FDA cigarette warning labels lower craving and elicit frontoinsular activation in adolescent smokers
FDA cigarette warning labels lower craving and elicit frontoinsular activation in adolescent smokers
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DOI：
10.1093/scan/nsv038
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发表时间：
2015-11-01
影响因子：
4.2
通讯作者：
Galvan, Adriana
中科院分区：
文献类型：
--
作者：
Do, Kathy T.;Galvan, Adriana
吸烟在经济上和流行病学上都是一个代价高昂的公共卫生问题。大多数成年吸烟者在青春期成瘾，这是预防和干预的关键时期。尽管诉讼要求推迟了实施，但美国食品和药物管理局（FDA）提出的图形警告标签可能是实现这一目标的有希望的方法。我们的目的是确定标签在减少扫描仪内渴望方面的功效，并表征青少年和成年吸烟者和非吸烟者的神经生物学反应。在接受功能性磁共振成像时，39名13至18岁的青少年和41名25至30岁的成年吸烟者和非吸烟者在看到带有情感色彩的警告标签和非图像标签时对自己的吸烟欲望进行了评分。与成年吸烟者相比，青少年吸烟者对警告标签的反应表现出更大的渴望减少。尽管吸烟者的脑岛和背外侧前额叶皮层（DLPFC）相对于不吸烟者总体上表现出迟钝的补充，这种影响在青少年吸烟者中更强，但参数化地增加这些区域的激活与更大的渴望减少有关。功能连通性分析表明，DLPFC对边缘区域的更大调节预示着香烟的渴望。这些数据强调了额岛回路在预测FDA图形警告标签在减少成人和青少年吸烟者渴望方面的功效方面的突出作用。
Cigarette smoking is an economically and epidemiologically expensive public health concern. Most adult smokers become addicted during adolescence, rendering it a crucial period for prevention and intervention. Although litigation claims have delayed implementation, graphic warning labels proposed by the U.S. Food and Drug Administration (FDA) may be a promising way to achieve this goal. We aimed to determine the efficacy of the labels in reducing in-scanner craving and to characterize the neurobiological responses in adolescent and adult smokers and non-smokers. While undergoing functional magnetic resonance imaging, thirty-nine 13- to 18-year-old adolescent and forty-one 25- to 30-year-old adult smokers and non-smokers rated their desire to smoke when presented with emotionally graphic warning labels and comparison non-graphic labels. Compared with adult smokers, adolescent smokers exhibited greater craving reduction in response to the warning labels. Although smokers evinced overall blunted recruitment of insula and dorsolateral prefrontal cortex (DLPFC) relative to non-smokers, an effect that was stronger in adolescent smokers, parametrically increasing activation of these regions was associated with greater craving reduction. Functional connectivity analyses suggest that greater DLPFC regulation of limbic regions predicted cigarette craving. These data underscore a prominent role of frontoinsular circuitry in predicting the efficacy of FDA graphic warning labels in craving reduction in adult and adolescent smokers.