Smoke and mirrors: Does the standard approach to studying the cognitive effects of smoking abstinence provide a reliable reflection?
Rhodes, Jessica D.
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Though there are effective treatments for smoking cessation, most smokers quickly return to smoking following a quit attempt. Research is focusing on mechanisms that lead to relapse and treatments are being designed to target these processes. There is growing interest in abstinence-induced decrements in cognition, with a common assumption that these deficits represent individual differences/traits that link risk factors to relapse and treatment outcome. Reliability is a basic assumption of any trait-like characteristic, however there is currently no evidence demonstrating the reliability of abstinence effects on cognition. The aim of the current work is to address this critical gap by examining the short-term test-retest reliability of acute smoking abstinence effects on key domains of cognition. Thirty-two dependent smokers completed the typical experimental paradigm twice; Visit Pair 1 (one smoking, one abstinence visit) and Visit Pair 2 (one smoking, one abstinence visit). Participants completed laboratory measures that provided two indices of sustained attention, working memory, and inhibitory control; a cognition composite was created from all variables. Results demonstrated that two measures of sustained attention, one measure of inhibitory control, one measure of working memory and general cognition were impacted by overnight abstinence when Visit Pairs were aggregated. The overall abstinence effects were larger than the effects observed with the standard, one Visit Pair. Test-retest reliability of abstinence effects was consistently weak. Taken together, the results of the present study suggest that the standard abstinence paradigm does not accurately represent abstinence effects on cognition and does not reliably capture individual differences in the effects of abstinence on cognition. Important psychometric and measurement considerations are discussed.