Smoking Cessation Through a Novel Behavior Modification Technique

May, Robin; Tofler, Geoffrey H.; Bartrop, Roger; Heinrich, Paul; Baird, John; Jozefiak, Edward; de Burgh, Simon

doi:10.1016/j.amjcard.2010.02.010

« Previous Next »American Journal of Cardiology
Volume 106, Issue 1 , Pages 44-46, 1 July 2010

Smoking Cessation Through a Novel Behavior Modification Technique

Robin May, M App Psych
- Department of Drug and Alcohol Services, Royal North Shore Hospital, Sydney Medical School (Northern), University of Sydney, Sydney, New South Wales, Australia
Geoffrey H. Tofler, MB, MD
- Department of Cardiology, Royal North Shore Hospital, Sydney Medical School (Northern), University of Sydney, Sydney, New South Wales, Australia
- Corresponding author: Tel: 61-2-9926-6359; fax: 61-2-9906-7807
Roger Bartrop, MB, MD
- Department of Psychiatry, Royal North Shore Hospital, Sydney Medical School (Northern), University of Sydney, Sydney, New South Wales, Australia
Paul Heinrich, PhD
- Pam McLean Centre, Royal North Shore Hospital, Sydney Medical School (Northern), University of Sydney, Sydney, New South Wales, Australia
John Baird, G Dip Med Tech
- Department of Medical Illustrations, Royal North Shore Hospital, Sydney Medical School (Northern), University of Sydney, Sydney, New South Wales, Australia
Edward Jozefiak, Dip Photog
- Department of Medical Illustrations, Royal North Shore Hospital, Sydney Medical School (Northern), University of Sydney, Sydney, New South Wales, Australia
Simon de Burgh, MB, PhD
- Department of Drug and Alcohol Services, Royal North Shore Hospital, Sydney Medical School (Northern), University of Sydney, Sydney, New South Wales, Australia

Received 22 December 2009; received in revised form 17 February 2010; accepted 17 February 2010.

Smoking remains a major public health problem. Experiencing a myocardial infarction (MI) can be a teachable moment that results in smoking cessation when previous efforts have failed. We tested the feasibility of providing a simulated and personalized experience of an MI to facilitate quitting smoking. Smokers, who were recruited from the community, had photographs taken of themselves, their partner, and family. These photographs were inserted into a video depicting the subject as a smoker experiencing an MI with potential consequences to themselves (death or disability) and their family. The subject watched the video and a psychologist used motivational interviewing to reinforce quitting efficacy. Thirteen subjects (11 men, 2 women) 45 ± 12 years of age with no smoking-related illness and a nonsmoking partner were studied. At week 1, 7 of 13 subjects (54%) reported stopping smoking, and the other 6 had decreased consumption. Daily cigarette consumption at week 1 decreased from 17.3 ± 9.3 at baseline to 2.7 ± 4.9 (p <0.005) and expired carbon monoxide levels from 15.7 ± 9 to 3.1 ± 3.2 parts per million (p <0.005). Seven subjects had observable responses to the video including “looking uncomfortable” and “red eyes, difficulty speaking.” Self-reports included “made me aware of the important things” and “it felt very real.” At 6 months, 7 of 13 subjects (54%) were still abstinent. Five of the 7 nonsmoking subjects used an additional antismoking aid. In conclusion, it is feasible to create a simulated and personalized teachable moment and these findings provide encouragement for evaluating this novel method for smoking cessation and other behavior modifications.