The Impact of Smoking Cessation on Real-World Prospective Memory UKNSCC, London, June 2016 Dr Thomas Heffernan Department of Psychology, Northumbria University, Newcastle Upon Tyne. NE1 8ST. Tel. 0191 227 4037 Email: tom.heffernan@northumbria.ac.uk

Introduction (1) Tobacco smoking ~ despite reductions in tobacco smoking, smoking remains a global health concern associated with a range of deleterious long-term outcomes. Including ~ increased incidence of physical harm, such as cancer, respiratory problems, heart disease (World Health Organization). Last few decades ~ greater understanding of impact persistent tobacco smoking upon neurocognitive function, including memory problems. Smoking-related memory decline linked with increased accelerated cerebral degeneration, possible structural damage to several cortical and subcortical regions that mediate memory.

Introduction (2) Memory deficits include working memory and attention (Gallinat et al. 2006; Nooyens et al. 2008; Durazzo et al. 2012). Working memory - part of immediate memory which is concerned with conscious perceptual and linguistic processing ~ kind of ‘workspace’. Important aspect of WM affected by smoking is ‘Executive Function’ ~ set of processes responsible for planning, attention, initiating actions and inhibiting inappropriate stimuli. Much less is known about impact smoking has upon everyday memory. One good example of everyday memory is ‘Prospective Memory’ ~ remembering to carry out activity at some future point in time (Brandimonte et al., 1996).

Introduction (3) PM important aspect of day-to-day memory, e.g. remembering to attend an appointment, to pay a bill on time, or take an important medication on time. Since PM involves range of everyday activities it is seen is crucial to independent living. Research has shown PM may be impaired by persistent smoking (e.g., Heffernan et al., 2005, 2012, 2013; Rash, 2007). Much less is known about what impact smoking cessations has upon PM. In a study presented at the UKNSCC in 2015 those who quit smoking showed sig improvements in lab-based PM tasks compared with AS. But what about real-world memory (PM) function ~ does quitting smoking produce real-life improvements?

Method Sample: 80 HE students (18-30yrs) canvassed; 36 omitted following screening, leaving 44: 14 active (current) smokers (the AS group) 17 never-smokers (the NS group) 13 previous smokers (the PS group) Measures: Drug-Use Questionnaire ~ measures smoking indices/other drug use. Real World Prospective Memory Test ~ event-based PM : ~ presented with list 15 location-action combinations to-be-remembered ~ completed tour of university campus ~ had to remember each correct combination once location is reached ~ higher scores = more proficient their PM. Hospital Anxiety & Depression Scale ~ general mood (Zigmond & Snaith, 1983). National Adult Reading Test ~ short measure of verbal IQ (Nelson 1982). 

Results: All Measures Measure AS (N=14) NS (N=17) Age 23.14(5.99) PS (N=13) Age 23.14(5.99) 19.0 (2.27) 24.4 (6.83) Anxiety scores 6.85 (3.23) Non-clinical levels 5.94 (2.94) 5.61 (2.36) Depression scores 3.00 (2.32) 2.23 (1.76) 3.00 (3.38) Alcohol units/week 22.4 (19.0) 18.2 (15.9) 13.3 (16.2) Cigarettes per week 72.0 (40.4) _____ _______ IQ (NART) 100 (2.28) 101 (1.69) 99 (1.93) RWPMT 8.25 (2.09) 12.0 (0.74) 11.1 (1.46)

Series of ANOVAs revealed: No significant impact of group on: Anxiety scores (F(2,41)=.687, p=.509); Depression scores (F(2,41)=.418, p=.661); Alcohol units per week (F(2,41)=.960, p=.391); IQ (F(2,41)=1.99, p=.148). But there was a significant variation between the groups on age (F(2,41)=4.69, p<.05). No significant difference between conditions on gender (χ2 (2) = 3.91, p = 0.14). For main RWPMT scores a 1-way ANCOVA (controlling for age) revealed: A significant impact of group on RWPMT scores: (F(2,41)=25.8, p<.001; Effect size = .557). Pairwise Comparisons revealed NS group recalled significantly more RWPMT combinations than AS groups (p<.05), PS group recalled sig. more RWPMT combinations than the AS group (p<.05); with no significant difference between NS and PS groups (P>.05).

Conclusions: Summary: After observing no between group differences on anxiety, depression, alcohol use and IQ, and controlling for age, AS performed significantly worse on the RWPMT than both the NS and PS groups. The PS group performance was on par with the NS group, suggesting improvements in their real-world prospective memory following smoking cessation. Findings consistent with improvements in other aspects of memory following smoking cessation, such as WM and EF. Also with PM improvements in PS shown from laboratory-based study presented at last year’s UKNSCC conference. The current study demonstrates this within a real-world context ~ improving ecological validity of the findings.

Explanation/Wider Implications Explanations: ~ tobacco smoke >50 toxic chemicals ~ damage structures? ~ such as hippocampus (Ghosh et al., 2009). ~ long-term smoking associated with cortical thinning (Karama et al., 2015). ~ including medial temporal and prefrontal cortices – supporting PM. ~ smoking cessation across several years improves neurocognitive function. Positive impact of smoking cessation upon health and cognition: ~ used in health campaigns on benefits of stopping smoking; ~ used to educate younger people about dangers smoking benefits cessation; ~ neuro-cognitive development still occurring during adolescence (Spear, 2013).

Cross disciplinary research could pursue a myriad of potential projects stemming from this research. Thank You! Any Questions?