Mark Wilson

Imagine how tantalizing, how powerful the craving for a cigarette is. Then imagine you could stem that craving by merely changing the way you think. A new study published in the Proceedings of the National Academy of Sciences suggests that merely thinking differently could help control cravings.

“Most people think that the reason smokers use substances is because of a lack of self-control,” said Kevin Ochsner, associate professor of psychology at Columbia University. “We show they don’t lack it, the problem they have is they may not know what strategy to use.“

Let’s face it, our brains are wired for short-term rewards, whether it is the first drag on a cigarette or the first bite of a hot stack of pancakes. According to study authors, the strategy to curb those cravings is almost deceptively simple: re-wiring the brain to think long-term.

Ochsner and colleagues gave brain scans to 21 people who reported regularly smoking. They posed two scenarios. In one, they measured what happened in the brain after asking smokers to think about the immediate rewards of smoking, for example the first drag on a cigarette, how the smoke would feel entering the lungs, or the sensation of smoke curling out of the mouth. In the second scenario smokers were asked to imagine the long-term consequences of smoking – health problems associated with it – such as emphysema or heart disease.

By way of comparison, the same was done with food. Study respondents were shown photos of delectable, fatty foods and asked to think about the short-term rewards (how great the food would taste), and the long-term consequences while their brain activity was measured.

Turns out, something as simple as focusing on the long-term consequences of smoking (or eating fatty foods) could control the craving.

“This gives us a biological explanation for how cognitive regulation of craving works,” said Hedy Kober, PhD, assistant professor of psychiatry at Yale University School of Medicine and the study’s lead author. “By changing the way they think about cigarettes in moments of craving, by focusing on the negative long-term consequences, [smokers] can reduce craving and change their own brain activity.“

Two areas of the brain are at work when we crave things – the prefrontal cortex and the ventral striatum. The prefrontal cortex is an area associated with reasoning and the ventral striatum is associated with emotion, desire, and craving. Among study participants, successfully curbing cravings involved activating the reasoning part of the brain more than the craving-driven region.

Except re-wiring the brain, re-shaping how one thinks about craving, is far from simple – it is a long process. And then there are important questions about the biological underpinnings of addiction. Still, study authors say that thinking differently is powerful therapy.

“It takes a sustained, continuous effort,” said Ochsner. “It is teaching you a new kind of emotional response instead of just going reflexively. It’s slow and painful but we absolutely have the potential to do it.“