A comprehensive analysis of craving in smoking cue-exposure research: Differential associations across racial identity and sex.

Abstract

Smoking cue-exposure research provides a powerful experimental method to investigate craving, test new treatments, and identify individuals and groups who may be at heightened risk for relapse. Exposure to smoking cues consistently increases craving levels, and research indicates that these peak cravings reliably predict a range of clinically meaningful outcomes. To date, studies have been underpowered, however, to evaluate sociodemographic differences in lab-based cravings. This is unfortunate, as differences across racial identities and sex exist in smoking trends and health-related consequences of smoking. The present cue-exposure study leveraged a large sample size and a multifaceted statistical approach, using both means-based and person-centered analyses, to examine craving dynamics among Black and White and male and female smokers. We conducted preregistered analyses of 617 nicotine-deprived individuals who smoke daily (pooled from seven studies) reporting levels of urge before and during smoking cue exposure (i.e., holding a lit cigarette). The results indicated that Black female and male participants exhibited heightened urge ratings at the outset of the study and were more prone to experiencing maximal peak-provoked craving during cue exposure compared to White female and male participants. Further, White female participants demonstrated heightened cue reactivity relative to White male participants. Findings provide compelling evidence to support a more comprehensive approach to understanding experimentally induced cigarette craving than is currently employed in the literature and highlight the importance of considering intersecting identity factors when examining craving. Clinically, the results underscore the value of lab-based research to address racial and sex inequities in smoking behavior and health outcomes. (PsycInfo Database Record (c) 2025 APA, all rights reserved).