SOME EFFECTS OF SMOKING WITHDRAWAL ON COMPLEX 

PERFORMANCE AND PHYSIOLOGICAL RESPONSES 

Henry W. Mertens, Jess M. McKenzie, and E. Arnold Higgins 

Civil Aeromedical Institute 

Federal Aviation Administration 

Oklahoma City, Oklahoma 73125 

JANUARY 1983 

Document is available to the public through the 

National Technical Information Service 

Springfield, Virginia 22161 

Prepared for 

U.S. DEPARTMENT OF TRANSPORTATION 

Federal Aviation Administration 

Office of Aviation Medicine 

Washington, D.C. 20591 
NOTICE 

This document is disseminated under the sponsorship 

of the Department of Transportation in the interest 

of information exchange. The United States 

Government assumes no liability for its content or 

use thereof. 
Technical Report Documentation Page 

1. Re port No. 2. Governm en t A cc ess ion No . 3. Re ci p ie nt's Cata log No . 

FAA-AM-83-4 

4 . T itle and Subti tl e 5 . Repo rt Date 

Some Effects of Smoking Withdrawal on Complex 

Performance and Physiological Responses 

JANUARY 1983 

6 . Perform ing Organ i zation Code 

1--::---:---:---:--:------------------------------! 8 . Performing Orgon i zoti on Report No . 7 · Autho r' s) Henry W. Mertens, Jess M. McKenz i e, and 

E. Arnold Higgins 

9. Performing Organ i zat ion Nome an d Addre s s 

FAA Civil Aeromedical Institute 

P.O. Box 25082 

Oklahoma City, Oklahoma 73125 

10. Work Un it No. (TRAIS) 

11 . Contract o r Grant No . 

13. Type of Report and Period Covered 

~~----------~--~~--------------------------~ 12. Sponsoring Agency Name and Add ress 

Office of Aviation Medicine 

Federal Aviation 

800 Independence 

Washington, D.C. 

15. Supplementary Notes 

Administration 

Avenue, SW. 

20591 

14. Sponsoring Agenc y Code 

Work was done under approved tasks AM-A-80/81/82 - PSY-85, and AM-A-80/81-PHY-123. 

16. Abstract 

The effects of smoking withdrawal on complex (time-shared) performance and physiological responses were studied at a simulated aircraft cabin altitude of 6,500 ft. 

Seventeen habitual smokers, nine women and eight men 23 to 59 years of age, served 

as subjects. Time-shared performance of monitoring, tracking, mental arithmetic, 

and problem solving tasks was measured by the Civil Aeromedical Institute (CAMI) 

Multiple Task Performance Battery (MTPB) in two 4-h test sessions, one in which 

smoking was permitted at 1/2-h intervals and a no-smokin~ session. Corollary 

physiological measurements involved urinary hormones (epinephrine, norepinephrine, 

and 17-ketogenic steroids), carboxyhemoglobin levels (COHb), and heart rate (HR). 

Overall composite scores for MTPB performance revealed decrements during withdrawal which were statistically significant (p < .01) beginning at the third 1/2-h 

period of withdrawal sessions. The principal sources of the withdrawal effect 

were a significant (p < .05) decrement in tracking and a tendency toward longer 

reaction times in one monitoring task during withdrawal. These performance decrements were associated with significantly lower HR (p < .001) and lower (p < .05) 

ratings of attentiveness during withdrawal from smoking. These findings support 

a cautious approach to the prohibition of smoking on the flight deck for aircrew 

members. 

17. Key Words 

Aviation Environment, Simulation, 

Smoking Withdrawal, Complex Performance, Physiology, Biochemistry 

18. Distribution Statement 

Document is available to the public 

through the National Technical Information Service, Springfield, Virginia 

22161 

19. Security Classif. (of this report) 20. Security Classif. (of this page) 21. No. of Pages 22. Price 

Unclassified Unclassified 16 

~orm DOT F 1700.7 <s-72l Reproduction of completed poge authorized 
INTRODUCTION. 

SOME EFFECTS OF SMOKING WITHDRAWAL ON COMPLEX 

PERFORMANCE AND PHYSIOLOGICAL RESPONSES 

In 1976, the Federal Aviation Administration (FAA) was petitioned to 

prohibit all smoking on the flight deck during all commercial flight 

operations and to ban smoking by commercial flight crew members within an 

8-h period before flights (15). In scientific evaluations of this petition, 

it was concluded that, although there are well demonstrated adverse effects 

on the health of smokers, carbon monoxide and nicotine at the levels of 

smoker intake have not been shown to produce adverse effects of practical 

significance on the performance of flight tasks in healthy pilots (4,14). 

Both reports, however, recognized the need for additional research on 

several issues including the potential adverse effects of short term 

withdrawal from smoking on the performance of pilots who are habitual 

smokers. Dille and Lindner (4) wrote "For some, withdrawal symptoms 

including tension, depression, irritability, difficulty in concentration, 

decreased heart rate, a fall in blood pressure, electroencephalographic 

changes, and impaired performance may occur and may more than offset any 

benefits to aviation safety that are expected from a ban on preflight and 

in-flight smoking." Although a number of experimental reports have addressed 

this issue, the need for additional research on the effects of smoking 

withdrawal on performance in aviation related tasks at an operational 

aircraft cabin altitude was recognized (4). The present experiment examined 

the effects of smoking withdrawal during a 4-h period on the complex 

(time-shared) performance of healthy habitual smokers in flight-related 

tasks at a simulated cabin altitude of 6,500 ft. 

METHOD. 

Subjects. Seventeen healthly paid volunteers who were all habitual 

smokers served as subjects. The nine female subjects ranged in age from 25 

to 59 yrs with a mean of 40 yrs. The eight male subjects ranged in age from 

23 to 59 yrs with a mean age of 39 yrs. All subjects had smoked at least 

one pack of cigarettes a day for the last 8 yrs. The mean duration of the 

smoking habit was 22 yrs. 

After selection, subjects received four 3 1/2-h training sessions on 

the Civil Aeromedical Institute's (CAM!) Multiple Task Performance Battery 

(MTPB). After training, subjects underwent two 4-h experimental sessions 

held with 2 days between sessions. Figure 1 summarizes the experimental 

protocol for test sessions. Each experimental session consisted of six 

30-min MTPB periods separated by 10-min "breaks." During the test session 

for the Smoking Condition, the subjects smoked one cigarette during the 10 

min immediately prior to the first 1/2-h period and one cigarette during 

each 10-min break thereafter. During the test session for the No Smoking 

Condition, subjects were allowed to smoke one cigarette prior to the first 

MTPB period but did not smoke again for the entire 4-h session. Each 

1 
subject completed preexperiment and postexperiment questionnaires consisting 

of subjective rating scales for attention, energy, strain, interest, 

irritability, and the state portion of the State-Trait Anxiety Inventory 

(STAI). 

EXPERIMENTAL PROTOCOL 

TIME (minutes) 

-15 o I 3o 40 n To eo m no 120 :rsr 150 1so v 190 200 1ZI 23o 1 !?zzzzzza rzzzzzzz1 qzzzzzzb rzzzzzzzJ rzzzzzzzJ pzzzzzzz1 It!'; n~, z : t- : : 

VOID I DISCARD 

URINE I - lii : MTP8 Periods * : BeQin smoklnQ one cigarette 

(no smoking In control condition) 

COLLECT 

URINE 

Figure 1. Experimental Protocol for test sessions. 

Venous blood samples were drawn after each subject smoked prior to the 

first MTPB period. Additional blood samples were drawn after the first and 

third MTPB periods at the end of the 10-min break periods. The latter two 

blood samples were taken just after the subject smoked one cigarette in the 

Smoking Condition. All urine that formed during the 4-h test session was 

collected, acidified with HC1 and frozen immediately. The blood sample was 

immediately analyzed for carboxyhemoglobin saturation; the instrument used 

was a Model 282 laboratory CO-Oximeter manufactured by Instrumentation 

Laboratories, Lexington, Massachusettes. Urine samples were later thawed 

and analyzed for epinephrine and norepinephrine by an adaptation of the 

method of Fiorica and Moses (3,5). In this adaptation, the catecholamines 

are isolated via alumina adsorption using a batch rather than a column 

technique. 

Before each experiment, chest electrodes were attached and heart rate 

(HR) was continuously recorded by means of an electromagnetic tape recorder. 

Multiple Task Performance Battery. The CAM! MTPB was used to measure 

time-shared performance in up to six component tasks simultaneously. The 

MTPB system is computerized; task presentation and data collection are 

automatic. The test panel displays and response controls are depicted in 

Figure 2. The system has been described elsewhere (2,10,11). A brief 

description follows: 

2 
~ 

I 

• 

• ., • 

• "' • ' ••••• .. 

\\ " 

• .:.. B C. >.1 c F G M 

J"LMNO~;lR 

; : u IJ w :( l' : • 

,. 

,. • • 

• 

•• 

• 

. . 

Figure 2. Multiple Task Performance Battery Console. 

Tasks ! and ~ Monitoring of Red and Green Warning Lights. This is a 

choice/reaction time task involving the monitoring of five green lights 

(normally on) and five red lights (normally off). The 10 lights were 

arranged in pairs of green and red. One pair is located in each corner of 

the test panel and a fifth is located in the center of the panel. The light 

lenses also serve as the pushbutton/switches. The subject was instructed to 

push the lens/switch whenever the light changed state. The measure of 

performance on these tasks is mean response latency recorded separately for 

red and green lights. 

3 
Task ~ Monitoring of Meters. This task involves monitoring four 

meters whose pointers move at random around the midpoint of the meter scale. 

The subject responds to a ~hift in the mean position of the pointer by 

pressing one of two buttons under the meter to report a left or right shift. 

The four meters are arranged across the top of the test panel. The 

performance measure is mean response latency. 

Task ~ Mental Arithmetic. The subject is required to add two numbers 

and subtract a third number from the sum of the first two. All numbers 

contain two digits. All computations are performed mentally without writing 

down or recording intermediate stages of the solution. Answers are recorded 

by a 10-key response panel. The arithmetic task display is located in the 

lower center of the test panel with the keyboard to the right of the 

display. Performance measures are the mean response latency and percent 

correct answers. 

Task~ Two-Dimensional Compensatory Tracking (TRK). The tracking 

task display is an oscilloscope screen mounted in the top center of the 

subject's panel. The target on the screen is a dot of light about 1 mm in 

diameter. A varying amplitude disturbance is imparted to the target in each 

dimension; the subject attempts to counteract the disturbance, keeping the 

dot at center screen, by moving a control stick with his right hand. 

Performance is measured in arbitrary units (volts) by analog circuitry in 

terms of mean integrated absolute error and mean error squared for both 

horizontal and vertical dimensions. These data are converted to measures of 

absolute vector error and root-mean-square (RMS) vector error, which are the 

performance measures. 

Task~ Problem Solving (PS). Each test panel is equipped with five 

response buttons, a "task active" light, and three "feedback" lights, all 

located at the left center of the test panel. The problem is to discover 

the correct sequence in which to press the five response buttons. Each 

button appears only once in a given trial. Subjects are instructed to use a 

trial-and-error procedure and a left-to-right search pattern. An amber 

feedback light is illuminated every time a button is pressed to show that 

the response is acknowledged by the system. Pressing buttons in incorrect 

order causes a red light to turn on and stay on until the next correct 

response is made. Pushing all five buttons in correct order causes a blue 

light to turn on. When a problem is solved, a lapse of 15 s occurs, 

following which the same problem is presented a second time. The subject is 

expected to reenter the previous solution from memory on the second, or 

confirmation presentation. After another 15 s a new problem is presented. 

Performance measures for this task are: (i) mean response latencies for the 

first solution and the confirmation stages; (ii) the percentage of 

nonredundant and correct responses made during the first solution and 

confirmation stages, respectively; and (iii) mean time per problem for both 

solution and confirmation stages. 

4 
• 

MTPB Procedure. A basic 30-min schedule of the six MTPB tasks was 

used. This 30-min period was divided into three 10-min intervals. Tasks 1, 

2, and 3 were given throughout the schedule. In the first 10-min interval, 

Task 5 was also active. In the second interval of each period, Tasks 5 and 

6 were also active. In the third interval, Tasks 4, 5, and 6 were also 

active. The task schedules for the three intervals were named the low, 

medium, and high workload conditions, respectively, and were always 

presented in the same order in each period. The four practice sessions were 

each of six 30-min periods. The experimental sessions also contained six 

30-min periods • 

Performance was assessed in terms of raw and composite scores for each 

task. Composite scores summarized all measures of performance for the 

particular task. An overall composite score (all tasks) was also obtained. 

Individual composite scores were calculated as follows: for each measure of 

performance on a task, the scores of an individual subject were converted to 

standard scores with a mean of 500 and a standard deviation of 100. The 

task composite score for each subject and experimental treatment was the 

mean of standard scores on each measure of performance for that task. The 

sign of scores was changed, when necessary, so that higher standard scores 

always indicated higher performance and lower scores, lower performance. An 

overall composite score was also calculated for each subject and treatment 

by averaging the composite scores for different tasks so that each task made 

an. equal contribution to the variance. Analyses of task and overall 

composite scores were made because they: (i) simplify the evaluation of a 

large amount of data; (ii) have been found to be more sensitive to the 

effects of experimental conditions than the individual measurements of 

performance; and (iii) have higher reliability than raw score data on 

individual performance measures (2,11). 

RESULTS. 

Physiological and Biochemical Responses. Carboxyhemoglobin levels are 

shown in Table 1 and were generally lower in the No Smoking Condition than 

in the Smoking Condition; however, the difference between conditions was 

significant (~ < .001) for those measurements taken 120 min after the 

experiment began. Data for the effects of experimental conditions on heart 

rate, urine production, and urinary excretion rate for catecholamines are 

summarized in Table 2. There were no statistically significant effects of 

withdrawal for excretion rates of urinary hormones or urine volume. Heart 

rate was significantly (~ < .001) higher when the subjects smoked. 

5 
Table 1. Mean and Standard Deviation of Carboxyhemoglobin 

Level %HbCO as a Function of Time the Sample was 

Taken and Smoking Condition 

Smoking No Smoking 

Time 

0 min (Before Period 1) Mean 7.69 6.04 

S.D. 3.44 2.48 

40 min (After Period 1) Mean 7.58 5.82 

S.D. 2.99 2.07 

120 min (After Period 3) Mean 8.02 4.26* 

S.D. 2.97 2.22 

*.£. < .001 

Complex Performance. Overall composite MTPB score data are shown in 

Figure 3 and Table 3. All performance data were analyzed by analysis of 

variance. Performance decreased during abstinence relative to the smoking 

condition. This decrement became apparent during the third 1/2-h of MTPB 

performance and continued through the remainder of the experimental session. 

Both the main effect of smoking (p < .01) and the interaction of smoking 

with time period (p < .OS) were statistically significant. Individual 

comparisons of means shown in Figure 3 indicated a significantly lower level 

of performance (p < .05) in the third, fourth, and sixth periods of the 

smoking withdrawal session. 

Composite score means and standard deviations for the main effects of 

smoking and test period are summarized in Table 4 for each component task. 

Tracking was the only MTPB component to exhibit a statistically significant 

main effect of smoking withdrawal, although there is also a tendency for 

performance in the monitoring of red lights to decrease during withdrawal 

over the first three 1/2-h periods of MTPB testing. There is also a 

tendency for performance to increase with time in the Smoking Condition in 

the latter task. In the case of tracking performance, the adverse effect of 

smoking withdrawal was independent of a trend toward decreasing performance 

with time, which occurred in both Smoking and No Smoking Conditions. The 

steady decline in tracking performance during the Smoking Condition was, 

however, apparently offset by increases in performance of other components 

of the MTPB as shown in the composite score data for the Smoking Condition 

in Figure 3. A tendency for increase in performance with time during MTPB 

testing in the Smoking Condition appears in the case of both red lights and 

arithmetic tasks. The main effect of periods was significant (.£. < .01) only 

6 
' 

in the arithmetic task. No significant interaction of smoking with time 

period occurred in composite score data for individual tasks. 

Table 2. Means and Standard Deviations of Heart Rate, Urine 

Production Rate, and Urinary Excretion Rate of 

Catecholamines as a Function of Smoking Condition 

Mean 

S.D. 

Mean 

S.D. 

Mean 

S.D. 

Mean 

S.D. 

*.e. < .001 

HEART RATE (bpm) 

Smokin8 No Smokin8 

80.5 73.4* 

11.1 9.0 

URINE VOLUME (mL/h) 

Smoking No Smoking 

339 312 

204 245 

EPINEPHRINE (ng/h) 

Smoking 

1000 

768 

Smokin8 

2561 

1034 

7 

No Smokin8 

900 

470 

NOREPINEPHRINE (ng/h) 

No Smokin8 

2532 

1222 
Table 3. 

Smoking Mean 

S.D. 

No Smoking Mean 

S.D. 

Difference 

(S-NS) 

Overall Composite Score Means, and Standard 

Deviations as a Function of Smoking Condition 

and Time Period 

Periods 

1 2 3 4 

504 505 530 501 

40 37 31 33 

507 497 493 473 

31 39 31 28 

-3 8 37 28 

OVERALL COMPOSITE 

600 

LLI 

~500 u 

en 

0 

Q: 

. 

0 

z 

~400 en 

2 

e SMOKING 

0 NO SMOKING 

3 4 5 

PERIOD 

5 

501 

31 

491 

68 

10 

6 

6 

521 

37 

471 

37 

50 

Figure 3. Overall MTPB composite scores summar1z1ng performance on all 

tasks as a function of smoking condition and time period. 

8 

.. 

r 

~ 

-" 

l, 

l 

~ 
Table 4. Composite Score Means and Standard Deviations 

as a Function of Smoking Condition and Time 

Period 

Conditions Periods 

Smoking No Smoking 1 2 3 4 5 

Green Lights Mean 498 502 

101 

504 

107 

512 

84 

509 

109 

488 

101 

503 

102 

Red Lights 

Meters 

Tracking 

Problem 

Solving 

Arithmetic 

* p < .05 

** p < .01 

SD 101 

Mean 514 

SD 92 

Mean 508 

SD 94 

Mean 535 

SD 79 

Mean 502 

SD 103 

Mean 507 

SD 71 

486 

103 

492 

103 

465* 

72 

498 

60 

491 

79 

515 

80 

500 

106 

576 

90 

495 

64 

445 

96 

483 

117 

496 

102 

526 

53 

485 

56 

505 

74 

509· 488 

84 98 

503 495 

94 104 

519 477 

83 60 

523 488 

47 55 

507 487 

69 76 

497 

121 

486 

106 

475 

82 

506 

68 

511 

74 

6 

485 

103 

507 

86 

520 

77 

427** 

84 

502 

50 

540** 

62 

Raw Score Data. Raw score data (means and standard deviations) for 

individual performance measures in each task are shown in Table 5 as a 

function of the main effects of smoking, workload, and test period. These 

data show slight decrements during withdrawal in 9 of the 13 performance · 

indices, with statistically significant (~ < .01) performance decrements in 

withdrawal occurring only in the case of absolute and RMS tracking errors. 

The workload factor was varied in all tasks but mental arithmetic. 

Increasing workload consistently caused a decrease in performance in all 

tasks. The effect of workload was statistically significant at the p < .01 

level in indices of tracking performance and problem solving performance, 

and significant at the p < .05 level in the monitoring of red lights and 

meters. Workload had no statistically significant interaction with smoking 

or periods. 

The effect of time period was statistically significant in tracking 

performance, problem solving and mental arithmetic. Both indices of 

tracking performance showed a significant (~ < .01) decline in performance 

9 
GREEN LIGHTS 

Response 

Latency (ms) 

RED LIGHTS 

Response 

Latency (ms) 

METERS 

Response 

Latency 

TRACK IN; 

Absolute 

Error 

RMS Error 

PROBUM SOLVING 

SOLUTION 

Time Per 

Response (ms) 

Percent 

Nonredundant 

Responses 

Time Per 

Problem 

PROBLEM SOLVING 

CONFIRMATION 

Time Per 

Response (us) 

Percent 

Correct 

Time Per 

Problem (ms) 

MENTAL 

ARITHMETIC 

Time Per 

Problem (ms) 

Percent 

Correct 

• p < .05 

** p < .01 

Table 5. The Main Effects of Smoking, Time Period, and 

Workload in the Individual Performance Measures 

(Raw Scores) for All Tasks 

Smoking Period Workload 

Yes No 1 2 3 4 5 , Low Medium 

Mean 4620 4579 4547 4484 4374 4809 4558 4823 3386 457"1 

S.D. 2656 2736 2747 2470 2586 2858 25ln )000 1993 2752 

Mean 2342 2929 2433 2721 256n 2664 2843 2585 1945 2~RO 

S.D. 1179 2019 1331 1651 1494 162R 2005 14R3 941 17n8 

Mean 20679 21035 20866 20686 20846 21028 2148n 20229 11951 16746 

S.D. 10602 9980 9224 9800 11540 11029 11187 9951 5053 6Rn2 

Mean 557.4 591.8* 535.2 562 . 6 564.9 583.2 588.2 n13. 7** 337 .7 n39.1 

s.o:- 157.2 153.7 158.4 154.2 158 . 5 150.7 146.9 11\4.2 135.0 171Ll 

Mean 88.6 93.0** 86 . 4 89 . 0 89.8 91.9 92.6 95.2** 59.5 100.0 

~ 22.5 22.5 22.9 22.1 23.2 22.5 21.9 22.7 20.4 24.0 

Mean 1030 1024 1101 1061 1002 985 1013 1000** RnR 

S.D. 226 200 227 206 236 195 220 196 150 

Mean 95.3 94.8 95 .2 95.1 95 . 5 95.2 95.0 94.4 95.9 

S.D. 4.2 4. 7 4. 3 4.6 5.5 4.5 4.1 4.2 3.5 

Mean 14886 14996 15211 15147 13964 15614 14914 14792* 12684 

S.D. 3616 3087 3599 3378 3492 3448 3303 2890 2310 

Mean 1081 1070 1107 1114 1086 1056 1044 104n 868 

S.D. 262 186 329 226 291 212 246 250 199 

Mean 82.2 82.1 83.7 82.4 83.2 80.2 81.1 82.2** 88 . 0 

S.D. 10.1 10.8 9.4 10 . 5 11.5 11.5 10.6 10.1 10.0 

Mean 9188 9002 8758 9166 9438 9586 8686 8935 6128 

S.D. 3865 4018 4167 3845 4731 3849 3286 3772 2714 

Mean 14009 14575 15309 14265 14223 14238 141q7 13520* 

S.D. 3077 3097 3291 3274 2778 3130 323"6 2815 

Mean 82.0 82.3 77 . 0 84.2 83.6 80.8 82.9 84.5* 

S.D. 16.4 15.5 15.8 16.1 16.6 16.3 17.3 13 . 6 

10 

.!!.!.&!! 

5840 

2696 

3280* 

2087 

33874* 

189nO 

74 7 .1** 

153 . 3 

112. ~·· 23.2 

1186** 

276 

94.2** 

5. 4 

17197** 

4393 

1283** 

259 

76 . 3** 

11.0 

12061 

3941 

14292 

3087 

82.2 

16 . 0 
over time, while both indices of mental arithmetic performance showed a 

significant (£ < .OS) increase in performance over the course of an 

experimental session. The significant effect of periods in problem solving 

seems to reflect only a temporary increase in performance during the third 

1/2-h period of a session. These trends can be inferred from Figure 4 which 

in turn shows the corresponding composite score data for these three tasks. 

In no case was there a significant interaction of the smoking factor with 

periods. 

Subjective Rating Scale Data. Ratings of attentiveness, shown in Table 

6, were significantly (£ < .OS) higher when subjects smoked. There was a 

slight but nonsignificant decline in attentiveness over time (before 

experimental testing vs. after testing) in both Smoking and No Smoking 

Conditions. Ratings indicated significantly (£ < .OS) higher levels of 

tiredness, tension, boredom, and irritation at the end of the experiment 

than before, but no effects of smoking withdrawal were found with these 

variables. Arousal, as measured by the State portion of the STAI, was not 

significantly affected by either smoking or time of testing, but smoking 

tended to increase arousal, and withdrawal to decrease arousal, over the 

course of the session. 

"" a: 

0 

u 

"' 

600 

400 

REO LIGHTS 

o 0 123 4 56 

~ .,J,R KINGCOMPOSP"E SCORES 

z 

.. 

"=~ 0 '-':-1 ,.----:-3 ~4:--:---!6 

600 GREEN LIGHTS 

400 

Jl I I I I I 

I 2 3 4 5 6 

6 00 PROBLEM SOLVING 

500 ~ 

400 

• SMOKING 

O NO SMOKING 

0 I 2 3 • 5 6 

PERIOD 

600 METERS 

400 

0 I 2 3 4 5 6 

600 ARITHMETIC 

500 p 

400 

0 I 2 3 • 5 6 

Figure 4. Composite scores for individual tasks of the MTPB 

as a function of smoking condition and time period. 

11 
Table 6. The Effects of Smoking and Time of Measurement 

on Subjective Rating Scale Responses 

Rating Scale Smoking No Smoking 

Before After Before After 

Attentiveness Mean 6.35 5.82 5. 71 5.00 

S.D. 2.15 1.91 1.96 1.12 

Tiredness Mean 4.76 5.63 4.24 6.18 

S.D. 1.68 1.71 1.60 1.19 

Tenseness Mean 3.59 4.41 3.82 4.59 

S.D. 1.66 1.80 1.33 1.46 

Boredom Mean 2.76 3.88 2.76 4.41 

S.D. 1.82 2.23 1.99 1. 70 

Irritation Mean 1.41 2.29 1.35 2.58 

S.D. 1.06 2.23 1.00 1.80 

STAI-Xl Mean 31.47 33.35 35.12 31.12 

(Arousal) S.D. 8.98 11.85 8.67 9.80 

DISCUSSION. 

In the present experiment in which complex performance was measured at 

a simulated operational cabin altitude of 6,500 ft, there was a significant 

adverse effect of smoking withdrawal. When smoking was permitted the 

overall index of performance was maintained at the initial level or higher 

over the 4-h of testing. When smoking was prohibited, however, performance 

declined with time. That effect was largely a result of a decrement in 

tracking performance, a psychomotor function important to flying. Vigilance 

performance regarding red lights also showed a similar trend, but the 

effects of smoking withdrawal were not statistically significant in that 

case. Decrements in performance due to smoking withdrawal were associated 

with subjective reports of decreased attentiveness, both prior to and after 

the experiment. The decrement in attentiveness ratings prior to the 

experiment suggests an effect of anticipation of withdrawal on the cognitive 

state of subjects, but no corresponding decrement in overall performance was 

found in the first 1/2-h test period. Tracking performance in the first 

1/2 h was, however, lower in the No Smoking condition than in the Smoking 

Condition. This suggests that anticipation of withdrawal may have 

restructured relative task priorities to the benefit of other tasks in the 

first 1/2 h of the withdrawal condition. Trends in tracking and arithmetic 

task performance over time also suggest changes in task priorities. The 

decline in tracking performance with time was balanced to some extent by an 

increase in performance of arithmetic. Both trends were independent of the 

effect of smoking. This suggests a reciprocal change in priorities or 

attention to those two tasks over time. This apparent change in priorities 

12 
or allocation of attention over time is unexplained but may be related to 

fatigue buildup during the test session. A fatigue buildup is supported by 

the significant increases in subjective ratings of tiredness, tenseness, 

boredom, and irritation that occurred in both Smoking and No Smoking 

Conditions. 

Increasing workload was consistently associated with decreasing 

performance in all tasks that occurred under varying workload conditions. 

In no case, however, did workload have a significant interaction with 

smoking treatment. 

The higher HR and higher attentiveness scores obtained when the 

subjects smoked are consistent with the performance data and suggest that 

decreased arousal in the absence of smoking may be the mechanism causing the 

detrimental effects of smoking withdrawal in habitual smokers. 

Although there was some disparity among subjects with respect to the 

yields of tar and nicotine of the cigarettes they usually smoked, there were 

no apparent effects of cigarette type on levels of COHb in the present 

study. This lack of correlation of yield with COHb saturation, and with 

blood nicotine levels, is well known (16). Although the effects of low 

levels of carbon monoxide on MTPB performance have not yet been studied, it 

might have been expected that lowered carboxyhemoglobin levels would 

contribute toward enhanced performance. We conclude that any positive 

effects that might have been obtained from a decreased carboxyhemoglobin 

level were offset by the negative effects of withdrawal. 

Our findings of decrements in complex task performance at an 

operational aircraft cabin altitude, and tracking performance in particular, 

corroborate the findings of several previous experiments conducted at ground 

"level. Heimstra, Bancroft, and DeKock (8) compared the performance of 

smokers, smokers deprived, and nonsmokers in a complex simulated automobile 

driving task involving tracking, reaction time, and vigilance components. 

Although there were no significant differences between the performance of 

nondeprived smokers and nonsmokers, smokers who were deprived had 

significantly inferior tracking and vigilance performance. A second 

experiment, by Heimstra, Fallesen, Kinsley and Warner (9), studied the 

effect of smoking withdrawal on complex performance using tracking, reaction 

time, vigilance, and mental arithmetic as component tasks. Tracking 

performance was significantly lower in the smoking deprivation condition. 

Performance in other tasks was not affected by withdrawal, as was the case 

in the present study. 

Two other studies involving tracking in dual task situations have also 

shown tracking to be sensitive to smoking withdrawal. In a study cited by 

Heimstra (7), Bancroft, Heimstra, and Warner (1) examined simultaneous 

performance in pursuit-rotor tracking and reaction time tasks in nonsmokers, 

smokers-deprived, and smoker groups in a 3-h test session. Under high and 

low tracking difficulty, tracking performance was significantly lower in the 

smoker-deprived group, and in the low tracking difficulty condition reaction 

13 
times were also slower. Warburton (20) cited a study of Tarriere and 

Hartman (18) in which smokers performed simultaneously in a central visual 

guiding task and a peripheral visual search task under smoking and smoking 

withdrawal conditions. Tracking (guiding) and search performance were lower 

during withdrawal. 

At least five complex performance studies have, therefore, shown 

significant adverse effects of smoking withdrawal on the tracking component. 

There is also additional evidence that short-term withdrawal from smoking 

can produce decrements in vigilance (6,13,19,21), choice reaction time 

(13,17), and selective attention (12,21), in single task situations. 

The present findings add to the body of evidence demonstrating 

important adverse effects of short-term smoking withdrawal on performance at 

a simulated operational air carrier altitude. These findings support the 

previous conclusion (4,9,14) that when considering the issue of restricting 

smoking in various work situations, including the flight decks of aircraft, 

the issue of negative effects of smoking deprivation on performance must be 

considered. Our results support a cautious approach to the prohibition of 

smoking for aircrew members. In light of the possibility that pilots who 

are habitual smokers may not perform well during withdrawal we recommend, as 

did Dille and Lindner (4), consideration of smoking cessation programs and 

other approaches milder than complete prohibiton of smoking during flight in 

aircraft. 

14 
REFERENCES 

1. Bancroft, N.R., N.W. Heimstra, and H.D. Warner. 1967. Relationship 

between psychomotor performance and stress. Technical Report, Human Factors 

Laboratory, The University of South Dakota. 

2. Chiles, W.D., A.E. Jennings, and G. West. 1972. Multiple-task 

performance as a predictor of the potential of air traffic controller 

trainees. FAA Office of Aviation Medicine Report No. FAA-AM-72-5. 

3. Davidson, I. and J.B. 

methods. Philadelphia: 

Henry (Eds.) 1974. Clinical diagnosis~ laboratory 

Saunders. pp 1377-1388. 

4. Dille, J.R., and M.K. Lindner. 1980. The effects of tobacco on aviation 

safety. Office of Aviation Medicine Report FAA-AM-80-11. 

5. Fiorica, V. and R. Moses. 1971. Automated differential fluorometric 

analysis of norepinephrine and epinephrine in blood plasma and urine. 

Biochemical Medicine, 5: 483-504. 

6. Frankenhaeuser, M., A.L. Myrsten, G. Johansson, and B. Post. 1971. 

Behavioral and physiological effects of cigarette smoking in a monotonous 

situation. Psychopharmacologia, 22: 1-7. 

7. Heimstra, N.W. 1973. The effects of smoking on mood change. In: W.L. 

8. 

Dunn (Ed.) Smoking Behavior: Motives and incentives. Washington, D.C.: 

Winston. pp. 197-207. 

Heimstra, N.W., N.R. Bancroft, and A.R. DeKock. 1967. 

upon sustained performance in a simulated driving task. 

York Academy of Science. 142: 295-307. 

Effects of smoking 

Annals of the New 

9. Heimstra, N.W., J.J. Fallesen, S.A. Kinsley, and N.W. Warner. 1980. The 

effects of deprivation of cigarette smoking on psychomotor performance. 

Ergonomics, 1980, 23: 1047-1055. 

10. Higgins, E.A., W.D. Chiles, J.M. McKenzie, A.W. 

Funkhouser, A.E. Jennings, S.R. Mullen, and P.R. 

of lithium carbonate on performance and biochemical 

of Aviation Medicine Report No. FAA-AM-77-17. 

Davis, Jr., G.E. 

Fowler. 1977. Effects 

functions. FAA Office 

11. Jennings, A.E., W.D. Chiles, and G. West. 1972. Methodology in the 

measurement of complex human performance: Two-dimensional compensatory 

tracking. FAA Office of Aviation Medicine Report No. AM-72-21. 

12. Leigh, G., J.E. Long, and A. 

tobacco on divided attention. 

1233-1239. 

Campbell. 1977. Effects of ethanol and 

Journal of Studies on Alcohol. 38: 

15 
13. Myrsten, A.L., B. Post, M. Frankenhaeuser, and G. Johansson. 1972. 

Enhanced behavioral efficiency induced by cigarette smoking. 

Psychopharmacologia. 8: 64-74. 

14. National Institute of Health. 1978. Cigarette smoking and airline pilots: 

Effects of smoking and smoking withdrawal on flight performance; a report 

of an expert panel of consultants. Department of Health, Education, and 

Welfare, Washington, D.C., April. 

15. Petition of the Airline Pilots Committee of 76, Public Citizen's Health 

Research Group, and the Aviation Consumer Project. 1976. Smoking in the 

cockpit, and smoking by flight crewmembers before commercial flight 

operations. Regulatory Docket No. 15614, filed April 20, 1976, before the 

Federal Aviation Administration, Washington, D.C. 

16. Russell, M.A.H., M. Jarvis, R. Iyer, and c. Feyerabend. 1980. Relation 

of nicotine yielo of cigarettes to blood nicotine concentrations in smokers. 

British Medical Journal, 280: 972-976. 

17. Smith, D.L., J.E. · Long, and G. Leigh. 1977. Combined effects of tobacco 

and caffeine on components of choice reaction-time, heart rate, and hand 

steadiness. Perceptual and Motor Skills, 45, 635-639. 

18. Tarriere, C., and F. Hartmann. 1964. Investigation into the effect of 

tobacco smoke on a visual vigilance task. Ergonomics, Proceedings of the 

Second International Ergonomics Association Congress, Dortmond. (pp. 

525-530). 

19. Walker, D., and S. Levander. 1980. The effects of tobacco smoking on CFF 

as related to personality and smoking habits. Psychophysiology, 70: 

131-136. 

20. Warburton, D.M. 1979. Physiological aspects of information processing and 

stress. In: V. Hamilton and D.M. Warburton. Human Stress and Cognition: 

An Information Processing Approach. New York: Wiley, pp. 33-55. 

21. Wesnes, K., and D.M. Warburton. 1978. The effect of cigarette smoking and 

nicotine tablets upon human attention. In: R.E. Thornton (Ed.), Smoking 

Behavior: Physiological and Psychological Influences. London: 

Churchill-Livingston. 

*u.S. GOVERNMENT PRINTING OFFICE: 1993 • 761-068/80061 

16