Brain Injury May Hold Key to Smoking Cessation

Quitting smoking can be really hard. A lot of people don't succeed the first time they try it; some never manage to quit at all. Almost everyone who tries it - whether they succeed or not - says that the cravings can be the hardest part of the whole process.

A lot of time and energy has been spent on finding ways to cut those cravings. Now scientists have found a clue to eliminating cravings once and for all. What may be most remarkable is that it comes from the study of individuals with brain damage.

The research, done at the University of Southern California, was prompted by the experience of a man - a two-pack-a-day smoker since the age of 14 - who abruptly quit smoking after he had a stroke at the age of 28. He said he never had any cravings and has not smoked at all since that time.

Scientists studied the brains of smokers who'd had injuries either from a stroke or from surgery (for example, to remove a tumor). They found 19 whose injuries affected a small area called the insula. All had quit smoking easily. Of another 50 smokers with injuries to other areas of the brain, only 19 had quit, and those people had found the process very difficult.

The insula seemed to be the key to the research. It's an area that hasn't been studied much. It does seem to be responsible for converting physical feelings into emotional ones, and because of that has been linked to addictions in the past. Now it's been discovered that the insula contains nicotine receptors. Perhaps an injury there turns those receptors off - researchers have compared it to a switch - making the process of quitting smoking almost effortless.

Does this mean that doctors would induce some kind of minor brain damage to help their patients quit smoking? In a word, no. But this research may point to a new direction for smoking cessation products. It may be possible to develop drugs that affect the insula's nicotine receptors, reducing the urge to smoke and making it easier for someone to quit.

There's still a lot of work to be done. Scientists need to find out what else the insula does besides regulate smoking cravings. It's been suggested that they apply small magnetic pulses - a technique called transcranial magnetic stimulation - to get more information.

It's not certain what the future holds for this kind of research. But what's been shown so far is extremely promising. It may be that this small area - about the size of a silver dollar - holds the key to effective treatment of many different kinds of addictions.