, 2009; Perkins, Mercincavage, Fonte, & Lerman, 2010; West, Baker, Cappelleri, & Bushmakin, 2008). Blocking or attenuating the rewarding and subjective effects of nicotine may be an important and unique aspect of the psychopharmacology of varenicline. Research suggests that the www.selleckchem.com/products/Oligomycin-A.html majority of smokers (95%) who take even a few puffs from a cigarette early in their quit attempt (i.e., experience a smoking lapse) soon relapse and may return to prequit levels of smoking (Brandon, Tiffany, Obremski, & Baker, 1990; Kenford et al., 1994). Shiffman, Ferguson and Gwaltney (2006) found that higher hedonic ratings associated with a smoking lapse (i.e., pleasantness of the cigarette, satisfying) were predictive of smoking relapse.

This suggests that a medication-produced attenuation of the subjective reward associated with a lapse cigarette may protect smokers who lapse from progressing to full relapse during a quit attempt. In placebo-controlled clinical trials conducted with varenicline, patient reports suggest that varenicline indeed reduced the subjective rewarding effects of lapse cigarettes (Gonzales et al., 2006; Jorenby et al., 2006; Oncken et al., 2006). However, the lapse cigarette ratings obtained in these studies were retrospective, which introduces the potential for recall bias, and were restricted to those who experienced a smoking lapse, which introduces the potential for sample bias. Thus, a prospective evaluation of varenicline on lapse cigarette effects is required to validate this finding.

A model of smoking cessation and relapse has been developed in which a brief period of objectively verified abstinence is followed by a programmed smoking lapse in a laboratory setting (Chornock, Stitzer, Gross, & Leischow, 1992; Juliano, Donny, Houtsmuller, & Stitzer, 2006). In this model, all participants experience the smoking lapse, and subjective ratings of the cigarette(s) can be immediately completed. Using this lapse model, Patterson et al. (2009) showed that varenicline, compared with placebo, improved mood and cognition, decreased the subjective rewarding effects of a smoking lapse, and increased latency to relapse in a subsequent 1-week quit attempt. However, this study used a within-subjects design and an order effect was observed such that varenicline��s relapse prevention effects were more robust in participants who received varenicline after exposure to placebo, suggesting that repeated exposure to the smoking cessation protocol impacted the study outcomes.

In a second study, Perkins et al. (2010) found decreases in smoking reward during varenicline administration compared with placebo but found no difference in abstinence rates during a subsequent 1-week quit attempt. It is possible that the sensitivity to detect between group relapse rate differences may have been Dacomitinib hindered by the short (1-week) postlapse assessment period. The current study was conducted to extend research with varenicline using the experimental lapse model.