The effects of psychological stress on approach tendencies for smoking-related cues in smokers.

Stress may potentiate the chronification of nicotine addiction, but the exact mechanisms remain elusive. We performed an explorative pilot study examining the effects of psychological stress, administered via the socially evaluated cold pressor task (SECPT), on implicit approach bias for smoking-related cues in smokers in the approach-avoidance task (AAT). Smokers (N=24) were subjected to the stress or control condition of the SECPT by using a within-subject design. Consistent with previous findings, a strong approach bias for smoking-related cues in the AAT was found in smokers. Exposure to stress did not affect the general bias for smoking-related cues in the AAT relative to the control condition of the SECPT. In additional explorative analyses, an interaction between carbon monoxide (CO) levels in expired air, cortisol levels, and stress on approach bias for smoking-related cues was found. Higher CO levels, possibly due to recent smoking, prior to stress exposure were associated with an approach bias for smoking-related cues. Our findings suggest that CO levels in interaction with stress can modulate implicit, automatic processing in the context of nicotine-addiction. Our findings might provide novel cues to how stress influences cigarette craving and smoking behavior.