Effects of smoking abstinence on impulsive behavior among smokers high and low in ADHD-like symptoms

Abstract

Rationale: Impulsivity, a multifaceted construct that includes inhibitory control and heightened preference for immediate reward, is central to models of drug use and abuse. Within a self-medication framework, abstinence from smoking may lead to an increase in impulsive behavior and the likelihood of relapse, particularly among persons with disorders (e.g., attention-deficit/hyperactivity disorder, ADHD) and personality traits (e.g., impulsivity) linked to impulsive behavior.

Objectives: This study aimed to examine the effects of smoking abstinence on multiple measures of impulsivity among a non-clinical sample of adult smokers selected for high and low levels of ADHD symptoms.

Methods: In a within-subjects design, participants selected for high or low levels of self-reported ADHD symptoms (N = 56) completed sessions following overnight abstinence and when smoking as usual (order counterbalanced). Measures of impulsive behavior included response inhibition (i.e., stop signal task), interference control (i.e., attentional modification of prepulse inhibition (PPI) of startle), and impulsive choice (i.e., hypothetical delay discounting).

Results: As hypothesized, abstinence decreased response inhibition and PPI. Although ADHD symptoms moderated abstinence effects on impulsive choice and response inhibition, the pattern was opposite to our predictions: the low-ADHD group responded more impulsively when abstinent, whereas the high-ADHD group was relatively unaffected by abstinence.

Conclusions: These findings highlight the importance of utilizing multiple laboratory measures to examine a multifactorial construct such as impulsive behavior and raise questions about how best to assess symptoms of ADHD and impulsivity among non-abstinent smokers.

Fig. 1

Response inhibition. Mean (SE) stop signal reaction time (SSRT) for all ADHD group × abstinence conditions

Fig. 2

Interference control. Mean (SE) percent prepulse inhibition for all ADHD group × abstinence × stimulus type conditions

Fig. 3

Impulsive choice. Mean (SE) area under the curve (AUC) for all ADHD group × abstinence conditions on the hypothetical delay discounting task

Fig. 4

Post hoc analyses for response inhibition and delay discounting. Means (SEs) for all d′ × abstinence conditions for response inhibition (SSRT; a) and impulsive choice (AUC; b)