Advances in biofeedback and neurofeedback studies on smoking

Area of Science:

• Neuroscience
• Behavioral Science
• Public Health

Background:

• Smoking remains a significant global health issue, causing widespread morbidity and mortality.
• Current smoking cessation interventions, including pharmacotherapy, have limitations in efficacy and safety for certain populations.
• Non-pharmacological methods like biofeedback (BF) and neurofeedback (NF) may offer alternative strategies for self-regulation of relapse triggers such as stress and craving.

Purpose of the Study:

• To review and synthesize existing evidence on the effectiveness of biofeedback and neurofeedback training for smoking cessation.
• To evaluate the potential of BF and NF in helping smokers self-regulate factors contributing to relapse.

Main Methods:

• A systematic literature search was conducted across major databases (Scopus, PubMed, Cochrane Library) and reference lists.
• Included studies were peer-reviewed, controlled or uncontrolled, involving BF and/or NF training for smokers.
• A narrative qualitative synthesis was performed on ten eligible studies, categorized by training type.

Main Results:

• Biofeedback outcomes appeared influenced by pre-training smoking behavior.
• Individualized electroencephalography (EEG) neurofeedback shows promise in modulating craving responses with fewer sessions.
• Real-time functional magnetic resonance imaging (fMRI) neurofeedback demonstrated that individuals could modulate craving-related brain activity, though results on modulating resistance to urges were mixed.

Conclusions:

• Biofeedback and neurofeedback training appear capable of modulating autonomic and central nervous system activity, with potential for behavioral transfer.
• Further research is required to address specificity, scientific validity, and diverse demographics.
• Standardized methodologies and clinical guidelines are necessary for BF and NF to be recognized as viable complementary smoking cessation aids.