Flexible emotion-based decision-making behavior varies in current and former smokers.

INTRODUCTION Suboptimal decision-making is a feature in the initiation and maintenance of substance use, often manifested in choosing for short-term benefits rather than long-term gain, and the failure to display cognitive flexibility, respectively. Studies of nicotine users typically focus on characterizing those who are already addicted; less is known about decision-making in former smokers. METHODS Non- (n=21), former daily- (n=23) and current daily smokers (n=24), completed the contingency-shifting variant Iowa Gambling Task (csIGT), in which the reward and punishment contingencies of the decks are systematically varied after 100 trials of the 'standard' IGT. Scores on the standard blocks of the csIGT provided an index of emotion-based decision-making, while the contingency-shifting blocks assessed flexible decision-making. Subjective ratings were also recorded at 20-trial intervals. RESULTS Both current and former smokers showed significantly impaired performance relative to non-smokers when making decisions during the standard blocks of the csIGT. Both former and non-smokers' awareness of the reward/punishment contingencies was significantly higher than those of current smokers at the end of the standard IGT. Both former and non-smokers had significantly better performance on the contingency shifting blocks, relative to current smokers. CONCLUSIONS The findings indicate that both current and former smokers display a suboptimal pattern of decision-making than non-smokers during the standard IGT. However, with respect to the ability to change behavior following reversed contingencies, former smokers are more similar to non-smokers than to current smokers. Former smokers were also more aware of the contingencies than current smokers.