Attentional bias toward emotional and cigarette cues: Insights from a computer mouse-tracking task in adults who smoke and adults who do not smoke.

Abstract

Attentional bias to drug-related cues is widely considered a core feature of addiction, yet its empirical assessment is highly sensitive to task design and stimulus selection. We used a computer mouse-tracking paradigm to examine attentional bias toward cigarette-related, pleasant, unpleasant, and neutral images. Ninety-six participants (49 adults who smoke, 47 adults who did not smoke) completed the task. Trajectory deviation, measured via maximum absolute deviation (MAD), served as index of attentional bias. To examine individual differences in cue reactivity among participants who smoked, we applied k-means clustering to the MAD data and replicated the findings in an independent sample of 85 individuals who smoked cigarettes. Both groups showed stronger bias for emotionally salient distractors, especially pleasant images, highlighting how the inclusion of emotionally matched control stimuli could reveal overlooked confounds in addiction research. Contrary to expectations, individuals who smoked did not show greater attentional bias to cigarette cues than nonsmokers. K-means clustering revealed two subgroups among individuals who smoked: one selectively biased toward cigarette cues, and another more reactive to pleasant stimuli. We replicated these results in an independent sample of 85 individuals who smoked cigarettes. The identification of different attentional bias profiles among individuals who smoke aligns with prior neuroimaging findings and suggests that the mouse-tracking paradigm may serve as a scalable, cost-effective tool for detecting individual differences in reactivity to drug-related and non-drug-related pleasant stimuli.