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Abstract
Cigarette smoking causes economic and health-related troubles that are resistant to behavioral and pharmacological intervention. Models of nicotine dependence suggest that the ability to tolerate the distress associated with withdrawal is a key factor leading to relapse. During stressful tasks, the salience network and frontoparietal attention network activate, while emotion processing and default mode regions deactivate. However, it is unclear how these systems mediate the likelihood of relapses. The present study used functional neuroimaging to measure brain response to a stressful cognitive task (the n-Back) and identify regions associated with smoking cessation outcomes. Results demonstrated that less suppression of the left and right amygdala was associated with successful abstinence, and less suppression of the posterior cingulate cortex was associated with the number of days it takes to relapse. After controlling for known predictors of cessation, Fagerstrom Test for Nicotine Dependence scores and right amygdala suppression were shown to uniquely predict abstinence. These findings indicate that unsuccessful task-related regulation of cognitive and emotional brain networks is associated with poorer cessation outcomes.