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A psychological and behavioural comparison of ex-smokers and smokers
J Chron Dis 1976, Vol. 29, pp. 431434. Pergamon
Press. Printed in Great Britain
A PSYCHOLOGICAL AND BEHAVIOURAL COMPARISON OF EX-SMOKERS AND SMOKERS* LINDA L. PEDERSON
and NEVILLE M. LEFCOE
Department of Medicine, Victoria Hospital and the University of Western Ontario. London, (Rrceiued
Ontario,
in reciwd.form
Canada
15 Srpremhrr
1975)
Abstract-The purposes of this investigation were to compare ex-smokers to participants in a smoking withdrawal programme on a number of personality characteristics and to detect consistent phenomena associated with successful quitting. No statistically significant differences were found between the two groups on the personality characteristics which were measured. Successful ex-smokers usually have tried at least once and failed. quit for current health reasons, experienced cravings and discomfort, and used substitutes.
smoking withdrawal programmes and techniques have very low success rates [e.g. l-51. Yet, as Premack [S] suggests, thousands of people outside psychologists’ labs, doctors’ offices, and clinics are successfully quitting smoking. This paper attempts to deal with two issues concerning people who quit smoking spontaneously. First, are they in some way different from people who seek help in quitting smoking? Do they differ from participants in a smoking withdrawal programme on measurable personality characteristics, demographic information and smoking history information? Second, what characterizes them as a group? Are there any consistencies which tend to be associated with successful quitting‘? MOST
METHOD
Design and subjects
A group of 46 ex-smokers volunteered in response to an advertisement in a university newspaper. The 15 women and 31 men were required to have been off cigarettes for at least a year. One of the members of this group underwent hypnosis as an aid to quitting; the remaining 45 people quit without formal help. The second group (smokers) consisted of 24 men and 24 women who had volunteered through an advertisement in the same paper to participate in a smoking withdrawal programme. All smokers had tried to quit at least once before on *This investigation Association.
was supported
by a grant
from the Ontarlo
431
Tuberculosis
and Respiratory
Disease
432
L. L. PEDERSON and N. M. LEFCOE
TABLE ~.MEAN
AGE,YEARS SMOKED AND AMOUNT SMOKERS AND EX-SMOKERS
Smokers Mean Mean Mean
age years smoked amount smoked
37.91 17.25 25.37
SMOKED FOR
Ex-smokers 34.30 (age quit) 16.58 25.82
their own and had been unsuccessful. A minimum age limit of 25 yr was set for both groups. Procedure
Demographic information was obtained from the ex-smokers during a telephone interview. Also, they were questioned about how long, how much and why they smoked and how they quit. The questions about why they smoked were based on Tomkins’ [6] model. Then, as a group, they filled out standard personality questionnaires (Jackson Personality Inventory and a modification of the ReidWare Internal-External Control Scale). The group of smokers were participants in a smoking withdrawal programme. Prior to their attempts to quit smoking, the smokers were interviewed regarding the same demographic and smoking history information, and filled out the same personality questionnaires. RESULTS
Table 1 presents the mean age, mean years smoked and mean amount smoked for each group. There were no statistical differences between the groups on any of the measures. No statistically significant differences between smokers and exsmokers on any of the scales of the Jackson Personality Inventory or the InternalExternal Control measures were obtained using the multiple-t procedure. Table 2 presents the information collected on the ex-smokers with regard to how and why they quit smoking. In response to some questions, the ex-smokers gave more than one answer, so some of the frequency counts total more than 46. DISCUSSION
No statistically significant differences were found between the smokers and the ex-smokers in the personality characteristics which were measured. The failure to find statistical significance was unexpected since it would seem reasonable that they would differ on measures of anxiety, self-control, self-esteem and risk-taking, if not others [see 6-91. There are consistencies which are associated with successful quitting. Most successful quitters have tried unsuccessfully to quit smoking at least once before. Food and physical activity seem to be the most popular substitutes for cigarettes. Most people who quit smoking do so for health reasons. Leventhal’s [lo] investigation on anti-smoking communications would suggest that this reason for quitting smoking would not be potent enough. Possibly, general remote health scare tactics are fairly ineffective in getting people to quit smoking. However, when the health effects are more immediate and personal (e.g. shortness of breath), the needed
Comparison
TABLE 2. SUMMARY Times
tried to quit
Number Reason
of ex-smokers for smoking
Number
of ex-smokers
Substitutes Number
Reason
0
I
2
3
4-5
6+
9
9
13
3
4
x
Habit
Enjoyment
of ex-smokers
Smoking
environment
Number
of ex-smokers
Withdrawal
symptoms
of ex-smokers
10
Hypnosis
30
Pipes and cigars
20
2
with smokers
Living
I5
Physical actrvity
None
4
16 Other IX
with non-smokers
18 Physical
9
Family pressure
2
Other
I
II
Model for children
3
3
Living
3
Financial
Pregnancy
Stimulant
Food
I
I Health
Addiction
Relaxant
18
34
of ex-smokers
for quitting
433
and Smokers
DATA FROM EX-SMOKERS ABOLIT THE PROCESS OF QUITTING
Medication
Number
Number
of Ex-Smokers
2X Emotional 19
Weight
gain
No symptoms
12
20
Craving 36
motivation to quit is present. Surprisingly, almost half of the sample (43”/,) experienced no immediate withdrawal symptoms, except for craving a cigarette. For the rest, the different kinds of symptoms appeared with about equal frequency. One-third of the group reported experiencing at least two symptoms. Almost all of the group reported craving cigarettes when they quit. Only 22% of the sample reported no withdrawal symptoms or cravings when they quit-a fact which makes it easier to understand why so many people try and fail. This investigation may be criticized because of the use of retrospective information from the ex-smokers. Sampling bias may have arisen because only ex-smokers who volunteered to be questioned about smoking and quitting are included. However, the information obtained from this study has already been put to use in the smoking withdrawal programme in which the authors are involved. People who want to quit smoking are informed about the fact that many ex-smokers fail before they are successful, that most people experience cravings and withdrawal symptoms. that many people find the use of a substitute helpful, that living in a non-smoking environment is not essential, and no particular personality characteristics are strongly related to successful quitting. AckrtoM;lrdllmlr~lr-The authors are indebted to Irene Faveri, who conducted ex-smokers. administered and scored the ex-smokers’ personality questionnaires, the data.
the interviews of the and helped analyze
REFERENCES I. 2.
Bernstein DA: The modification of smoking behavior: an evaluative review. Learning Mechanisms in Smoking. Hunt WA (Ed.) Chicago: Aldine, 1970 Hunt WA. Matarazzo JD: Three years later: recent developments in the experimental modification of smoking behavior. J Abnormal Psycho1 81: 107-114, 1973
L. L. PEDERSJNand N. M. LEFCOE
434 3.
Keutzer
CS, Lichtenstein L, Mees HL: Modification of smoking behavior: a review. Psycho1 1968 Lichtenstein E: Modifications of smoking behavior: good designs-ineffective treatments. J Consult Clin Psycho1 36: 163-166, 1971 Premack D: Mechanisms of self-control. Learning Mechanisms in Smoking. Hunt WA (Ed.) Chicago: Aldine, 1970 Tomkins S: A modified model of smoking behaviour. Smoking, Health and Behaviour. Borgatta EF. Evans RR (Eds.) Chicago: Aldine, 1968 Schwartz JL, Dubitzky M: Requisites for success in smoking withdrawal. Smoking, Health and Behaviour. Borgatta EF, Evans RR (Eds.) Chicago: Aldine, 1968 Best JA, Steffy RA: Smoking modification procedures tailored to subject characteristics. Behav Bull 70: 520-533,
4. 5. 6. 7. 8.
Therapy 9. 10.
2: 177-191,
1971
Best JA. Steffy RA: Smoking modification clients. Can J Behav Sci 7: 155-165, 1975
procedures
for internal
Leventhal H: Experimental studies of anti-smoking communications. ior. Borgatta EF, Evans RR (Eds.) Chicago: Aldine, 1968
and external Smoking.
locus of control Health
and Behav-
Press. Printed in Great Britain
A PSYCHOLOGICAL AND BEHAVIOURAL COMPARISON OF EX-SMOKERS AND SMOKERS* LINDA L. PEDERSON
and NEVILLE M. LEFCOE
Department of Medicine, Victoria Hospital and the University of Western Ontario. London, (Rrceiued
Ontario,
in reciwd.form
Canada
15 Srpremhrr
1975)
Abstract-The purposes of this investigation were to compare ex-smokers to participants in a smoking withdrawal programme on a number of personality characteristics and to detect consistent phenomena associated with successful quitting. No statistically significant differences were found between the two groups on the personality characteristics which were measured. Successful ex-smokers usually have tried at least once and failed. quit for current health reasons, experienced cravings and discomfort, and used substitutes.
smoking withdrawal programmes and techniques have very low success rates [e.g. l-51. Yet, as Premack [S] suggests, thousands of people outside psychologists’ labs, doctors’ offices, and clinics are successfully quitting smoking. This paper attempts to deal with two issues concerning people who quit smoking spontaneously. First, are they in some way different from people who seek help in quitting smoking? Do they differ from participants in a smoking withdrawal programme on measurable personality characteristics, demographic information and smoking history information? Second, what characterizes them as a group? Are there any consistencies which tend to be associated with successful quitting‘? MOST
METHOD
Design and subjects
A group of 46 ex-smokers volunteered in response to an advertisement in a university newspaper. The 15 women and 31 men were required to have been off cigarettes for at least a year. One of the members of this group underwent hypnosis as an aid to quitting; the remaining 45 people quit without formal help. The second group (smokers) consisted of 24 men and 24 women who had volunteered through an advertisement in the same paper to participate in a smoking withdrawal programme. All smokers had tried to quit at least once before on *This investigation Association.
was supported
by a grant
from the Ontarlo
431
Tuberculosis
and Respiratory
Disease
432
L. L. PEDERSON and N. M. LEFCOE
TABLE ~.MEAN
AGE,YEARS SMOKED AND AMOUNT SMOKERS AND EX-SMOKERS
Smokers Mean Mean Mean
age years smoked amount smoked
37.91 17.25 25.37
SMOKED FOR
Ex-smokers 34.30 (age quit) 16.58 25.82
their own and had been unsuccessful. A minimum age limit of 25 yr was set for both groups. Procedure
Demographic information was obtained from the ex-smokers during a telephone interview. Also, they were questioned about how long, how much and why they smoked and how they quit. The questions about why they smoked were based on Tomkins’ [6] model. Then, as a group, they filled out standard personality questionnaires (Jackson Personality Inventory and a modification of the ReidWare Internal-External Control Scale). The group of smokers were participants in a smoking withdrawal programme. Prior to their attempts to quit smoking, the smokers were interviewed regarding the same demographic and smoking history information, and filled out the same personality questionnaires. RESULTS
Table 1 presents the mean age, mean years smoked and mean amount smoked for each group. There were no statistical differences between the groups on any of the measures. No statistically significant differences between smokers and exsmokers on any of the scales of the Jackson Personality Inventory or the InternalExternal Control measures were obtained using the multiple-t procedure. Table 2 presents the information collected on the ex-smokers with regard to how and why they quit smoking. In response to some questions, the ex-smokers gave more than one answer, so some of the frequency counts total more than 46. DISCUSSION
No statistically significant differences were found between the smokers and the ex-smokers in the personality characteristics which were measured. The failure to find statistical significance was unexpected since it would seem reasonable that they would differ on measures of anxiety, self-control, self-esteem and risk-taking, if not others [see 6-91. There are consistencies which are associated with successful quitting. Most successful quitters have tried unsuccessfully to quit smoking at least once before. Food and physical activity seem to be the most popular substitutes for cigarettes. Most people who quit smoking do so for health reasons. Leventhal’s [lo] investigation on anti-smoking communications would suggest that this reason for quitting smoking would not be potent enough. Possibly, general remote health scare tactics are fairly ineffective in getting people to quit smoking. However, when the health effects are more immediate and personal (e.g. shortness of breath), the needed
Comparison
TABLE 2. SUMMARY Times
tried to quit
Number Reason
of ex-smokers for smoking
Number
of ex-smokers
Substitutes Number
Reason
0
I
2
3
4-5
6+
9
9
13
3
4
x
Habit
Enjoyment
of ex-smokers
Smoking
environment
Number
of ex-smokers
Withdrawal
symptoms
of ex-smokers
10
Hypnosis
30
Pipes and cigars
20
2
with smokers
Living
I5
Physical actrvity
None
4
16 Other IX
with non-smokers
18 Physical
9
Family pressure
2
Other
I
II
Model for children
3
3
Living
3
Financial
Pregnancy
Stimulant
Food
I
I Health
Addiction
Relaxant
18
34
of ex-smokers
for quitting
433
and Smokers
DATA FROM EX-SMOKERS ABOLIT THE PROCESS OF QUITTING
Medication
Number
Number
of Ex-Smokers
2X Emotional 19
Weight
gain
No symptoms
12
20
Craving 36
motivation to quit is present. Surprisingly, almost half of the sample (43”/,) experienced no immediate withdrawal symptoms, except for craving a cigarette. For the rest, the different kinds of symptoms appeared with about equal frequency. One-third of the group reported experiencing at least two symptoms. Almost all of the group reported craving cigarettes when they quit. Only 22% of the sample reported no withdrawal symptoms or cravings when they quit-a fact which makes it easier to understand why so many people try and fail. This investigation may be criticized because of the use of retrospective information from the ex-smokers. Sampling bias may have arisen because only ex-smokers who volunteered to be questioned about smoking and quitting are included. However, the information obtained from this study has already been put to use in the smoking withdrawal programme in which the authors are involved. People who want to quit smoking are informed about the fact that many ex-smokers fail before they are successful, that most people experience cravings and withdrawal symptoms. that many people find the use of a substitute helpful, that living in a non-smoking environment is not essential, and no particular personality characteristics are strongly related to successful quitting. AckrtoM;lrdllmlr~lr-The authors are indebted to Irene Faveri, who conducted ex-smokers. administered and scored the ex-smokers’ personality questionnaires, the data.
the interviews of the and helped analyze
REFERENCES I. 2.
Bernstein DA: The modification of smoking behavior: an evaluative review. Learning Mechanisms in Smoking. Hunt WA (Ed.) Chicago: Aldine, 1970 Hunt WA. Matarazzo JD: Three years later: recent developments in the experimental modification of smoking behavior. J Abnormal Psycho1 81: 107-114, 1973
L. L. PEDERSJNand N. M. LEFCOE
434 3.
Keutzer
CS, Lichtenstein L, Mees HL: Modification of smoking behavior: a review. Psycho1 1968 Lichtenstein E: Modifications of smoking behavior: good designs-ineffective treatments. J Consult Clin Psycho1 36: 163-166, 1971 Premack D: Mechanisms of self-control. Learning Mechanisms in Smoking. Hunt WA (Ed.) Chicago: Aldine, 1970 Tomkins S: A modified model of smoking behaviour. Smoking, Health and Behaviour. Borgatta EF. Evans RR (Eds.) Chicago: Aldine, 1968 Schwartz JL, Dubitzky M: Requisites for success in smoking withdrawal. Smoking, Health and Behaviour. Borgatta EF, Evans RR (Eds.) Chicago: Aldine, 1968 Best JA, Steffy RA: Smoking modification procedures tailored to subject characteristics. Behav Bull 70: 520-533,
4. 5. 6. 7. 8.
Therapy 9. 10.
2: 177-191,
1971
Best JA. Steffy RA: Smoking modification clients. Can J Behav Sci 7: 155-165, 1975
procedures
for internal
Leventhal H: Experimental studies of anti-smoking communications. ior. Borgatta EF, Evans RR (Eds.) Chicago: Aldine, 1968
and external Smoking.
locus of control Health
and Behav-