Treatments for cigarette smoking: an evaluation of the contributions of aversion and counseling procedures

The role of aversive conditioning in rapid smoking was examined by randomly assigning smokers to one of three aversive treatments designed to induce three distinct levels of central malaise. These treatments, full-scale rapid smoking (FS; n = 22), truncated rapid smoking (TC: n = 20) and rapid puffing (RP; n = 20) were combined with a full-scale counseling package. A fourth treatment, full-scale rapid smoking with reduced counseling (RC; n = 20), was included to evaluate the contribution of coping response training to rapid-smoking efficacy. Among post-treatment measures of aversion, only heart rate (HR) response to cigarettes discriminated groups, with FS Ss exhibiting an apparent conditioned cardiac acceleration to cigarettes. Six-month follow-up data revealed that both the type of counseling and level of aversion had an impact on cigarette abstinence. At 6-months post-treatment, the FS group produced the best outcome, while the TC group and the RC group had the worst outcomes. The RP group was intermediate to these groups. Regression analysis showed that across all groups, confidence ratings of remaining abstinent were most predictive of outcome whereas within the two full-scale rapid-smoking treatments, post-treatment HR response to cigarettes was most predictive of latency to relapse. The results were discussed with respect to the contributions of aversion conditioning and full counseling to the success of aversive treatment packages for smoking cessation.