Smokers are inundated with enticements to stop smoking. Commercials and posters warn about the risk of cancer, nicotine gum advertisements tempt smokers with images of healthy people living fresh, outdoorsy lives, and even their own packs of cigarettes warn them that it might be wise to quit.
But quitting is hard. Relapse is common (Shaffer et al., 2004), and smokers often avoid quitting to avoid the frustration of the relapse. A recent study examined whether reactivity exhibited prior to quitting to smoking-related images and words might indicate an increased risk of relapse (Janes et al., 2010).
The study was based on the assumption that if markers for high risk of relapse could be identified, then smokers might be targeted for additional opportunities to intervene before relapse has taken place.
The researchers identified 21 women who met criteria for nicotine dependence and smoked a minimum of 10 cigarettes per day over the last six months, produced more than 10 ppmv air CO, and were part of an 8-week smoking cessation clinical trial.
The participants were asked to complete written questionnaires and to engage in two reactivity tasks. The first task was a Stroop task, in which participants were asked to indicate a word color for smoking-related and neutral words and their accuracy and time were recorded.
In the second task, participants were measured using fMRI scans while they responded to smoking-related, neutral or animal images. The participants were measured each week for smoking levels using expired CO measurement and self-report.
The results of the study showed that the participants who relapsed back into smoking behaviors showed more fMRI reactivity to smoking cues in multiple brain areas.
The small number of participants in the study presents a limitation to the generalizability of the study’s results. The enrollment of the participants in the smoking cessation trial also limits the generalization of the results, because the circumstance might indicate that the participants are help-seekers and different from the general population of smokers.
The findings of this study are important because establishing markers for smoking relapse could be critical in helping to identify individuals who are about to relapse. A type of early detection and warning system could be established with more research to allow smokers to quit with the reassurance that their relapse could be identified and prevented.
The identification of markers using fMRI may offer some comfort to smokers who are being encouraged to quit at every turn. Their relapse risk could be measured as an enticement to cessation success, giving them a temptation to quit that could hardly be refused.
