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Meta-analysis of the acute effects of nicotine and smoking on human performance

Abstract

Rationale and objective

Empirical studies indicate that nicotine enhances some aspects of attention and cognition, suggesting a role in the maintenance of tobacco dependence. The purpose of this review was to update the literature since our previous review (Heishman et al. Exp Clin Psychopharmacol 2:345–395, 1994) and to determine which aspects of human performance were most sensitive to the effects of nicotine and smoking.

Methods

We conducted a meta-analysis on the outcome measures of 41 double-blind, placebo-controlled laboratory studies published from 1994 to 2008. In all studies, nicotine was administered, and performance was assessed in healthy adult nonsmokers or smokers who were not tobacco-deprived or minimally deprived (≤2 h).

Results

There were sufficient effect size data to conduct meta-analyses on nine performance domains, including motor abilities, alerting and orienting attention, and episodic and working memory. We found significant positive effects of nicotine or smoking on six domains: fine motor, alerting attention-accuracy and response time (RT), orienting attention-RT, short-term episodic memory-accuracy, and working memory-RT (effect size range = 0.16 to 0.44).

Conclusions

The significant effects of nicotine on motor abilities, attention, and memory likely represent true performance enhancement because they are not confounded by withdrawal relief. The beneficial cognitive effects of nicotine have implications for initiation of smoking and maintenance of tobacco dependence.

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Acknowledgments

This research was supported by the Intramural Research Program of the NIH, National Institute on Drug Abuse, and NIH grant T32DA007209-29. We thank Dr. Michael Borenstein for answering questions regarding the conduct of the meta-analyses and Drs. Jack Henningfield and Andrew Waters for comments on the manuscript. We also thank Dr. Rex Robison, Dr. Mary Pfeiffer, Richard Taylor, Heather Andes, Rebecca Evans, and Gina Marrone for assistance in searching, obtaining, and organizing references.

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Correspondence to Stephen J. Heishman.

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This research was supported by the Intramural Research Program of the NIH, National Institute on Drug Abuse, and NIH grant T32DA007209-29.

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Heishman, S.J., Kleykamp, B.A. & Singleton, E.G. Meta-analysis of the acute effects of nicotine and smoking on human performance. Psychopharmacology 210, 453–469 (2010). https://doi.org/10.1007/s00213-010-1848-1

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  • DOI: https://doi.org/10.1007/s00213-010-1848-1

Keywords

  • Nicotine
  • Tobacco
  • Smoking
  • Performance
  • Motor
  • Attention
  • Memory
  • Cognition
  • Smokers
  • Nonsmokers