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Volume 177 , 1 August 2017, Pages 268-276 Reward-related frontostriatal activity and smoking behavior among adolescents in treatment for smoking cessation Author links open overlay panel Kathleen A.Garrisona One of the first longitudinal fMRI studies of smoking cessation treatment in adolescents. Adolescents show increased non-drug reward-related brain activity pre- to post-treatment. Increases in reward-related brain activity were associated with smoking abstinence. Tobacco use is often initiated during adolescence and continued into adulthood despite desires to quit. A better understanding of the neural correlates of abstinence from smoking in adolescents may inform more effective smoking cessation interventions. Neural reward systems are implicated in tobacco use disorder, and adolescent smokers have shown reduced reward-related ventral striatal activation related to increased smoking. The current study evaluated nondrug reward anticipation in adolescent smokers using a monetary incentive delay task in fMRI pre- and post- smoking cessation treatment (n = 14). This study tested how changes in neural responses to reward anticipation pre- to post-treatment were related to reduced smoking. An exploratory analysis in a larger sample of adolescents with only pre-treatment fMRI (n = 28) evaluated how neural responses to reward anticipation were related to behavioral inhibition and behavioral activation scales. Adolescent smokers showed pre- to post-treatment increases in reward anticipation-related activity in the bilateral nucleus accumbens and insula, and medial prefrontal cortex, and greater increases in reward anticipation-related activity were correlated with larger percent days of smoking abstinence during treatment. These findings suggest that reduced smoking during smoking cessation treatment is associated with a “recovery of function” in frontostriatal responses to nondrug reward anticipation in adolescent smokers, although comparison with a developmental control group of adolescent nonsmokers is warranted.
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The revenue collected from cigarette sales was used to finance local smoking cessation programmes like mQuit . From the year 2016 to 2019, the Health Ministry targets to help 390,000 smokers quit the habit. The targeted quantity of smokers is only equivalent to 7.8% of the current smoking population, and resources allocated are evidently insufficient. Malaysia’s current minimum legal age for smoking is 18 . Countries like Singapore and Sri Lanka have made progress to raise the age requirement to 21 while Malaysia is still debating on its 2018 tobacco bill . Although the government has designated non-smoking zones , there seemed to be negligible enforcement and issuance of fines. Is Malaysia’s government just too incompetent? The government may have been aware of the possible consequences in hasty cigarette tax hikes. It decided tax hikes were necessary to meet its budget deficit target. “As per the trends of past years, there is usually a surplus to offset the deficit from the first half, in turn keeping the deficit within the target,” said Lee Heng Guie, executive director of Socio-Economic Research Centre.
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’s profit margin will continue to narrow as an increase in levies on cigarettes prompts some smokers to switch to the cheaper alternative, said Emma Ridley, finance director of the Colombo-based BAT unit. The company’s operating profit margin , the highest among listed Asian peers, narrowed to 64 percent in 2016 from 67 percent a year earlier in a cigarette market estimated at about $1.1 billion. The gap between the price of cigarettes and beedis, cheap tobacco wrapped in a coarse leaf, has widened after the government raised excise duties and slapped a 15 percent value-added tax last year. The lowest-priced offering sold by Ceylon Tobacco -- the only licensed manufacturer of cigarettes -- is about four times more expensive than leaf-rolled products, which are produced by a segment of the industry that’s relatively less regulated and has seen smaller increases in levies. “In 2017, we foresee the beedi industry capturing at least half the tobacco market, posing a serious threat to the legal cigarette industry,” said Ridley. “As the affordability of legally manufactured cigarettes continues to diminish, more consumers are expected to downgrade to this cheaper alternative.” Beedis accounted for about 44 percent of the total tobacco market last year, up from 20 percent in 2007, Ridley said. The share of smuggled cigarettes is expected to rise to about 8 percent this year from 2 percent in 2016, according to the company. The numbers for the market share shift being claimed for beedis are exaggerated, said Health Minister Rajitha Senaratne. The government is in discussions with farmers cultivating tobacco to wean them away from the crop, he said.
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