Have you ever seen the movie “Up”? It’s a wonderful computer animated comedy by Disney that was nominated for a ‘best picture’ Academy Award in 2009. In it, there are a couple of talking dogs – it’s Disney – who occasionally become completely distracted by the presence of a squirrel. Here is a short and humorous YouTube clip from the movie as an example. http://www.youtube.com/watch?v=bBWrMQVsuak
What does this have to do with smoking? I’ve used this squirrel analogy to help explain craving to our patients. Recently a body of scientific literature has emerged describing what scientists call “cue reactivity.” Using a brain imaging technique called functional MRI, specific areas of the brain have been identified which react to smoking-related cues in the environment. These brain areas are responsible for reward and how we react to reward triggers. Like squirrels are to the dogs in “Up”, cues are the things that you run into every day that make you think of lighting up, because they actually “trip a switch” in your brain.
For humans, cues can be very personal. What are they for you? Some common ones are: seeing a cigarette or someone smoking, seeing an ashtray, hearing the flick of a lighter, smelling smoke, drinking coffee, seeing tobacco advertising, having an alcoholic drink, or just being in a room or a place where you normally smoke. Scientists now understand how significant it is to be exposed to these cues when a person is trying to stop smoking. When you are exposed to smoking-related cues, these specific areas of your brain go into overdrive and can overwhelm your intentions not to smoke with cravings to smoke.
However cravings to smoke are usually short lived, and people can ‘re-train’ their brain to quiet the reaction to smoking related cues. Medications and nicotine replacement can moderate the reaction to smoking cues. Having a firm commitment to not smoke, distracting oneself, developing new patterns and other rewards, and through time, the automatic reaction to smoking cues becomes muffled, predictable, and less powerful. We can become our own master again.