Longitudinal Examination of Abstinence Maintenance and Relapse in Cigarette Smokers

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Project Summary: Approximately fifteen percent of individuals in the US smoke cigarettes. Despite multiple attempts to quit, most smoking cessation attempt fails within one year. Predicting who will be unable to remain abstinent from smoking would improve cessation outcomes by providing objective feedback regarding relapse risk and allowing for more efficient allocation of relapse prevention resources. Our own pilot data and recent reviews of the literature suggest considerable promise in identifying biomarkers for relapse using neuroimaging approaches. While some studies have begun to investigate relapse prediction, few, if any studies have exam- ined the process of relapse or prolonged abstinence longitudinally after initial abstinence has been achieved. The focus of this proposal is to derive neuroimaging markers that prospectively predict subsequent relapse as well as to understand how the brain changes to support continued abstinence. To accomplish the aims of this project, 50 former smokers who have quit within the last three to six months will complete functional MRI scans of cognitive control, cue reactivity, and intrinsic connectivity at baseline and at 3-, 6-, and 9-month follow-up ses- sions to identify those biomarkers that are stable over time prior to relapse. Deriving neural predictors of future relapse among those individuals who have recently made a quit attempt could be extremely important for patient- treatment matching and/or differential allocation of resources based on risk for relapse. In addition, by identifying the changes that occur in brain function after recovery, it may be possible to target relevant networks with brain stimulation techniques.