Brain Connectivity May Determine Smoking Cessation Success

The increased connectivity may help inhibit the motor reaction to a cigarette craving.

People who successfully quit smoking may be hard-wired for success, according to findings from a study conducted by researchers at Duke Medicine.

fMRI data showed that those who were able to successfully quit smoking had more brain connectivity between specific regions tied to cravings and motor control compared to those that tried and failed.

The study, published in Neuropsychopharmacology, documented resting-state fMRI data from 85 participants, all who attempted to quit smoking. Resting-state fMRI scans were conducted one month prior to their attempts at quitting. The group was then split in two, with one group smoking usual brand cigarettes and the other smoking very low nicotine cigarettes plus nicotine replacement therapy for 30 days prior to a target quit date. After the quit date, all participants received nicotine replacement therapy and were monitored for 10 weeks.

During the 10-week follow-up, 41 participants relapsed. Data from the fMRI scans showed that the 44 participants who successfully quit showed greater connectivity between the right and left posterior insula regions and the somatosensory cortex compared to those who tried and failed.

“There’s a general agreement in the field that the insula is a key structure with respect to smoking and that we need to develop cessation interventions that specifically modulate insula function,” Joseph McClernon, PhD, said. “But in what ways do we modulate it, and in whom? Our data provides some evidence on both of those fronts, and suggests that targeting connectivity between insula and somatosensory cortex could be a good strategy.”

Although the results suggest that greater connectivity inhibits a motor response to cigarette cravings, the researchers point out that more studies need to be conducted to better understand the mechanism of how brain connectivity affects the odds of successfully quitting.

“We have provided a blueprint,” McClernon said. “If we can increase connectivity in smokers to look more like those who quit successfully, that would be a place to start. We also need more research to understand what it is exactly about greater connectivity between these regions that increases the odds of success.”


  1. Addicott MA et al. Neuropsychopharmacology. 2015; doi:10.1038/npp.2015.114.