments led to greater craving than the standard smoking- related contexts. The findings suggest that the actual bar or couch in a living room where a person typically smokes might alone bring about cigarette craving even after an ex-smoker has gotten rid of all lighters, ashtrays and other related paraphernalia.

A key to quitting smoking may be to break the association between smoking and familiar environments, suggests Conklin and others. Doing that won't be easy, but Conklin aims to apply her finding to develop new extinction procedures to help smokers quit.

--Z. Stambor