Note: This excerpt contains language that some readers may find offensive.
Chapter 1: A Rush of Blood to the Head
Marlene, one of the smokers in the study, took her place lying flat on her back inside the fMRI. The machine made a little ticking sound as the platform rose and locked into place. Marlene looked a little hesitant — who wouldn't? — but managed a gung-ho smile as a technician placed the protective head coil over most of her face in preparation for the first brain scan of the day.
From Marlene's pretesting questionnaire and interview, I knew she was a recently divorced mother of two from Middlesex, and that she'd started smoking at boarding school fifteen years earlier. She thought of herself less as a nicotine addict than a "party smoker," that is, she smoked just a couple of "small" cigarettes during the day, as well as eight to ten more at night.
"Are you affected by the warnings on cigarette packs?" the questionnaire had asked.
"Yes," Marlene had written, twirling her pen around in her fingers as though she was about to ignite the thing.
"Are you smoking less as a consequence of these?"
Another yes. More pen-spinning. I've never been a smoker, but I felt for her.
Her interview answers were clear enough, but now it was time to interview her brain. For those who've never had an MRI, it's not what I'd call the most relaxing or enjoyable ex¬perience in the world. The machine is clankingly noisy, lying perfectly still is tedious, and if you're at all prone to panic or claustrophobia, it can feel as if you're being buried alive in a phone booth. Once inside, it's best you remain in a state of yogic calm. Breathe. In, out, in again. You're free to blink and swallow, but you better ignore that itch on your left calf if it kills you. A tic, a jiggle, a fidget, a grimace, body twitching — the slightest movement at all and the results can be compromised. Wedding bands, bracelets, necklaces, nose rings, or tongue studs have to be taken off beforehand, as well. Thanks to the machine's rapacious magnet, any scrap of metal would rip off so fast you wouldn't know what just belted you in the eye.
Marlene was in the scanner for a little over an hour. A small reflective apparatus resembling a car's rearview mirror projected a series of cigarette warning labels from various angles, one after another, on a nearby screen. Asked to rate her desire to smoke during this slideshow, Marlene signaled her responses by pressing down on what's known as a button box — a small black console resembling a hand-sized accordion — as each image flashed by.
We continued to perform brain scans on new subjects over the next month and a half.
Five weeks later, the team leader, Dr. Calvert, presented me with the results. I was, to put it mildly, startled. Even Dr. Calvert was taken aback by the findings: warning labels on the sides, fronts, and backs of cigarette packs had no effect on suppressing the smokers' cravings at all. Zero. In other words, all those gruesome photographs, government regulations, billions of dollars some 123 countries had invested in nonsmoking campaigns, all amounted, at the end of a day, to, well, a big waste of money.
"Are you sure?" I kept saying.
"Pretty damn certain," she replied, adding that the statistical validity was as solid as could be.
But this wasn't half as amazing as what Dr. Calvert discovered once she analyzed the results further. Cigarette warnings — whether they informed smokers they were at risk of contracting emphysema, heart disease, or a host of other chronic conditions — had in fact stimulated an area of the smokers' brains called the nucleus accumbens, otherwise known as "the craving spot." This region is a chain-link of specialized neurons that lights up when the body desires something — whether it's alcohol, drugs, tobacco, sex, or gambling. When stimulated, the nucleus accumbens requires higher and higher doses to get its fix.
In short, the fMRI results showed that cigarette warning labels not only failed to deter smoking, but by activating the nucleus accumbens, it appeared they actually encouraged smokers to light up. We couldn't help but conclude that those same cigarette warning labels intended to curb smoking, reduce cancer, and save lives had instead become a killer marketing tool for the tobacco industry.
Most of the smokers checked off yes when they were asked if warning labels worked — maybe because they thought it was the right answer, or what the researchers wanted to hear, or maybe because they felt guilty about what they knew smoking was doing to their health. But as Dr. Calvert concluded later, it wasn't that our volunteers felt ashamed about what smoking was doing to their bodies; they felt guilty that the labels stimulated their brains' craving areas. It was just that their conscious minds couldn't tell the difference. Marlene hadn't been lying when she filled out her questionnaire. But her brain — the ultimate no-bullshit zone — had adamantly contradicted her. Just as our brains do to each one of us every single day.
Excerpted from Buyology by Martin Lindstrom Copyright © 2008 by Martin Lindstrom. Excerpted by permission of Doubleday Business, a division of Random House, Inc. All rights reserved.