Prefrontal cognitive dysfunction is associated with tobacco dependence treatment failure in smokers with schizophrenia.
BACKGROUND
Patients with schizophrenia have higher rates of smoking (58-88%) than in the general population ( approximately 22%), and are more refractory to smoking cessation. These patients also exhibit numerous neurocognitive deficits, some of which may be ameliorated by cigarette smoking. The neurocognitive benefits derived from nicotine may, in turn, contribute to elevated rates of smoking and smoking persistence in schizophrenia. The present study examined the relationship between neurocognitive function and smoking cessation in schizophrenia.


METHODS
Treatment-seeking smokers with schizophrenia (N=58) participated in a 10-week placebo-controlled trial of sustained-release (SR) bupropion plus transdermal nicotine patch. Neuropsychological performance was evaluated in a subset of patients (n=31), prior to pharmacological treatment, using a neurocognitive battery.


RESULTS
Subjects were compared as a function of endpoint smoking status (Quit versus Not Quit), assessed by end of trial 7-day point prevalence abstinence, confirmed by CO level (< 10 ppm) on demographic traits, smoking, and clinical outcomes. While there were no significant baseline differences between quitters and non-quitters, non-quitters exhibited significantly greater deficits in performance on Trail Making Test, Part B (p=0.01) and on Digit Span backwards (p=0.04) compared to quitters. No associations were found between quit status and performance on other neuropsychological measures.


CONCLUSIONS
Our findings extend results of previous studies which suggest deficits in frontal executive function are associated with smoking cessation failure in schizophrenia. This may have implications for the development of tailored smoking cessation treatments in this population.
Moss
Taryn G
TG
Department of Psychology, The University of Toronto, 100 St. George Street, Toronto, ON M5S1A1, Canada.
Sacco
Kristi A
KA
Allen
Taryn M
TM
Weinberger
Andrea H
AH
Vessicchio
Jennifer C
JC
George
Tony P
TP
D000328:Adult; D001143:Arousal / Q000502:physiology; D001288:Attention / Q000502:physiology; D003072:Cognition Disorders / Q000503:physiopathology / Q000523:psychology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory / Q000187:drug effects; D008570:Memory, Short-Term / Q000502:physiology; D009483:Neuropsychological Tests; D017397:Prefrontal Cortex / Q000503:physiopathology*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011597:Psychomotor Performance / Q000502:physiology; D012559:Schizophrenia / Q000150:complications*; D012565:Schizophrenic Psychology; D016540:Smoking Cessation; D014029:Tobacco Use Disorder / Q000628:therapy*; D017211:Treatment Failure