Tuesday, August 14, 2007

If It Works for Smokers . . .

Is this research on how spontaneous “quitters” among smokers seem to do as well as or better than those who carefully plan it all out (but may not really be motivated) relevant to other substance abuse treatment?

In a recent study putting that question to the test, smokers who quit spontaneously -- without advance planning -- had a greater chance of succeeding than those who planned ahead. The results, published in the British Medical Journal, seem to flout traditional smoking-cessation guidance.
Study authors Robert West and Taj Sohal liken the unplanned quit attempt to what mathematicians call "catastrophe theory." The idea is simply this: As tensions build up, even small triggers can lead to sudden and dramatic shifts in action. In nature, such forces might lead to, say, an avalanche. In much the same way, a smoker becomes disgusted with his habit, creating tension that, eventually, triggers a split decision to kick the habit.

Siegel said the study points to the need to focus on motivating smokers to want to quit. He said there's been too much emphasis on promoting pharmaceutical aids to help people quit. "If we can get smokers motivated enough, they will succeed in quitting, regardless of the mechanism."
Presuming their theory is correct, the researchers propose that public health campaigns focus on what they dub the "3 Ts" -- creating motivational tension in smokers, triggering action in those who are on the cusp of change, and supporting them with treatment, such as nicotine patches and counseling.

"In practice, worry about health and being fed up with the cost of smoking seem to be the main sources of tension that people can report," said West, a professor of health psychology at University College London and lead author of the study.

As for what finally triggers a quit attempt, West has compiled a list based on results of monthly surveys he conducts of people on their most recent quit attempt. For some, it's health-related. They worry about future health problems or a current health problem, they get advice from a health professional or they get pregnant. Others stop because they know someone who is stopping, decide it's too expensive, face smoking restrictions or encounter pressure from family or friends.

"For most smokers, (quitting) is a process, and it may culminate for many people -- more than we thought, if this study proves to be correct -- that they do make a very spontaneous decision," Glynn observed. "But that's in all likelihood the culmination of a series of decisions over a period of years leading to that day."

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