Self Change Program (Behaviour modification)

Topics: Nicotine, Smoking, Smoking cessation Pages: 17 (3166 words) Published: November 13, 2014


Behaviour Modification
A Self-Control Program for Smoking Cessation
Christine Chambers
Trent University

Introduction
The behaviour modified for this self-directed behaviour change project is smoking. Smoking was selected as the behaviour I wish to change because it is known that tobacco use is the leading cause of premature, preventable death and disease (Edwards, Bondy, Callaghan, & Mann, 2014). Smoking is a behaviour that has been recently initiated; I started smoking occasionally in August 2013 (one cigarette a few times a week) and intended to buy only the one pack. However over a period of several months, my smoking has increased. The rationale for this choosing this target behaviour is that it is still a relatively new behaviour and is likely to become more difficult to extinguish over time. The target behaviour of smoking cessation was operationally defined as: consuming zero cigarettes or tobacco-containing products for a period of 2 continuous weeks. The goal was to reduce smoking behaviour to zero consumed cigarettes within 8 weeks of initiating the intervention phase.

The following data collection methods were used to complete the functional assessment of smoking behaviour: 1. Structured Diary: A structured diary was used to record each occurrence of smoking (event recording). The information recorded for each occurrence of smoking included: date/time, situation when smoking occurred, mood & anxiety rating at the time of smoking, and perceived outcomes of smoking. 2. Fagerstrom Test for Nicotine Dependence: The Fagerstrom Test for Nicotine Dependence is a six question self-report questionnaire that provides an indication of the level of dependence on smoking. It is considered a gold standard of assessment smoking addiction (Khara, Rotem, Van Driesum, 2013). 3. Autonomy Over Smoking Checklist: The Autonomy Over Smoking Checklist (AUTOS) is a 12 item symptom checklist for assessing loss of autonomy over smoking. The checklist assesses withdrawal symptoms, cue-induced cravings, and psychological dependence (Di Franza, Wellman, Ursprung, & Sabistom, 2008). A functional assessment was completed using information collected from the above data collection methods. The assessment results suggested that smoking was most often associated with antecedents of elevated anxiety and/or lower mood rating, and cravings for a cigarette. It was observed that smoking occurred in specific places and the S∆’s were: being in non-smoking environments, being inside my home, and being around my children or others who do not smoke. In terms of maintaining consequences, the assessment results suggested that smoking behaviour was maintained by escape from busy or stressful environments and by positive sensory stimulation (experiencing a “buzz”). The scores from both the Fagerstrom Test for Nicotine Dependence and the AUTOS suggested that the level of nicotine dependence is very low which indicates that a pharmacological approach would be not be necessary and a behavioural approach to cessation would be appropriate (Khara, Torem, & Van Driesum, 2013).

The intervention phase consisted of a gradual reduction in the number of cigarettes smoked per day. The number of cigarettes allowed per day was decreased by one every 2 weeks with the goal of reaching zero cigarettes smoked after 8 weeks of intervention. Self-monitoring continued during the intervention phase using the structured diary and a monetary reinforcement system was implemented using fixed ratio schedule. As well, alternative behaviours were identified that could function as positive alternatives for smoking when dealing with stressful/busy situations or when experiencing higher anxiety and/or lower mood. During the intervention phase, it was determined that the weekly incentive of earning ten dollars was not salient enough to maintain the goal of decreasing the frequency of smoking. Therefore, the reinforcement system was altered and a...


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