No smoking signs with strong smoking symbols induce weak cravings: an fMRI and EEG study

No smoking signs (NSSs) that combine smoking symbols (SSs) and prohibition symbols (PSs) represent common examples of reward and prohibition competition. To evaluate how SSs within NSSs influence their effectiveness in guiding reward vs. prohibition, we studied 93 male smokers. We collected self-reported craving ratings (N=30), cue reactivity under fMRI/EEG (N=33), and smoking-behavior anticipation for paired NSSs and SSs (N=30). We found that NSS-induced cravings were negatively correlated with SS-induced cravings and PS-induced inhibition. fMRI indicated that both correlations were mediated by activation of the inferior frontal gyrus and precuneus, suggesting that the effects of SSs and PSs interact with each other. EEG revealed that the prohibition response occurs after the cigarette response, indicating that the cigarette response might be precluded by the prohibition, supporting the effect of SSs in discouraging smoking. Moreover, stronger SSs induced stronger slow positive waves and late positive potentials, and the stronger the late positive potentials, the stronger the late positive potentials. Both the amplitudes of late positive potentials and slow positive waves were positively correlated with the amplitude of N2, which was positively correlated with the attention grabbed score by the NSS. In addition, the weaker the NSS-induced craving, the greater the smoking behavior anticipation reduction, indicating the capability of NSSs to decrease smoking behavior. Our study provides empirical evidence for selecting the most effective NSSs: those combining strong SS and PS, offering insights about competition between cigarette reward and prohibition and providing neural evidence on how cigarette reward and prohibition interact.