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29 - The importance of assessing base rates for clinical studies: an example of stimulus control of smoking

from PART V - PSYCHIATRIC RESEARCH APPLICATIONS: PRACTICAL ISSUES and ATTENTION POINTS

Published online by Cambridge University Press:  03 May 2010

Marten W. de Vries
Affiliation:
Rijksuniversiteit Limburg, The Netherlands
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Summary

Cigarette smoking poses serious health risks, including cancer (US DHHS, 1982), cardiovascular disease (US DHHS, 1983) and chronic obstructive lung disease (USD DHHS, 1984); it is the leading cause of premature death and disease in the Western World. Despite these dangers, one quarter to one half of adults smoke in North America and Europe. Several theoretical models have attempted to explain – with limited success – why people continue to smoke in the face of such severe consequences.

Most current theories emphasize the role of nicotine and nicotine dependence in smoking. These models assert that, once smokers become addicted, their smoking is driven by the need to avoid the nicotine withdrawal symptoms they experience when they go without tobacco (e.g. Jarvik, 1979; Schachter, 1978). This implies that smokers smoke in order to keep nicotine from dropping below a certain level in their bloodstreams. Additionally, it has been suggested that smokers may also strive to achieve acute peaks or surges of blood nicotine that produce direct and immediate pharmacological effects (Russell & Feyerabend, 1978). Some of these effects seem to include: enhancement of pleasure, stimulation, improvement of learning and performance on cognitive tasks, and anxiety reduction (see Pomerleau & Pomerleau, 1984, and Russell, 1976, for reviews).

A simple pharmacological dependence model predicts that smoking will occur at regular intervals, as nicotine is depleted from the bloodstream. However, studies indicate that smoking is cued by a variety of environmental and proprioceptive stimuli.

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The Experience of Psychopathology
Investigating Mental Disorders in their Natural Settings
, pp. 347 - 352
Publisher: Cambridge University Press
Print publication year: 1992

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