Twenty-four-hour monitoring of heart rate,motor activity and smoking behavior including comparisons between smokers and nonsmokers

The present study was an attempt to monitor continuously and in parallel cigarette consumption, heart rate, and physical activity under field conditions. In a first experiment the test-retest reliability of the recording devices was evaluated with a small number of nonsmoking students on days with similar schedules. The intraday development of heart rate and activity revealed a remarkable intraindividual stability, and the test-retest reliability coefficients calculated between the totals of heart rate and activity revealed values of 0.73 and higher for heart rate and 0.47 and higher for activity on comparable days. The second experiment was done with housewives as subjects to see whether heart rate and/or activity might differentiate smokers from nonsmokers in subjects who are less strictly bound to a fixed daily work program. The smoker/nonsmoker comparisons revealed significantly higher heart rates for smokers but almost identical activity readings. In a third experiment it was tested whether partial smoking abstinence in the morning might differentiate the morning and afternoon heart rates in smokers. Heart rate but not activity was significantly decreased during the abstinence period. Taken together, the simultaneous monitoring of heart rate and activity might be a valuable instrument in smoking research, since it is sensitive enough to detect manipulations of the smoking behavior under natural conditions.     

Biofeedback: a possible substitute for smoking, experiment I

Biofeedback techniques were utilized in this study to identify those physiological variables which possibly contribute to maintenance of cigarette smoking and to investigate the hypothesis that smoking frequency would decrease when individuals were trained via biofeedback procedures to increase 8-12 Hz occipital EEG activity as a substitute for smoking. Results of the study indicate that of the six smokers physiologically monitored, the following physiological changes occurred while actually smoking one cigarette: four smokers increased the percent of time they were producing 4-8 cycle per second (Hz) brain waves; five smokers increased their heart rate (beats per minute); all six smokers decreased their 8-12 Hz activity. Immediately after the smoking of one cigarette, six of the smokers demonstrated an increase in their heart rate and four of the smokers demonstrated a decrease in their skin temperature. There did not appear to be any specific consistent brain wave change across the subjects. Two smokers, who were able to continue producing high levels of 8-12 Hz activity without use of the biofeedback equipment, were able to quit completely at the end of an eight-month followup period.     

Action profiles of smoking and caffeine: Stroop effect, EEG, and peripheral physiology.

Twenty female regular cigarette smokers and coffee drinkers performed a numerical Stroop task in a 2 x 2 (caffeine x smoking) prepost crossover design. In the easier of the two different versions, caffeine and smoking reduced the reaction times (RT's) when given alone, but there was no additive effect. The Stroop effect itself (difference between RT's to numbers and RT's to symbols) was reduced by the two treatments only in the more difficult version, but the combination did not differ from the placebo condition. The physiological reactions to both treatments were additive, although the two reaction profiles were different. Smoking increased heart rate, blood pressure, finger vasoconstriction, respiratory frequency, EEG dominant alpha-frequency, and beta power and reduced respiratory amplitude, EEG delta and theta power. Caffeine increased blood pressure, finger vasoconstriction, motor activity, frontal EMG, and EEG theta power and decreased heart rate and EEG beta power.     

Caffeine and cigarette smoking: behavioral, cardiovascular, and metabolic interactions

Coffee drinking and cigarette smoking are strongly correlated behaviors which have been suggested to act synergistically to produce adverse health consequences, particularly coronary heart disease (CHD). We studied in smokers the influence of four days of multiple daily doses of coffee containing different doses or no caffeine on cigarette smoking behavior, nicotine intake from smoking, heart rate and blood pressure, circadian serum glucose, and urinary catecholamine excretion. We observed a tendency toward greater cigarette consumption during caffeine consumption, and a tendency toward higher plasma nicotine levels during low-dose caffeine compared with the no-caffeine condition; however, these effects were small. No caffeine effects on any other of the above parameters were observed. Previously published research has usually studied effects of single doses of caffeine, which does not account for development of tolerance to effects of caffeine. If caffeine does contribute to CHD risk, it is not likely to be related to caffeine effects on smoking behavior, nicotine intake, blood pressure, heart rate, glucose tolerance, or catecholamine release. Adverse effects of long-term caffeine consumption on lipids cannot be excluded.     

The acute effects of smoking on heart rate and blood pressure: An ambulatory study

Under laboratory conditions smoking has been found to acutely increase blood pressure and heart rate in healthy subjects. Little is known about the short-term effects of smoking under more naturalistic conditions when subjects are engaged in various activities. In this study, the short-term effects of smoking on blood pressure and heart rate in natural settings were investigated in a group of healthy smokers. The degree to which these effects are moderated by other factors known to affect the cardiovascular system was investigated as well. Subjects (eight males, seven females) were dispatchers in the greater Los Angeles area. They wore an ambulatory blood pressure and heart rate monitor on two workdays for a total of 48 h. The present study confirmed that the acute effects of smoking on blood pressure and heart rate under natural conditions are similar to results from laboratory studies. Smoking acutely increased blood pressure and heart rate. Male and female smokers displayed similar cardiovascular reactivity to smoking. There was no indication of development of intraday tolerance. The acute action of smoking on blood pressure and heart rate was additive to the influence of posture on the cardiovascular system.     

Tobacco dependence, risk perceptions and self-efficacy among Korean American smokers

Psychosocial variables related to smoking cessation may differ among ethnic groups. This research focuses on Korean Americans, a group that receives little attention in smoking cessation research, yet has an elevated smoking rate when compared with that of the general US population. This article reports our findings on tobacco dependence, risk perceptions and self-efficacy and examines potential associations between these psychosocial variables and key demographic variables. One hundred Korean American adult smokers enrolled in the study and completed the psychosocial measurement. The majority of the participants (61%) were heavy smokers. The findings indicated that demographic factors were associated with key psychosocial variables that have been demonstrated to play a role in smoking cessation behaviors. In particular, younger age and higher educational level were associated with greater self-efficacy in quitting smoking. No differences in risk perception were observed by any of the demographic indicators assessed. The findings suggest that enhancing self-efficacy among older and less educated smokers may improve the efficacy of smoking cessation efforts that target Korean smokers.     

Reactivity to smoking cues in adolescent cigarette smokers

This study examined reactivity to smoking cues in adolescent smokers (n=12) and nonsmokers (n=32), between 14 and 19 years of age. Participants were presented with videotaped smoking and neutral cues in a counterbalanced order. Subjective and physiological responses to each cue type were obtained. Findings indicated that smokers reported greater desire to smoke cigarettes in response to smoking cues, relative to neutral cues, when the smoking cues were presented first. Smokers also reported greater dominance (i.e., sense of control) during smoking-cue presentations, but only when these cues were presented second. Finally, smokers' heart rate was faster during the initial portion of the smoking-related video, relative to the neutral cue. Overall, this study demonstrates the feasibility of conducting laboratory-based cue-reactivity studies with adolescent smokers. Findings suggest that adolescents smokers show similar patterns of responding to smoking cues as adult smokers, although effects were not particularly robust in this sample and subjective effects were dependent on cue order.     

The effects of cigarette smoking on the response to stress in a driving simulator

1. Some behavioural and physiological responses of cigarette smokers and non-smokers exposed to varying degrees of stress in a driving simulator were compared.2. When the smokers were smoking a cigarette, some of their reaction times to light signals differed significantly from those of non-smokers, some being longer and some shorter. These differences disappeared when the smokers were not smoking.3. Of the physiological measurements, only heart rate differed significantly between smokers and non-smokers, being higher at all levels of stress in the smokers. There were no significant differences in blood pressure, calf blood flow and respiration rate between smokers and non-smokers.4. The results of the Cattell Sixteen Personality Factor Questionnaire showed that the smokers were significantly more extroverted and self-reliant than the non-smokers.5. The results are discussed in relation to the pharmacology of cigarette smoking. It is concluded that the differences in reaction times and heart rates between smokers and non-smokers were a consequence of cigarette smoking.     

Cigarette smoking, ambulatory cardiovascular monitoring, and mood in Vietnam veterans with and without chronic posttraumatic stress disorder

This study investigated the association among cigarette smoking, posttraumatic stress disorder (PTSD), and ambulatory cardiovascular and mood monitoring in 117 male Vietnam combat veterans (61 with PTSD and 56 without PTSD). Positive smoking status was associated with higher systolic blood pressure (SBP) and heart rate (HR), as well as greater diastolic blood pressure (DBP) variability. Compared to individuals without PTSD, PTSD patients had higher HR, anger/hostility ratings, and depression/anxiety ratings. Significant diagnosis by smoking status interactions were found indicating that compared to nonsmokers with PTSD, smokers with PTSD had higher DBP, mean arterial pressure (MAP), and positive affect. Ad lib cigarette smoking during the previous 30 min did not have a significant effect on mood or cardiovascular parameters, except in non-PTSD smokers who reported lower depression/anxiety ratings after smoking. Findings suggest that the effect of smoking on cardiovascular parameters may be amplified in smokers in PTSD. Findings suggest that the interrelationships among cardiovascular parameters, cigarette smoking, and PTSD deserve more research attention.     

Smoking and hypertension: effects on clinical, biochemical and pathological variables due to isolated or combined action on cardiovascular system

Changes in clinical, biochemical and pathological variables characterize cardiovascular damage from smoking and hypertension when it acts independently. However, combined action of these major risk factors increases the rate of cardiovascular events. Ischaemic heart disease with stable effort angina, myocardial infarction and post-infarction arrhythmias may affect cardiovascular system because of smoking exposure. Among cerebrovascular disease, there is evidence that stroke would be related primarily to active smoking. Isolated hypertension plays significantly major action to cause cerebrovascular disease including stroke, recurrent stoke and transient ischaemic attack. Among cardiac events, heart failure is, often, the end-point of hypertensive disease, even if manifestations of ischaemic heart disease similar to those caused by smoking may be increased in rate. Combined action of smoking and hypertension usually increases the rate of cardiovascular complications and leads to a progression of atherosclerosis with narrowing and plaque primarily at the the level of coronary, carotid and cerebrovascular arteries. A pattern specific of both active and passive smoking exposure, but not hypertension, is the thromboangiitis obliterans that dramatically worsens in continuing smokers while it can be improved by stopping smoking.     

Acute psychomotor,subjective and physiological responses to smoking in depressed outpatient smokers and matched controls

Rationale Cigarette smoking is highly prevalent in people diagnosed with depression, and depressed smokers are less likely to quit. Examining depressed smokers’ responses to smoking will help determine the role of depression in maintaining cigarette smoking. Objectives To determine the psychomotor, subjective and physiological effects of cigarette smoking in currently depressed smokers versus matched controls. Materials and methods Fourteen currently depressed smokers and 14 never-depressed smokers, matched in age, gender, nicotine dependence and daily cigarette consumption, smoked three cigarettes at half-hourly intervals. All smokers were non-deprived. Self-reported mood and craving for cigarettes, performance on a simple reaction time task, expired-air carbon monoxide, heart rate and blood pressure were assessed before and after smoking each cigarette. Smoking topography was also assessed. Results Depressives and controls did not differ in terms of dependence on cigarettes or expired-air carbon monoxide. Topographic and cardiovascular measures were similar in depressed and control participants, suggesting that they smoke cigarettes in a similar manner. However, depressives displayed enhanced reaction time performance after the first cigarette. Positively reinforced craving was reduced after smoking each cigarette but returned to baseline levels within 30 min in depressed but not in control smokers. Depressed smokers also displayed higher levels of negatively reinforced craving. Both depressives and controls reported improved positive mood after smoking. Conclusions Cigarette smoking in non-deprived depressed smokers enhances psychomotor performance and the reduction of positively reinforced craving in depressed smokers after smoking is transient, suggesting that enhanced craving may play a role in the maintenance of smoking in depression.     

Interactive effect of combined exposure to active and passive smoking on cardiovascular system

A great number of observations show that cardiovascular damage from smoking may be a consequence of both active and passive smoking exposure. Some findings identify an increase in cardiovascular events in active smokers as well as in non-smokers exposed to passive smoking. The type and extension of damage seem to be similar qualitatively either in active smokers or in exposed never smokers. Artery vessels and myocardium feel particularly the effects of smoking. Ischaemic heart disease and atherosclerosis progression are the common alterations observed. Individuals exposed to both active and passive smoking feel the adverse effects of smoking. Result of the interaction consists primarily of increased rate of clinical events whereas the type of anatomical alterations is similar to those which characterize respectively isolated exposure to active or passive smoking. However, the extension of cardiovascular damage may vary even if, usually, in the same location of pre-existing lesions. The article also presents some of the patents regarding the effects of smoking on cardiovascular system.     

Exposure to smoking cues: cardiovascular and autonomic effects

Laboratory exposures to smoking cues have been shown to reliably induce self-reported cigarette cravings among smokers, a model of environmentally triggered urges to smoke that can contribute to poorer cessation success. Several studies have also demonstrated that cue exposures give rise to changes in heart rate and blood pressure. Few studies, however, have investigated possible cue effects on heart rate and blood pressure variability (HRV and BPV). Particularly intriguing in this regard are cardiac oscillations in the low (i.e., 0.04-0.15 Hz), and high (i.e., 0.15-0.50 Hz) frequency range, which are thought to reflect components of autonomic control and response to environmental challenges. A closer examination of cardiovascular reactivity may thus help characterize the autonomic response to smoking cue exposure. To that end, an experimental study was conducted in which nicotine dependent daily smokers (n=98) were exposed to guided imagery of neutral and smoking situations, while continuous, noninvasive, beat-to-beat cardiovascular data were collected. Consistent with previous research, the findings revealed significant increases in both systolic and diastolic blood pressure during smoking imagery, relative to neutral imagery. In addition, power spectral density analyses of heart rate and blood pressure variability revealed elevated HRV and BPV in both the low- and high-frequency ranges during the smoking imagery. The results suggest the presence of an autonomic component to smoking cue reactivity, and also raise the possibility of long-term negative cardiac consequences for smokers who ubiquitously encounter cues in their daily environments.     

Paced smoking in the laboratory and in the natural smoking setting: differential situation-specific effects in light and heavy smokers

The present study examined the situation-specific effects of smoking using a paced regimen of smoking to control the smoke intake. The subjects were first required to sham smoke and then actually smoke one of their cigarettes in two different test contexts: 1) in the laboratory where they had never previously smoked and 2) at home, alone in a quiet room where they regularly smoke. Light (<10 cigarettes/day) and heavy smokers (> 15 cigarettes/day) were studied to test for a possible effect of the paced regimen itself. In the light smokers, smoking produced a larger increase in heart rate (HR) in the laboratory than in the natural smoking environment; however, in the heavy smokers the smoking had a larger effect in the normal smoking environment than in the laboratory. There were no significant group or test situation differences for baseline HR, skin conductance and finger temperature. The groups also did not differ in the intensity of drawing on the cigarette or inhaling, as indicated by a puff sensor and a respiratory belt, respectively. It was concluded that differences between the effects of a cigarette in a laboratory setting and in a natural smoking environment may reflect pharmacodynamic effects of smoking that are modified by the subjects’ prior experience with smoking. The data are discussed with regard to conditioned tolerance to the effect of smoking.     

Paced smoking in the laboratory and in the natural smoking setting: differential situation-specific effects in light and heavy smokers

The present study examined the situation-specific effects of smoking using a paced regimen of smoking to control the smoke intake. The subjects were first required to sham smoke and then actually smoke one of their cigarettes in two different test contexts: 1) in the laboratory where they had never previously smoked and 2) at home, alone in a quiet room where they regularly smoke. Light (< 10 cigarettes/day) and heavy smokers (> 15 cigarettes/day) were studied to test for a possible effect of the paced regimen itself. In the light smokers, smoking produced a larger increase in heart rate (HR) in the laboratory than in the natural smoking environment; however, in the heavy smokers the smoking had a larger effect in the normal smoking environment than in the laboratory. There were no significant group or test situation differences for baseline HR, skin conductance and finger temperature. The groups also did not differ in the intensity of drawing on the cigarette or inhaling, as indicated by a puff sensor and a respiratory belt, respectively. It was concluded that differences between the effects of a cigarette in a laboratory setting and in a natural smoking environment may reflect pharmacodynamic effects of smoking that are modified by the subjects' prior experience with smoking. The data are discussed with regard to conditioned tolerance to the effect of smoking.     

The addiction Stroop task: examining the fast and slow effects of smoking and marijuana-related cues

Research has shown that attentional bias toward smoking-related stimuli is related to the maintenance of smoking behaviour and the chance of a relapse during a quit attempt. Effects of smoking attentional bias can occur both during smoking stimulus presentation (fast effect) and on stimuli that immediately follow smoking stimuli (slow effect). The current research builds on these findings by closely examining the temporal aspects of these fast and slow effects across groups of different smoking status. In Experiment 1 (n = 64), smokers, smokers attempting to quit (SATQ) and non-smokers completed an addiction Stroop task using smoking related, negative emotion and neutral stimuli. In Experiment 2 (n = 32), marijuana smokers and non-marijuana smokers completed an addiction Stroop task using marijuana and neutral stimuli. Results showed fast effects across all smoking groups (except non-smokers) and slow effects in SATQ and marijuana smokers. Furthermore, marijuana smokers showed slow effects over extended periods of time. Results also show a relationship between anxiety, nicotine dependence and attentional bias in SATQ. The implications of these findings are discussed.     

Attention,memory, and cigarette smoking

Four experiments tested the effects of smoking one cigarette on verbal memory and attention. In Experiment I, 18 men were tested under three conditions in a repeated-measures design (pretrial smoking, posttrial smoking, no smoking). Recall of a 50-word list was tested immediately and after intervals of 10 and 45 min. Pretrial smoking resulted in improved recall 10 and 45 min after learing, but not immediately. Posttrial smoking was ineffectual. In Experiment II, three posttrial smoking intervals (1, 5, and 30 min after presentation of a 20-word list) were compared with pretrial smoking and no smoking using a between-subjects design. The 76 light, moderate, and heavy smokers in Experiment II smoked a 1.38 mg nicotine cigarette and were tested 24 h later. Improved recall occurred for pretrial smoking, but not for any posttrial smoking interval and for light and moderate smokers only. Experiment III compared a low (0.40 mg) and high (1.38 mg) level of nicotine cigarette in light and heavy smokers using pretrial smoking. The high-nicotine cigarette resulted in improved recall for both immediate- and delayed-recall tests. The lownicotine cigarette was less effective. Light and heavy smokers different in effect of smoking on heart rate, but not in effect of smoking on recall. Experiment IV found no effect of smoking on depth of processing. The possible mechanisms by which nicotine affects recall are discussed.     

Attenuated adrenocortical and blood pressure responses to psychological stress in ad libitum and abstinent smokers

Chronic smoking may alter physiological systems involved in the stress response. This study was designed to examine the effects of ad libitum smoking and abstinence on adrenocortical and cardiovascular responses to acute psychological stress in dependent cigarette smokers. We evaluated differences among abstinent smokers, smokers who continued to smoke at their normal rate, and nonsmokers in salivary cortisol concentrations, systolic and diastolic blood pressure (BP), heart rate (HR), and mood reports. Measurements were obtained during rest and in response to acute psychological stress (public speaking) in one session (stress session) and during continuous rest in a control session. Thirty-eight smokers (21 women) and 32 nonsmokers (18 women) participated. Smokers were assigned to either abstain from smoking the night prior to and the day of each session, or to continue smoking at their normal rate before each session. All groups showed significant stress-induced changes in BP and HR. Smokers, regardless of their assigned condition, showed attenuated systolic BP responses to the public-speaking stressor when compared to nonsmokers. While resting cortisol levels were greater among smokers than nonsmokers, no cortisol response to the acute stressor was demonstrated in either ad libitum or abstinent smokers. These results indicate that chronic smoking diminishes adrenocortical and cardiovascular responses to stress, and that short-term abstinence does not correct these alterations.     

Smoking trajectories,health, and mortality across the adult lifespan

This study extends research on the association between smoking behavior and chronic disease by following a cohort from the time of initiation of regular smoking patterns into old age and by examining the association of lifetime smoking trajectories with chronic disease and mortality. Participants consisted of 232 males selected from the Harvard classes of 1942–1944 and followed biennially through 2003. Five distinct smoking trajectories were identified based on the age at which participants quit daily smoking. Participants following smoking trajectories with later cessation had a higher likelihood of developing lung disease and lived shorter lives than those who quit smoking at an earlier age. This study confirms that the earlier a smoker quits, the greater the health benefits, and that these benefits are observed even decades after smoking cessation. Additionally, by showing different survival rates between trajectory groups 25 and 40 years after quitting, the results run counter to previous work that has found no difference in mortality between smokers and non-smokers 15 years after cessation.     

A nicotine dependent and a nicotine independent component of smoking related pulse and activity variation

In a field study, heart rate and motor activity were continuously assessed during two days in smokers, abstinent smokers and non-smokers. Smoking abstinence reduced heart rates by about 10 bpm to the non-smoker level without affecting motor activity. Averaging heart rate and activity using lighting of the cigarettes as the triggering event revealed the characteristic profiles described previously. Both variables increased during the last five minutes before lighting the cigarettes and decreased immediately upon lighting to near or even below the prelighting levels. This lighting response was maintained in a similar fashion when the subjects marked the time points of the desire for smoking but omitted lighting the cigarettes and it remained highly similar for the first and last five cigarettes of the day. In non-smokers a similar pattern was also obtained using the first sip of coffee as triggering event. In smoking smokers, this lighting response was followed by an increase of heart rate without changes in activity. In contrast to the lighting response, this smoking related increase of heart rate disappeared for the last five as opposed to the first five cigarettes of the day, and it was also absent for ‘imaginary’ smoking without lighting.