ABA Fundamentals

Modifying how people smoke: instructional control and generalization.

Frederiksen et al. (1978) · Journal of applied behavior analysis 1978
★ The Verdict

Simple verbal rules can reshape how adults smoke, slashing carbon-monoxide exposure without increasing daily cigarette use.

✓ Read this if BCBAs working with adult clients who want to cut smoking harm but are not ready to quit.
✗ Skip if Clinicians focused only on full abstinence or treating adolescent smokers.

01Research in Context

01

What this study did

Frederiksen et al. (1978) asked adults who smoked to follow short verbal rules. The rules told them how often to puff, how long each puff should last, and how long to keep the cigarette lit.

The team used a multiple-baseline-across-behaviors design. They watched each smoker in the lab and tracked carbon-monoxide levels in their breath.

02

What they found

The smokers quickly matched the target puff rate, puff length, and total cigarette time. These changes stuck around after the rules stopped.

Carbon-monoxide readings dropped almost in half. Daily cigarette count stayed the same, so the adults did not smoke more to make up for shorter puffs.

03

How this fits with other research

Schroeder et al. (1969) showed that men could raise or lower sexual arousal with words alone. W et al. built on this idea by proving that instructions can also reshape a drug-use habit.

Roll (2005) paid teens to stay off cigarettes and got brief abstinence. W et al. took a different path: they kept the same daily count but made each cigarette less harmful. The two studies do not clash; they target different goals—quitting versus safer use.

Gowen et al. (2020) later used attention instructions to normalize imitation in autistic adults. Like W et al., they showed that a short verbal cue can re-wire complex adult behavior.

04

Why it matters

You can give adult clients who smoke a clear, brief rule set and watch their toxic intake fall without raising daily cigarette number. Try it next time you write a behavior plan for nicotine reduction.

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Tell your adult client three exact targets—puff count, puff seconds, and total cigarette time—and graph the CO readings each week.

02At a glance

Intervention
prompting and fading
Design
multiple baseline across behaviors
Sample size
3
Population
substance use disorder
Finding
positive
Magnitude
large

03Original abstract

The modification of smoking behavior usually involves the target goal of total abstinence. However, many smokers are unable or unwilling to quit completely. An alternative is to teach people to smoke in ways that minimize the associated health risks. Such an approach would involve decreasing smoking rate, switching to “safer” tobacco products, and modifying the topography of consumption. Previous research has shown that topographical components of smoking behavior such as puff frequency, puff duration, cigarette duration, and amount smoked can be reliably measured and experimentally manipulated (Frederiksen, Miller, and Peterson, Addictive Behaviors , 1977, 2 , 55–61). Further, there is preliminary evidence from a single‐subject experiment that topography can be changed in clinically relevant directions and that such changes can generalize to the smoker's natural environment (Frederiksen and Simon, Behavior Therapy, in press ). To replicate and extend these findings, three single‐subject experiments were conducted. In each experiment, verbal instructions to modify individual components of smoking topography were sequentially introduced using a multiple‐baseline design across components. The components of puff frequency and puff duration were modified in three experiments. Cigarette duration was also modified in two experiments. Following the topography change phase, daily smoking rate was stabilized, using a behavioral contracting procedure (Frederiksen, Peterson, and Murphy, Addictive Behaviors , 1976, 1 , 193–196). Generalization was assessed during sessions in which no instructions were given (Subjects 1 and 3) and at six monthly followups (Subjects 2 and 3). For Subjects 2 and 3, data were also available on the amount of carbon monoxide (CO) uptake associated with the consumption of a cigarette (postcigarette CO‐precigarette CO). This physiological measure is important because CO and its byproducts constitute a major health risk (Russell, Lancet , 1974, 1 , 254–258). Results showed that instructions were effective in modifying components of smoking topography. These changes generalized to sessions in which no instructions were given and across six months of followup. Daily smoking rate did not increase during topography change nor did smoking topography deteriorate when smoking rate was subsequently stabilized on a behavioral contract. Subjective ratings of smoking enjoyment decreased during topography change for two of three subjects but subsequently returned to baseline levels during followup. The observed topography changes were associated with a decrease in the amount of each cigarette smoked. Mean CO uptake was also reduced from baseline levels of 6.0 ppm and 8.0 ppm (Subjects 2 and 3, respectively) to followup levels of 3.3 ppm and 2.1 ppm. These results replicate and extend previous work and suggest that moderate or “controlled” smoking is an approach that deserves continued attention. The importance of assessing smoking topography and physiological variables, as well as directions for subsequent investigation, are discussed.

Journal of applied behavior analysis, 1978 · doi:10.1901/jaba.1978.11-431