Using psychological insights to help people quit smoking

Abstract

Aims: This paper sets out to evaluate the possibility that smoking cessation interventions which make use of current psychological theories and constructs can be more successful than programmes based largely on nicotine replacement therapy and will be more satisfying to participants.

Rationale: Nicotine replacement therapy is currently the most widely used method for helping smokers give up the habit. Numerous studies have shown this to be a successful approach for many smokers, but the majority still fail to benefit. Typically three quarters of smokers given nicotine replacement are smoking again one year later. This study investigates whether nicotine replacement can be enhanced by the addition of psychological techniques.

Design: Smokers recruited via publicity in the local media were randomly assigned to one of two treatment conditions. The first condition consisted of a series of group sessions in which volunteers were instructed in nicotine replacement, and a number of psychological techniques, the most important being cognitive counter conditioning. The second condition was identical to the first but without the cognitive counter conditioning. Finally background quit rate was determined using waiting list controls.

Results: Both interventions were successful in helping smokers quit the habit, based upon an analysis at 6 months, compared with waiting list controls. The experimental condition incorporating cognitive counter conditioning produced a much higher quit rate than the condition based largely upon nicotine replacement, although the difference was not significant.

Conclusions: This study is highly suggestive that nicotine replacement therapy can be enhanced by the inclusion of psychological techniques in group work, resulting in abstention rates higher than nicotine replacement alone and increasing participant satisfaction. Further work is needed with larger numbers to verify that this is indeed a significant gain and to investigate whether psychological techniques can give longer term benefits.