SA48. Tobacco Craving and Triggers in Smokers With Schizophrenia

Abstract

Background: The prevalence of tobacco use is 2-3 times greater in people with schizophrenia than the general population. Tobacco craving is an important reason why people relapse; cessation efforts in this population have been modest. Understanding the triggers that lead to tobacco craving and potential relapse will help to target the testing of new interventions. Virtual reality (VR) platforms can expose smokers to multisensory tobacco cues/triggers by immersion into an environment where they can see and smell tobacco-related cues and interact in virtual social environments. It is hypothesized that smokers who heavily identify environmental triggers to smoking urges may be more likely to respond to these types of stimuli. Method(s): We enrolled those with a DSM-IV diagnosis of schizophrenia who consistently smoked >=10 cigarettes daily. Participants underwent a baseline assessment and acclimation period followed by an experimental condition of 4 VR cues (Virtually BetterTM); 2 smoking cues (a paraphernalia room and a social interaction/gathering room), and 2 neutral rooms. Symptom and craving assessments were performed prior to and following the VR session and at a subsequent visit 1 week after the experimental session. Participants reported triggers to smoking in environmental, emotional, or routine categories and rated their tobacco craving using the Questionnaire of Smoking Urges-Brief (QSU-B). Result(s): The mean number of cigarettes smoked daily was 16.0 (8.5), and participants reported smoking tobacco for an average of 21.9 (11.7) years (N = 30). Forty-three percent (13 of 30) of the participants stated at least 70% of potential environmental triggers led to an increased urge to smoke. A trend for change in craving as measured by the QSU-B was found between baseline and completion of the VR cue session (7.03 +/- 19.15, P =.058); however, this was not signifcant. Furthermore, QSU-B scores did not differ in participants who self-ranked as highly responsive to environmental cues (n = 13) versus less responsive to environmental cues (n = 17; P = NS). Conclusion(s): Virtual reality provides a mechanism to investigate tobacco craving in smokers with schizophrenia; further investigation is needed to explore the importance of triggers and cue responsivity in craving research.