Neural correlates of craving and resisting craving for tobacco in nicotine dependent smokers
Open accessAbstract
Craving is a significant factor which can lead to relapse during smoking quit attempts. Attempts to resist urges to smoke during cue‐elicited craving have been shown to activate regions in the brain associated with decision‐making, anxiety regulation and visual processing. In this study, 32 treatment‐seeking, nicotine‐dependent smokers viewed blocks of smoking and neutral cues alternating with rest periods during magnetic resonance imaging scanning in a 3T Siemens scanner (Siemens AG, Erlangen, Bavaria, Germany). While viewing cues or control images, participants were instructed either to ‘allow yourself to crave’ or ‘resist craving.’ Data were analyzed with FSL 4.1.5, focused on the smoking cues versus neutral cues contrast, using cluster thresholding (Z > 2.3 and corrected cluster threshold of P = 0.05) at the individual and group levels. During the Crave condition, activation was seen on the left anterior cingulated cortex (LACC), medial prefrontal cortex, left middle cingulate gyrus, bilateral posterior cingulated gyrus and bilateral precuneus, areas associated with attention, decision‐making and episodic memory. The LACC and areas of the prefrontal cortex associated with higher executive functioning were activated during the Resist condition. No clear distinctions between group crave and resist analyses as a whole were seen without taking into account specific strategies used to resist the urge to smoke, supporting the idea that craving is associated with some degree of resisting the urge to smoke, and trying to resist is almost always accompanied by some degree of craving. Different strategies for resisting, such as distraction, activated different regions. Understanding the underlying neurobiology of resisting craving to smoke may identify new foci for treatments.
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Complementary strategies to promote acceptance of emotional states could be useful to overcome automatic reactions.
“Complementary strategies to promote acceptance of emotional states could be useful to overcome such automatic reactions.7–9”
From Feasibility, acceptability and preliminary outcomes of a mindfulness-based relapse prevention program in a naturalistic setting among treatment-seeking patients with alcohol use disorder: A prospective observational study (2019) · cites this paper as [9]
The Discussion (page unavailable) suggests that resisting cue-elicited tobacco craving may require overriding learned associations and identifies cognitive therapies as a possible way to enhance resistance. It does not discuss promoting acceptance of emotional states, so it supports the idea of overcoming learned reactions but not the proposed acceptance strategy. (LLM, conf=0.79)
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“Neuroimaging studies showed that craving and resisting craving often activates the same brain networks.(9) Trying to resist the urge could then lead to an extension of craving intensity.”
Background
- Authors
- Hartwell, K. J., Johnson, K. A., Li, X., Myrick, H., LeMatty, T., George, M. S., & Brady, K. T.
- Affiliations
- Medical University of South Carolina (US)
- Stanford University (US)
- Corresponding author
- Hartwell, Karen J.
- Venue
- Addiction Biology
- Publisher
- Wiley
- Published
- 2011-07-25
- Volume
- 16
- Issue
- 4
- Pages
- 654-666
- ISSN
- 1355-6215 (ISSN-L)
- 1369-1600
- PMC
- PMC3182826
- OpenAlex
- W2150980655
- Cited by
- 129
- References
- 63
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 3 · 2023: 7 · 2022: 6 · 2021: 13 · 2020: 2 · 2019: 7 · 2018: 6 · 2017: 10 · 2016: 9 · 2015: 19 · 2014: 7 · 2013: 16 · 2012: 11
- FWCI
- 8.08
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Addiction Biology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Medical University of South Carolina (UL1 RR029882, K12HD055885)
- Georgia Clinical and Translational Science Alliance
- National Institutes of Health (RR029882)
- National Institute on Drug Abuse (R21DA026085, R33DA026085)
- National Center for Research Resources (UL1RR029882)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K12HD055885)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Nicotinic Acetylcholine Receptors Study
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- nicotine craving, nicotine dependence, smoking cues, cue reactivity, anterior cingulate cortex, medial prefrontal cortex, decision-making, executive function, smoking cessation, relapse, distraction techniques
- MeSH terms
- Adult, Arousal, Brain, Brain Mapping, Cues, Dominance, Cerebral, Female, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Middle Aged, Motivation, Substance Withdrawal Syndrome, Tobacco Use Disorder, Smoking Cessation, Young Adult
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