Chronic tobacco smoking and emotional processing abilities: a systematic review.

Introduction: Tobacco use disorder (TUD) remains highly prevalent and is associated with widespread cognitive impairments, particularly in attentional functions. Conversely, the understanding of emotional deficits related to TUD remains limited, despite its potential impact on mood regulation.

Methods: We conducted the first systematic review on emotional processing in TUD, based on a well-established model of emotion distinguishing three processes (emotional identification, emotional response and emotional regulation), to which we added emotional attention as a fourth component. Capitalizing on a pre-registered approach and following PRISMA guidelines, we synthesized existing literature on emotional processing impairments in TUD, identifying 14 relevant studies.

Results: Findings indicate large-scale impairments encompassing all emotional components in TUD, demonstrating that emotional processing constitutes a crucial dimension of TUD.

Conclusion: Emotional processing emerges as a key aspect of TUD but, in view of the currently limited quantity and quality of research in this area, we offer guidelines for more comprehensive and theory-grounded investigations, to advance theoretical knowledge and pave the way for efficient interventions.

Implications: This systematic review shows that tobacco use disorder (TUD) is associated, beyond the already documented cognitive deficits, with emotional impairments encompassing emotional identification, response, regulation and attention. Such widespread modifications of emotional processing might be involved in the emergence and persistence of TUD, and hence constitute new targets for researchers and clinical practitioners.