Heart rate, blood pressure and salivary cortisol levels were measured before and after all cue exposures. All participants also completed a questionnaire to gauge their feelings of cravings after all the cues.
Bedi and her team found that even though both withdrawal symptoms and independent cravings subsided with abstinence, cravings triggered by exposure to smoking-related cues actually increased the further down the abstinence road a former smoker went.
Such cue-induced cravings were found to be more prevalent among the smokers at the five-week abstinence mark than among those asked to stop for just a week. Similarly, those exposed to smoking-related imagery along the way showed more cravings at the five-week point than at the two-week point.
As a result, the authors suggest that clinicians should consider the possibility that ex-smokers might actually face a more difficult long-term struggle with cravings than previously thought.
"Knowing this may help people to prepare better for these kinds of experiences," Bedi suggested, "so that they don't relapse when they experience a jump in craving after coming into contact with people, places or things that they associate with smoking."
"This could," she added, "also apply to other drugs, although more research needs to be done to investigate this possibility."
Dr. Adam O. Goldstein, director of University of North Carolina's Tobacco Intervention Programs in Chapel Hill, said that cues for cigarettes are probably stronger than similar cues for alcohol and opiates.
"People underestimate these cues," he cautioned. "That's one of the real take-home lessons of this kind of research. They are very powerful, and the return to smoking when these cues come can be rapid. But they are treatable."
"Coping strategies can moderate the effect
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