Centerstone :: Attention and Verbal Memory: A Look at the Effects of Acute Nicotine Abstinence

October 22, 2008

Attention and Verbal Memory: A Look at the Effects of Acute Nicotine Abstinence

Principal Investigator: David Ayer, PhD

This study looked at the effects of nicotine on attention and verbal memory in people who do not have a psychiatric diagnosis. The study found that the short-term abstinence of nicotine (from 6-14 hours), caused a decrease in verbal memory skills, especially with females and heavy smokers. There was no statistically significant effect on attention, although trend lines showed abstinent smokers performed worse. Previous research has shown that the effects of nicotine on cognition extend beyond the mere mitigation of nicotine withdrawal (Pritchard, Robinson, & Guy, 1992; Koelega, 1993).

Between 70% and 90% of people diagnosed with schizophrenia smoke cigarettes: a rate nearly 300% that of the general population. This phenomenon has been widely studied. Just as for the general population, individuals with schizophrenia who are chronic smokers are at an increased risk of cancers, premature death and poverty (Centers for Disease Control, 2001). Chronic smoking has also been shown to reduce the gray matter in a person’s brain and negatively affect their ability to function (Brody, et al, 2004; Razani, et al, 2004).

There are unique concerns for people with schizophrenia who smoke tobacco. Due to cigarette additives, tobacco smokers metabolize some commonly prescribed antipsychotic medications (i.e. clozapine, olanzapine, haloperidol) 50% faster and can need twice the dosage of non-smokers (Ziedonis et al., 2005). Also, while the chronic use of cigarettes is harmful for a person with schizophrenia, there is evidence that acute use can improve cognitive functioning. People diagnosed with schizophrenia and related disorders (i.e. Alzhiemer’s) have different nicotine receptors than people without a mental health diagnosis (Levin and Rezvani, 2006; Heckers, 2001). These same receptors have been shown to be important for cognitive function (Levin and Rezvani, 2006).

This study found that short-term abstinence from nicotine did not affect attention for people without a diagnosis. However, other research shows that abstinence from nicotine reduces both verbal memory and attention in people diagnosed with schizophrenia and other related disorders such as Alzheimer’s (George, et al, 2000). This suggests that smoking cigarettes has an "optimizing" effect, rather than a simple linear increase. This means that if a person is already doing well cognitively, smoking will not improve attention or verbal memory and may be impairing. However, if a person has cognitive challenges due to schizophrenia or Alzehimer’s or a related disorder, smoking may cause an increase in performance. This is a bimodal effect, also known as a Yerkes-Dodson Effect.

References
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Centers for Disease Control. (2001). Annual smoking-attributable mortality, years of potential life lost, and economic costs---United States, 1997--2001. MMWR
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Centers for Disease Control. (2004). Cigarette smoking among adults---United States, 2004. MMWR 2005;54:1121--4.

George, T.P., Vessicchio, J.C. Termine, A., Sahady, D.M., Head, C.A., Pepper, T., et al. (2000). Effects of smoking abstinence on visual spatial working memory function in schizophrenia. Neuropsychopharmacology. 26: 75-85.

Heckers, S. (2001). Neuroimaging studies of the hippocampus in schizophrenia. Hippocampus. 11: 520-528.

Koelega, H. S. (1993). Stimulant drugs and vigilance performance: a review. Psychophamracology, 111, 1-16.

Levin, E. D. & Rezvani, A. H. (2006). Nicotinic-antipsychotic drug interactions and cognitive function. In Levin, E. D. (Ed.), Neurotransmitter interactions and cognitive function (pp. 185-205). Basel, Switzerland: Birkhauser Verlag.

Pritchard, W. S., Robinson, J. H., & Guy, T. D. (1992). Enhancement of continuous performance task reaction time by smoking in non-deprived smokers. Psychopharmacology, 108, 437-442.

Razani, J., Boone, K., Lesser, I., & Weiss, D. (2004). Effects of cigarette smoking history on cognitive functioning in healthy older adults. American Journal of Geriatric Psychiatry. 12: 404-411.

Ziedonis, D.M., Smelson, D., Rosenthal, R.N., Batki, S.L., Green, A.I., Henry, R.J., Montoya, I., Parks, J., and Weiss, R.D.( 2005). Improving the care of individuals with schizophrenia and substance use disorders: Consensus recommendations. Journal of Psychiatric Practice. 11(5): 315-339.