Due to their exceedingly graphic nature, antismoking TV commercials are hard to miss, but many question if their attention-grabbing tactics actually persuade smokers to quit. A new study claims that brain imaging can determine which aspects of an anti-smoking public service announcement (PSA) will convince a smoker to break the habit.

These findings are extremely fortuitous, as public health officials are searching for new, efficient ways to engage smokers. National efforts to curb smoking have apparently flatlined, as after decades of decline, the adult smoking rate has hovered at 20 percent in recent years, according to reports from U.S. Centers for Disease Control and Prevention. At the same time, states have dramatically cut funding for tobacco prevention programs, as reported in the New York Times, by nearly 40 percent — $250 million — since 2008, which will undoubtedly force public health officials to maximize the reach and impact of future antismoking campaigns.

In what is possibly a landmark study, researchers at the University of Pennsylvania have found that brain activity can dictate how a smoker will respond to the content and format of a televised ad. This finding could allow advertisers to streamline the development of PSAs by providing a direct readout for consumer behavior.

"It's one of the first papers to embed concepts from the world of communications into the world of biology," said Dr. Daniel D. Langleben, senior author on the study and a psychiatrist at the Pearlman School of Medicine.

While creating a PSA, communication specialists typically focus on two basic elements: its 'argument strength' (how persuasive is its message?) and its 'sensation value' (does it have enough special effects?). Smokers have long been considered to be sensation/thrill seekers, so for decades, PSAs have often tried to engage this trait with vivid imagery and gripping soundtracks. The results have been mixed. While smokers are more likely to recall flashier ads, there has been limited success with convincing individuals to actually quit.

To determine if neural activity could predict quitting behavior, 71 smokers were asked to view a series of short, 30-second antismoking PSAs, while their brains were scanned by functional magnetic resonance imaging (fMRI). Each participant watched 16 commercials that had either strong arguments ("If the personal health dangers aren't enough, consider quitting for your children and those you love") or weak arguments ("Smoking makes you less attractive to potential partners.")

One month after the screening, the researchers sampled the subjects' urine for cotinine — a metabolite of nicotine — to see who had changed their smoking behavior.

They found that activation in one brain region, the dorsal medial prefrontal cortex (dmPFC), predicted whether a person would eventually reduce their cigarette consumption. The largest spikes in dmPFC brain activity were seen when the PSAs had a strong argument, regardless of the level of special effects or pizzazz.

"Thus, greater activation in dmPFC predicts long-term outcomes; i.e., less smoking," said Dr. An-Li Wang, a neuroscientist and first author of the study. She added that these subjects were not seeking treatment at the outset of the study, suggesting that their viewing sessions had a direct impact on their subsequent smoking behavior.

Before Dr. Langleben tells advertisers to add neuroscientists for their staffs, he would like to perform a larger follow-up study where PSAs are precisely tailored to induce specific neural responses in subjects. Although this might spawn 'Manchurian' commercials and highly suggestive marketing, it could ultimately provide empirical variables that can build better ads to deter smoking.

"Overall, what we have here is another substantial step towards objective measures for evaluating health communications," said Langleben.