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Drug and Alcohol Dependence Volume 177 , 1 August 2017, Pages 268-276 Reward-related frontostriatal activity and smoking behavior among adolescents in treatment for smoking cessation Author links open overlay panel Kathleen A.Garrisona One of the first longitudinal fMRI studies of smoking cessation treatment in adolescents. Adolescents show increased non-drug reward-related brain activity pre- to post-treatment. Increases in reward-related brain activity were associated with smoking abstinence. Tobacco use is often initiated during adolescence and continued into adulthood despite desires to quit. A better understanding of the neural correlates of abstinence from smoking in adolescents may inform more effective smoking cessation interventions. Neural reward systems are implicated in tobacco use disorder, and adolescent smokers have shown reduced reward-related ventral striatal activation related to increased smoking. The current study evaluated nondrug reward anticipation in adolescent smokers using a monetary incentive delay task in fMRI pre- and post- smoking cessation treatment (n = 14). This study tested how changes in neural responses to reward anticipation pre- to post-treatment were related to reduced smoking. An exploratory analysis in a larger sample of adolescents with only pre-treatment fMRI (n = 28) evaluated how neural responses to reward anticipation were related to behavioral inhibition and behavioral activation scales. Adolescent smokers showed pre- to post-treatment increases in reward anticipation-related activity in the bilateral nucleus accumbens and insula, and medial prefrontal cortex, and greater increases in reward anticipation-related activity were correlated with larger percent days of smoking abstinence during treatment. These findings suggest that reduced smoking during smoking cessation treatment is associated with a “recovery of function” in frontostriatal responses to nondrug reward anticipation in adolescent smokers, although comparison with a developmental control group of adolescent nonsmokers is warranted.

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Cigarette ads Adverse health effect of exposure to secondhand smoke. “This industry has changed dramatically over the last 20 years, including becoming regulated by the FDA, which we supported,” Murray Garnick, the general counsel for Philip Morris USA’s parent company Altria Group Inc., said in a statement. “We’re focused on the future and, with FDA in place, working to develop less-risky tobacco products.” The newspaper ads with the corrective statements will appear in the front section of the Sunday edition on five different dates: Nov. 26, Dec. 10, Jan. 7, Feb. 4 and March 4. Each week will feature a different statement theme. Some Spanish-language publications are among the newspapers listed for the ads. The five broadcast TV ads will run weekly for an entire year, with the manufacturers having the option of when the ads run between 7 and 10 p.m.

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For more than a decade, the companies did not act on this knowledge out of fear of FDA regulation. But once the federal agency started regulating cigarettes in 2009, they went all out in their bid to develop and sell NRT. The Tobacco Papers reveal that companies conjectured that their new nicotine products could successfully compete with pharmaceutical NRT and they set the goal of gaining market control of all products containing nicotine. "It was surprising to discover the industry came to view NRT as just another product," Dorie Apollonio, associate professor in clinical pharmacy and lead author of the study, was quoted as saying in a UCSF news release. "The tobacco companies want people to get nicotine - and they're open-minded about how they get it." Smoking is responsible for more than 480,000 deaths every year in the United States, according to the U.S. Centers for Disease Control and Prevention (CDC), and another 16 million Americans live with a smoking-related disease. The costs of such illnesses total more than 300 billion U.S. dollars each year, when including both costs of direct medical care and lost productivity due to secondhand smoke exposure. Clinical trials show that NRT can help people quit smoking, but only if used in conjunction with counseling and in tapering doses. Over-the-counter availability of NRT made it easy for smokers to get a nicotine fix in non-smoking environments like offices and inside airplanes, with the net result that they were less likely to quit.

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