Relapse prevention for smoking cessation: testing explicit and implicit regulation processes using dismantling designs

Smoking is a major preventable cause of premature death and disability.
Nowadays, there is great amount of studies about interventions for smoking
cessation. Most of these studies do not explicitly focus on relapse, but merely
on smoking cessation. This study focuses on two smoking relapse prevention
interventions. The first intervention is about the role of explicit cognitions
and based on computer tailoring and the second intervention is about the role
of implicit cognitions and based on Attentional Retraining.

The aim of this study is the development of an effective intervention to
prevent smoking relapse and the improvement of existing interventions.

The study about the intervention based on computer tailoring is a randomized
control trial with three conditions with a baseline assessment, and two follow
ups, 6 and 12 months after the baseline measurement.

The study about the intervention based on Attentional Retraining follows the
same design as the previous study and has only two conditions.

Intervention 1
In the first study we aim at testing an intervention aimed at explicit
regulatory processes and based on computer tailoring. During the past couple of
years a system which gives computer tailored information about smoking has been
developed and tested. Studies show that computer tailoring is an effective
intervention to motivate smokers to quit smoking. One of the most important
marks of computer tailoring is that the information is personalized and that
the feedback is based on the individual characteristics of the participant.
Computer tailoring has mostly been used for smoking cessation and not
explicitly for smoking relapse.
The goal of this intervention is to gain insight into the working mechanisms of
computer tailoring with regard to relapse, so that computer tailored
intervention can also be used to prevent smoking relapse. It is also important
to analyze whether different strategies are needed for different groups (e.g.
low SES). The results of this study will be used to improve mechanisms to
change behavior in smokers who motivated to quit smoking and to abstain from
smoking.
The first condition to which participants can be assigned is the control
condition. The control condition consists of filling out the three
questionnaires. In the second condition the participants also need to fill out
the questionnaire and they will get feedback after the first questionnaire.
Participants in the third conditions will receive multiple feedback. The
effects of the different ways of providing feedback and the effects of the
concepts used in the feedback will be compared. Assignment to the conditions
will be at random.


Intervention 2

Most interventions focus on explicit cognitions and ignore less conscious
processes. however, implicit associations have also been shown to be of
importance and can exist besides explicit cognitive processes. The goal of this
study is to test the efficacy of a non-cognitive approach for smoking cessation
and relapse prevention using Attentional retraining. The principle implies that
the automatic attentional bias for drug related stimuli is *unlearnt *or better
that alternative associations are formed.

The design of the study follows the first one. There are two groups, one
control condition in which the participants only fill out the three
questionnaires, and a condition in which the participants actually do the
Attentional Retraining.

Filling out the questionnaire takes about 30 minutes. There are no risks
related to these studies. Participation is voluntarily and participants have
the right to stop participation at any moment.