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Nicotine Self-Regultion in Heavy and Light Smokers University of Rhode Island DigitalCommons@URI Open Access Dissertations 1982 Nicotine Self-Regultion in Heavy and Light Smokers Gwendolyn A. Underhill University of Rhode Island Follow this and additional works at: https://digitalcommons.uri.edu/oa_diss Recommended Citation Underhill, Gwendolyn A., "Nicotine Self-Regultion in Heavy and Light Smokers" (1982). Open Access Dissertations. Paper 1106. https://digitalcommons.uri.edu/oa_diss/1106 This Dissertation is brought to you for free and open access by DigitalCommons@URI. It has been accepted for inclusion in Open Access Dissertations by an authorized administrator of DigitalCommons@URI. For more information, please contact [email protected]. NICOTINESELF-REGULATION IN HEAVYAND LIGHT SMOKERS BY GWENDOLYNA. UNDERHILL A DISSERTATIONSUBMITTED IN PARTIALFULFILLMENT OF THE REQUIREMENTSFOR THE DEGREEOF DOCTOROF PHILOSOPHY IN CLINICAL PSYCHOLOGY UNIVERSITYOF RHODEISLAND 1982 Abstract The purpose of the present .study was to provide a further test of the nicotine addiction theory. It was designed to determine the extent to which smokers regulate plasma nicotine levels and smoking behavior in response to varying nicotine yields. More specifically, it was designed to assess differences between heavy and light smokers in nicotine regulation. Age differences were also explored. The effects of varying nicotine yield (high and low nicotine dose) was measured in 19 male smokers (10 heavy smokers and 9 light smokers) on the following dependent variables: smoking behavior (puff frequency, intensity, duration and volume), ANS physiological measures (heart rate and peri­ pheral skin temperature), subjective states (nicotine craving and withdrawal ) , -plasma nicotine and carboxyhemo­ globin levels. Urinary pH was also measured. Subjects attended two one-hour smoking sessions in which an oppor­ tunity to smoke a cigarette was provided every 10 minutes. Statistical analyses on all dependent variables were perform­ ed using an Analysis of Variance with Repeated Measures Design. Results showed no evidence for nicotine regulation at the pharmacological level, however, there · was strong support for behavioral regulation. Heavy and light smokers responded in a similar fashion on most all of the dependent variables. There were some age differences in smoking style characterized by a greater puff frequency for older smokers. It was concluded that nicotine regulation at the plasma nicotine level may be a long-term process which is not amenable to short-term study. Acknowledgments I would like to thank Dominic Valentino, my major professor, for the support, care and concern which he has most graciously and generously given to myself and to my work for the past five years. I would also like to thank Jerry Cohan for his valuable statistical assistance, I am most appreciative of the support provided by my other committee members including Larry Grebstein, John Stevenson, Jim Loy and Al Willoughby. iv Table of Contents Abstract•·••·•••••••·•··•••••·•••••••••••••••••••••••• ii Acknowledgements•••••••••••••••••••••••••••••••••••••• iv I. Introduction ••••••••••••••••••••••••• •·• •••••• , ••• , 1 lVIaintenance of smoking Behaviors Theoretical Views Tomkins• smoking Topology ••••••••••••••••••• , 2 Behavioral Approaches•••••••••••••••••••••••• 5 Opponent-Process Theory•••••••••••••••••••••• 6 Multidimensional Models•••••••••••••·•••••••• 7 Nicotine Addiction Theory•••••••••••••••••••• 10 Pharmacological Aspects of Nicotine . Nicotines ·stimulant or Depressant? ••••••••• ,. 14 Nicotine: The Primary Reinforcer?•••••••••••• 17 Nicotines An Addictive Substance?•••••••••••• 18 A Closer Look at the Nicotine Addiction Theorys Nicotine Regulation studies••••••••••••••••••••••• 22 Nicotine Yield and Smoking Behavior •••••••••• 23 Measurements of Nicotine Intakes Plasma Nicotine and Carboxyhemoglobin •••••••• 27 Nicotine Yields Plasma Nicotine and COHb••••• JO Intravenous Nicotine and smoking Behavior •••• J4 Nicotine chewing Gum and smoking Behavior •••• J6 Nicotine Regulation in Heavy and Light .. smokers •••••••••••••••••• ,................... 37 V Page Statement of the Problem ••••. • e t • a e I • I I e I ■ I I e e I • I 40 Hypotheses • ••••••••.••••••••••.•••••••••••.••.••.• 4J II. Method • ••••••• , •••••• , ••••••••••••••••••••••••• , •• 45 Subjects. 45 Apparatus. 4-8 ' . Dependent Measures •••••••••••••••••••••.••.• 49 Procedure ••••••••••••••••••• , • • • • • • • • • • • • • • • 52 III. Rasul ts . .....•............................ , ... , . , .59 IV. Discussion. • . • • • • • • • • • • • • • . • • • • • • • • • • • • • • • • . • • • • • 101 v. Conclusion •.••••••.•••••••••••••••••••••••••••••• 111 References. 116 Appendix A Consent Form. • • • • • • • • • • • • • • • • • • • • • • • • 128 Appendix B Shiffman Withdrawal Scale •••••••••••• lJl Appendix C Subject Preparatory Instructions ••••• lJJ Appendix D smoking History ••••••••••••• -• • • • • • • • • 135 Appendix E Subject Instructions for Experimental Sessions •••••••••••••••. 144 Appendix F Group Means and Standard Deviations, Biochemical Measures ••• ·•••••••••••••• 146 Appendix G Group Means and Standard Deviations: Smoking Tope.logy. • • • • • . • • • • • • • • •.• • • • • 147 Appendix H Group Means and Standard Deviations: Physiological Measures •••••••••••• ; •• 150 Appendix I Group Means and Standard Deviations, Subjective Measures ••••••.••••••...•• 152 vi List of Tables Table Title Page · l Age Distribution of Subjects 28 2 Reported Daily Nicotine Intake JO J Analysis of Variance for Plasma Nicotine Pre First Cigarette - Post Last Cigarette 6J 4 Percent Reduction in Plasma Nicotine Levels 64 5 Analysis of Variance for Plasma Nicotine Pre - Post First Cigarette 66 6 Analysis of Variance for COHb 68 7 Analysis of variance for Total Number of Cigarettes 69 8 Simple Effects Test for Nicotine Dose X Age Interaction (Total Number of Cigarettes) 71 9 Analysis of Variance for Puff Frequency 72 10 Analysis of ·Variance for Puff Intensity 73 11 Analysis of Variance for Puff Duration 74 12 Analysis of Variance for Total Puff Volume 75 lJ Analysis of Variance for Average Puff Volume 77 14 Analysis of Variance for Heart Rate Pre First Cigarette - Post Last Cigarette 78 15 Newman-Keuls Test for Nicotine Dose Heart Rates Pre First Cigarette - Post Last Cigarette 79 16 Analysis of Variance for Heart Rate ·Pre - Post First Cigarette 81 17 Newman-Keuls Test for Nicotine Dose Heart Rate: Pre - Post First Cigarette 82 18 Analysis of Variance for Peripheral Skin Temperature SJ 19 Newman-Keuls Test for Nicotine Dose Peripheral Skin Temperature 84 vii List of Tables Table Title Page 20 Simple Effects Test for Nicotine Dose X Type of smoker Interaction Peripheral Skin Temperature 85 21 Newman-Keuls Test for Effects of Nicotine Dose on Heavy smokerss Peripheral Skin Temperature 87 22 Newman-Keuls Test for Effects of Nicotine Dose on Light Smokers, Peripheral Skin Temperature 87 2J Analysis of Variance for Shiffman Withdrawal Scale 88 24 Newman-Keuls Test for Nicotine Dose Shiffman Withdrawal Scale 89 25 Total Shiffman Withdrawal Scale Scores Converted to Mean Scores 89 26 Analysis of Variance for Shiffman Withdrawal Scale Physical Symptoms Subscale 91 27 Analysis of Variance for Shiffman Withdrawal Scala Stimulation Subscale 92 28 Analysis of Variance for Shiffman Withdrawal Scale Psychological Symptoms Subscale 9J 29 Analysis of Variance for Shiffman Withdrawal Scale Craving Subscale 94 JO Newman-Keuls Test for Nicotine Dose Shiffman Craving Subscale 95 J1 Total Shiffman Craving scores Converted to Mean Scores 95 J2 Analysis of Variance for Craving 96 3J · Newman-Keuls Test for Nicotine Dose: Craving 98 J4 Average Craving Scores 99 35 Fagerstrom Tolerance Questionnaire Scores 100 viii - - ...--- ' Nicotine Self-Regulation in Heavy and Light Smokers Perhaps the most widely occuring, frequently eng~ged in, publicly permissible, physically harmful behavior in the history of mankind is cigarette smoking. If it were not for the growing awareness of the health hazards of cigarette smoking, the mysteriously powerful nature of this behavior might never be questioned. Since the alarm sounded by the Surgeon General's Report (1964) alerting the public to the significant health risks associated with smoking, a host of various intervention strategies have been developed. However, in an exhaustive review of 89 treatment studies, Hunt and Bespalac (1974) conclude that most treatment programs produce less than a 50% abstinence rate at the end of treatment. This abstinence rate is reduced to_20% to JO% at one year to 18 month follow-ups. These findings lead to one conclusions we do not know enough about why people smoke in order to help them stop smoking. Cigarette smoking is a multidimensional behavior, involving psychological, behavioral and physiological levels of functioning. Consequently, any theory which addresses one or all of these components will provide further under­ standing of smoking behavior. However, the following question presents itself1 which theoretical viewpoint is the most promising, given our present state of knowlege regarding the maintenance and cessation of smoking behavior? Since the primary objective of understanding smoking behavior is - to develop effective treatment strategies, this question can 2 be answered, in part, by the following evidence, The majority of the present treatment techniques; which as stated, provide disappointing results, focus on the psycho­ logical and behavior~l aspects of smoking behavior, largely neglecting the physiological
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