The Smoking Mind: A Psycho-Cognitive Perspective

Smoking behavior involves not only a biological addiction, but also psycho-cognitive components. This runs from smoking initiation, through to maintaining, attempts at quitting, and relapse. This perspective is an important element in studying and intervening in smoking behaviors. The main aim of this narrative review is to explore tobacco cigarette smoking behavior, considering the pivotal role of cognitive mechanisms embedded in decision-making and in risk judgment, with particular attention to the so-called Optimistic Bias (OB). The mechanisms through which this fallacy supports smoking initiation and continuance are explored, considering the transition from young to adult smokers and the case of light and intermittent smokers. Furthermore, additional cognitive mechanisms associated with the OB, which sustain smoking behavior and prevent the efficacy of smoking cessation, are described. Finally, a stimulus for reflection and for discussion about how the impact of the cognitive bias perspective in tobacco cigarette smoking is provided, focusing on how it could support tailored interventions, both in smoking initiation prevention in adolescents and young adults, as well as in smoking cessation in high-risk categories.