The effects of a multiple treatment program and maintenance procedures on smoking cessation

doi:10.1016/0091-7435(81)90010-4

Preventive Medicine

Volume 10, Issue 1, January 1981, Pages 94-104

https://doi.org/10.1016/0091-7435(81)90010-4 Get rights and content

Abstract

This study evaluated the efficacy of a multiple treatment smoking cessation program and three maintenance strategies. Phase I of the study involved 51 subjects who participated in a 5-day smoking cessation project. The program consisted of lectures, demonstrations, practice exercises, aversive smoking, and the teaching of self-control procedures. In Phase II, all subjects were randomly assigned to one of three maintenance conditions: a 4-week support group which offered an opportunity to discuss feelings and thoughts, a 4-week telephone contact system which enabled group members to call one another, and a no-contact control group. To evaluate efficacy, extensive follow-up data were collected at the end of treatment and at 2, 4, 6, and 12 months post-treatment. The treatment program was extremely effective; 100% of the subjects were abstinent at the end of treatment, and at 1 year post-treatment, 63% of the subjects reported total abstinence. As to sex differences, at the 1-year period 66% of the women and 59% of the men were ex-smokers. Recidivists reported a smoking rate that was 52% of baseline at the 6-month follow-up. At 2 months post-treatment, 40% of the abstainers reported that the quitting experience was easy, and subjects reported an average weight gain of only 4.69 lb. The authors offer suggestions for future smoking cessation research based upon the promising findings of this study.

References (40)

B.G. Danaher
Research on rapid smoking: Interim summary and recommendations
Addict. Behav.
(1977)
C.M. Franks et al.
An improved apparatus for the aversive conditioning of cigarette smokers
Behav. Res. Ther.
(1966)
J. Sipich et al.
A comparison of covert sensitization and nonspecific treatment in the modification of smoking behavior
J. Behav. Ther. Exp. Psychiat.
(1974)
T.L. Whitman
Aversive control of smoking behavior in a group context
Behav. Res. Ther.
(1972)
D.A. Bernstein
Modification of smoking behavior: An evaluative review
Psychol. Bull.
(1969)
P.H. Bornstein et al.
Reduction of Smoking Behavior through Token Reinforcement Procedures
(1975)
J.R. Cautela
Treatment of smoking by covert sensitization
Psychol. Rep.
(1970)
R.F. Chapman et al.
Elimination of cigarette smoking by punishment and self-management training
Behav. Res. Ther.
(1971)
J.B. Conway
Behavioral self-control of smoking through aversive conditioning and self-management
J. Consult. Clin. Psychol.
(1977)
B.G. Danaher
Rapid smoking and self-control in the modification of smoking behavior
J. Consult. Clin. Psychol.
(1977)

R. Dubren

Self-reinforcement by recorded telephone messages to maintain nonsmoking behavior

J. Consult. Clin. Psychol.

(1977)

R.A. Eisinger

Nicotine and addiction to cigarettes

Brit. J. Addict.

(1971)

R. Elliot et al.

Breaking the cigarette habit: Effects of a technique involving threatened loss of money

Psychol. Rec.

(1968)

D.T. Frederickson

The community's response to substance misuse

Int. J. Addict.

(1968)

D. Geisinger

A broad range program to eliminate cigarette smoking

J.S. Guilford

Factors Related to Successful Abstinence from Smoking

(1966)

M. Gutmann et al.

Problems of S's motivation in a behavioral program for reduction of cigarette smoking

Psychol. Rep.

(1967)

W. Hunt et al.

Relapse rates in addiction program

J. Clin. Psychol.

(1971)

M. Kanzler et al.

Long and short term effectiveness of a large-scale proprietary smoking cessation program: A four-year follow-up of Smokenders participants

J. Clin. Psychol.

(1976)

H.A. Lando

A comparison of excessive and rapid smoking in the modification of chronic smoking behavior

J. Consult. Clin. Psychol.

(1975)

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To assess the effectiveness of including a social support intervention (‘buddy system’) in a group treatment programme to aid smoking cessation.
Five hundred and sixty-three smokers attended groups at a smokers’ clinic. These groups were randomized either to be (a) groups in which smokers were paired with another person to provide mutual support (buddy condition: n = 237 in 14 groups) or (b) to receive the same treatment without the buddy component (control: n = 326 in 20 groups). Participants were seen weekly for the first 4 weeks after stopping then followed up again after 26 weeks.
Smokers in the buddy condition were no more likely than smokers in the control condition to stay abstinent at 1, 4 or 26 weeks. The effect was in the right direction at week one post-quit but after controlling for potential confounders the difference was not significant (odds ratio = 1.45 (95% CI; 0.92–2.29), p = 0.06).
We were unable to show that a buddy system improved abstinence rates of group treatment programmes. This might be due to the high level of social support already achieved through the groups.
The buddy system is a simple and very low cost addition to a group treatment programme; but the results from this study suggest that the kind of buddy system tested may not add substantially to the success rates. However there may be merits in a more intensive or protracted form of buddying.
Social support for smoking cessation and abstinence: The lung health study
1995, Addictive Behaviors
This article evaluates the relationship of social support to smoking cessation and continued abstinence of 3923 men and women with mild to moderate airway obstruction in the Lung Health Study. At both the end of a 12-week group program and after 1 year, men but not women who were supported in quitting were more likely to be successful. Married status facilitated quitting but was less strongly related to long-term abstinence. Participants supported by an ex-smoker who had attended the group program with them were very likely not smoking after 1 year (men, 74.7%; women, 72.4%). Participants supported by a smoker were less than half as likely to have achieved abstinence after 1 year but still had cessation rates greater than 30%. The nature of these relationships has implications for the distinction between women and men in studies of social support and for intervention strategies. Support people should be included in cessation intervention programs. Spouse involvement, however, is more evidently useful for men than for women.
Dropping out of substance abuse treatment: A clinically oriented review
1992, Clinical Psychology Review
Early attrition from substance abuse treatment is very high, although rates do not differ dramatically from those found in medical and psychiatric treatments. The consequences of substance abuse treatment dropout are severe, however, with early dropouts having the same outcome as untreated clients. Evidence is considered regarding the impact of demographic and social variables on continuation in treatment. The effects of client motivation, substance use, criminality and legal pressure, prior treatment history, and psychopathology are also examined. An analysis of treatment factors and procedures used to enhance retention indicates that more conveniently located, smaller, decentralized clinics, with higher clinical staff ratios and more per capita expenditures, have lower attrition rates. Clients are also likely to continue in treatment longer when they receive rapid initial response and individual attention, and when they are seen in smaller groups in friendly, comfortable environments. Inexpensive techniques such as reminder phone calls and personal letters can be employed in the absence of resources needed to mount more extensive attrition prevention interventions.
A randomized comparison of worksite-sponsored smoking cessation programs
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This worksite study assesses the relative effectiveness of three smoking cessation programs. Computerized medical files indicated that 29% of 13,171 employees were current smokers. Of smokers responding to a worksite-wide survey, 79% indicated interest in a smoking cessation program; 402 smokers agreed to participate and were randomly allocated, within their preference for a group or self-help approach, to the three different programs. Overall, 11% of smokers participated, an excellent rate for a large worksite. Participants were followed for 12 months (91% follow-up). Smokers in the group preference had better short-term results than did those following the self-help approach. The Multiple Component Program had 61% who quit, the Relapse Prevention Program had 37%, and the American Cancer Society Quitter’s Guide had 12%. Long-term quit rates ranged from 16% to 26%; all groups exceeded the usual spontaneous quit rate of 5%.
Effectiveness of Peer-Support Interventions for Smoking Cessation: A Systematic Review and Meta-analysis
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View all citing articles on Scopus

²: Current address: Department of Clinical Psychology, Rutgers University, Bush Campus, Piscataway, N.J. 08850.

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General articleThe effects of a multiple treatment program and maintenance procedures on smoking cessation

Abstract

Addict. Behav.

Behav. Res. Ther.

J. Behav. Ther. Exp. Psychiat.

Behav. Res. Ther.

Modification of smoking behavior: An evaluative review

Psychol. Bull.

Reduction of Smoking Behavior through Token Reinforcement Procedures

Treatment of smoking by covert sensitization

Psychol. Rep.

Elimination of cigarette smoking by punishment and self-management training

Behav. Res. Ther.

Behavioral self-control of smoking through aversive conditioning and self-management

J. Consult. Clin. Psychol.

Rapid smoking and self-control in the modification of smoking behavior

J. Consult. Clin. Psychol.

Self-reinforcement by recorded telephone messages to maintain nonsmoking behavior

J. Consult. Clin. Psychol.

Nicotine and addiction to cigarettes

Brit. J. Addict.

Breaking the cigarette habit: Effects of a technique involving threatened loss of money

Psychol. Rec.

The community's response to substance misuse

Int. J. Addict.

A broad range program to eliminate cigarette smoking

Factors Related to Successful Abstinence from Smoking

Problems of S's motivation in a behavioral program for reduction of cigarette smoking

Psychol. Rep.

Relapse rates in addiction program

J. Clin. Psychol.

Long and short term effectiveness of a large-scale proprietary smoking cessation program: A four-year follow-up of Smokenders participants

J. Clin. Psychol.

A comparison of excessive and rapid smoking in the modification of chronic smoking behavior

J. Consult. Clin. Psychol.

General article
The effects of a multiple treatment program and maintenance procedures on smoking cessation