Investigation of the relationships between tobacco use, mood and cognitive processes in university students

Widespread use of tobacco products is a global health problem. Indeed, a considerable number of Turkish adolescents and adults are cigarette smokers. According to the World Health Organization (2016), 31.6% of those over the age of 15 and 44.1% of men in Turkey use tobacco or nicotine products such as cigarettes, hookah, and electronic cigarettes. When health problems associated with tobacco use are considered, research which examines the impact of cognitive processes on smoking behavior is of great importance. The aim of the current research was to investigate whether there is a relationship between intuitive and analytical thinking as assessed by Cognitive Reflection Test (CRT) performance and tobacco use among university students. Successful performance on the CRT requires the subject to suppress an intuitively appealing but incorrect response and employ an analytical/reflective problem-solving approach. It was expected that current smokers would make more incorrect responses (i.e., give intuitive answers) on the CRT than non-smokers who would obtain higher scores by giving correct analytical (i.e., reflective) answers. The latter thinking mode requires inhibitory control, while the former reflects a more impulsive cognitive style. Additional cognitive tests and self-report measures were employed to determine whether intelligence, numeracy skills, inhibitory control (based on color-word interference test), subclinical depressive symptoms or state anxiety influenced CRT performance or differed between smokers and non-smokers (thus influencing CRT outcomes). Unexpectedly, current smokers (n=63), former smokers (n=37), and tobacco-naïve participants (n=94) did not obtain significantly different scores on the CRT. Indeed, smokers obtained higher scores on the CRT relative to tobacco-naïve participants; however, group differences were not significant. Groups did not differ on measures of intelligence, depressive symptoms, and anxiety; however, a disproportionately greater number of males were current smokers. Moreover, smokers obtained significantly higher scores on one, but not a second, numeracy test relative to tobacco-naïve participants. Thus, non-significant smoker group differences on the CRT could reflect gender and numeracy skills. After controlling for gender, groups did not differ significantly on CRT or numeracy tests. Smokers committed significantly fewer uncorrected errors during the set-shifting/inhibitory control condition of color-word interference test relative to former smokers, but not tobacco-naïve subjects, and group differences remained significant after controlling for gender. Direct comparison of genders revealed that males obtained significantly higher scores on CRT-number correct and numeracy tests, and made significantly fewer CRT-calculation errors relative to females; however, males demonstrated significantly slower response times on the set-shifting/inhibitory control condition. Males were significantly older than females, while genders did not differ significantly on measures of anxiety and intelligence. After controlling for age, gender differences in numeracy skills were no longer significant. In contrast to published work, females did not commit a significantly greater number of CRT-intuitive errors. Further analysis revealed that numeracy skills had a substantial impact on CRT performance; however, gender differences on CRT-correct remained significant after controlling for numeracy skills and age. Gender and numeracy skills influenced CRT performance, while smoking status was not associated with a specific reasoning mode. To the best of my knowledge, this study was the first to examine the relationship between tobacco/nicotine use, gender, numerical skills, and CRT performance among Turkish university students.