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Researchers from the Center for BrainHealth at The University of Texas at Dallas have come across an interesting quirk of the mind. They rounded up a bunch of smokers and told some of them that the cigarettes they were holding lack any trace of nicotine. This was a lie, these were normal cigarettes. Oddly enough, the smokers didn’t satisfy their nicotine craving like they normally would have, which raises some interesting speculations about the nature of so-called physical addiction and its relation to the psyche, particularly the power of suggestion.

Substance craving depends on belief, the study finds

The team enlisted only nicotine addicts for their study. Over the course of four visits, each participant was twice given a nicotine cigarette and twice a placebo. Half the time they would visit the researchers, the participants were lied to. More plainly, the four conditions were:

• Believes the cigarette contains nicotine but receives placebo.
• Believes the cigarette does not contain nicotine but receives a nicotine cigarette.
• Believes the cigarette contains nicotine and receives nicotine.
• Believes the cigarette does not contain nicotine and receives placebo.

After having the smoke, participants were asked to complete a learning task while their brain was scanned with an fMRI. Specifically, the researchers were interested in tracking activity in the insula cortex, which is involved in a wide range of brain functions like bodily perception and self-awareness. The insula cortex is, however, also were drug cravings and addiction manifest themselves.

The participants were also asked to self-report the level of nicotine craving before smoking and after completing the task.

Smokers showed significant ventral anterior insula activation and post-smoking craving only when they were told “nicotine in cigarette” and smoked nicotine but not in other conditions. Credit: Frontiers of Psychiatry.

Findings suggest that those participants who smoked a nicotine cigarette and were convinced they had the ‘real deal’ displayed both craving and learning signals. Smoking nicotine, but believing it was fake, did not deliver the same results, though.

It is worth noting that belief selectively modulated subjective craving and insula activation, but not learning-related behavior

“These results suggest that for drugs to have an effect on a person, he or she needs to believe that the drug is present,” said Dr. Xiaosi Gu, assistant professor in the School of Behavioral and Brain Sciences and the study‘s lead author.

“We show that in deprived smokers, belief about nicotine modulates subjective craving and activity in neural structures that process interoceptive information such as the insular cortex. These results provide compelling evidence supporting a strong influence of beliefs to counter drug effects on craving and addiction, as well as insights into the mechanisms of cognitive treatments for addiction,” the team wrote.