Stress decreases the ability to resist smoking and potentiates smoking intensity and reward
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We have developed a novel human laboratory model to examine two primary aspects of stress-precipitated tobacco relapse: (1) Does stress reduce the ability to resist the first cigarette? (2) Once the first cigarette is initiated, does stress facilitate subsequent smoking? Using a within-subject design, daily smokers ( n = 37) who were nicotine deprived overnight received a personalized imagery induction (stress or neutral) on two separate days, and then had the option of initiating a tobacco self-administration session or delaying initiation for up to 50 min in exchange for three levels of monetary reinforcement. Subsequently, the tobacco self-administration session entailed a 1-hour period in which subjects could choose to smoke using a smoking topography system. Following the stress induction, subjects were less able to resist smoking, smoked more intensely (increased puffs, shorter inter-puff interval, and greater peak puff velocity), and perceived greater satisfaction and reward from smoking. Stress significantly increased hypothalamus–pituitary–adrenal (HPA) axis reactivity, tobacco craving, negative emotion, and physiologic reactivity relative to the neutral condition. In addition, increased cortisol, ACTH, and tobacco craving were associated with reduced ability to resist smoking following stress. These findings have implications for understanding the impact of stress on smoking relapse and model development to assess smoking lapse behavior.
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Neurologically, this may be related to higher levels of cortisol and adrenocorticotrophic hormone as a response to stress.
“Neurologically, this may be related to higher levels of cortisol and adrenocorticotrophic hormone as a response to stress.103”
From Evaluating Long-term Outcomes of NHS Stop Smoking Services (ELONS): a prospective cohort study (2015) · cites this paper as [103]
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Self-citationHeckman, B. W., Kovacs, M. A., Marquinez, N. S., Meltzer, L. R., Tsambarlis, M. E., Drobes, D. J., & Brandon, T. H. (2013) · Addiction · doi:10.1111/add.12284 · Cited by 71 · see citing works
Acute effects of low and high dose alcohol on smoking lapse behavior in a laboratory analogue task
Kahler, C. W., Metrik, J., Spillane, N. S., Day, A., Leventhal, A. M., McKee, S. A., Tidey, J. W., McGeary, J. E., Knopik, V. S., & Rohsenow, D. J. (2014) · Psychopharmacology · doi:10.1007/s00213-014-3613-3 · Cited by 52 · see citing works
Self-citationEffects of α-2A adrenergic receptor agonist on time and risk preference in primates
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The effects of varenicline on stress-induced and cue-induced craving for cigarettes
Ray, L. A., Lunny, K., Bujarski, S., Moallem, N., Krull, J. L., & Miotto, K. (2013) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2012.12.015 · Cited by 27 · see citing works
Drusch, K., Lowe, A., Fisahn, K., Brinkmeyer, J., Musso, F., Mobascher, A., Warbrick, T., Shah, J., Ohmann, C., Winterer, G., et al. (2013) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-012-0377-9 · Cited by 25 · see citing works
Smoking and Stress in the General Population in Denmark
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Otto, M. W., Zvolensky, M. J., Rosenfield, D., Hoyt, D. L., Witkiewitz, K., McKee, S. A., Bickel, W. K., & Smits, J. A. J. (2020) · Health Psychology · doi:10.1037/hea0000858 · Cited by 12 · see citing works
Self-citation
- Authors
- McKee, S. A., Sinha, R., Weinberger, A. H., Sofuoglu, M., Harrison, E. L., Lavery, M., & Wanzer, J.
- Affiliations
- Yale University (US)
- Corresponding author
- McKee, Sherry A
- Venue
- Journal of Psychopharmacology
- Publisher
- SAGE Publications
- Published
- 2010-09-03
- Volume
- 25
- Issue
- 4
- Pages
- 490-502
- ISSN
- 0269-8811 (ISSN-L)
- 1461-7285
- PMC
- PMC3637660
- OpenAlex
- W2107896722
- Cited by
- 276
- References
- 93
- Citations by year
- 2026: 12 · 2025: 13 · 2024: 14 · 2023: 15 · 2022: 20 · 2021: 23 · 2020: 18 · 2019: 26 · 2018: 22 · 2017: 15 · 2016: 22 · 2015: 20 · 2014: 22 · 2013: 15 · 2012: 12
- FWCI
- 7.37
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Psychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (T32AA015496)
- National Institute on Drug Abuse (RL1DA024857, PL1DA024860, R21DA017234, PL1DA024859, K12DA000167)
- National Institute of Dental and Craniofacial Research (UL1DE019586)
- National Center for Research Resources (UL1RR024139)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Keywords
- stress, smoking relapse, nicotine deprivation, HPA axis reactivity, cortisol, ACTH, cigarette craving, smoking intensity, negative emotions, smoking cessation
- MeSH terms
- Adrenocorticotropic Hormone, Adult, Female, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Male, Middle Aged, Motivation, Nicotine, Pituitary-Adrenal System, Reinforcement, Psychology, Reward, Smoking, Stress, Psychological, Smoking Cessation, Behavior, Addictive, Imagery, Psychotherapy, Young Adult
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