Two things people say when they hear about research on smoking tobacco are: "Why do research on smoking? We all know it's bad for you," and "Smoking is just a bad habit. You can quit if you have enough willpower."
Now it turns out that a new study published in the The Journal of Neuroscience shows that those people who said, "smoking is a bad habit," were partially right. In addition to activating brain areas linked to addiction, watching movies in which people smoke activates brain areas that drive the body movements a smoker makes hundreds of times a day while puffing on a cigarette. The physical habit of reaching for a cigarette and moving it up for a drag is learned so well that watching people smoke in the movies makes brain areas responsible for those movements more active, which could contribute to relapse.
The American Lung Association and the Centers for Disease Control and Prevention, among others, have called for a stop to smoking in movies for a long time. The argument has been that when actors smoke in movies, they make smoking look cool and increase the likelihood that kids will start smoking. This new study suggests that there may be another consequence of movies featuring smoking -- it may activate brain areas linked to the physical habits of smoking, leading ex-smokers to reach for a pack of cigarettes again.
By now, most people know that tobacco smoking is not just bad for you, but that it is the leading preventable cause of death in most countries, with about 443,000 deaths per year attributed to smoking in the United States alone. According to the CDC, that's more deaths each year than AIDS, illegal drug use, alcohol use, motor vehicle injuries, suicides and murders combined. If that weren't bad enough, I was surprised to find out that smoking prevents wounds from healing and is a major reason for poor outcomes of surgery or fractures.
Similarly, most people also acknowledge that smoking tobacco is addictive. Although, as recently as 1994 the CEO's of seven tobacco companies testified before Congress and, one after the other, got up and said, "I believe nicotine is not addictive."
Despite widespread knowledge of the health and addictive effects of smoking, about 20 percent of U.S. adults are smokers. Of those, more than 50 percent try to quit smoking each year, but less than 5 percent of all smokers succeed. That rate can be improved with behavioral therapies like those offered by telephone helplines called "quitlines," cognitive behavioral therapy, nicotine replacement therapies such as the nicotine patch, or medicines that can decrease brain responses to images that remind ex-smokers of their cigarettes. But even with multiple therapies, more than 50 percent of ex-smokers still relapse to smoking within a year.
All this means that, yes, we know that smoking is bad and that the nicotine in cigarettes makes them addictive, but we still have a long way to go before we know how to help smokers who want to quit.
We are still learning why smokers who want to quit relapse repeatedly. This new study shows that our bodies' combined response to the content of cigarette smoke and the physical act of smoking leads to changes in brain activity that can drive the urge to smoke long after that successful New Year's resolution to quit.