Temporal discounting and smoking cessation: choice consistency predicts nicotine abstinence in treatment-seeking smokers
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ORIGINAL INVESTIGATION
Temporal discounting and smoking cessation: choice consistency predicts nicotine abstinence in treatment-seeking smokers Charlotte M. Grosskopf 1 & Nils B. Kroemer 1,2 & Shakoor Pooseh 1,3 & Franziska Böhme 1 & Michael N. Smolka 1 Received: 12 October 2019 / Accepted: 19 October 2020 # The Author(s) 2020
Abstract Introduction Smokers discount delayed rewards steeper than non-smokers or ex-smokers, possibly due to neuropharmacological effects of tobacco on brain circuitry, or lower abstinence rates in smokers with steep discounting. To delineate both theories from each other, we tested if temporal discounting, choice inconsistency, and related brain activity in treatment-seeking smokers (1) are higher compared to non-smokers, (2) decrease after smoking cessation, and (3) predict relapse. Methods At T1, 44 dependent smokers, 29 non-smokers, and 30 occasional smokers underwent fMRI while performing an intertemporal choice task. Smokers were measured before and 21 days after cessation if abstinent from nicotine. In total, 27 smokers, 28 non-smokers, and 29 occasional smokers were scanned again at T2. Discounting rate k and inconsistency var(k) were estimated with Bayesian analysis. Results First, k and var(k) in smokers in treatment were not higher than in non-smokers or occasional smokers. Second, neither k nor var(k) changed after smoking cessation. Third, k did not predict relapse, but high var(k) was associated with relapse during treatment and over 6 months. Brain activity in valuation and decision networks did not significantly differ between groups and conditions. Conclusion Our data from treatment-seeking smokers do not support the pharmacological hypothesis of pronounced reversible changes in discounting behavior and brain activity, possibly due to limited power. Behavioral data rather suggest that differences between current and ex-smokers might be due to selection. The association of choice consistency and treatment outcome possibly links consistent intertemporal decisions to remaining abstinent. Keywords Choice consistency . fMRI . Intertemporal choice . Relapse . Smoking . Tobacco
Introduction The concept that a reward’s value decreases when being delivered with delay is described as temporal or delay discounting (Mischel, 1966; Stevens, 1975). Economic deciSupplementary Information The online version contains supplementary material available at https://doi.org/10.1007/s00213-02005688-5. * Michael N. Smolka [email protected] 1
Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, 01187 Dresden, Germany
2
Department of Psychiatry and Psychotherapy, University of Tübingen, 72076 Tübingen, Germany
3
Freiburg Center for Data Analysis and Modeling (FDM), University of Freiburg, 79098 Freiburg, Germany
sion theory posits that the choice between two outcomes is based on the utility or value of each offer (Neumann and Morgenstern 1944). For instance, who would not choose €10 immediately over €10 in 1 year? But what if the later amount was €11 o
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