Naturalistic measurement of dual cue attentional bias in moderate to heavy-drinking smokers: A preliminary investigation.

ABSTRACT

INTRODUCTION: Although cigarettes and alcohol are frequently used together, few studies have evaluated evidence of attentional bias to both smoking and alcohol cues. Attentional bias (AB) is defined as preferential attention to drug-specific cues and is most often studied in a laboratory with one cue type. AB may be an important mechanism associated with cigarette and alcohol co-use. In this study, we evaluated AB to both smoking and alcohol cues in daily life using ambulatory assessment. METHODS: Daily smokers (N = 21) who consume moderate to heavy amounts of alcohol completed surveys and a dot probe task four times per day using a personal digital assistant over a period of 1 week. RESULTS: Aggregated over subjects, there was evidence of AB to smoking and AB to alcohol cues. When smoking AB was higher than the person-specific average, alcohol AB was elevated, and when alcohol AB was higher than the person-specific average, smoking AB was elevated. AB was not significantly associated with craving for cigarettes or alcohol. CONCLUSIONS: It is feasible to assess AB for cigarette and alcohol cues using ambulatory assessment. To the best of our knowledge, this is the first study to report a within-subject association between AB for two drug cues. The relationship between cigarette and alcohol use is likely dynamic and depends on context and exposure to substance-specific cues. Additionally, a larger sample may be needed to evaluate relationships between AB and craving. Further research on possible cognitive mechanisms that increase the likelihood of co-use can inform targeted interventions.