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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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Studies show that more men and women die in Malaysia from tobacco-related diseases than on average in middle-income countries. What is more alarming is that you don’t need to be a smoker to be at risk. The Global Adult Tobacco Survey 2012 on Malaysia revealed that four out of 10 adults were found to be exposed to secondhand smoke at home (7.6 million adults), and four out of 10 were found to be exposed to secondhand smoke indoors at their workplace (2.3 million adults). Among those adults who visited a restaurant in the past 30 days, seven out of 10 would have been exposed to secondhand smoke (8.6 million adults). 4. Another critical area of consideration is economics. Tobacco use reduces overall national incomes by up to 3.6%. At the society level, direct costs are estimated from public and private medical costs of treating cigarette-related diseases. According to a study reported by Bernama in 2007, three smoking-related diseases – ischemic heart disease, lung cancer and chronic obstructive pulmonary disease – consumed about RM3.5bil of Malaysia’s healthcare budget. 5. More importantly, a 2007 study demonstrated that retailer compliance with laws limiting sales to minors appears to be significant in reducing youth access to cigarettes.

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