Prefrontal cognitive dysfunction is associated with tobacco dependence treatment failure in smokers with schizophrenia

Abstract Background Patients with schizophrenia have higher rates of smoking (58–88%) than in the general population (∼22%), and are more refractory to smoking cessation. These patients also exhibit numerous neurocognitive deficits, some of which may be ameliorated by cigarette smoking. The neurocognitive benefits derived from nicotine may, in turn, contribute to elevated rates of smoking and smoking persistence in schizophrenia. The present study examined the relationship between neurocognitive function and smoking cessation in schizophrenia. Methods Treatment-seeking smokers with schizophrenia ( N = 58) participated in a 10-week placebo-controlled trial of sustained-release (SR) bupropion plus transdermal nicotine patch. Neuropsychological performance was evaluated in a subset of patients ( n = 31), prior to pharmacological treatment, using a neurocognitive battery. Results Subjects were compared as a function of endpoint smoking status (Quit versus Not Quit), assessed by end of trial 7-day point prevalence abstinence, confirmed by CO level (