Think abstractly, smoke less: a brief construal-level intervention can promote self-control, leading to reduced cigarette consumption among current smokers

The Link between Abstract Thinking Style and Subjective Well-Being: Its Impact when People are in (Real or Perceived) Financial Scarcity

Across three studies, we explored the link between an abstract mindset and subjective well-being (SWB) in participants with real and/or perceived financial scarcity. In Studies 1 and 2, samples presented real objective financial vulnerability: Adolescents from lower-middle income districts (Study 1; N = 256), and adults without higher education and with very low incomes (Study 2; N = 210). In Studies 1 and 2 participants completed a survey including measures of thinking style and SWB. In Studies 2 and 3 perception of financial difficulty and SWB were also measured. Study 3 (N = 161) used a sample of university students and employed an experimental design manipulating participants' thinking style (i.e., concrete versus abstract mindset conditions); additionally, all participants were induced to perceive financial scarcity. Correlations revealed a significant and positive relationship between an abstract thinking style and SWB (Studies 1 and 2). Thus, these results showed that a relatively more abstract thinking style was associated with greater life satisfaction. In Studies 2 and 3 mediation analyses indicated that adults who presented a more abstract thinking style, perceived lower financial difficulties and then reported greater SWB. Overall, given that an abstract thinking style can be induced, these results offer a new intervention approach for improving the SWB of people living in situations of financial scarcity.

A culturally targeted video to promote genetic counseling in a community sample of at-risk US Latina women: The role of the concrete mindset

Latina women, who are at increased risk of hereditary breast and ovarian cancer (HBOC), have lower use of genetic counseling and testing (GCT) than non-Hispanic White women. In a recent study, culturally targeted video improved psychosocial outcomes related to GCT. Additional analyses examine whether the culturally targeted video improved positive reactions in women who focus on difficulties (concrete mindset) versus women who focus on the final goals (abstract mindset). Participants (N = 32) completed surveys before and immediately after watching the video. The surveys measured attitudes, emotions, and women's mindset. Before watching the video, women with a concrete mindset reported more negative attitudes and negative emotions about GCT than women with an abstract mindset. After watching the video, women with a concrete mindset reported negative attitudes and feelings at levels comparable to those of women with an abstract mindset, reflecting a reduction in their negative attitudes and emotions. The sample size limits the power to find statistically significant differences. Results support the relevance of considering the audience's mindset in the development and testing of public health messages to promote the use of GCT.

Implicit theories of body weight and engagement in healthy lifestyles among young adults: The mediating effect of self-control

Engaging in a healthy lifestyle could be helpful to decrease lifestyle-related health risks and bring long-term health benefits. This research investigated how implicit theories of body weight influence people's engagement in healthy lifestyle among young adults in China. The results suggested that implicit theories of body weight significantly influence people's engagement in heathy eating behaviors and physical activity. Self-control mediated the effect of implicit (incremental) theories of body weight on people's engagement in healthy eating. Implications of the current research for understanding how to promote engagement in healthy lifestyle and directions for future research are discussed.

Trait self-control and disinhibited eating in COVID-19: The mediating role of perceived mortality threat and negative affect

As the coronavirus disease 2019 (COVID-19) spreads globally, people are at risk of developing disinhibited eating behaviors. This study aimed to examine whether perceived mortality threat and negative affect mediate the relationship between trait self-control and disinhibited eating during the pandemic. A longitudinal survey was administered to a sample of college students (N = 634) before the outbreak (September 2019, T1), during the mid-term (February 2020, T2), and in the later stage of the pandemic (April 2020, T3). Self-report measures of trait self-control (T1), perceived mortality threat (T2, T3), negative affect (T2, T3), and disinhibited eating (T2, T3) were successively completed. Trait self-control was found to be negatively associated with negative affect, perceived mortality threat, and disinhibited eating during the mid-term and later stage of the pandemic. Disinhibited eating was positively associated with negative affect and perceived mortality threat. The longitudinal mediation results demonstrated that trait self-control (T1) could negatively predict disinhibited eating (T3) through negative affect (T2) rather than through perceived mortality threat. These findings suggest that trait self-control is of great importance in regulating psychological discomfort and disinhibited eating during stressful periods and that negative affect might be the main psychological mechanism underlying the relationship between self-control ability and disinhibited eating.

Does poverty promote a different and harmful way of thinking? The links between economic scarcity, concrete construal level and risk behaviors

We tested the relationships between economic scarcity, concrete construal level and risk behaviors. We manipulated the lack of economic resources using a priming task in Studies 1 and 2, and participants reported their real income and completed the BIF scale to measure their construal level in Study 3. Studies 1–3 supported the link between perceived economic scarcity and the concrete construal level. Study 4 demonstrated the mediating role played by the concrete construal level in the influence of economic scarcity on risk behaviors using two opposite priming procedures (scarcity plus abstraction). Study 5, in a real context of economic vulnerability, supported the link between concrete mindset and risk behavioral intentions, while abstraction was associated with fewer risk intentions. Concrete thinking implies focusing on the immediate situation, which might facilitate adaptation to the demanding conditions that characterize scarcity contexts but leaves people without a broad perspective of the future to make safe decisions in situations that involve self-control, such as health-risk behaviors. Because an abstract construal level can be induced, these findings open up challenging ways to improve the conditions in which people in scarcity contexts make some behavioral decisions while we continue working to reduce situations of economic scarcity.

Envisaging Mitigation Action Can Induce Lower Discounting toward Future Environmental Gains and Promote Pro-Environmental Behavior

Low engagement with climate change may stem from the tendency to discount the distant benefits of mitigation action. Hence, a reduced tendency to discount the future should be associated with increased involvement in climate change mitigation. Prior research has demonstrated that episodic future thinking (EFT; i.e., envisioning future events that involve self-projection) can reduce discounting. In two laboratory studies, we showed that engaging in EFT about mitigation action was associated with a lower discounting tendency toward future environmental gains (Experiments 1 and 2) and a greater tendency to act pro-environmentally, as manifested by using air conditioning in an energy-saving manner (Experiment 1), choosing a meal with less environmental impact (Experiment 2), and willingness to participate in beach cleaning (Experiment 2). The present findings suggest that engagement in EFT about mitigation action may represent a promising strategy for improving personal involvement in climate change.

The Relationships between Economic Scarcity, Concrete Mindset and Risk Behavior: A Study of Nicaraguan Adolescents

Background: Nicaragua is one of the poorest countries in Latin America, with an extremely low human development index (HDI). Fifty-two percent of the Nicaraguan population are children and adolescents under 18 years of age. Nicaraguan adolescents present several risk behaviors (such as teenage pregnancies, consumption of alcohol, tobacco, cannabis). Our study examines the links between risk behaviors, fatalism, real economic scarcity, and concrete construal level for adolescents with low and middle-low socioeconomic status in Nicaragua. Methods: Nicaraguan adolescents (N = 834) from schools located in especially vulnerable areas (low economic status) or in neighborhoods with middle-low social class completed several scales and questions to evaluate fatalism (SFC-social fatalism scale), construal level (BIF) and their past and future risk behaviors (smoking cigarettes, smoking cannabis, unsafe sex, and alcohol consumption). Results: We identified that the poorest individuals who maintained a concrete style of thinking had the highest rates of past and future risk behaviors. This vulnerable group also reported the highest levels of fatalism, i.e., negative attitudes and feelings of helplessness. Encouragingly, the adolescents who were able to maintain an abstract mindset reported healthier past and future habits and lower fatalism, even when they belonged to the lowest social status. In the middle-low economic group, the construal level was not as relevant to maintaining healthy habits, as adolescents reported similar rates of past and future risk behavior at both construal levels. Conclusions: All these results support the importance of considering construal level when studying vulnerable populations and designing risk prevention programs.

Exposure to pictures of natural landscapes may reduce cigarette smoking

BACKGROUND AND AIMS

Reducing temporal discounting may help smokers to reduce their smoking by improving inhibitory control. This study aimed to assess whether viewing pictures of natural versus urban scenes would cause participants to smoke fewer cigarettes mediated by lower temporal discounting.

DESIGN

A single-factor (natural scene, urban scene and control) between-subjects design was employed.

SETTING

Laboratory at Kaohsiung Medical University, Taiwan.

PARTICIPANTS

A community sample of 93 daily smokers.

INTERVENTION AND COMPARATOR

Participants were exposed to pictures of natural or urban scenes or no images (control).

MEASUREMENTS

The discounting measure was implemented after the landscape exposure manipulation. Participants expressed their preferences related to winning a lottery by answering a series of nine binary choice questions, opting either to receive a certain amount of money immediately or varying amounts of money 1 year in the future. The dependent measure was cigarette consumption during an ostensible survey.

FINDINGS

Participants exposed to pictures of natural scenes smoked fewer cigarettes [mean = 1.1 cigarettes, 95% confidence interval (CI) = 0.7, 1.6] than did those exposed to pictures of urban scenes (mean = 2.1 cigarettes, 95% CI = 1.7, 2.6, 0.002) and control participants (mean = 1.8 cigarettes, 95% CI = 1.4, 2.3, 0.029). The discounting rate mediated the association between exposure to nature and the amount of smoking (B = -0.62, 95% CI = -1.07, -0.20, P < 0.01).

CONCLUSIONS

Exposing smokers to pictures of natural landscapes may lead to reduced smoking by lowering temporal discounting.

Looking at Spillovers in the Mirror: Making a Case for "Behavioral Spillunders"

Behavioral spillovers refer to the influence that a given intervention targeting behavior 1 exerts on a subsequent, non-targeted, behavior 2, which may or may not be in the same domain (health, finance, etc.) as one another. So, a nudge to exercise more, for example, could lead people to eat more or less, or possibly even to give more or less to charity depending on the nature of the spillover. But what if spillovers also operate backward; that is, if the expectation of behavior 1 influences behavior 0 that precedes it? For example, a person may form an intention to exercise prompted by a policy intervention but overeat at present as a result. We define such a possibility as a "spillunder." In the proposed article, we critically review the few papers that we have identified through a narrative literature review which have demonstrated spillunder effects to date, and we propose a conceptual framework. Based on evidence about the human mind and behavior from psychology and economics, we argue that spillunder effects may be more common than the limited empirical findings suggest. We propose six representative mechanisms through which the prospect of behavior 1 may impact behavior 0: executive functions, moral licensing and moral cleansing, emotion regulation, energization, construal level, and savoring and dread. We further discuss the policy and practical implications of spillunder effects and examine methodological issues that need to be considered when empirically testing these effects. As with our earlier paper on spillovers, we aim to motivate other behavioral scientists to research behavioral spillunders more systematically and extensively, and to prompt decision makers to consider these effects when designing behavioral interventions.

Cognitive Bridging: Using Strategic Communication To Connect Abstract Goals With The Means To Achieve Them

Three studies test several mechanisms of cognitive bridging, or how a strategic communication message functions to connect the abstract goal of an individual with the specific means to achieve the goal. Across all of the experiments (n = 276, n = 209, n = 145), it was demonstrated that participants who received an induced bridging mechanism were more likely to produce cognitive bridging outputs and report more abstract responses than participants who did not receive a bridging technique. We do not find the same pattern of results among participants who received an integrated bridging technique. Taken together, these studies provide evidence that how abstractly or concretely an individual is thinking can be influenced by abstraction cues planted within a strategic message, providing promise for messaging efforts at the moment of decision. In other words, the level of abstract thinking an individual is carrying into an exposure situation is possible to change using cues within the message itself. This is the first article to juxtapose the induced and integrated mechanisms of cognitive bridging.

Construing Morality at High versus Low Levels Induces Better Self-control, Leading to Moral Acts

Human morality entails a typical self-control dilemma in which one must conform to moral rules or socially desirable norms while exerting control over amoral, selfish impulses. Extant research regarding the connection between self-control and level of construal suggest that, compared with a low-level, concrete construal (highlighting means and resources, e.g., answering ‘how’ questions), a high-level, abstract construal (highlighting central goals, e.g., answering ‘why’ questions) promotes self-control. Hence, construing morality at higher levels rather than lower levels should engender greater self-control and, it follows, promote a tendency to perform moral acts. We conducted two experiments to show that answering “why” (high-level construal) vs. “how” (low-level construal) questions regarding morality was associated with a situational state of greater self-control, as indexed by less Stroop interference in the Stroop color-naming task (Experiments 1 and 2). Participants exposed to “why” questions regarding morality displayed a greater inclination for volunteerism (Experiment 1), showed a lower tendency toward selfishness in a dictator game (Experiment 2), and were more likely to return undeserved money (Experiment 2) compared with participants exposed to “how” questions regarding morality. In both experiments, self-control mediated the effect of a high-level construal of morality on dependent measures. The current research constitutes a new approach to promoting prosociality and moral education. Reminding people to think abstractly about human morality may help them to generate better control over the temptation to benefit from unethical acts and make it more likely that they will act morally.

Exposure to Sexual Stimuli Induces Greater Discounting Leading to Increased Involvement in Cyber Delinquency Among Men

People frequently encounter sexual stimuli during Internet use. Research has shown that stimuli inducing sexual motivation can lead to greater impulsivity in men, as manifested in greater temporal discounting (i.e., a tendency to prefer smaller, immediate gains to larger, future ones). Extant findings in crime research suggest that delinquents tend to focus on short-term gains while failing to adequately think through the longer-term consequences of delinquent behavior. We experimentally tested the possibility that exposure to sexual stimuli is associated with the tendency to engage in cyber delinquency among men, as a result of their overly discounting remote consequences. In Experiment 1, participants exposed to pictures of "sexy" women were more likely to discount the future and were more inclined to make cyber-delinquent choices (e.g., cyberbullying, cyber fraud, cyber theft, and illegal downloading), compared with male participants who rated the sex appeal of less sexy opposite-sex pictures. However, these relationships were not observed in female participants exposed to either highly or less sexy pictures of men. In Experiment 2, male participants exposed to sexual primes showed a greater willingness to purchase a wide range of counterfeit rather than authentic products online and experienced a higher likelihood of logging into the other person's Facebook webpage (i.e., invading online privacy). The discounting tendency mediated the link between exposure to sexual primes and the inclination to engage in cyber-delinquent behavior. These findings provide insight into a strategy for reducing men's involvement in cyber delinquency; that is, through less exposure to sexual stimuli and promotion of delayed gratification. The current results suggest that the high availability of sexual stimuli in cyberspace may be more closely associated with men's cyber-delinquent behavior than previously thought.

If you want to save, focus on the forest rather than on trees. The effects of shifts in levels of construal on saving decisions

Although financial decisions are expected to be rational, there is a growing body of experimental research indicating that small psychological changes in one’s mind-set in the actual decision-making moment might affect saving ratios. In this article, another type of change in one’s mind-set, which can influence saving decisions, is explored, namely the level of construal. Construal level is a key descriptor of people’s cognitive representations of targets, and is a way of characterising the mental mind-sets people use. Building on recent advances in the link between construal levels and intertemporal choices, the present research evaluates the effect of shifts in levels of construal in the very moment of decision making on people’s propensity to save money. It is suggested that triggering a high-level construal mind-set would influence individuals’ financial decisions and result in greater willingness to save than triggering a low-level construal mind-set. This assumption is supported by the findings: across three experiments, those with an abstract mind-set showed an increased willingness to save when compared to those with a concrete mind-set. The first experiment demonstrated that people in an abstract mind-set are more willing to delay financial gratification than those in a concrete mind-set. In the second and third experiments, those with an abstract mind-set showed an increased willingness to save when compared to those with a concrete mind-set. The research provides further evidence that mental states, which can be evoked by previous, unrelated tasks, such as level of cognitive abstraction, can influence everyday financial decisions. It, thus, highlights the role of situational factors that consumers may be not aware of, which still affect their savings decisions.

Episodic Future Thinking about the Ideal Self Induces Lower Discounting, Leading to a Decreased Tendency toward Cheating

Delay discounting refers to a pervasive tendency toward preferring smaller immediate gains over larger future gains. Recent empirical research has shown that episodic future thinking (EFT; i.e., projecting oneself into the future to pre-experience forthcoming events) can reduce the tendency toward discounting. A common tenet of psychological theories of crime is that delinquency results from focusing on short-term gains while failing to consider adequately the longer-term consequences of delinquent behavior. We investigated whether an EFT intervention involving the ideal self could induce lower discounting rates and, as a consequence, reduced delinquency. The results showed that, compared with control participants, participants engaging in EFT, that is, envisaging life events that would be experienced by their ideal selves, exhibited a lower discounting rate in a monetary choice task (Experiments 1 and 2), as well as a decreased tendency to make delinquent choices in imaginary scenarios (Experiment 1) and cheat in a matrix task (Experiment 2). The discounting tendency mediated the relationship between engaging in EFT pertaining to the ideal self and the tendency toward morally questionable behavior (Experiments 1 and 2). The findings of the two experiments indicate that engagement in EFT with a focus on the ideal self is sufficient to induce lower discounting rates, by promoting consideration of distant costs and thus increasing resistance to delinquent involvement and cheating (given the temptation of the immediate benefits that may accrue from such behavior). The current research constitutes an innovative approach to delinquency prevention and the promotion of morality.

Cognitive Mechanisms and Therapeutic Targets of Addiction

Fundamental to cognitive models of addiction is the gradual strengthening of automatic, urge-related responding that develops in tandem with the diminution of self-control-related processes aimed at inhibiting impulses. Recent conceptualizations of addiction also include a third set of cognitive processes related to self-awareness and superordinate regulation of self-control and other higher brain function. This review describes new human research evidence and theoretical developments related to the multicausal strengthening of urge-related responding and failure of self-control in addiction, and the etiology of disrupted self-awareness and rational decision-making associated with continued substance use. Recent progress in the development of therapeutic strategies targeting these mechanisms of addiction is reviewed, including cognitive bias modification, mindfulness training, and neurocognitive rehabilitation.

Interventions to reduce harm from continued tobacco use

BACKGROUND

Although smoking cessation is currently the only guaranteed way to reduce the harm caused by tobacco smoking, a reasonable secondary tobacco control approach may be to try and reduce the harm from continued tobacco use amongst smokers unable or unwilling to quit. Possible approaches to reduce the exposure to toxins from smoking include reducing the amount of tobacco used, and using less toxic products, such as pharmaceutical, nicotine and potential reduced-exposure tobacco products (PREPs), as an alternative to cigarettes.

OBJECTIVES

To assess the effects of interventions intended to reduce the harm to health of continued tobacco use, we considered the following specific questions: do interventions intended to reduce harm have an effect on long-term health status?; do they lead to a reduction in the number of cigarettes smoked?; do they have an effect on smoking abstinence?; do they have an effect on biomarkers of tobacco exposure?; and do they have an effect on biomarkers of damage caused by tobacco?

SEARCH METHODS

We searched the Cochrane Tobacco Addiction Group Trials Register (CRS) on the 21st October 2015, using free-text and MeSH terms for harm reduction, smoking reduction and cigarette reduction.

SELECTION CRITERIA

Randomized or quasi-randomized controlled trials of interventions to reduce the amount smoked, or to reduce harm from smoking by means other than cessation. We include studies carried out in smokers with no immediate desire to quit all tobacco use. Primary outcomes were change in cigarette consumption, smoking cessation and any markers of damage or benefit to health, measured at least six months from the start of the intervention.

DATA COLLECTION AND ANALYSIS

We assessed study eligibility for inclusion using standard Cochrane methods. We pooled trials with similar interventions and outcomes (> 50% reduction in cigarettes a day (CPD) and long-term smoking abstinence), using fixed-effect models. Where it was not possible to meta-analyse data, we summarized findings narratively.

MAIN RESULTS

Twenty-four trials evaluated interventions to help those who smoke to cut down the amount smoked or to replace their regular cigarettes with PREPs, compared to placebo, brief intervention, or a comparison intervention. None of these trials directly tested whether harm reduction strategies reduced the harms to health caused by smoking. Most trials (14/24) tested nicotine replacement therapy (NRT) as an intervention to assist reduction. In a pooled analysis of eight trials, NRT significantly increased the likelihood of reducing CPD by at least 50% for people using nicotine gum or inhaler or a choice of product compared to placebo (risk ratio (RR) 1.75, 95% confidence interval (CI) 1.44 to 2.13; 3081 participants). Where average changes from baseline were compared for different measures, carbon monoxide (CO) and cotinine generally showed smaller reductions than CPD. Use of NRT versus placebo also significantly increased the likelihood of ultimately quitting smoking (RR 1.87, 95% CI 1.43 to 2.44; 8 trials, 3081 participants; quality of the evidence: low). Two trials comparing NRT and behavioural support to brief advice found a significant effect on reduction, but no significant effect on cessation. We found one trial investigating each of the following harm reduction intervention aids: bupropion, varenicline, electronic cigarettes, snus, plus another of nicotine patches to facilitate temporary abstinence. The evidence for all five intervention types was therefore imprecise, and it is unclear whether or not these aids increase the likelihood of smoking reduction or cessation. Two trials investigating two different types of behavioural advice and instructions on reducing CPD also provided imprecise evidence. Therefore, the evidence base for this comparison is inadequate to support the use of these types of behavioural advice to reduce smoking. Four studies of PREPs (cigarettes with reduced levels of tar, carbon and nicotine, and in one case delivered using an electronically-heated cigarette smoking system) showed some reduction in exposure to some toxicants, but it is unclear whether this would substantially alter the risk of harm. We judged the included studies to be generally at a low or unclear risk of bias; however, there were some ratings of high risk, due to a lack of blinding and the potential for detection bias. Using the GRADE system, we rated the overall quality of the evidence for our cessation outcomes as 'low' or 'very low', due to imprecision and indirectness. A 'low' grade means that further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. A 'very low' grade means we are very uncertain about the estimate.

AUTHORS' CONCLUSIONS

People who do not wish to quit can be helped to cut down the number of cigarettes they smoke and to quit smoking in the long term, using NRT, despite original intentions not to do so. However, we rated the evidence contributing to the cessation outcome for NRT as 'low' by GRADE standards. There is a lack of evidence to support the use of other harm reduction aids to reduce the harm caused by continued tobacco smoking. This could simply be due to the lack of high-quality studies (our confidence in cessation outcomes for these aids is rated 'low' or 'very low' due to imprecision by GRADE standards), meaning that we may have missed a worthwhile effect, or due to a lack of effect on reduction or quit rates. It is therefore important that more high-quality RCTs are conducted, and that these also measure the long-term health effects of treatments.

The Power of the Virtual Ideal Self in Weight Control: Weight-Reduced Avatars Can Enhance the Tendency to Delay Gratification and Regulate Dietary Practices

The tendency to discount larger future benefits in favor of smaller immediate gains (i.e., temporal discounting) is relevant to the issue of obesity. Successful weight loss requires individuals to sacrifice immediate culinary pleasures in favor of future health gains. Based on the notion that increasing the vividness of one's future self may mitigate temporal discounting and promote the ability to delay gratification, we examined whether viewing one's weight-reduced self (i.e., the ideal self) in a virtual environment can decrease temporal discounting and lead to better regulation of dietary practices. Seventy-six undergraduates who had reported an intention to lose weight were recruited to participate in a laboratory experiment and were randomly assigned to interact with either the weight-reduced self (experimental condition) or the present self (control condition) by looking into a dressing mirror in a virtual fitting room. A temporal-discounting task and a taste test were subsequently administered. Results showed that, compared with control participants, participants who viewed their weight-reduced avatars ate less ice cream in a taste test and were more likely to choose a sugar-free drink as a reward. The discounting rate mediated the association between the avatar manipulation and the amount of ice cream eaten in the subsequent taste test. Overall, our findings suggest that a computer-generated image of one's weight-reduced self may assist in resisting impulses that promote immediate gratification over delayed benefits. This research provides a new approach for controlling impulsive behavior such as dietary regulation and weight control.

[Smoking cessation and social deprivation]

Smoking is a major of public health policy issue; one in two lifelong smokers will die from a disease related to tobacco use. In France, smoking is responsible for more than 70,000 deaths every year. The benefits linked to stopping smoking include reduced mortality and morbidity related to the use of tobacco. Recent data show an increase in the prevalence of smoking in the lowest socioeconomic population. Tobacco control needs a better understanding of the determinants of smoking in this population, which are also factors in the failure of cessation attempts. Based on international literature, this review specifies the educational and socioeconomic factors involved in tobacco smoking and in the result of an attempt to quit. Its aim is to propose ways to improve the management of smoking cessation in a socially deprived population.

Cerebral lateralization of pro- and anti-social tendencies

Mounting evidence suggest that the right-hemisphere (RH) has a relative advantage, over the left-hemisphere (LH), in mediating social intelligence - identifying social stimuli, understanding the intentions of other people, awareness of the dynamics in social relationships, and successful handling of social interactions. Furthermore, a review and synthesis of the literature suggest that pro-social attitudes and behaviors are associated with physiological activity in the RH, whereas unsocial and anti-social tendencies are mediated primarily by the LH. This hemispheric asymmetry is rooted in several neurobiological and functional differences between the two hemispheres. (I) Positive social interactions often require inhibiting one's immediate desires and considering the perspectives and needs of others. Given that self-control is mediated by the RH, pro-social emotions and behaviors are, therefore, inherently associated with the RH as it subserves the brain's self-restraint mechanisms. (II) The RH mediates experiences of vulnerability. It registers the relative clumsiness and motor weakness of the left limbs, and it is involved, more than the LH, in processing threats and mediating fear. Emotional states of vulnerability trigger the need for affiliation and sociality, therefore the RH has a greater role in mediating pro-social attitudes and behaviors. (III) The RH mediates a holistic mode of representing the world. Holistic perception emphasizes similarities rather than differences, takes a long-term perspective, is associated with divergent thinking and seeing other points-of-view, and it mediates a personal mode of relating to people. All these features of holistic perception facilitate a more empathetic attitude toward others and pro-social behaviors.

Integrating a Behavioural Sleep Intervention into Smoking Cessation Treatment for Smokers with Insomnia: A Randomised Pilot Study

INTRODUCTION

Sleep disturbance is common among cigarette smokers and predicts smoking cessation failure.

AIMS

The purpose of this study was to conduct a pilot test of whether provision of a sleep intervention might bolster smoking cessation outcomes among this vulnerable group.

METHODS

Smokers with insomnia (N = 19) seeking smoking cessation treatment were randomly assigned to receive 8 sessions over 10 weeks of either: (1) cognitive-behavioural therapy for insomnia + smoking cessation counselling (CBT-I+SC; n = 9) or (2) smoking cessation counselling alone (SC; n = 10). Counselling commenced 4 weeks prior to a scheduled quit date, and nicotine patch therapy was also provided for 6 weeks starting on the quit date.

RESULTS

There was no significant effect of counselling condition on smoking cessation outcomes. Most participants had difficulty initiating and maintaining smoking abstinence in that 7-day point prevalence abstinence rates at end of treatment (CBT-I+SC: 1/7, 14%; SC: 2/10, 20%) and follow-up (CBT-I+SC: 1/7, 14%; SC: 0/10, 0%) were low for both conditions. CBT-I+SC participants reported improvements in sleep efficiency, quality, duration and insomnia symptoms. Sleep changes were not associated with the likelihood of achieving smoking abstinence.

CONCLUSIONS

This randomised pilot study suggests that behavioural interventions may improve sleep among smokers with insomnia, but a larger sample is needed to replicate this finding and evaluate whether these changes facilitate smoking cessation.