"Extinction Therapy" Taunts Addicted Smokers With More Cigarettes


It may seem counterintuitive — even cruel — to hand cigarettes to people trying to end their addiction, but that was exactly the plan behind a recent study on smoking behavior. Not only were cigarette addicts given boxes of their favorite vice — they were also forced to look at videos and photos of people puffing away while they abstained. The idea behind this seemingly torturous experience was that repeated exposure could help curb their desire for a drag — and help them forget they even wanted one in the first place.

In a recent study published in JAMA Psychiatry, a team of South Carolina-based researchers explain that this process, called “retrieval-extinction training,” is a promising new way to treat addiction. They found that the people who sat through two hour-long retrieval-extinction sessions were more likely to smoke fewer cigarettes a month later, compared to the placebo group.

The goal of this therapy is to prevent an all too easy relapse.


The researchers behind this study were inspired by the success of other retrieval-extinction trials; in the past, scientists have found that it can curb cravings in heroin addicts and rats addicted to cocaine.

Retrieval-extinction therapy is based on the Pavlovian idea that repeated exposure to a specific stimulus, along with a signal, will result in a conditioned response. The classic example is a dog that hears a bell when it’s time to eat, so it eventually learns that the bell means it’s time to munch on some grub. Similarly, the sight of people smoking is thought to trigger the desire to smoke in addicts.

However — and this is at the crux of retrieval-extinction therapy — researchers increasingly believe that exposure to a new set of experiences over an extended period of time can actually override old memories associated with the substance. The trick is to first activate the old memory to destabilize it; this is thought to make altering it easier. In the experiment, exposing participants to videos of people smoking constituted the activation stage, and alteration involved them holding cigarettes but not smoking them. The effects weren’t perfect, but they are promising.

Though the group that underwent extinction therapy smoked fewer cigarettes, the change wasn’t particularly drastic — the control group smoked an average of seven a day, compared to the placebo’s ten. Still, the study authors told The Guardian that they find the study results “eye-opening” and are hopeful that follow-up experiments will reveal a larger change.

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