Extending the role of associative learning processes in nicotine addiction

Behav Cogn Neurosci Rev. 2004 Sep;3(3):143-58. doi: 10.1177/1534582304272005.


Compulsive smoking is a worldwide public health problem. Although research has confirmed the importance of associative learning processes in nicotine addiction, therapies targeting nicotine-associated cues still have a high relapse rate. Most theories conceptualize nicotine as an 'outcome' that reinforces behaviors and/or changes the affective value of stimuli. Albeit important, this view does not capture the complexity of associative processes involved in nicotine addiction. For example, nicotine serves as a conditional stimulus acquiring new appetitive/affective properties when paired with a non-drug reward. Also, nicotine functions as an occasion setter that participates in higher-order associative processes that likely permit a more pervasive influence of conditioned cues that are resistant to typically cue-exposure therapy techniques. Finally, nicotine appears to amplify the salience of other stimuli that have some incentive value resulting in enhanced nicotine self-administration and conditioned reinforcement processes. Future smoking intervention strategies should take into consideration these additional associative learning processes.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Affect
  • Association Learning*
  • Conditioning, Classical / physiology
  • Cues
  • Humans
  • Psychological Theory
  • Psychotherapy / methods*
  • Recurrence
  • Tobacco Use Disorder / psychology*
  • Tobacco Use Disorder / therapy*