Chapter 10 Advances in the scientific study of craving for alcohol and tobacco

This chapter reviews contemporary empirical research on craving for alcohol and tobacco toward and explores its relationship to alcohol and tobacco dependence. The emphasis of the chapter is on advances in understanding the determinants, phenomenology, and neurobiology of craving through human and animal laboratory approaches. Complementing neurotransmitter-level findings, neuroimaging studies of alcohol and tobacco craving have commonly revealed selective activation of the anterior cingulate, dorsolateral prefrontal cortex, and orbitofrontal cortex from a neuroanatomical standpoint. The research is further advanced by studies indicating that genetic variation responsible for functional differences in the preceding neurotransmitter systems is associated with differences in the expression of craving. The data suggests that craving is significantly associated with alcohol and tobacco use, and post-treatment relapse. The associations range from modest to moderate magnitudes, suggesting that craving is far from the sine qua non of alcohol or tobacco use. The application of a coordinated and integrated transdisciplinary approach to understanding the role of craving in alcohol and tobacco use, and addictive behavior in general is emphasized in the chapter.