Startle cue-reactivity differentiates between light and heavy smokers

Aims It was assumed that the startle amplitude in smokers is reduced while viewing pictures of smoking, suggesting that smoking cues are appetitive. The goal of the present study was to investigate (i) whether smoking scenes induce appetitive cue effects in smokers, and (ii) whether smoking intensity is related to cue-reactivity. Design Smokers and non-smokers participated in a single session. Participants A total of 62 individuals participated: 36 smokers and 26 non-smokers. Measurements Participants took part in an acoustic affective startle experiment using standardized pleasant, neutral and unpleasant scenes from the International Affective Picture System (IAPS), as well as pictures of smoking. The effect of smoking cues was assessed by comparing neutral and smoking scenes (termed cue-related startle suppression, CSS). Findings While there was no overall difference between smokers and non-smokers regarding the CSS, light smokers showed significantly increased cue-reactivity towards smoking-related cues, as compared with heavy smokers and non-smokers. In addition, light smokers also displayed stronger appetitive responses towards positive stimuli. Conclusions These data support recent theories which discriminate between habit-based and incentive-based drug abuse. This distinction may have consequences for the assessment and treatment of drug-addicted subjects. Furthermore, incentive-based light smoking seems to have general effects on the reward system.