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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.

The gap between the price of cigarettes and beedis, cheap tobacco wrapped in a coarse leaf, has widened after the government raised excise duties and slapped a 15 percent value-added tax last year. The lowest-priced offering sold by Ceylon Tobacco -- the only licensed manufacturer of cigarettes -- is about four times more expensive than leaf-rolled products, which are produced by a segment of the industry that’s relatively less regulated and has seen smaller increases in levies. “In 2017, we foresee the beedi industry capturing at least half the tobacco market, posing a serious threat to the legal cigarette industry,” said Ridley. “As the affordability of legally manufactured cigarettes continues to diminish, more consumers are expected to downgrade to this cheaper alternative.” Beedis accounted for about 44 percent of the total tobacco market last year, up from 20 percent in 2007, Ridley said. The share of smuggled cigarettes is expected to rise to about 8 percent this year from 2 percent in 2016, according to the company. The numbers for the market share shift being claimed for beedis are exaggerated, said Health Minister Rajitha Senaratne. The government is in discussions with farmers cultivating tobacco to wean them away from the crop, he said. Sri Lanka hasn’t seen any evidence of an increase in the market share of beedis as imports of tendu leaf haven’t climbed, said Palitha Abeykoon, chairman of the National Authority on Tobacco and Alcohol. Tighter regulations on the beedi segment are being considered, he said.

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Drug and Alcohol Dependence Much less is known about the effects of smoking on subcortical regions. We compared smokers and non-smokers on regional subcortical volumes, and predicted that smokers demonstrate greater age-related volume loss across subcortical regions than non-smokers. Non-smokers (n = 43) and smokers (n = 40), 22–70 years of age, completed a 4 T MRI study. Bilateral total subcortical lobar white matter (WM) and subcortical nuclei volumes were quantitated via FreeSurfer. In smokers, associations between smoking severity measures and subcortical volumes were examined. Smokers demonstrated greater age-related volume loss than non-smokers in the bilateral subcortical lobar WM, thalamus, and cerebellar cortex, as well as in the corpus callosum and subdivisions. In smokers, higher pack-years were associated with smaller volumes of the bilateral amygdala, nucleus accumbens, total corpus callosum and subcortical WM. Results provide novel evidence that chronic smoking in adults is associated with accelerated age-related volume loss in subcortical WM and GM nuclei. Greater cigarette quantity/exposure was related to smaller volumes in regions that also showed greater age-related volume loss in smokers.

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