24th Annual Duke Nicotine Research Conference: "Craving, Compulsion, and Cigarette Smoking: Mechanisms & Therapies"

Recent conceptualizations of addiction emphasize the compulsive nature of addictive behaviors, accompanied by craving and loss of control, more than physical withdrawal symptoms accompanying abstinence. Indeed, it is the compulsive use in the absence of severe physical withdrawal symptoms, that characterizes addiction to cigarettes. The focus of this daylong conference will be the brain mechanisms underlying craving and compulsion, as well as treatment approaches to address these mechanisms to promote successful cessation. Leading experts in the field will discuss brain pathways linking brain regions critically involved in addiction, such as the striatum, amygdala, habenula, insular and prefrontal cortices and hypothalamus. The neuropharmacologic basis of cue-elicited craving and its role in smoking relapse will be described. Cognitive processes that help "wire in" compulsive behavior and link it to situational cues will also be discussed. Presentations will consider innovative treatment approaches designed to satiate, block or extinguish craving and compulsive use. These approaches include novel drug treatments, behavioral approaches such as cue extinction, substitution strategies using e-cigarettes, and noninvasive transcranial magnetic brain stimulation. The insights gained from understanding the mechanisms of compulsion for tobacco addiction might add to the understanding of other addictions as well.