Behavior Modification, a New Way to Quit Smoking?

Behavior Modification: Smoking

Even as a child, I’ve always known smoking was bad for your health. My dad smoked when I was very young, but quit due to the health risks he imposed on his family as well as himself. He quit cold turkey, meaning immediately and solely by himself. He said it was hard, but he got over it. Since then he told me never to smoke. Now I can’t exactly tell you how I picked up smoking, but it definitely started after my 18th birthday when I was legally able to purchase cigarettes. I bought my first pack just because I could, and I smoked them periodically at school, especially when others were doing it, and especially if they were attractive females. This made me think I was cool enough to associate with them. As the months went on, I started getting more and more stressed with school and work, I slowly grew dependent on cigarettes. By the time I was 19, I needed to smoke whenever I studied, worked, or socialized with my friends, because most of my friends were also smokers. I have quit numerous times and succeeded at the goals I’ve set because I would set goals such as not smoking for two weeks, however I have never set a permanent goal due to fear of losing my crutch. For example, I would not smoke for two weeks, what allowed me to abstain was the thought that I can have a cigarette after two weeks.

Tracy Orleans, et al., (1991) conducted a research study on quitting smoking interventions. The study consisted of four groups, (a) the self help group, who were given a standard self quitting guide to quit with no other support, (b) the social support group, who were given the same self quitting guide along with a support guide for their family and friends, (c) the telephone group, who were given the same self quitting material, but with four telephone calls to a counselor, and (d) the control, who were given only tips to quit smoking and a referral to local quit smoking programs. The results of the study were not significant, the quit rates of the control and experimental groups were about the same, the only difference was the way the two groups quit. The experimental groups tended to quit using behavioral requiting strategies (e.g. setting a quit date, switching brands, etc.) while the control group tended to use outside interventions (like voluntary group therapy, nicotine gum/patches, etc). An interesting finding in this article was that heavier, long time smokers were less likely to quit using self help interventions alone, than were lighter, less addicted smokers (Orleans et al., 1991). This may appear like common sense in hindsight, because clearly longer, heavier smokers are more addicted, therefore its harder for them to quit, similar reasoning could be added to the opposite; lighter smokers are less likely to quit because they feel that the health threats are trivial because there is no immediate concern, whereas long time smokers are more likely to be diagnosed with a chronic illness as a result of their smoking, thus forcing them to stop due to their health. Although the former is a finding as a result of the study, the latter was found in my specific intervention, as well as my brief encounter with smokers in the past.

My specific strategy was to monitor my smoking for five days, then implement my plan, which was to smoke one less cigarette a day. Now I only smoked about 4-5 cigarettes a day so my plan was to start with five, then kick it down to zero. Of course, as I’ve stated before I knew this would be easy because my goal for the future was to smoke again. I started my change in behavior smoking five the first day, only three the next day, but then on the third day I was angry at the thought that nicotine was controlling me, so using self control, I smoked no cigarettes on day three. Day four I was supposed to smoke two, but only smoked one at night, this one cigarette at night felt better than any cigarette I had previously smoked in weeks. I wanted this feeling again; I knew it was from nicotine withdrawal. The next three days I went off track of my original plan and smoked one cigarette a night. I used a form of operant conditioning, where “the individual performs a behavior, and the behavior is followed by positive reinforcement” (Taylor et al., 2006). In this case the very euphoric feeling of a nicotine rush is the reward due to a nicotine withdrawal from not smoking all day (which is the behavior). Sure this may not be the ideal goal of operant conditioning, but it did greatly reduce the number of cigarettes I smoked in a day.

This behavior change was only temporary in my mind, as were the past attempts. I chose to monitor my smoking habits because it is probably my most health compromising behavior (aside from riding my motorcycle but I don’t think that is a “health” issue, more of a “lifestyle” issue). According to the text, “smoking is the single greatest cause of preventable death…In the United States, it accounts for at least 430,700 deaths each year” (Taylor et al., 2006) Even without the book, and without the media telling me the negative effects of smoking, I knew it could not be good for me. When I go to sleep just after smoking, I notice my heart rate is very high, anytime I do strenuous physical activity, I always gasp for air after, although I do notice that I can hold my breath longer than many of my non smoking peers. I smoke mainly because the immediate payoffs outweigh the immediate consequences, and because I am human, evolutionary psychology shows that my immediate future is more salient than anything many years ahead (Ornstein, 1991). Sure I can get lung cancer or heart disease in 20-30 years, but that is less salient on my mind, besides I, like many others fall into the false consensus effect theory; I believe that the same health compromising behavior that kills hundreds of thousands a year, probably won’t affect me.

After the twelve day period, I continued with the one cigarette a night, after a few days of that, I went to one every other night. As I am writing this paper, I am down to two a week. My goal is to bring it down to zero, however as I have implied, the thought of being able to smoke in the future is the only thing allowing me to go without a cigarette for a period of time. What worked well in my intervention was that I did not give in to the abstinence violation effect which is “a feeling of loss of control that results when a person has violated self-imposed rules” (Taylor et al., 2006). On a couple of days I gave in and smoked more then I was supposed to, mainly because I was with my smoking friends, a main effect of abstinence violation is relapse, but I made sure I did not by telling myself it was a one time thing and I will continue with my original plan, that definitely helped me from saying “screw it” and continue to my old ways of four to five cigarettes

This intervention has taught me a lot about my specific cues for smoking and I have realized that for the most part it is not a severe addiction for me; rather it is just something to do between classes, lunch breaks, or socializing with friends. I am very thankful that I had the opportunity to do this, as I probably would have never monitored my smoking otherwise. Because of this project, I have cut my cigarettes down to only six percent of what I used to smoke, with no signs of relapse, or cravings during the day. Perhaps for the future, I will only smoke when girls hit on me, which is never. :)

References

1) Orleans, CT, Schoenbach, VJ, Wagner, EH, et al. (1991). Self-help quit smoking interventions: effects of self-help materials, social support instructions, and telephone counseling. Journal of consulting and clinical psychology, 59(3), 439-448.

2) Ornstein, R (1991). Evolution of Consciousness: The Origins of the Way We Think. New York: Touchstone

3) Taylor, S.E (2006). Health Psychology: Sixth Edition, Health-Compromising Behaviors (pp. 133-148), Health Behaviors (pp. 54-78). New York: McGraw Hill