6.6Cognitive effects

Last updated: January 2018

Suggested citation: Christensen, D. 6.6 Cognitive effects. In Scollo, MM and Winstanley, MH [editors]. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2018. Available from http://www.tobaccoinaustralia.org.au/chapter-6-addiction/6-6-cognitive-effects

Nicotine can significantly affect both physical and cognitive performance. A meta-analysis of laboratory studies reported that nicotine has a significant positive effect on fine motor abilities, attention-accuracy, orienting attention, short-term recall tasks, and working memory response times.1

There is some evidence to suggest that nicotine can improve attention in non-smokers,2, 3 and decrease working memory errors.4 However, chronic tobacco smoking is also associated with decrements in cognitive functioning, including an increased risk of cognitive impairment,5 decreased processing capacity,6 higher impulsivity, and an external locus of control.7 Cardiovascular disease—which is often caused by smoking—is associated with lower memory performance.8


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1. Heishman SJ, Kleykamp BA, and Singleton EG. Meta-analysis of the acute effects of nicotine and smoking on human performance. Psychopharmacology (Berl), 2010; 210(4):453–69. Available from: https://www.ncbi.nlm.nih.gov/pubmed/20414766

2. Levin E, Simon B, and Conners C. Nicotine effects and attention deficit disorder, in Nicotine in psychiatry: Psychopathology and emerging therapeutics.  Piasecki M and Newhouse P, Editors. Washington, DC: America Psychiatric Society Press; 2000.

3. Levin E, McClernon J, and Rezvani A. Nicotine effects on cognitive function: Behavioural characterization, pharmacological specification, an anatomic localization. Psychopharmacology, 2006; 184:523–39. Available from: https://www.ncbi.nlm.nih.gov/pubmed/16220335

4. McClernon FJ, Gilbert DG, and Radtke R. Effects of transdermal nicotine on lateralized identification and memory interference. Human Psychopharmacology, 2003; 18(5):339–43. Available from: https://www.ncbi.nlm.nih.gov/pubmed/12858319

5. Galanis D, Petrovich H, Launer L, Harris T, Foley D, et al. Smoking history in middle-aged and subsequent cognitive performance in elderly Japanese-American men. The Honolulu-Asia aging study. American Journal of Epidemiology, 1997; 145:507–15. Available from: https://www.ncbi.nlm.nih.gov/pubmed/9063340

6. Aleman A, Muller M, de Haan EH, and van der Schouw YT. Vascular risk factors and cognitive function in a sample of independently living men. Neurobiology of Aging, 2005; 26(4):485–90. Available from: https://www.ncbi.nlm.nih.gov/pubmed/15653177

7. Sheffer C, Mackillop J, McGeary J, Landes R, Carter L, et al. Delay discounting, locus of control, and cognitive impulsiveness independently predict tobacco dependence treatment outcomes in a highly dependent, lower socioeconomic group of smokers. American Journal on Addictions, 2012; 21(3):221–32. Available from: https://www.ncbi.nlm.nih.gov/pubmed/22494224

8. Muller M, Grobbee DE, Aleman A, Bots M, and van der Schouw YT. Cardiovascular disease and cognitive performance in middle-aged and elderly men. Atherosclerosis, 2007; 190(1):143–9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/16488420