Efficacy and working mechanisms of a Go/No-Go task-based inhibition training in smoking: A randomized-controlled trial

Franziska Motka; Charlotte E Wittekind; Leonie Ascone; Simone Kühn

doi:10.1016/j.brat.2024.104672

Efficacy and working mechanisms of a Go/No-Go task-based inhibition training in smoking: A randomized-controlled trial

Behav Res Ther. 2024 Dec 15:185:104672. doi: 10.1016/j.brat.2024.104672. Online ahead of print.

Authors

Franziska Motka¹, Charlotte E Wittekind², Leonie Ascone³, Simone Kühn⁴

Affiliations

¹ Division of Clinical Psychology and Psychotherapy, Department of Psychology, LMU Munich, Munich, Germany. Electronic address: Franziska.Motka@psy.lmu.de.
² Division of Clinical Psychology and Psychotherapy, Department of Psychology, LMU Munich, Munich, Germany. Electronic address: Charlotte.Wittekind@psy.lmu.de.
³ Neuronal Plasticity Working Group, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany. Electronic address: l.ascone-michelis@uke.de.
⁴ Neuronal Plasticity Working Group, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany; Center for Environmental Neuroscience, Max Planck Institute for Human Development, Lentzeallee 94, 14195, Berlin, Germany. Electronic address: kuehn@mpib-berlin.mpg.de.

PMID: 39733608
DOI: 10.1016/j.brat.2024.104672

Abstract

Objective: Deficits in inhibitory control contribute to smoking behavior. Inhibitory control training (ICT), which involves repeatedly inhibiting responses to general or substance-related stimuli, shows promise in reducing problematic substance use. This preregistered randomized-controlled trial is the first to investigate the efficacy of general and smoking-specific Go/No-Go task-based ICT on smoking behavior compared to control groups receiving no ICT. Three potential working mechanisms were examined: inhibitory enhancement, automatic stimulus-stop associations, and stimulus devaluation.

Method: Individuals who smoke (N = 122) were randomly assigned to complete 28 sessions of smoking-specific Go/No-Go, general Go/No-Go, Sham training, or to a Waitlist control condition. Clinical outcomes included daily cigarettes (primary outcome), carbon monoxide levels, tobacco dependence severity, and craving, assessed at post-intervention and 3-month follow-up.

Results: Go/No-Go training resulted in a significantly greater reduction in tobacco dependence (β = -0.88, p = .004) and craving (β = -4.31, p = .012) post-intervention compared to both control groups. The greater reduction in craving remained significant when compared to the Sham training group only (β = -4.64, p = .026). No significant effects of group were observed on daily cigarette consumption (β = -1.97, p = .093) or carbon monoxide levels (β = 2.16, p = .818) post-intervention. At the 3-month follow-up, no significant effects of group emerged (all ps > .794). Smoking-specific Go/No-Go training did not outperform general Go/No-Go training (all ps > .075). No working mechanism for clinical outcome improvements was identified.

Conclusions: Preliminary evidence suggests that (smoking-specific) GNG training reduces tobacco dependence severity and craving post-intervention in individuals who smoke compared to non-ICT-based control conditions. Its efficacy as an add-on in smoking cessation needs to be investigated.

Clinical trial registration number: DRKS00014652.

Keywords: Go/No-Go; inhibitory control training; response inhibition; smoking.