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A Person-Centered Analysis of Craving in Smoking-Cue-Exposure Research

Smoking-cue-exposure research offers a powerful method to examine craving, test new interventions, and identify at-risk smokers. Meta-analyses consistently show smoking-cue exposure increases craving levels. By focusing on mean levels, however, investigators fail to consider person-centered analyses addressing the percentage of smokers responding to cue exposure with increased urge. We conducted preregistered analyses of the percentages of 672 nicotine-deprived daily smokers (pooled from seven studies) who reported target levels of urge before and during smoking-cue exposure. Sixty-nine percent of smokers increased their ratings during cue exposure. Note that 31% of nonresponders reported a maximal urge before cue exposure, which precluded their classification as a responder using traditional cue-reactivity analyses and suggests that traditional analyses underreport cue-reactivity effects. An alternative, peak-provoked-craving analysis revealed the effectiveness of cue exposure to generate potent urges (more than three quarters of the sample reported at least 70% of scale maximum). Further research integrating person-centered analyses into the craving literature promises to advance addiction theory and research.