Smoking is a psycho-organic disorder characterised by a compulsive urge to smoke despite the negative effects of such abuse. Such addictive behaviour constitutes one of the main causes that lead to the development of diseases and mortality, causing more than 7 million deaths per year. In Spain, the daily smoking rate ranges between 23.3% of men and 16.4% of women, according to the European Health Survey 2020.
Numerous scientific reviews highlight the impact of smoking on physical health and the development of cardiovascular and cerebrovascular diseases. In fact, chronic smoking has been associated with differences in executive functioning between smokers and non-smokers. In addition, smokers show marked impairments in cognitive flexibility, visual attention, impulsivity, maladaptive decision-making, lower inhibitory control abilities, poorer working memory performance, as well as altered brain functioning patterns. However, studies on smoking have mostly focused on studying the executive components separately. Thus, a comprehensive assessment that clarifies the contribution of each executive component in smoking is still lacking.
Given the lack of neuropsychological assessment protocols in smoking, there is a need to develop a neuropsychological battery aimed at measuring executive performance in such a specific group in order to fill this methodological gap. Also, clinical practice requires assessments with ecological validity where the instruments show a certain degree of correspondence with real situations.
Based on the above, we outline a validated protocol that adopts an academic approach to the assessment of executive functioning in smokers seeking treatment.The protocol specifies the structure of the screening process and incorporates a screening schedule to assess the patient's executive capacity. This protocol can be implemented easily over several sessions and is designed to ensure reliable assessment of executive function inhibition, flexibility and updating in adults. With regard to the neuropsychological instruments used, six executive function tasks were selected based on the type of measurement construct provided as a psychometric indicator of validity established in the technical manuals of each test used, as well as on their degree of correspondence with the criteria of ecological validity.