Aversive smoking
May 16th, 2008 | By quitsmoking-review | Category: TechniquesAversion methods are not unique to smoking cessation, but have been used for many years to modify various behavioural flaws: smoking, alcohol abuse, overeating. This technique is based on ‘classical conditioning’ which entails adding an unpleasant (aversive) stimulus to an attractive behaviour (smoking) will reduce the attractiveness of the behaviour over time. In the context of smoking, heightening the sensation of stale smoke, nausea and vomiting reduces the desire to smoke and may even eliminate cravings.
Several methods of aversive smoking have been developed and they are discussed below:
- Self paced smoking / paced smoking - Smokers are asked to take a puff at a paced interval (often 15-30 seconds) or at their own pace and instructed to focus of the negative sensations such as the warm stale smoke of the cigarette.
- Rapid smoking - Smokers are asked to take a puff every 5-10 seconds and continue to do so for 3 minutes or until either they finish 3 cigarettes or feel physically unable to continue. They are then given a brief rest period (1-2 minutes) and then repeat the procedures three or four times.
- Rapid puffing - This is similar to rapid smoking but participants do not inhale the smoke, keeping the smoke in the mouth. This aims to increase the unpleasant stimulus of smoking
- Smoke holding - This involves smokers sucking the smoke into their mouths and holding it there for 30 seconds while breathing fresh air in through their nose. They are then asked to think about the aversive sensation in their mouths.
- Symbolic aversion - Subjects imagine the unpleasant stimulus like nausea and staleness of smoking and the concentrate on the relief offered by extinguishing the cigarette.
- Excessive smoking, oversmoking - Smokers take smoking to the next level and smoke more cigarettes a day than what they would normally smoke. Some smoke double their daily intake, while others can follow an increasing regime (150% for 2 days, then 200% for a day).
Other techniques developed were not as widely received as those mentioned above. They include administering an external shock to smokers in order to negatively associate smoking with pain. Years ago, electric shocks were used (Conway 1977) and subjects were even asked to self inflict pain by snapping on a rubber band around their wrists. Another method include putting a chemical (silver acetate) at the tip of cigarettes in order to give a rather unpleasant taste to cigarettes.
Many studies have been done on aversive smoking including a recent review by Hajek in 2001 (upon which this article is based), and the data coming back have shown a significant trend in helping reduce smoking and cravings. Only one out of twelve studies did not show a difference in outcome (Hall 1984: but this was also the largest study). There is also a borderline suggestion that increasing the aversive nature of the technique can improve outcome.
Conclusions: Mild forms of aversive smoking might not offer added benefits to help smokers quit. There is currently insufficient evidence to draw any scientific conclusions from previous studies but there are suggestions that increasing the severity of the aversion, when used together with other quitting techniques can be useful.
