Study finds impulsive smokers have harder time quitting

A new study finds that impulsive people who smoke have more difficulty quitting than non-impulsive smokers, said Danielle McCarthy, an associate professor in the Department of Psychology.

McCarthy discussed her study yesterday at the Institute for Health, Health Care Policy and Aging Research in New Brunswick.

She said the study was conducted because according to the Centers for Disease Control in 2011, 69 percent of smokers want to quit annually, but only 52 percent actually try to quit. The overall population three-month success rate is only six percent of smokers.

She said that 35 percent are smoke-free after 6 to 12 months later with treatment, including medication or transplants, and 50 percent of lifetime smokers have been able to quit.

Dr. Howard Leventhal, professor of Health Psychology, gave a brief introduction before McCarthy’s presentation, highlighting her experience in the field and expertise with the study.

“[McCarthy] has been a member of this community for a long time, working out in Wisconsin before coming here,” he said. “She has a sharpness of intelligence and a depth of knowledge. She is an anchor for this program.”

According to the Institutes website, McCarthy’s research focuses on the development and refinement of treatments to help people stop smoking cigarettes.

Her special interest is in identifying mediators of treatment effects as a part of a strategy for enhancing smoking cessation treatments, according to the website. Her research gathers empirical support for models of addiction to improve treatments.

McCarthy said she started the study on tobacco dependence because most people take for granted that smoking is bad. Smoking is the leading preventable cause of death in the U.S.

Five to 10 years ago, 21 percent of American’s smoked cigarettes, she said. That figure has dropped to 19 percent today, but it could be better.

“We need to get beyond the 35 percent glass ceiling we are at,” she said. “Sixty five percent of smokers use nothing when trying to quit, when there are all these resources available to them. There are medications, treatments, and even free help lines they can call.”

Smoking reinforces behavior that smokers have become accustomed to, McCarthy said. They feel crabbiness, sadness, depression and restlessness coming on. While it could just be a bad day, these could also be the effects of withdrawal from not smoking.

“You grab your cigarettes to stop these feelings from coming on,” she said. “We need to try a top-down approach. Steps have already been taken, such as banning smoking in public places like classrooms and theaters.”

Researchers tested the impulsiveness of the smokers using the Stanford Marshmallow Experiment, McCarthy said. In the original test, children were placed in a room with a marshmallow and told if they didn’t eat it, they would be rewarded later with a second marshmallow.

For the researchers version of the test with smokers, McCarthy said 35 participants were individually placed in an empty room with concrete walls, and nothing but a table and a fancy dinner tray that held two cigarettes, a lighter and an ashtray.

Participants were asked not to smoke for at least 12 hours prior, and had their carbon monoxide levels checked to ensure they had not smoked, McCarthy said. This ensured they would be craving a cigarette by the time they took the test.

“They were told they could smoke if the urge became too overwhelming,” she said. “Out of the 35 participants, 26 smoked during the test.”

Along with this test, the study initially started with 1,039 interested applicants, McCarthy said. They had to be over the age of 18 and smoke about a half a pack of cigarettes a day for six months.

“Out of the 1,039 interested, 276 passed our screening, 136 enrolled and by the end 110 had been retained,” she said.

The participants were given a Palm device and asked to take a survey four times a day, McCarthy said. They were also given a behavioral disinhibition test after each survey.

A participant was shown a letter every random interval of 1, 2 or 4 seconds and asked to press the GO button for every letter except “X,” she said. They were paid $0.02 for every correct answer. They were not informed that “X” had a 10% chance of showing up during the test.

The survey would ask questions about instant gratification, McCarthy said. It would feature questions asking if the participant would prefer $24 now or $25 in a week, and would change the following questions based on their answer.

“If they would take the [$24] now, the next question would ask if they would prefer $15 now or $25 in a week,” she said. “If they chose to wait, the first amount would be increased and they would be asked if they would prefer $35 now or $100 in a week.”

The researchers found that people are consistent, McCarthy said. If they smoke today, they are 3.2 times likely to smoke tomorrow. If they had an urge to smoke today, they were 1.25 times likely to smoke tomorrow.

After the study, she said it would need to be modified to focus on more controllable factors. Impulsiveness was not as related to daily smoking as originally thought, and urge was a key variable.

“Impulsiveness creates a conflict between immediate goals and future goals,” she said.

Dr. Stephen Crystal, Board of Governors professor at the University, said the presentation was intriguing.

“This is another perspective of things that happen when we dig in to something we may not understand very well,” he said. “This helps us see the complexity and multi-dimensional of the issue.”