Lower but not higher doses of transdermal nicotine facilitate cognitive performance in smokers on gender non-preferred tasks

One of the most widely used treatments for smoking cessation is nicotine replacement therapy (NRT). There is some evidence that smokers experience abstinence-induced deficits in cognitive function, which are attenuated by NRTs. Additionally it's been suggested that the degree of reversal of cognitive deficits may depend on the NRT dose and the smoker's gender. In the present placebo-controlled study we investigated effects of three doses of transdermal nicotine (7 mg, 14 mg and 21 mg) on cognitive performance of 48 male and 48 female smokers after overnight abstinence and 6 h of patch application. Cognitive tasks used in the study included the Conners' CPT, emotional Stroop, mental arithmetic, and verbal recall of affective prose passages. The results showed greater probability of attentional problems in the male sample compared to females as identified by the Conners' CPT. Within gender women showed improved performance in the 7 mg and 14 mg conditions on several measures of the Conners' CPT, and faster hit reaction time on the emotional Stroop test compared to women in the placebo and 21 mg of nicotine groups. Conversely, males showed a moderate overall advantage on the mental arithmetic task and were differentially sensitive to nicotine treatment on the prose recall task, on which the greatest improvement in recall of affective material was observed for the 14 mg group compared to the 21 mg group. The results are explained on the basis of an inverted U-shaped relationship between nicotinic stimulation and cognitive performance as well as greater sensitivity to nicotine dose manipulation on gender non-preferred cognitive tasks.

► 7 and 14 mg patches improved performance of women on the Conners' CPT and E-Stroop.
► 14 mg patches improved recall of affective material in men.
► 21 mg patches impaired recall in men and CPT and E-Stroop performance in women.
► 14 mg-treated females had significantly greater cravings than same-group males.
► 21 mg-treated males had greater withdrawal than same-group females.