Neurocognitive Function as a Treatment Target for Tobacco Use Disorder

Abstract

Novel approaches are needed to improve the treatment of tobacco use disorder (TUD). Two distinct literatures have examined the impact of cognitive function in the maintenance of TUD. One approach has focused on automatic cognitive processes, and the second approach has addressed the role of executive cognitive processes. This review focuses on interventions that target automatic and cognitive processes for TUD. There appears to be evidence that attention re-training (AR) reduces automatic cognitions, but the effect on smoking requires further research. Several medications including varenicline, bupropion, and galantamine can improve executive processes and potentially reduce craving and smoking. However, whether the beneficial effects of these medications are mediated by cognitive improvement remains to be determined. Other strategies including the approach-avoidance task, transcranial direct current stimulation, and exercise require further study. Most research focuses on targeting automatic and controlled cognitive processes, separately in relatively small samples. Future research should consider targeting both processes simultaneously.