The effects of approach bias modification on smoking cue-reactivity in individuals who smoke: a randomized controlled fMRI study
Approach bias modification (ApBM), a computerized training designed to retrain involuntary approach action tendencies toward drug-related cues, has been shown to reduce relapse rates when added to treatment-as-usual (TAU) in alcohol use disorder. A potential working mechanism involves reduced neural...
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| Main Authors: | , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
28 March 2026
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| In: |
Scientific reports
Year: 2026, Volume: 16, Pages: 1-12 |
| ISSN: | 2045-2322 |
| DOI: | 10.1038/s41598-026-45748-y |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.1038/s41598-026-45748-y Verlag, kostenfrei, Volltext: https://www.nature.com/articles/s41598-026-45748-y 
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| Author Notes: | Franziska Motka, Haoye Tan, Sabine Vollstädt-Klein, Katja Bertsch & Charlotte E. Wittekind |
| Summary: | Approach bias modification (ApBM), a computerized training designed to retrain involuntary approach action tendencies toward drug-related cues, has been shown to reduce relapse rates when added to treatment-as-usual (TAU) in alcohol use disorder. A potential working mechanism involves reduced neural drug cue-reactivity in reward-related brain regions. In smoking cessation, however, the efficacy and neural mechanisms of ApBM remain unclear. In this randomized-controlled trial, individuals with chronic, moderate-to-heavy tobacco dependence (N = 117, Mage = 41.5, 45.3% female) received a one-day smoking cessation intervention (TAU) and were subsequently randomized to complete seven sessions of ApBM (TAU+ApBM), Sham control training (TAU+Sham), or no training (TAU-only). Neural reactivity toward smoking-related versus neutral stimuli (smoking cue-reactivity) was assessed using functional magnetic resonance imaging (fMRI) before and after intervention. Abstinence was the primary clinical outcome. Results showed no significant group×time interactions on cue-reactivity, and ApBM did not enhance abstinence rates. In the precuneus (sensorimotor region), increased cue-reactivity following ApBM was associated with higher long-term abstinence probability, while the control groups showed the opposite descriptive pattern. In conclusion, ApBM did not reduce smoking cue-reactivity in reward-related regions, consistent with the lack of beneficial effects on clinical outcomes. Alternative neural target processes (e.g., sensorimotor-related) and respective training procedures should be explored. |
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| Item Description: | Gesehen am 23.04.2026 |
| Physical Description: | Online Resource |
| ISSN: | 2045-2322 |
| DOI: | 10.1038/s41598-026-45748-y |