Neural Mechanisms Associated With Risk of Smoking Relapse

Inclusion Criteria

Eligible participants will be:

• Treatment-seeking smokers between the ages of 18 and 65, reporting consumption of at least 5 cigarettes per day for at least the past 6 months;
• Planning to live in the area for at least the next 3 months;
• Capable of giving written informed consent, which includes compliance with the requirements and restrictions listed in the combined consent and HIPAA form;
• Able to communicate fluently in English (speaking, writing, and reading).

Exclusion Criteria

Subjects who present and/or self-report with the following criteria at any point during study participation will not be eligible to participate in the study:

Smoking Behavior:

• Use of chewing tobacco or snuff or cigars;
• Current enrollment or plans to enroll in another smoking cessation program or research study in the next 3 months;
• Current or anticipated (within the next 3 months) use of smoking cessation medications or nicotine replacement therapy (NRT);
• A baseline carbon monoxide (CO) reading less than or equal to 8ppm.

Alcohol/Drugs:

• Diagnosis or treatment for alcohol or drug abuse in the past two years as reported during phone screen (e.g., alcohol, opioids, cocaine, or stimulants);
• Current alcohol consumption that exceeds 25 standard drinks/week;
• Positive breath alcohol concentration test (BrAC greater than or equal to 0.01) at intake;

a. Participants testing positive for breath alcohol with a reading equal to or greater than .08 (the legal driving limit) or who are visibly impaired will be instructed not to drive themselves home after the appointment. If a participant needs to use a phone to call for a safe ride home, an office telephone will be made available to the participant.

• A positive urine drug screen for cocaine, opiates, PCP, benzodiazepines, methadone, MDMA, amphetamine, methamphetamine, tri-cyclic antidepressants and/or barbiturates at any session;

Medication:

Current use or recent discontinuation (within the past 30 days at the time of Intake) of:

• Smoking cessation medication (e.g., Zyban, Wellbutrin, Wellbutrin SR, Chantix, NRT);
• Anti-psychotic medications;
• Anti-depressants (tricyclics, SSRI's, selective and nonselective MAOIs, Wellbutrin/Zyban);
• Anti-anxiety agents;
• Anti-panic agents;
• Prescription (e.g., Provigil, Ritalin) or over-the-counter stimulants;
• Prescription sleep aids (e.g., Ambien, Lunesta) if used more than 2x/week. If participants report use less than twice a week, they will just be asked to refrain from use during imaging portion of the study.
• Any medication that could compromise participant safety as determined by the Principal Investigator and/or Study Physician;

Daily use of:

• Opiate-containing medications for chronic pain.

Medical/Neuropsychiatric:

• Women who are pregnant, planning a pregnancy, and/or breast feeding. All female subjects of childbearing potential will undergo a urine pregnancy test at Intake and both fMRI scan visits (3 urine pregnancy tests in total).
• History of epilepsy or a seizure disorder;
• History of stroke;
• Self-reported brain or spinal tumor;
• Self-reported history or current diagnosis of psychosis, bipolar disorder, schizophrenia, current major depression (subjects with a history of major depression but in remission for past 6 months are eligible), or any Axis 1 disorder.

fMRI-Related:

• Self-reported history of head trauma;
• Self-reported brain (or CNS) or spinal tumor;
• Self-reported use of pacemakers, certain metallic implants, or presence of metal in the eye as contraindicated for fMRI;
• Self-reported history of claustrophobia;
• Being left-handed;
• Color blindness;
• Weight greater than 299lbs;
• Self-reported history of gunshot wounds;
• Any impairment preventing participants from using the response pad necessary for the cognitive testing;
• Circumstances or conditions that may interfere with magnetic resonance imaging (MRI).

General Exclusion:

• Any medic