提取-消除程序對重度吸菸者在內隱與外顯認知的影響

在眾多死亡原因中，菸草雖被認為是可被預防的首要死因，然根據行政院衛福部國民健康局(2018)的調查發現，菸害在台灣每年仍至少造成2萬7,000人死亡。近年來，記憶的提取-消除程序(The memory retrieval-extinction procedure)（簡稱提取-消除程序）被視為一種能使戒除者在戒除期間，降低其對藥物的渴求以及復發之有潛力的非藥物方法。關於提取-消除程序，過去的研究多數在動物研究上，且未探討其對認知的影響。鑑於此，本研究欲瞭解提取-消除程序對重度吸菸者的外顯認知與內隱認知的影響，為少數將提取-消除程序應用於人類參與者的研究。 本研究共招募75位（實驗組28位；控制組26位）每日至少抽10根菸，且至少維持一年的男性參與者，並追蹤參與者的認知變化至21天後。在測量內隱認知上，採用情緒促發作業(Affective Priming Task)與視覺偵測作業(Visual probe task)。在測量外顯認知上，採用自陳式量表主觀渴求度、物質使用疾患確認檢查表(Drug Use Disorders Identification Test-Extended; DUDIT-E)及尼古丁成癮度量表(Fagerstrom Test for Nicotine Dependence)。綜合研究結果發現，記憶的提取-消除程序無法影響重度吸菸者的內隱認知與外顯認知。

The retrieval-extinction procedure (the RE procedure) is a nonpharmacological and noninvasive method for decreasing addictive substance use. Many studies employed this procedure on the animal models, rather than the human participants. Also, the above-mentioned studies did not consider participants’ explicit and implicit cognitions toward addictive substances, critical for substance use. We aimed to examine whether that the RE procedure can alter the heavy smokers’ implicit attitudes and explicit attitudes. Heavy smokers with high motivation to quit smoking were assigned randomly to the RE group (N=28) or active control group (N=26). We measured heavy smokers’ implicit (attentional bias and affective priming effect task) and explicit (self-reported craving, DUDIT and FTND) cognitions at three time points: Before and after the manipulation (the RE or the active control) and 21 days after the manipulation (follow-up). There has no significant between-group differences on attentional bias, DUDIT and FTND across three time points. We found that the current study did not show the RE effects on the alternations of the heavy smokers’ implicit and explicit cognitions. The current study is one of the few human studies adopted the RE procedure. Also, among these studies, the current study is the only one to examine the possible variations of heavy smokers’ implicit and explicit cognitions caused by the RE procedure.