title: Smoke and mirrors: The overnight abstinence paradigm as an index of disrupted cognitive function.
abstract: BACKGROUND
  Smoking abstinence is known to cause decrements in cognition, but the effects are small and variable. One way to reduce variance may be to aggregate measures or visits. Although trait-like individual differences in smoking abstinence effects on cognition are theorized to predict relapse, the test-retest reliability (TRR) assumed in trait models has not been evaluated.
  
  
  OBJECTIVE
  The objectives of this study were to assess the value of aggregating measures to determine effect sizes (ESs) of smoking versus abstinence on measures of cognition and to assess the short-term TRR of abstinence effects on cognition.
  
  
  METHODS
  Thirty adult smokers completed the typical overnight abstinence paradigm twice; each visit pair consisted of one smoking visit and one abstinent visit. Measures of attention, working memory, and inhibitory control were obtained in each visit.
  
  
  RESULTS
  There were small to medium ESs for smoking abstinence on individual cognitive measures during the first abstinence experience ("visit pair"). Aggregating the measures within the visit pair and across visit pairs additively increased the ES of smoking versus abstinence. Although TRRs were acceptable between smoking visits and between abstinent visits, TRRs for abstinence effects (smoking vs. abstinent visit differences) on cognition were consistently weak.
  
  
  CONCLUSIONS
  The ability of the typical overnight abstinence paradigm to reflect disrupted cognition at the group level can be substantially improved by aggregating across cognitive outcomes and/or multiple study visits. However, the patterns of poor TRR of smoking-abstinence differences in cognition caution against their use as trait-like markers in studies of relapse or treatment response.
authors.affiliation: Department of Psychology, University at Buffalo, Buffalo, NY, USA. rhodesjd@upmc.edu.|Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA. rhodesjd@upmc.edu.
authors.forename: Jessica D
authors.initials: JD
authors.lastname: Rhodes
authors.affiliation: Department of Psychology, University at Buffalo, Buffalo, NY, USA.
authors.forename: Larry W
authors.initials: LW
authors.lastname: Hawk
mesh_terms: D000328:Adult; D001288:Attention / Q000502:physiology; D003071:Cognition / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008570:Memory, Short-Term / Q000502:physiology; D008875:Middle Aged; D015203:Reproducibility of Results; D012907:Smoking / Q000378:metabolism / Q000523:psychology*; D016540:Smoking Cessation / Q000379:methods / Q000523:psychology*; D013997:Time Factors; D014029:Tobacco Use Disorder / Q000523:psychology
keywords: Abstinence; Attention; Cigarette smoking; Cognition; Inhibitory control; Nicotine; Test-retest reliability; Working memory