Chronic tobacco smoking and neuropsychological impairments: A systematic review and meta-analysis

A. A. Conti, L. McLean, S. Tolomeo, J. D. Steele, A. Baldacchino (Lead / Corresponding author)

Research output: Contribution to journalReview article

6 Citations (Scopus)
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The link between neuropsychological impairments and chronic tobacco smoking is not clear and in the current literature there is a lack of robust analyses investigating this association. A systematic review of the literature was conducted in order to identify relevant longitudinal and cross-sectional studies conducted from 1946 to 2017. A meta-analysis was performed from 24 studies testing the performance of chronic tobacco smokers compared with non-smokers on neuropsychological tests related to eight different neuropsychological domains. The results revealed a cross-sectional association between neuropsychological impairments and chronic tobacco smoking in cognitive impulsivity, non-planning impulsivity, attention, intelligence, short term memory, long term memory, and cognitive flexibility, with the largest effect size being related to cognitive impulsivity (SDM = 0.881, p <0.005), and the smallest effect size being related to intelligence (SDM = 0.164, p < 0.05) according to Cohen's benchmark criteria. No association was found between chronic smoking and motor impulsivity (SDM = 0.105, p = 0.248). Future research is needed to investigate further this association by focusing on better methodologies and alternative methods for nicotine administration.

Original languageEnglish
Pages (from-to)143-154
Number of pages12
JournalNeuroscience and Biobehavioral Reviews
Issue number1
Early online date28 Nov 2018
Publication statusPublished - Jan 2019



  • Attention
  • Chronic smoking
  • Cognitive flexibility
  • Impulsivity
  • Intelligence
  • Memory
  • Meta-Analysis
  • Neuropsychology
  • Nicotine
  • Humans
  • Cognition Disorders/etiology
  • Tobacco Smoking/psychology
  • Tobacco Use Disorder/complications

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