Retraining automatic action tendencies for smoking using mobile phone-based approach-avoidance bias training: A study protocol for a randomized controlled study

Abstract

BackgroundAutomatic tendencies to approach drug-related cues have been linked to the development and maintainance of harmful drug-taking behavior. Recent studies have demonstrated that these automatic approach tendencies can be targeted directly by means of cognitive bias modification (CBM). Moreover, changing those approach tendencies may enhance treatment outcomes. However, training and therapy effects tend to be rather small and adherence to the training might be impaired by time-consuming multiple laboratory training sessions. Here, we present a protocol for a randomized controlled design to improve CBM training efficiency and facilitate access to the training by providing mobile-phone-based training sessions at home to current smokers motivated to quit smoking.MethodsParticipants (n = 100) are current smokers who smoke at least six cigarettes per day for at least 6 months and are willing to quit smoking. All participants attend a brief behavioral smoking cessation intervention (TAU) and are randomly assigned either to an experimental (TAU + training) or a control group. Participants in the experimental condition are given access to a training application (app) aimed at retraining automatic approach biases for smoking cues. Participants are instructed to perform the app training outside the laboratory context on a daily basis for 14 consecutive days. Participants in the control group do not receive the training. Primary outcome measures are changes in smoking-related approach biases and reductions in daily nicotine consumption as assessed at baseline, post-training and at 6-week follow up. Secondary outcome measures include approach biases for alternative stimuli or smoking stimuli to which participants were not exposed during training, attentional and association biases, biochemical outcomes, and self-reported smoking behavior, also measured at three different time points (baseline, post-training, and follow up). After completion of the study, smokers in the control condition will receive access to the training app.DiscussionThis randomized controlled trial is the first to test the effectiveness of an app-based CBM intervention as an adjunct to a brief smoking cessation intervention in smokers motivated to quit smoking. The results of this study can inform future research in the optimization and advancement of CBM treatment for addiction.Trial registrationCurrent Controlled Trials, ISRCTN15690771. Registered on 20 November 2018.

Association between Smartphone Addiction and Suicide

“…[ 5 , 21 ]. Therefore, a variety of drastic physical, psychological, and social relation changes that adolescents have no control over and cannot avoid occur as a result of smartphone addiction [ 22 ]. The addiction could grow extremely hard to control, both mentally and physically; the resulting stressful events and experiences can cause adolescents to mentally break down, consider self-harm, have suicidal thoughts, and even resort to suicide attempts.…”

“Push it!” or “Hold it!”? A comparison of nicotine-avoidance training and nicotine-inhibition training in smokers motivated to quit

“…Indeed, more recent attempts have been undertaken to deliver psychological interventions via smartphone apps (for a review, see Zhang et al 2018 ). In the realm of nicotine dependence, members of this research (Machulska et al 2019 ) have developed an app-based nicotine-avoidance training and results are expected to be published in the near future. Relatedly, Wiers and colleagues (2020) refer to a new theoretical perspective based on an inferential rather than associative account and suggest special advancements for the development of effective interventions.…”

“…Maybe the current control conditions were not sufficiently different to produce reliable differences in training effects . Hence, future studies in this context would profit from including modified or additional control conditions such as waitlist control groups or minimal substance exposure conditions (for a similar approach, see Machulska et al 2019 ).…”

Smoking behavior intervention based on implicit approach: a cross-sectional pilot study

“…13,16 Smoking as an addictive behavior has been proved caused by implicit association factor and could be trained to reduce by implicit approach. [17][18][19][20][21][22] This research tried to develop an alternative smoking intervention based on an implicit approach that has never been applied in Indonesia.…”

“…[23][24][25] Second, the study aimed to apply implicit intervention using retraining approach-avoidance task (AAT) as an intervention to shape smoking-avoidance behavior. 21,26,27 A two-step study can be illustrated in the following flow chart (Figure 1).…”