The Role of Attentional Networks in Smoking Behavior Among Young Adults: Specific Contribution of Executive Control

Abstract

Introduction The exploration of cognitive impairments associated with tobacco use disorder has expanded during the last decades, centrally showing working memory and executive deficits among smokers. Despite their critical role in everyday life and in the smoking cessation process, attentional abilities have seldom been explored. Previous studies yielded discordant results, and the involvement of attentional deficits in smoking habits remains unclear. Methods Capitalizing on the Attention Network Test, a theory-grounded task allowing the simultaneous but distinct evaluation of three attentional networks (alerting, orienting, executive control), we explored attentional abilities in three groups of 25 college students (non-smokers, light smokers, heavy smokers), matched for demographic and psychopathological characteristics. Results While light smokers did not present any deficit compared to non-smokers, heavy smokers showed a specific impairment of the executive control subcomponent of attention, contrasting with preserved alerting and orienting attentional abilities. The executive control deficit was not related to current craving or to smoking duration. Conclusions Beyond the already explored memory and executive deficits, tobacco use disorder is associated with attentional impairments, characterized by a reduced ability to focus attentional resources on pertinent stimuli and resist to distractors interference. Given the assumed role of attentional impairments in smoking, our findings suggest that a critical step in future translational iterations is to develop neuropsychological rehabilitation programs tapping into the executive network of attention among smokers. Implications This study clarifies the presence and extent of attentional impairments in tobacco use disorder. We measured three attention networks (alerting, orienting, executive control) in light smokers, heavy smokers and matched healthy controls through a theory-grounded task (Attention Network Test). Heavy smokers (but not light ones) present a specific deficit for the executive control of attention. This deficit, uncorrelated with psychopathological comorbidities or current craving, appears directly related to smoking. Given the currently scattered literature on this topic, attentional processes deserve a thorough audit in tobacco use disorder, notably to develop specific neurocognitive rehabilitation.

Chronic tobacco smoking and neurocognitive impairments in adolescents and young adults: a systematic review and meta-analysis

“…One study included in the quantitative synthesis reported data from an additional comparator group (‘Light Smokers’) ( 53 ). Therefore, to comply with the exclusion and inclusion criteria and the aim of this study, only the appropriate comparator groups were included in this meta-analysis.…”

“…The studies included in the analysis originated from four countries, including the one from United States of America ( 30 ), five from China ( 5 , 18 , 21 , 43 , 54 ), two from Saudi Arabia ( 44 , 55 ), and one from Belgium ( 53 ).…”

“…Since adolescents and young adults were the targets for this study, the mean age range of the adolescent and young adult tobacco smokers ranged from 17 years to 24.7 years, and for the control population their mean age ranged from 16.6 years to 23.3 years ( 30 , 44 , 55 ). Most of the studies were conducted on a predominantly male population except for two studies that had more females than males ( 30 , 53 ). The average amount of time in education ranged from 10.1 years to 13.8 years.…”

“…The average amount of time in education ranged from 10.1 years to 13.8 years. However, of the included studies that were pooled, several did not include data for the years of education ( 44 , 53 – 55 ). Most of the papers included in this meta-analysis reported pack-years, years of smoking, and cigarettes per day, except for one study that did not report any of these data ( 55 ) and two studies not mentioning pack-years specifically ( 30 , 54 ).…”

“…Maurage et al. ( 53 ) assessed attention in chronic tobacco smoking cohort with the Attention Network Test (ANT). Li et al.…”