Relevance of Cue Reactivity to Understanding Alcohol and Smoking Relapse

Raymond S. Niaura, Damaris J. Rohsenow, Jody A. Binkoff, Peter M. Monti, Magda Pedraza, David B. Abrams

Research output: Contribution to journalArticlepeer-review


Several learning-based theories have been forwarded to account for the problem of drug relapse, including conditioned withdrawal, conditioned compensatory responding, appetitive motivational models, and social learning models. The various models are compared and evaluated against available evidence from studies with humans pertaining to alcohol and tobacco addiction. Studies that are reviewed focus primarily on the antecedents and consequences of alcohol and smoking relapse, as well as on reactions to cues that have been associated with prior drug ingestion, in an attempt to understand their motivational relevance. Problems in evaluating the various relapse models in humans are discussed. It is concluded that the appetitive model is better supported than withdrawal model, and the compensatory model is least supported. Reactions to substance use stimuli may play an important role in alcohol and smoking relapse. Concepts drawn from the various theoretical models are linked tentatively in a schematic diagram of a hypothesized sequence of cognitive/affective, physiological, and behavioral events that lead to initial drug use after a period of abstinence (slip) and then to continued use (a relapse). The treatment implications of some of the cue reactivity models are discussed.

Original languageEnglish (US)
Pages (from-to)133-152
Number of pages20
JournalJournal of abnormal psychology
Issue number2
StatePublished - May 1988

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry


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