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CORESTA Kyoto 2004 Reality of Beneficial Aspects of Smoking and Nicotine Professor David M. Warburton (Neil Sherwood)

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Page 1: CORESTA Congress 2004

CORESTA Kyoto 2004

Reality of Beneficial Aspects

of Smoking and Nicotine

Professor David M. Warburton

(Neil Sherwood)

Page 2: CORESTA Congress 2004

CORESTA Kyoto 2004

David M.

Warburton

A Retrospective

Page 3: CORESTA Congress 2004

CORESTA Kyoto 2004

US Surgeon General 1988

“Smokers claim that smoking improves

their performance and mood…”

But this finding effectively ignored for the

remainder of the report!

Page 4: CORESTA Congress 2004

CORESTA Kyoto 2004

West 1993

Beneficial Effects of Nicotine: Fact or

Fiction?

West says Fiction!

Page 5: CORESTA Congress 2004

CORESTA Kyoto 2004

Parrott 2003

Cigarette-Derived Nicotine is Not a

Medicine

“…cigarette smoking does not provide

mood control benefits, but rather

nicotine dependency is associated with

mood lability…”

Page 6: CORESTA Congress 2004

CORESTA Kyoto 2004

Our Questions Today

Are smokers deluded?

Are the reported improvements in

performance and mood merely due to

relief of nicotine withdrawal?

Page 7: CORESTA Congress 2004

CORESTA Kyoto 2004

Page 8: CORESTA Congress 2004

CORESTA Kyoto 2004

Effects of Smoking on

Performance

Warburton DM and Arnell C (1994)

Improvements in performance without nicotine

withdrawal

Psychopharmacology 115, 539-542

Page 9: CORESTA Congress 2004

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Rapid Visual Information

Processing Test

1 9 4 8 7 2 5 1 3 4 6 5 3 8 2 6 5

_________________|______________|_

- Correct Detections (Hits)

- Latency (Time to Respond)

Page 10: CORESTA Congress 2004

CORESTA Kyoto 2004

Smoking Regimen

Healthy undergraduate students

Smoking more than 15 cigarettes per day

Minimally deprived for two hours

Puff-by-puff methodology

Page 11: CORESTA Congress 2004

CORESTA Kyoto 2004

18 Smokers

Sham Smokers

RVIP – Mean Number of Hits

Time (minutes)

Smoking start

Page 12: CORESTA Congress 2004

CORESTA Kyoto 2004

RVIP – Mean Reaction Time

18 Smokers

Sham Smokers

Time (minutes)

Smoking start

Page 13: CORESTA Congress 2004

CORESTA Kyoto 2004

Effects of Nicotine on

Performance in Non-smokers

Wesnes K and Warburton DM (1984)

Effects of scopolamine and nicotine on

human rapid visual information processing

Psychopharmacology 82, 147-150

Page 14: CORESTA Congress 2004

CORESTA Kyoto 2004

Page 15: CORESTA Congress 2004

CORESTA Kyoto 2004

Effects of Nicotine on Performance

in Alzheimer Patients

Sahakian BJ, Jones GMM, Levy R, Gray JR

and Warburton DM (1989)

Effects of nicotine on attention, information

processing and short-term memory in patients

with dementia of the Alzheimer type

British Journal of Psychiatry 154, 797-800

Page 16: CORESTA Congress 2004

CORESTA Kyoto 2004

Page 17: CORESTA Congress 2004

CORESTA Kyoto 2004

Page 18: CORESTA Congress 2004

CORESTA Kyoto 2004

Spilich 1993

A review of the effects of smoking and

nicotine upon cognitive performance

"… the effect of nicotine upon cognitive

performance has been conducted with a

very restricted set of tasks …..all of which

involve a rapid response to a simple

perceptual demand."

Page 19: CORESTA Congress 2004

CORESTA Kyoto 2004

Effects of Smoking on Complex

Information Processing

Warburton DM, Skinner A and Martin CD (2001)

Improved incidental memory with nicotine after

semantic processing

Psychopharmacology 153, 258-263

Page 20: CORESTA Congress 2004

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Task Requirements

DOG - CHICKEN - TAXI - LIGHT

Phonological Task: 1 or 2 syllables?

Semantic Task: Are these alive or not?

Page 21: CORESTA Congress 2004

CORESTA Kyoto 2004

Phonological Processing

Signal

Physical Features

Letters

Syllables (One or Two)

Decision (Press Left or Right)

Page 22: CORESTA Congress 2004

CORESTA Kyoto 2004

Semantic Processing Signal

Physical Features

Letters

Word Recognition

Class (Living or Non-Living)

Decision (Press Left or Right)

Page 23: CORESTA Congress 2004

CORESTA Kyoto 2004

Smoking Regimen

Healthy undergraduate students

Smoking more than 15 cigarettes per day

Minimally deprived for two hours

Non-smoker comparison group

Page 24: CORESTA Congress 2004

CORESTA Kyoto 2004

Reaction Time

0

200

400

600

800

1000

1200

Phonological Semantic

Non-smokers Smokers sham Smokers smoking

Page 25: CORESTA Congress 2004

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Number of Words Remembered

0

2

4

6

8

10

12

14

16

Phonological Semantic

Non-smokers Smokers sham Smokers smoking

Page 26: CORESTA Congress 2004

CORESTA Kyoto 2004

A Possible Mechanism

Page 27: CORESTA Congress 2004

CORESTA Kyoto 2004

Effects of Smoking on Mood

Warburton DM (1988)

The Functional Use of Nicotine

In: Nicotine, Smoking and the Low-tar

Programme (Eds. Wald N & Froggatt P)

Page 28: CORESTA Congress 2004

CORESTA Kyoto 2004

Mood Measurement

Psychopharmacology scales for mood

Happy__________|___________Sad

Relaxed __________|___________Tense

Page 29: CORESTA Congress 2004

CORESTA Kyoto 2004

Smoking Regimen

Healthy undergraduate students

Smoking more than 15 cigarettes per day

Minimally deprived for two hours

Puff-by-puff methodology

Page 30: CORESTA Congress 2004

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Page 31: CORESTA Congress 2004

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Page 32: CORESTA Congress 2004

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Stressors and Smoking

Warburton DM (1990)

Psychopharmacological Aspects of Nicotine

In: Nicotine Psychopharmacology (Eds.

Wonnacott S, Russell MAH & Stolerman IP)

Page 33: CORESTA Congress 2004

CORESTA Kyoto 2004

The Stressors

Lo-Stress situation:

Rapid Visual Information Processing

Hi-Stress situation:

RVIP and “Your performance is being

filmed and will be assessed by a panel of

trained psychologists”

Page 34: CORESTA Congress 2004

CORESTA Kyoto 2004

Smoking Regimen

Healthy undergraduate students

Smoking more than 15 cigarettes per day

Minimally deprived for two hours

20 high in Neuroticism (Hi N)

20 low in Neuroticism (Lo N)

Page 35: CORESTA Congress 2004

CORESTA Kyoto 2004

Smoking Behaviour Measures

Puff Number (from video)

Puff Interval (from video)

Butt Nicotine

End-tidal carbon monoxide boost

Page 36: CORESTA Congress 2004

CORESTA Kyoto 2004

Puff Number

0

2

4

6

8

10

12

Lo Stress Hi Stress

Lo N

Hi N

Page 37: CORESTA Congress 2004

CORESTA Kyoto 2004

Puff Interval (sec)

0

10

20

30

40

50

60

Lo Stress Hi Stress

Lo N

Hi N

Page 38: CORESTA Congress 2004

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Smoking Intensity

BUTT NICOTINE

--------------------------------------- X 100

MACHINE-ESTIMATED YIELD

Page 39: CORESTA Congress 2004

CORESTA Kyoto 2004

Smoking Intensity (%)

0

20

40

60

80

100

120

Lo Stress Hi Stress

Lo N

Hi N

Page 40: CORESTA Congress 2004

CORESTA Kyoto 2004

CO Boost (ppm)

0

2

4

6

8

10

12

Lo Stress Hi Stress

Lo N

Hi N

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CORESTA Kyoto 2004

Lo N - More or Less Calm?

-0.2

-0.1

0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

Lo Stress Hi Stress

No Smoke

Smoke

Page 42: CORESTA Congress 2004

CORESTA Kyoto 2004

Hi N - More or Less Calm?

-1.4

-1.2

-1

-0.8

-0.6

-0.4

-0.2

0

0.2

0.4

0.6

Lo Stress Hi Stress

No Smoke

Smoke

Page 43: CORESTA Congress 2004

CORESTA Kyoto 2004

Pathway from Genes to Smoking

Neuroticism Genes

Prone to Anxiety Prone to Depression

Self-Medication by Smoking

Page 44: CORESTA Congress 2004

CORESTA Kyoto 2004

The Functional Model

Smoking has functions for the

smoker

Page 45: CORESTA Congress 2004

CORESTA Kyoto 2004

Page 46: CORESTA Congress 2004

CORESTA Kyoto 2004

Smoking is Purposive and

Rational

•Individuals control their psychological state

•Coping with problems and enhancing function

•Satisfies everyday psychological needs and so is pleasurable

•Enhances quality of life

Page 47: CORESTA Congress 2004

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Page 48: CORESTA Congress 2004

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Users are a Heterogeneous Group

•Smokers use the product for different reasons

•Mood changing, performance enhancement or

sensory pleasure

•May have different functions for a person on

different occasions

Page 49: CORESTA Congress 2004

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Motivation

•Both exogenous and endogenous motives

•Use determined by the interaction of the person and the situation

•Reasons can predate commencement

•People will vary their consumption and smoking behaviour depending on the situation

Page 51: CORESTA Congress 2004

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Page 52: CORESTA Congress 2004

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Quitting

•Experiences vary, because the functions differ

for individuals

•Not a stereotyped withdrawal syndrome

•Unhappiness due to both loss of functions and

to the loss of personal control over their

psychological state

Page 53: CORESTA Congress 2004

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Page 54: CORESTA Congress 2004

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Resumption of Smoking

•As a result of abstinence experiences,

individuals may choose to return to smoking

•Decision to resume may be countered by

– Family Pressure

– Societal Pressure

– Health Considerations

Page 55: CORESTA Congress 2004

CORESTA Kyoto 2004

Thanks to:

Gemma Jones

Neena Kochhar

Giovanna Mancuso

Andy Revell

Dewi Thompson

Anne Walters