Although craving has long been hypothesized to play a role in addiction (Niaura et al., 1988
; World Health Organization, 1955
), only recently has research provided support for this belief. Observational studies have found that craving ratings predict drug relapse in both adults (e.g., Killen & Fortmann, 1997
; Shiffman et al., 1997
) and adolescents (e.g., Bagot, Heishman, & Moolchan, 2007
). Other studies have disentangled the cognitive and motivational dimensions of craving (see Baker, Morse, & Sherman, 1987
; Sayette, 2004
) and identified effects ranging from impacts on basic perception to consequences for higher-order decision making. For example, studies using diverse methods, such as dot-probe tasks, emotional Stroop tasks, and eye tracking, have found that drug craving draws upon attentional resources and focuses attention on drug-related cues and away from stimuli unrelated to drug use (e.g., Cepeda-Benito & Tiffany, 1996
; Cox, Fadardi, & Pothos, 2006
; Sayette & Hufford, 1994
; Waters & Sayette, 2006
), and, more specifically, one study has found that such attentional bias actually predicts smoking relapse (Waters et al., 2003
In addition to changes in attentional processes, a variety of cognitive and decision-making shifts that may promote smoking have been observed (Sayette, Martin, Hull, Wertz, & Perrott, 2003
). For example, compared with when they are not craving, smokers who are craving tend to generate more positive, but not more negative, aspects of smoking (Sayette & Hufford, 1997
), and also to evaluate positive, but not negative, consequences of smoking to be more likely to occur (e.g., Sayette, Loewenstein, Kirchner, & Travis, 2005
). According to this motivated-cognition view of craving, the decision to smoke is thought to become more attractive during high craving states (see Sayette, 2004
). Craving smokers also tend to anticipate that their craving will intensify over time if they do not smoke, although in actuality this often is not the case (Sayette et al., 2005
, Experiment 2). Finally, studies have found that craving smokers experience a slowing down of time (Klein, Corwin, & Stine, 2003
; Sayette et al., 2005
), which is consistent with Vohs and Schmeichel’s (2003)
depiction of an “extended now” state. Both the anticipated intensification of craving and the feeling that time is moving slowly may contribute to a sense of desperation among smokers trying to resist an urge to smoke.
Drug addiction is not the only motivational state that produces such wide-ranging effects. According to a “visceral model of addiction” proposed by Loewenstein (1999)
, drug addiction is only one, albeit an extreme, example of a wide range of behaviors that are influenced or controlled by “visceral factors,” which include, in addition to drug craving, motivational states (e.g., hunger, thirst, and sexual desire), moods and emotions, and physical pain.
One key premise of the visceral account of addiction is that people underestimate the extent to which visceral factors they will experience in the future will affect their own behavior. This is referred to as the cold-to-hot empathy gap
—the tendency for individuals when “cold” (i.e., when not experiencing an elevated visceral factor) to mispredict how they will behave when “hot” (i.e., when experiencing an elevated visceral factor; Loewenstein, 1996
), in part because they cannot recall the intensity of their own past cravings.
In a series of studies dealing with a range of positive and negative visceral states, Loewenstein and other researchers have documented the occurrence of cold-to-hot empathy gaps for visceral states as diverse as sexual arousal, hunger, pain, and embarrassment (see Loewenstein, 2004
). Moreover, a preliminary study involving 13 heroin users provided support for the cold-to-hot empathy gap with respect to drug craving (Badger, Bickel, Giordano, Jacobs, & Loewenstein, 2007
). The study found that addicts placed greater monetary value on receiving an extra dose of opiate 5 days later if they made the decision right before receiving their current opiate treatment (when they were likely to be in a high-craving state) than if they made the same decision minutes later, after they had received their current treatment and were in a low-craving state.
Other research has examined the consequences of cold-to-hot empathy gaps for a wide range of behaviors and attitudes. In one set of studies, participants evaluated a person who succumbed to a visceral drive more negatively when they were not themselves experiencing the same drive (Nordgren, van der Pligt, & van Harreveld, 2007
) than when they were experiencing that drive. For example, people evaluated an individual who stuffed himself with hamburgers much more unfavorably when they themselves were not hungry than when they were hungry. In another set of studies, people were less merciful in evaluating their own past viscerally motivated behavior when they were not currently experiencing the same visceral state (Nordgren, van der Pligt, & van Harreveld, 2006
). And in the study most closely related to the current study (Nordgren, van der Pligt, & van Harreveld, in press
), smokers who were induced to experience cigarette craving were less optimistic about their own ability to quit than were satiated smokers and, as a result, expressed lower intentions to quit smoking in the future.
In the study reported here, we examined the cold-to-hot empathy gap in a group of active smokers, and specifically examined whether the monetary value that smokers place on future smoking depends on their current state of craving. If smokers who are not craving have trouble imagining what it is like to crave, as predicted by the cold-to-hot empathy gap, then they should place a lower value on future smoking than those who are actively craving.
Participants in the two key conditions attended two sessions. In the initial session, they were either craving or not craving, and were asked to predict how much money they would need to postpone smoking during a future session, when they would be craving. During the second session, they were given a chance to revise their valuations. The rewards received for actually postponing smoking were both real (i.e., additional money) and immediate. This type of measure has several advantages over more traditional choice measures that have involved hypothetical outcomes (e.g., Perkins, Grobe, & Fonte, 1997
). A behavioral choice measure with real consequences also addresses concerns about the sensitivity of self-report ratings of motivation. Ratings of the urge to smoke are often subject to ceiling effects because it is common for nicotine-deprived smokers to provide maximal or near-maximal ratings (see Sayette et al., 2000
). Were high urge ratings to be recorded during the initial session, it would be virtually impossible for them to underpredict urges during the second session. (For a detailed discussion of the advantages of a nonhypothetical behavioral choice measure over self-report ratings of visceral states, see Read & Loewenstein, 1999
In sum, we hypothesized that smokers would exhibit a cold-to-hot empathy gap. Specifically, we hypothesized that participants in a noncraving state (in Session 1) would assign lower values to being able to smoke at a future point when they would be craving (in Session 2) than they would assign at that future time (i.e., they would underpredict their future craving); in contrast, we hypothesized that this underprediction would not be observed among participants who made the initial prediction while in a craving state.