Personalizing smoking cessation pharmacotherapy using neuroaffective reactivity profiles: A randomized controlled...

Area of Science:

• Neuroscience
• Addiction Medicine
• Clinical Psychology

Background:

• Neuroaffective response to motivationally relevant cues differentiates smokers.
• Sign-trackers (ST) attribute greater incentive salience to cigarette cues than non-cigarette rewards.
• Goal-trackers (GT) exhibit the opposite neuroaffective reactivity profile.

Purpose of the Study:

• To test if varenicline's efficacy differs from nicotine replacement therapy (NRT) based on neuroaffective profiles (ST vs. GT).
• To extend previous findings on varenicline benefits for ST smokers.

Main Methods:

• Double-blind, randomized controlled trial comparing varenicline and NRT.
• Stratification based on baseline ST/GT neuroaffective profiles.
• 158 adult smokers received 12 weeks of treatment plus counseling.

Main Results:

• A significant interaction (92.7% probability) between treatment and neuroaffective profile was found.
• ST smokers showed significantly higher abstinence rates with varenicline (47%) vs. NRT (11%).
• GT smokers showed a smaller benefit with varenicline (29%) vs. NRT (17%).

Conclusions:

• Smokers with high incentive salience for cigarettes (ST) respond better to varenicline than NRT.
• Neuroaffective biomarkers can guide personalized smoking cessation interventions.
• Varenicline shows superior efficacy for ST smokers in smoking cessation.