Parisians dig cigs

Upon arrival in Paris, all students part of the NBB Paris Program sat through an orientation, during which we essentially received a crash course on French culture and its intricacies. One of the tips we were given was to observe the facial expressions of daily metro riders and to adopt their expressions so as to not look like wide-eyed tourists trying to take in all of our surroundings. I adopted their expressions, but I also found myself eavesdropping on other’s conversations.

Figure 1:Photo of me at The Mazet. Hopefully this confused expression is not the one I have on the metro…

One of the more interesting conversations I heard was between a lady who seemed quite irritated, and her husband. Her words essentially translated to “I’m dying to smoke a cigarette”. It is quite apparent that smoking is fairly common in France, or at least in Paris. I became curious to better understand the neurological effects of smoking.

We all have all too often seen not so subtle “Smoking kills!” warnings in movie scenes. But why exactly is smoking “bad” for you and more specifically, your brain? Before diving into how smoking negatively impacts the brain, it may be helpful to gain a brief overview of the parts of the main parts of the brain involved. The increased activation of the ventral striatum and the nucleus accumbens, in smokers, has been of immense interest because addictive substances such as nicotine, stimulate dopaminergic neurons in these structures, which triggers the brain to think of nicotine as a rewarding stimulus (Benwell et al., 1995). Essentially the brain begins to crave this “reward”.

Figure 2: The Reward Pathway

But in exactly what way does smoking cause damage to the brain? A recent study suggested that smoking decreases brain connectivity. Firstly, what does “brain connectivity” really mean and how it is measured?  Brain connectivity refers to how closely different parts of the brain are “interacting” with each other (Cheng et al., 2019). This can be measured using fMRI (functional magnetic resonance imaging), which measures brain activity when a person is at rest, allowing researchers to analyze patterns of activity in the brain (Cheng et al., 2019). The study by Cheng et al. (2019) used fMRI data of 831 subjects from the Human Connectome Project. The study suggested that smokers had low overall functional connectivity between brain regions as opposed to drinkers who had high overall functional connectivity between brain regions (Cheng et al., 2019).

One of the most interesting findings from the by Cheng et al. (2019) study was that the smoker’s brain regions impacted the most included the lateral orbitofrontal cortex (OFC) and inferior frontal gyrus (IFG). The lateral OFC plays a significant role in modifying and inhibiting behavior. So it makes sense that decreased connectivity of the lateral OFC to other parts of the brain, is associated with increased impulsivity (Cheng et al., 2019). Impulsivity was measured using stop-signal tasks that measure response inhibition. Additionally, the researchers make an important point that it is important to consider the possibility that decreased functional connectivity may not just be a result of smoking, but instead could have an impact on the likelihood of smoking (Cheng et al., 2019).This is only the tip of the iceberg in terms of the various neurological changes that may occur as a result of smoking.

All these negative impacts yet people still continue to smoke. Is it due to unawareness? Is it due clever advertising? Since I am interested in neuromarketing, I wondered about the history of tobacco advertisements in France. This past semester, I took part in the Intramural Emory Global Health Case Competition and the goal was to offer solutions to address the use of electronic nicotine delivery systems in China’s Guandong Province. Advertising and marketing were essential considerations. I was surprised but at the same time not really surprised by the amount of recent literature and research that exists on “Using Neuroscience to Inform Tobacco Policy Control” (Maynard et al., 2019).

Figure 3: Commonly seen “No smoking” sign in Paris metro stations

In 2010, in France, the Droits des Non-Fumeurs association (Non-Smokers Rights Association) used a suggestive analogy, comparing smoking to sexual slavery, to convey the message that – “Smoking is equivalent to being a slave to tobacco”. It is provocative so fair warning. I will link the image of the advertisement here for those who want to see what the controversy was about. While this advertisement created quite a stir, the ad came to be known as a “prevention flop” (Oullier & Sauneron, 2010).


Figure 4 and 5: Different approaches to anti-smoking advertisements – Non graphic vs. graphic

Dr. Langleben is known for his research on investigating what type of ads have the potential to actually change behavior and not to simply shock the viewer. Dr. Langleben, in collaboration with Wang et al. (2013) observed increased activation in the dorsomedial prefrontal cortex (dMPFC) when smokers watched an anti-smoking ad with a strong argument as compared to one with a weak argument. “Smoking causes disease and/or death” qualifies as a strong argument whereas “Smoking makes you less attractive to potential partners” qualifies as a weak one (Penn Medicine News, 2013). Increased activation of the dMPFC, which mediates future behavior, may be associated with the study’s finding that the participants who watched the strong argument ads had significantly less of a metabolite of nicotine in their urine, one month later (Wang et al., 2013).

These findings suggest that neuroscience is an extremely useful tool not only in terms of understanding the impacts of smoking on the brain but also in terms of informing the creation of media content. Supporting my (definitely biased) viewpoint that neuroscience applies everywhere!

I guess now I’ll start handing out copies of this blogpost to smokers in the streets of Paris? Stay tuned to see how that goes..

Shelby Walia

 

References

Benwell, M. E., Balfour, D. J., & Birrell, C. E. (1995). Desensitization of the nicotine-induced mesolimbic dopamine responses during constant infusion with nicotine. British journal of pharmacology, 114(2), 454–460. doi:10.1111/j.1476-5381.1995.tb13248.x

Cheng, W., Rolls, E. T., Robbins, T. W., Gong, W., Liu, Z., Lv, W., … Feng, J. (2019). Decreased brain connectivity in smoking contrasts with increased connectivity in drinking. eLife, 8, e40765. doi:10.7554/eLife.40765

Karama, S., Ducharme, S., Corley, J., Chouinard-Decorte, F., Starr, J. M., Wardlaw, J. M., …

Deary, I. J. (2015). Cigarette smoking and thinning of the brain’s cortex. Molecular psychiatry, 20(6), 778–785. doi:10.1038/mp.2014.187

Oullier, O., & Sauneron S. (2010). Dans le cerveau du fumeur : neurosciences et prévention du tabagisme. In Nouvelles approches de la préventionen santé publique : L’apport des sciences comportementales, cognitives et des neurosciences (pp. 86-104). Centre d’analyse stratégique, AWS Édition Paris. https://www.ladocumentationfrancaise.fr/var/storage/rapports-publics/104000139.pdf (French) http://oullier.free.fr/files/2010_Calvert-Gallopel-Morvan-Sauneron-Oullier_Neuroscience-Prevention-Public-Health_Prevention-Public-Health-Neuroscience-Book_Antismoking-Tobacco.pdf (English)

Penn Medicine News. (2013, April 23). Anti-Smoking Ads with Strong Arguments, Not Flashy Editing, Trigger Part of Brain That Changes Behavior, says Penn Study [Press release]. Retrieved from https://www.pennmedicine.org/news/news releases/2013/april/antismoking-ads-with-strong-ar

Wang, A. L., Ruparel, K., Loughead, J. W., Strasser, A. A., Blady, S. J., Lynch, K. G., Langleben, D. D. (2013). Content matters: neuroimaging investigation of brain and behavioral impact of televised anti-tobacco public service announcements. The Journal of neuroscience : the official journal of the Society for Neuroscience, 33(17), 7420–7427. doi:10.1523/JNEUROSCI.3840-12.2013

Figure 1 – Photo of me taken by friend

Figure 2 – Dopamine Reward Pathway, Indiana Prevention Resource Center, taken from http://desalledesigns.com/cdesalle/Tobacco1/development/a_04_05_01.html

Figure 3 – France, ile de france, paris 20e arrondissement, bd de menilmontant, station du metro pere lachaise, ratp, Hector Guimard, Date : 2011-2012, taken from https://www.alamy.com/stock-photo-france-ile-de-france-paris-20e-arrondissement-bd-de-menilmontant-station-72247555.html

Figure 4 – Tobacco Teeth Anti-smoking Advertising by Miroslav Vujovic, taken from https://competition.adesignaward.com/design.php?ID=55730

Figure 5 – Graphic Anti-Smoking Ads May Backfire, Pacific Standard (2017), taken from https://psmag.com/economics/graphic-anti-smoking-ads-may-backfire

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