Wednesday, January 1, 2014

Breaking Bad Habits

In an attempt to reduce craving in cigarette smokers, Kathleen Brady and Mark George of the Medical University of South Carolina have been using neurofeedback, a real-time display of a brain region’s activity. One particular region, the anterior cingulate cortex (ACC), becomes reliably activated for nicotine-dependent individuals in response to smoking cues — that is, greater activation is indicative of greater craving when looking at pictures of cigarettes. Because of this, Brady and George were interested in seeing if patients in an fMRI machine could tone down their craving by seeing real-time illustrations of their own brain activity.

After just three visits to the lab and with no medicine or explicit therapy, subjects who used the neurofeedback had both a reduction in craving and less activity in the ACC when looking at pictures of cigarettes. Encouraged by these preliminary results, Brady and George hope to replicate the findings with more participants, since this pilot study was conducted with only nine smokers.

Even if this method is confirmed as a viable therapy, however, neurofeedback using fMRI is not a feasible tactic to implement in the general population. Fortunately for millions of cigarette smokers, there are less expensive behavioral techniques that might produce similar results — an overall reduction in craving.

According to APS Fellow Yi-Yuan Tang of Texas Tech University, Rongxiang Tang of the University of Texas at Austin, and APS William James Fellow Michael Posner of the University of Oregon, mindfulness meditation might be one such technique. After just two weeks of mindfulness training — only 5 hours in aggregate — smokers puffed about 60% less and reported less craving than when they started the study, even if they had no intention to quit beforehand. In addition, participants who practiced mindfulness meditation also showed increased baseline brain activity in the ACC and prefrontal cortex — signals associated with greater self-control.
Just as with other studies in the field, unanswered questions remain. It’s still unclear, for instance, whether participants would need to continue the training to keep cravings at bay over the long term. Still, the data are promising, if only for their originality. Mindfulness meditation does not explicitly require participants to resist craving or to quit smoking; instead, it focuses on improving self-control capacity writ large.

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