Visual search and attentional bias for smoking cues: the role of familiarity.

Despite decades of work, the relationship between drug cues and actual drug use remains unclear. One promising area of research that may help explain this disconnect is the role of cognitive processing of drug cues, including attentional bias. This study utilized a visual search task that has previously been used to examine attentional bias in anxiety and eating disorders, but was modified to assess attentional bias for smoking cues. The task was completed by 106 participants (42.5% female), divided among three groups: smokers who continued smoking ad libitum, smokers who had abstained for 12 hours, and nonsmokers. An attentional bias for smoking stimuli was observed for both the initial orienting and maintenance subcomponents of attention. However, maintenance bias depended heavily upon the type of neutral stimuli used for comparison. Neither orienting nor maintenance bias differed across groups, indicating that these effects were not limited to smokers. Critically, the strongest predictor of attentional bias for smoking cues was previous environmental exposure to tobacco smoke. This raises questions about whether the traditional interpretation of attentional bias as an index of the incentive-motivational value of smoking cues is appropriate. Future empirical and theoretical work on smoking-related attentional bias should give greater consideration to the role that environmental exposure may play in its development.