Smoking Cessation Through a Novel Behavior Modification Technique

Smoking remains a major public health problem. Experiencing a myocardial infarction (MI) can be a teachable moment that results in smoking cessation when previous efforts have failed. We tested the feasibility of providing a simulated and personalized experience of an MI to facilitate quitting smoking. Smokers, who were recruited from the community, had photographs taken of themselves, their partner, and family. These photographs were inserted into a video depicting the subject as a smoker experiencing an MI with potential consequences to themselves (death or disability) and their family. The subject watched the video and a psychologist used motivational interviewing to reinforce quitting efficacy. Thirteen subjects (11 men, 2 women) 45 ± 12 years of age with no smoking-related illness and a nonsmoking partner were studied. At week 1, 7 of 13 subjects (54%) reported stopping smoking, and the other 6 had decreased consumption. Daily cigarette consumption at week 1 decreased from 17.3 ± 9.3 at baseline to 2.7 ± 4.9 (p <0.005) and expired carbon monoxide levels from 15.7 ± 9 to 3.1 ± 3.2 parts per million (p <0.005). Seven subjects had observable responses to the video including “looking uncomfortable” and “red eyes, difficulty speaking.” Self-reports included “made me aware of the important things” and “it felt very real.” At 6 months, 7 of 13 subjects (54%) were still abstinent. Five of the 7 nonsmoking subjects used an additional antismoking aid. In conclusion, it is feasible to create a simulated and personalized teachable moment and these findings provide encouragement for evaluating this novel method for smoking cessation and other behavior modifications.