title: Executive Functions in Tobacco Dependence: Importance of Inhibitory Capacities.
abstract: BACKGROUND
  Executive functions are linked to tobacco dependence and craving. In this cross-sectional study, we assessed the impact of three executive functions: updating, inhibition and shifting processes on tobacco craving and dependence.
  
  
  METHODS
  134 tobacco consumers were included in this study: 81 moderately (Fagerström score <7) and 53 heavily dependent (Fagerström score >7). Dependence was assessed with the Fagerström test and craving with the tobacco craving questionnaire (TCQ 12). We used the Stroop test and the Hayling test to measure inhibition, the Trail Making Test to measure shifting processes and the n-back test to measure updating processes. A multivariate logistic model was used to assess which variables explained best the level of nicotine dependence.
  
  
  RESULTS
  Inhibition (p = 0.002) and updating (p = 0.014) processes, but not shifting processes, were associated with higher tobacco dependence. Inhibition capacity had a significant effect on the nicotine dependence level independently of age, education, time since last cigarette, intellectual quotient, craving, updating and shifting process.
  
  
  CONCLUSIONS
  Nicotine dependence level seems better explained by inhibition capacities than by craving and updating effects. The capacity to inhibit our behaviours is a good predictor of the severity of tobacco dependence. Our results suggest a prefrontal cortex dysfunction affecting the inhibitory capacities of heavy tobacco dependent smokers. Further studies are needed to investigate the application of these findings in the treatment of tobacco dependence.
authors.affiliation: Clermont Université, Université d'Auvergne, EA NPsy-Sydo, BP 10448, F-63000, Clermont-Ferrand, France; CHU Clermont-Ferrand, Pôle Psychiatrie B, F-63001, Clermont-Ferrand, France.
authors.forename: Valentin
authors.initials: V
authors.lastname: Flaudias
authors.affiliation: DIM, CHU Montpellier, Montpellier, France.
authors.forename: Marie Christine
authors.initials: MC
authors.lastname: Picot
authors.affiliation: Department of Psychiatry, CHRU Nimes / INSERM U1061, Nimes, France.
authors.forename: Jorge
authors.initials: J
authors.lastname: Lopez-Castroman
authors.affiliation: Clermont Université, Université d'Auvergne, EA NPsy-Sydo, BP 10448, F-63000, Clermont-Ferrand, France; CHU Clermont-Ferrand, Pôle Psychiatrie B, F-63001, Clermont-Ferrand, France.
authors.forename: Pierre-Michel
authors.initials: PM
authors.lastname: Llorca
authors.affiliation: Clermont Université, Université d'Auvergne, EA NPsy-Sydo, BP 10448, F-63000, Clermont-Ferrand, France; CHU Clermont-Ferrand, Pôle Psychiatrie B, F-63001, Clermont-Ferrand, France.
authors.forename: Audrey
authors.initials: A
authors.lastname: Schmitt
authors.affiliation: Dispensaire Émile Roux, Université d'Auvergne, Clermont-Ferrand, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Perriot
authors.affiliation: DIM, CHU Montpellier, Montpellier, France.
authors.forename: Vera
authors.initials: V
authors.lastname: Georgescu
authors.affiliation: Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier / INSERM U1061, Montpellier, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Courtet
authors.affiliation: Respiratory Disease Department, CHU Montpellier / Laboratoire Epsylon, Montpellier, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Quantin
authors.affiliation: Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier / INSERM U1061, Montpellier, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Guillaume
mesh_terms: D000328:Adult; D015897:Comorbidity; D066249:Craving; D003430:Cross-Sectional Studies; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology*