Executive function fails to predict smoking outcomes in a clinical trial to motivate smokers to quit

Andrew T. Fox, Laura E. Martin, Jared Bruce, Jose L. Moreno, Vincent S. Staggs, Hyoung S. Lee, Kathy Goggin, Kari Jo Harris, Kimber Richter, Christi Patten, Delwyn Catley

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Background Executive function (EF) is considered an important mediator of health outcomes. It is hypothesized that those with better EF are more likely to succeed in turning their intentions into actual health behaviors. Prior studies indicate EF is associated with smoking cessation. Experimental and longitudinal studies, however, have yielded mixed results. Few studies have examined whether EF predicts post-treatment smoking behavior. Fewer still have done so prospectively in a large trial. We sought to determine if EF predicts quit attempts and cessation among community smokers in a large randomized trial evaluating the efficacy of motivational interventions for encouraging cessation. Methods Participants (N = 255) completed a baseline assessment that included a cognitive battery to assess EF (Oral Trail Making Test B, Stroop, Controlled Oral Word Association Test). Participants were then randomized to 4 sessions of Motivational Interviewing or Health Education or one session of Brief Advice to quit. Quit attempts and cessation were assessed at weeks 12 and 26. Results In regression analyses, none of the EF measures were statistically significant predictors of quit attempts or cessation (all ps > 0.20). Conclusions Our data did not support models of health behavior that emphasize EF as a mediator of health outcomes. Methodological shortcomings weaken the existing support for an association between EF and smoking behavior. We suggest methodological improvements that could help move this potentially important area of research forward.

Original languageEnglish
Pages (from-to)227-231
Number of pages5
JournalDrug and Alcohol Dependence
StatePublished - Jun 1 2017


  • Clinical trial
  • Community sample
  • Executive function
  • Health education
  • Motivational interviewing
  • Smoking cessation


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