Anyone who has quit smoking can tell you it’s no easy feat that can require multiple attempts before it's deemed successful. Some experts liken nicotine — the drug found naturally in tobacco — to a substance that can be just as addictive as heroin, cocaine, or alcohol. A recent study conducted by Duke Medicine, however, has found that smokers with the capacity to kick the habit are hard-wired for success due to better connectivity among certain areas of the brain.

"Simply put, the insula is sending messages to other parts of the brain that then make the decision to pick up a cigarette or not," Dr. Merideth Addicott, assistant professor at Duke and lead author of the study, said in a statement.

Addicott and her colleagues recruited 85 smokers who were willing to quit smoking and have their progress tracked for 10 weeks. The research team examined MRI scans taken from each smoker one month before they attempted to kick the habit. Forty-one participants relapsed by the end of the 10 weeks. Upon examination of the 44 brain scans from smokers who quit successfully, researchers noticed similarities in certain areas of the brain before they stopped smoking.

Smokers who quit successfully had better synchrony (coordinated activity) between the insula and the somatosensory cortex. The insula, a large area of the brain’s cerebral cortex, is often attributed to a smoker’s tobacco cravings. Evidence has shown that smokers who suffer damage to the insula suddenly lose interest in smoking. The somatosensory cortex is the area of the brain responsible for our sense of touch and motor control.

"There's a general agreement in the field that the insula is a key structure with respect to smoking and that we need to develop cessation interventions that specifically modulate insula function," McClernon said. "But in what ways do we modulate it, and in whom? Our data provides some evidence on both of those fronts, and suggests that targeting connectivity between insula and somatosensory cortex could be a good strategy."

McClernon explained that the group would look further into treatments that control brain activity and can aid in smoking cessation. Two such treatments, neurofeedback and transcranial magnetic stimulation, are currently used to improve depressive symptoms. According to the Centers for Disease Control and Prevention, seven out of every 10 adult smokers report that they want to quit. The number of former smokers has been greater than the number of current smokers starting in 2002.

"We have provided a blueprint," McClernon added. "If we can increase connectivity in smokers to look more like those who quit successfully, that would be a place to start. We also need more research to understand what it is exactly about greater connectivity between these regions that increases the odds of success."

Source: Sweitzer M, Froeliger B, Rose J, McClernon F, Addicott M. Increased Functional Connectivity in an Insula-Based Network is Associated with Improved Smoking Cessation Outcomes. Neuropsychopharmacology. 2015.