Background. Special populations like people living with HIV/AIDS (PLWHA) and people with opioid use disorder (OUD) smoke tobacco cigarettes at rates three to four times greater than the general population. Patients with tobacco use disorder exhibit attentional bias (AB) for cigarette cues, which is theorized to be caused by classical conditioning and motivational salience. Eye tracking can quantify this bias by measuring fixation time (FT) on cigarette and matched neutral cues, which consequently helps calculate an AB score. Although previous studies have measured this bias in people who smoke without any other comorbid conditions, no study has measured this bias in special populations. Methods. We analyzed eye tracking data collected from participants in two randomized clinical trials (RCTs). The study protocols that recruited participants were approved by Medical Institutional Review Board (IRB) at University of Kentucky and were registered on clinical trials.gov (NCT05049460, NCT05295953). We compared FT and AB score towards cigarette cues between PLWHA and people with OUD who smoke, using a visual probe task and Tobii Pro Fusion eye tracker. We used two cigarette cue types, one encompassing people smoking cigarettes and the other consisting of cigarette paraphernalia. We used two cue presentation times, 1000 and 2000 milliseconds (ms). Results. Cues of people smoking cigarettes elicited greater AB than cues of cigarette paraphernalia across both subject groups when cues were presented for 2000 ms, but not 1000 ms. PLWHA who smoke exhibited greater AB for cues of people smoking cigarettes than cigarette paraphernalia when presented for 2000 ms compared to people with OUD who smoke. Conclusion. The addition of social cues potentiates cigarette cue AB, based on cue type and stimulus presentation time. Understanding the neurobiology of this relationship can help design treatments that can target AB and prevent relapse.

The authors have declared no competing interest.

NCT05049460, NCT05295953

This work was supported by the National Institutes of Health (grant numbers CA225419, DA035200) and University of Kentucky College of Medicine.

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