Incubation of cue-induced cigarette craving during abstinence in human smokers

Biol Psychiatry. 2011 Apr 1;69(7):708-11. doi: 10.1016/j.biopsych.2010.07.014.


Background: Abstinent drug users remain at risk for relapse long after withdrawal subsides. Animal studies indicate that responses to drug-related cues not only persist but increase with abstinence, a phenomenon termed "incubation of drug craving." It is unknown whether cue-induced craving increases, decreases, or remains constant with abstinence in humans. We investigated effects of abstinence on cue-induced craving in cigarette smokers.

Methods: Eighty-six non-treatment-seeking, adult smokers (≥10 cigarettes daily) were paid to abstain for 7 (Group 1), 14 (Group 2), or 35 (Groups 3 and 4) days. Abstinence was verified daily. Groups 1, 2, and 3 underwent a single cue session on the final abstinence day (7, 14, or 35). Group 4 viewed cues on Days 7, 14, and 35.

Results: Between and within groups, smoking-cue-induced craving increased with abstinence on some measures. Cue-induced craving was greater in Group 3 (35-day) compared with Group 1 (7-day). Within Group 4, cue-induced craving was greater at 35 than 14 days. Cue-induced craving did not decrease with abstinence on any measure.

Conclusions: We present initial evidence of incubation of cue-induced craving in humans. The observation that cue-induced craving increases with abstinence, even as "background" craving and withdrawal symptoms subside, might have treatment implications.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural

MeSH terms

  • Adult
  • Analysis of Variance
  • Cues*
  • Drug-Seeking Behavior / physiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Motivation / physiology*
  • Psychiatric Status Rating Scales
  • Self Report
  • Smoking / adverse effects*
  • Substance Withdrawal Syndrome / psychology*
  • Surveys and Questionnaires
  • Time Factors
  • Young Adult