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The effects of varenicline on stress-induced and cue-induced craving for cigarettes
Lara A Ray1, Katy Lunny, Spencer Bujarski
1Department of Psychology, University of California-Los Angeles, CA, USA. lararay@psych.ucla.edu
Background:
Varenicline is a partial agonist of the α4β2 nicotinic acetylcholine receptor approved by the FDA for the treatment of nicotine dependence. While the clinical efficacy of varenicline for smoking cessation is well-supported, its biobehavioral mechanisms of action remain poorly understood. This randomized, crossover, placebo-controlled, human laboratory study combines guided imagery stress exposure with in vivo presentation of cigarette cues to test the effects of varenicline on stress-induced and cue-induced craving for cigarettes.
Method:
A total of 40 (13 females) daily smokers (≥10 cigarettes per day) completed a guided imagery exposure (stress and neutral) followed by the presentation of cigarette cues at the target dose of varenicline (1mg twice per day) and on matched placebo.
Results:
Multilevel regression models revealed a significant main effect of varenicline (p<.01) such that it reduced cigarette craving across the experimental paradigm, compared to placebo. There was also a significant medication×stress×trial interaction indicating that varenicline attenuated cue induced craving following neutral imagery but not when cues were preceded by stress induction (i.e., stress+cues).
Conclusions:
These results elucidate the biobehavioral effects of varenicline for nicotine dependence and suggest that varenicline-induced amelioration of cigarette craving is unique to tonic craving and cue-induced craving following neutral imagery but does not extend to the combination of stress plus cues.
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