Behavioural tasks sensitive to acute abstinence and predictive of smoking cessation success: a systematic review and meta-analysis

Meryem Grabski, H Valerie Curran, David J Nutt, Stephen M Husbands, Tom P Freeman, Meg Fluharty, Marcus R Munafò

Research output: Contribution to journalReview article


BACKGROUND AND AIMS: Performance on cognitive tasks may be sensitive to acute smoking abstinence and may also predict whether quit attempts fail. Our aim was to conduct a systematic review and meta-analysis to identify cognitive tasks sensitive to acute abstinence and predictive of smoking cessation success.

METHODS: Embase, Medline, PsycInfo and Web of Science were searched up to March 2016. Studies were included if they enrolled adults and assessed smoking using a quantitative measure. Studies were combined in a random effects meta-analysis.

RESULTS: We included 42 acute abstinence studies and 13 cessation studies. There was evidence for an effect of abstinence on delay discounting [d = 0.26, 95% confidence interval (CI) = 0.07-0.45, P = 0.005], response inhibition (d = 0.48, 95% CI = 0.26-0.70, P < 0.001), mental arithmetic (d = 0.38, 95% CI = 0.06-0.70, P = 0.018), and recognition memory (d = 0.46, 95% CI = 0.23-0.70, P < 0.001). In contrast, performance on the Stroop (d = 0 .17, 95% CI = -0.17-0.51, P = 0.333) and smoking Stroop (d = 0.03, 95% CI = -0.11-0.17, P = 0.675) task was not influenced by abstinence. We found only weak evidence for an effect of acute abstinence on dot probe task performance (d = 0.15, 95% CI = -0.01-0.32, P = 0.072). The design of the cessation studies was too heterogeneous to permit meta-analysis.

CONCLUSIONS: Compared with satiated smokers, acutely abstinent smokers display higher delay discounting, lower response inhibition, impaired arithmetic and recognition memory performance. However, reaction-time measures of cognitive bias appear to be unaffected by acute tobacco abstinence. Conclusions about cognitive tasks that predict smoking cessation success were limited by methodological inconsistencies.

Original languageEnglish
Pages (from-to)2134-2144
Number of pages11
Issue number12
Early online date24 Jun 2016
Publication statusPublished - Dec 2016



  • Adult
  • Cognitive Therapy/methods
  • Female
  • Humans
  • Male
  • Psychomotor Performance/physiology
  • Recurrence
  • Sample Size
  • Smoking Cessation/methods
  • Treatment Outcome

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