Addicted to green: priming effect of menthol cigarette packaging on brain response to smoking cues

IntroductionMentholated tobacco cigarettes are believed to be more addictive than non-menthol ones. Packaging of most menthol cigarette brands includes distinctive green hues, which may act as conditioned stimuli (ie, cues) and promote menthol smoking. To examine the cue properties of menthol cigarette packaging, we used a priming paradigm to assess the effect of packaging on the neural substrates of smoking cue reactivity. We hypothesised that menthol packaging will exert a specific priming effect potentiating smoking cue reactivity in menthol compared with non-menthol smokers.MethodsForty-two menthol and 33 non-menthol smokers underwent functional MRI while viewing smoking and neutral cues. The cues were preceded (ie, primed) by briefly presented images of menthol or non-menthol cigarette packages. Participants reported craving for cigarettes in response to each cue.ResultsMenthol packaging induced greater frontostriatal and occipital smoking cue reactivity in menthol smokers than in non-menthol smokers. Menthol packaging also enhanced the mediation by neural activity of the relationship between cue exposure and cigarette craving in menthol but not non-menthol smokers. Dynamic causal modelling showed stronger frontostriatal-occipital connectivity in response to menthol packaging in menthol compared with non-menthol smokers. The effects of non-menthol packaging did not differ between categories of smokers.ConclusionsOur findings demonstrate heightened motivational and perceptual salience of the green-hued menthol cigarette packaging that may exacerbate menthol smokers’ susceptibility to smoking cues. These effects could contribute to the greater addiction severity among menthol smokers and could be considered in the development of science-based regulation and legal review of tobacco product marketing practices.

Environmental Tobacco Smoke Exposure and Brain Functioning Associated with Smoking Cue-Reactivity and Inhibitory Control in Nonsmoking Adolescents

<b><i>Introduction:</i></b> Despite its well-established negative effects, environmental tobacco smoke (ETS) exposure remains highly prevalent worldwide. ETS exposure is associated with a wide range of physical and mental health-related problems among youth, including an increased likelihood to develop nicotine dependence. Up till now, neurocognitive effects of ETS exposure are largely unknown, while such effects could explain the role of ETS exposure in the development of nicotine dependence. Therefore, this preregistered study investigated the role of current ETS exposure in brain functioning associated with smoking cue-reactivity and inhibitory control. <b><i>Method:</i></b> Concurrent with functional magnetic resonance imaging, nonsmoking adolescents aged 14–18 years (<i>N</i> = 51) performed a smoking cue-reactivity task, assessing brain functioning to smoking cues, and a Go/NoGo task measuring inhibitory control. ETS exposure was measured using a self-report questionnaire and biochemically verified. <b><i>Results:</i></b> No significant associations were observed between current ETS exposure and brain functioning associated with smoking cue-reactivity and inhibitory control. <b><i>Conclusion:</i></b> These findings suggest that low-to-moderate levels of current ETS exposure are not associated with increased salience of smoking cues or deficits in inhibitory control in nonsmoking adolescents. Longitudinal research is needed to further clarify the exact effect of lifetime ETS exposure on brain functioning, as well as research focusing on the effects of higher levels of ETS exposure.

Smoking-related cue reactivity in a virtual reality setting: association between craving and EEG measures

Background Cue-reactivity is the array of responses that smokers exhibit when exposed to conditioned and contextual stimuli previously associated to substance use. The difficulty to experimentally recreate the complexity of smokers’ spatial experience and context requires more ecological models. Virtual reality (VR) creates a state of immersion close to reality allowing controlled assessments of behavioral responses. To date, no studies investigated brain activation associated to smoking cue-reactivity in VR using electroencephalography (EEG). Aims To investigate whether a VR cue-reactivity paradigm (a) may increase smoking craving, (b) is feasible with EEG recording, and (c) induces craving levels associated to EEG desynchronization. Methods Smokers (N = 20) and non-smokers (N = 20) were exposed to neutral and smoking-related VR scenarios, without and with smoking conditioned stimuli, respectively. EEG was recorded from occipital and parietal leads throughout the sessions to assess alpha band desynchronization. Smoking and food craving and presence visual analogue scales (VAS) were assessed during the session. Results To be smoker, but not non-smoker, significantly influenced smoking craving VAS induced by smoking cue VR but not by neutral VR. No significant food craving changes was observed during the VR sessions. The new finding was that EEG alpha band power in posterior leads was significantly increased by the smoking context scenario only in smokers, and that the degree of smoking (i.e., heavy vs. light) was significantly associated to this neurophysiological measure. Conclusions This study demonstrated, for the first time, the feasibility of EEG recording in a VR setting, suggesting that EEG desynchronization may be a neurophysiological marker of smoking cue-reactivity.

A Combined Alcohol and Smoking Cue-Reactivity Paradigm in People Who Drink Heavily and Smoke Cigarettes: Preliminary Findings

Aims Previous studies have shown that there may be an underlying mechanism that is common for co-use of alcohol and tobacco and it has been shown that treatment for alcohol use disorder can increase rates of smoking cessation. The primary aim of this study was to assess a novel methodological approach to test a simultaneous behavioral alcohol-smoking cue reactivity (CR) paradigm in people who drink alcohol and smoke cigarettes. Methods This was a human laboratory study that utilized a novel laboratory procedure with individuals who drink heavily (≥15 drinks/week for men; ≥8 drinks/week for women) and smoke (&gt;5 cigarettes/day). Participants completed a CR in a bar laboratory and an eye-tracking (ET) session using their preferred alcohol beverage, cigarettes brand and water. Results In both the CR and ET session, there was a difference in time spent interacting with alcohol and cigarettes as compared to water (P’s &lt; 0.001), but no difference in time spent interacting between alcohol and cigarettes (P &gt; 0.05). In the CR sessions, craving for cigarettes was significantly greater than craving for alcohol (P &lt; 0.001), however, only time spent with alcohol, but not with cigarettes, was correlated with craving for both alcohol and cigarettes (P &lt; 0.05). Conclusion This study showed that it is feasible to use simultaneous cues during a CR procedure in a bar laboratory paradigm. The attention bias measured in the integrated alcohol-cigarettes ET procedure predicted participants’ decision making in the CR. This novel methodological approach revealed that in people who drink heavily and smoke, alcohol cues may affect craving for both alcohol and cigarettes.