Effects of transdermal nicotine on attention in adult non-smokers with and without attentional deficits.

Extant evidence suggests a possibility of self-medication to account for greater prevalence of cigarette smoking among adults with ADHD as they tend to show improvements on affective and cognitive measures, particularly on measures of sustained attention following nicotine administration. The present study was conducted to evaluate whether adult non-smokers with low attentiveness might exhibit greater improvements on measures of sustained attention than those with higher attentiveness using neuropsychological tests that had previously shown sensitivity to ADHD. On the basis of their scores on attention scales used in the diagnosis of adult ADHD, 62 male non-smokers were divided into 2 groups of either low or high attentiveness and treated with either a placebo or 7 mg nicotine patch. After 6 h of patch application each participant completed the Wisconsin Card Sorting Test (WCST), classic Stroop task, and Conners' Continuous Performance Test (CPT), which were administered in a counterbalanced order and a double-blind manner. No significant drug or group differences were observed on the Stroop task. On the Conners' CPT participants in the low attention group treated with nicotine committed significantly fewer errors of commission, showed improved stimulus detectability and fewer perseverations than those in the low attention placebo group. On the WCST nicotine significantly impaired the ability of participants in the high attention group to learn effective strategies to complete the test with fewer trials. The results showed nicotine-induced improvement on some measures of sustained attention in the low attention group and some decrement in working memory in the high attention group, which suggests that nicotine tends to optimize rather than improve performance on cognitive tasks.

RCT Entities:   Population Interventions Outcomes