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Cognitive conflict following appetitive versus negative cues and smoking cessation failure

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Abstract

Rationale

Attentional biases and executive control deficits may play a role in smoking cessation failure.

Objectives

The object of this study was to determine whether smokers' pre-quit reaction times on a computerized modified Simon task (which assesses attentional biases and executive control deficits) predict abstinence following a quit attempt.

Methods

Participants (N = 365) in a larger smoking cessation clinical trial completed the modified Simon task twice (while 10-h nicotine-deprived vs. not deprived). In the task, two photographs (i.e., two digital slides) were displayed—one always neutral, the other positive, negative, smoking-relevant, or neutral. A probe (<<< or >>>) then appeared to the left or right of center, and participants indicated the arrow's direction (left or right) which was either congruent or incongruent with the arrow's location on the screen. The incongruency effect, a measure of executive control, was calculated by subtracting the reaction time to congruent probes from the reaction time to incongruent probes.

Results

Greater impairment in executive control (i.e., greater probe incongruency effects) after viewing positive and smoking slides relative to negative slides predicted an inability to establish initial cessation and to maintain abstinence up to 8 weeks post-quit.

Conclusions

These effects may be because smokers who avoid/escape from processing negative affect are more likely to fail in a cessation attempt. Differences in relatively automatic responses to affective cues distinguish smokers who are successful and unsuccessful in their smoking cessation attempts, but effects were modest in size.

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Notes

  1. Trials involving two neutral slides were included as filler trials and were not analyzed.

  2. The mean arousal and valence ratings for the smoking slides were computed for a set of 36 smoking slides developed by Shi (1998). The current study used a subset of 24 of those 36 smoking slides. Ratings for the individual slides were not accessible.

  3. We also calculated the following attentional bias scores (by subtracting slide–probe match from slide–probe mismatch reaction times) for negative (M = 2 ms, SD = 67.6), positive (M = −3 ms, SD = 59.6), and smoking slides (M = 5 ms, SD = 68.2). These findings suggest there was not a meaningful effect of slide–probe match (i.e., sticky attention) for any of the slide types. Although the findings seemingly conflict with findings from the visual probe task discussed earlier, the current study used the modified Simon task which may explain the different findings.

  4. As mentioned earlier, we selected short-term outcomes because we believed long-term outcomes would be less sensitive to baseline information processing biases and more sensitive to fortuitous events. When longer-term outcomes were examined (i.e., 6-month abstinence), task performance did not predict cessation outcome.

  5. These findings were fairly robust when simple contrasts instead of planned Helmert contrasts were used for the Slide Type factor (i.e., when we first tested that the omnibus F-test was significant and then followed-up with simple contrasts for negative versus positive slides and for smoking versus negative slides). For three of the four cessation outcomes, the omnibus F-test showed that the Slide Type × Probe Congruency × Cessation Outcome Measure interaction was significant. (For the cessation outcome abstinence at 8 weeks post-quit, this interaction was not significant, although the effect was in the right direction, p = 0.09). We then followed up the three significant omnibus F-tests with simple contrasts. For the first simple contrasts (negative versus positive slides), the Slide Type (negative versus positive slides) × Probe Congruency × Cessation Outcome Measure interaction was significant for the three cessation outcomes. For the second simple contrasts (smoking versus negative slides), we found only a Slide Type (smoking versus negative slides) × Probe Congruency × Abstinence interaction at 1 week post-quit (p = 0.01).

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Acknowledgments

Tanya R. Schlam, Sandra J. Japuntich, Megan E. Piper, Rebecca Gloria, and John J. Curtin have no potential conflicts of interest to disclose. Timothy B. Baker has served as an investigator on research projects sponsored by pharmaceutical companies including Pfizer, Glaxo Wellcome, Sanofi, and Nabi.

This research was conducted at the University of Wisconsin-Madison and was supported by grant #P50 DA019706 from NIH/NIDA; by grant #M01 RR03186 from the General Clinical Research Centers Program of the National Center for Research Resources, NIH; by grant 1UL1RR025011 from the Clinical and Translational Science Award (CTSA) program of the National Center for Research Resources, NIH; and by grant #1K05CA139871 from NIH. Medication was provided to participants at no cost under a research agreement with GlaxoSmithKline (GSK); no part of this manuscript was written or edited by anyone employed by GSK. The authors are solely responsible for the analyses, content, and writing of this article. The authors have full control of all primary data, and they agree to allow the journal to review the data if requested.

We declare that this research complies with the current laws of the USA. All participants gave written informed consent, and the study was approved by the University of Wisconsin Health Sciences Institutional Review Board.

We would like to thank the staff at the Center for Tobacco Research and Intervention in the University of Wisconsin School of Medicine and Public Health for their help with this research. We are particularly grateful to Linda Kurowski, Christine Ripley, and Wendy Theobald for their assistance.

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Authors and Affiliations

  1. Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, 1930 Monroe St., Suite 200, Madison, WI, 53711, USA

    Tanya R. Schlam, Sandra J. Japuntich, Megan E. Piper & Timothy B. Baker

  2. Department of Psychology, University of Wisconsin-Madison, 1202 West Johnson Street, Madison, WI, 53706, USA

    Sandra J. Japuntich, Rebecca Gloria & John J. Curtin

  3. Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA

    Tanya R. Schlam, Megan E. Piper & Timothy B. Baker

Authors
  1. Tanya R. Schlam
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  2. Sandra J. Japuntich
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  4. Rebecca Gloria
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  5. Timothy B. Baker
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Corresponding author

Correspondence to Tanya R. Schlam.

Additional information

S. J. Japuntich is now at the Tobacco Research and Treatment Center and Mongan Institute for Health Policy, Massachusetts General Hospital, Harvard Medical School.

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Schlam, T.R., Japuntich, S.J., Piper, M.E. et al. Cognitive conflict following appetitive versus negative cues and smoking cessation failure. Psychopharmacology 214, 603–616 (2011). https://doi.org/10.1007/s00213-010-2063-9

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  • DOI: https://doi.org/10.1007/s00213-010-2063-9

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