Attentional Retraining Administered in the Field Reduces Smokers' Attentional Bias and Craving

Objective: Attentional retraining (AR) is a potential new treatment for addiction. AR trains addicts to attend away from drug-related cues, thereby reducing exposure to drug cues and reducing craving. We examined the utility of delivering AR to smokers on a personal digital assistant (PDA) in the natural environment. Method: Smokers (N = 60) not seeking to quit were randomly assigned to an AR group or a control group (i.e., a group with no training). They carried a PDA with them for one week. They were prompted to complete four assessments daily, including three attentional retrainings (AR group) or three control trainings (control group), and one evaluation of attentional bias. AR was implemented using a modified visual probe task. Attentional bias was assessed using a standard visual probe task on the PDA. Results: The AR group completed an average of 15.0 attentional retrainings and the control group completed an average of 14.9 control trainings. As hypothesized, attentional bias declined over the week in the AR group, but not in the control group, Group x Day interaction, F(1, 232) = 4.77, p = .03. AR also reduced craving ratings following a briefly presented picture containing smoking and nonsmoking features, group main effect, F(1, 234) = 3.89, p = .04. AR did not significantly influence smoking behavior. Conclusion: AR can be administered on a mobile device in the natural environment, and AR can reduce attentional bias and craving.