Maintaining behavior change: in investigation of three maintenance strategies and the relationship of self-attribution to the long-term reduction of cigarette smoking

Self-initiated, cue extinction, and covert sensitization procedures in smoking cessation

Two studies tested the utility of self-control procedures and covert sensitization as alternatives to rapid smokers in smoking cessation. Subjects were at least 21 years old and had smoked at least one pack per day for at least 5 years. Relaxation training and discussion of goals were given in three meetings per week for 2 weeks prior to subject-chosen quit dates. A total of 10 sessions was held during the 90 days following cessation. In Study I, both groups received self-control strategies. One group also received covert sensitization. At 3-month follow-up, 33% of those without and 27% of those with covert sensitization were abstinent. At 6-month follow-up these percentages were 33 and 13, respectively. Covert sensitization apparently added nothing to the effects of the self-control package. In Study II, one group received the same combination of self-control manual and the basic package as in Study I. A second group received the basic package with cue extinction procedures designed to extinguish associations between desires for cigarettes and cues paired with previous smoking. A third group received a combination of both sets of procedures. At 3-month follow-up, 71 and 60%, respectively, of the first two groups were abstinent, while only 31% of the combination group was abstinent. At 6-month follow-up, these percentages were 29, 27, and 8, respectively. The low abstinence rate for the combination group likely reflects problems associated with presenting too much material in the 2 weeks prior to cessation.