A new method for giving up smoking, the Learning Abstinence Theory (LAT) developed in Groningen, approaches this widespread problem from a completely different angle. Karin Menninga, one of the researchers who devised and tested the method, will be awarded a PhD by the Faculty of Behavioural and Social Sciences on 17 January 2013.
The LAT focuses on learning about smoking and not smoking. Current practices urge ex-smokers to avoid risk situations in which they used to smoke. LAT on the other hand assumes that these situations are an essential part of the process of quitting the habit. Even if a situation causes a relapse, this does not automatically mean that the person has failed to stop smoking. The experience gained from a relapse can provide him or her with a fundamentally different take on smoking and not smoking. This is the bottom line when it comes to stopping: the person concerned must undergo a psychological change. Menninga: ‘You have to make the transition from smoker to non-smoker. This is something you must learn. You will only really give up smoking once you have learned all there is to learn. It’s a process, not just a concerted effort.’
We are now in the second week of January, and many prospective ex-smokers who vowed to give up the fags for New Year have already admitted defeat. Of the thousands of smokers who try to give up every year, most soon succumb to their old smoking habits. No more than one in seven smokers who try to stop smoking without extra help manage to kick the habit for a year. This percentage rises to only thirty percent for those who receive counselling or use nicotine chewing gum, for example. So despite all the developments in this area, a high percentage of ex-smokers still resume smoking.
In her thesis, Menninga presents a new theoretical perspective, the Learning Abstinence Theory, which combines elements of previous theories with new elements. The basic premise is that to stop smoking permanently, there are certain things you have to learn. You learn these things by experiencing situations in which you would previously have lit up a cigarette (known as high-risk situations). What you actually learn depends on how you look at the situation in question. Do you believe that you can stop smoking? Or are you secretly convinced that you cannot manage without your cigarettes? Or are you feeling confident because someone has just paid you a compliment? These states of mind are responsible for what you learn in any given risk situation. People also need to know that they are on the right track towards their goal: to stop smoking painlessly and permanently. Menninga: ‘If you see that your attempt to stop smoking is working and you feel less dependent on your cigarettes, you will be motivated to carry on. Feedback about how you are progressing is essential.’
A vital part of the method is to see abstinence as a process of trial and error. Smokers should see every moment they are tempted to light up a cigarette as a chance to learn. Some smokers may only need one such occasion to stop smoking with very little effort, while others may need more. To abstain permanently, a smoker must realize/learn three things: 1) that there are no benefits to smoking. For example, it does not help you to cope with stress; 2) that he or she is capable of stopping; 3) that life without smoking has added benefits and is good and meaningful. Coaching people who want to stop smoking via the LAT method should focus on supporting the right learning process. In principle, an internet coach will suffice, but this could be a task for GPs and stop smoking clinics in the future.
Menninga: ‘At the moment, many people who try to stop smoking light up in a weak moment and then say “I’ve failed”. It may then take some time before they try again. Every attempt becomes a guilt-ridden process, simply because you risk being a failure. Looking at your attempt to stop from a different angle and not branding yourself a loser if you fall at the first hurdle makes the whole process much less stressful.’
Menninga (who does not smoke) monitored the smoking behaviour of 323 ex-smokers, all of whom had stopped within the previous six months. They completed three extensive questionnaires: one when they signed up, another three months into the study and the last one after six months. The results showed that ex-smokers who considered themselves worse off than when they smoked were more likely to start again after 1 and 6 months. The LAT claims that if people trying to stop smoking become uncertain about whether their attempt is working, they will lose confidence. Even if they have not smoked for months, once they start to think that they are worse off than when they smoked or that their attempt to stop is failing, they will give up. Menninga: ‘So feedback about your progress is vital. Realizing that things are going well will motivate you to carry on.’
Menninga hopes that the LAT will form a new basis for the way stopping smoking is approached. According to the LAT method, smokers embark on a process of learning to abstain from smoking rather than ‘making an attempt’ to stop. Menninga: ‘As things stand, a lot of ex-smokers lapse into their old habits. It would be fantastic if the knowledge acquired from the LAT eventually led to more long-term abstinence. That’s what it’s all about.’
Karin Menninga (Ten Boer, 1978) studied social and health psychology in Groningen and conducted her PhD research at the Department of Social Psychology. Her thesis is entitled ‘Exploring Learning Abstinence Theory: A new theoretical perspective on continued abstinence in smoking cessation’. Prof. A. Dijkstra was her supervisor and Dr W.A. Gebhart her co-supervisor.
Contact: Karin Menninga, e-mail:
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