The associative basis of cue-elicited drug taking in humans

Drug cues play an important role in motivating human drug taking, lapse and relapse, but the psychological basis of this effect has not been fully specified. To clarify these mechanisms, the study measured the extent to which pictorial and conditioned tobacco cues enhanced smoking topography in an ad libitum smoking session simultaneously with cue effects on subjective craving, pleasure and anxiety. Both cue types increased the number of puffs consumed and craving, but pleasure and anxiety responses were dissociated across cue type. Moreover, cue effects on puff number correlated with effects on craving but not pleasure or anxiety. Finally, whereas overall puff number and craving declined across the two blocks of consumption, consistent with burgeoning satiety, cue enhancement of puff number and craving were both unaffected by satiety. Overall, the data suggest that cue-elicited drug taking in humans is mediated by an expectancy-based associative learning architecture, which paradoxically is autonomous of the current incentive value of the drug.