Neural Sensitivity to Smoking Stimuli Is Associated With Cigarette Craving in Adolescent Smokers

Purpose: Adolescents initiate cigarette smoking at disproportionately high rates, despite widespread knowledge of its health-compromising and long-term consequences. Psychosocial factors clearly play a role in adolescent smoking initiation, but the role of the developing adolescent brain in this behavior remains unclear. The goal of the present study was to determine whether greater neural sensitivity to smoking cues in adolescents compared to adults underlies increased proclivity toward smoking behavior and craving. Methods: We addressed this question in a sample of adolescent (n = 39) and adult (n = 39) smokers and nonsmokers by assessing craving in response to smoking videos that featured late adolescents/young adults while participants underwent functional magnetic resonance imaging. Results: Ventral striatal activation mediated the relationship between video-induced craving and subsequent desires to smoke following the scan in adolescent smokers only. We also found that functional coupling between striatal and cortical regions was associated with increased craving in adolescent smokers. Conclusions: These novel results demonstrate that adolescent smokers may be more neurobiologically responsive to smoking stimuli than adults, perhaps because of ongoing ontogenetic changes in adolescents that normatively occur in frontostriatal circuitry. (c) 2016 Society for Adolescent Health and Medicine. All rights reserved.