Smokers’ brains show cognitive avoidance toward visual quitting aids

A small but fascinating functional MRI study has shown how smokers may stubbornly harden their minds against the psychological quitting-assistance technique known as aversive conditioning.

When shown ugly images of cigarettes intended to curb cravings, the smokers distracted themselves. By comparison, a control group of nonsmokers paid full attention. fMRI showed what was going on in all participants’ brains.

The study was published online in Addictive Behaviors.

Researchers at Chung Ang University in South Korea had 15 smokers and 15 nonsmokers complete cue-reactivity tasks while undergoing fMRI.

All 30 were shown aversion-inducing cues such as spent butts in an overfilled ashtray.

The participants were also shown craving-inducing cues like a freshly lit cigarette.

The team observed that brain activation in response to the smoking-friendly images was greater in the smokers than in the nonsmokers. (The region was the left frontal subcallosal gyrus.)

More telling still, the smokers had significantly less activation (in the right temporal lobe) in response to the aversion images than the nonsmokers.

Further, in the smokers, brain activation in response to the craving-inducing images was positively correlated with Fagerstrom Test for Nicotine Dependence scores.

And, in the nonsmokers, brain activation in response to the aversion images was negatively correlated with a standardized questionnaire designed to score cognitive avoidance.  

“Compared to nonsmokers, in response to an aversion-inducing cue, smokers showed decreased temporal lobe activation associated with the emotional memory system, especially regarding fear and aversive reactions,” the authors summarize.

The negative correlation in nonsmokers between temporal lobe activation in response to an aversion-inducing cue and cognitive avoidance, they write, “may indicate that nonsmokers may not cognitively avoid the aversive environment but rather emotionally confront the adverse effects of smoking.” 

As for smokers, the authors conclude, “cognitive avoidance during aversive stimulation might result in sustaining addictive behaviors.”