Rapid smoking may not be aversive in schizophrenia

Introduction: Aversive smoking has been investigated as a smoking cessation technique that involves rapid smoking in a clinic or laboratory and typically involves (a) puffing every 6-10 s or (b)smoking 3 or more cigarettes sequentially in 8-20 min. Rapid smoking usually results in dizziness, sore throat, nausea, and other unpleasant feelings. Methods: To explore rapid smoking, 161 smokers (75 with schizophrenia [SS]; 86 controls [CON]) were assessed in a single day (24 ± 2 hr), ad libitum smoking topography session using the Clinical Research Support System micro portable topography device. Results: SS smoked significantly more cigarettesin the 24-hr period versus CON and the time between puffs, or interpuff interval (IPI) was shorter in SS versus CON by an average of6.5 s (p < .001). The median IPI was also significantly shorter in SS versus CON (9.3 vs.15.7 s; p < .001). SS were twice aslikely to have IPIs=6 s than CON (OR=2.32, 95% CI=1.68, 3.20; p < .001). SS were also more likely to smoke 3 or more cigarettes in any 20 min during a 24-hr topography session (OR=2.32, 95% CI=1.03,2.44; p < .001). Rapid smoking was associatedwith baselinecharacteristics of smoking more cigarettes per day, higher Fagerstr̈m score, and higher carbon monoxide level but notwith serum cotinine values or trans-3'-hydroxycotinine/cotinine ratios. Conclusions: Using either definition, SS exhibit patterns of rapid smoking that they seemingly do not experience as aversive, since it reflects their naturalistic pattern of smoking, outside of the laboratory.