Smoking extinction: smoke-them-out-of-pleasure (STOP) technique.

TLDR: The present technique increases the self-induced stress to a level 'beyond' tolerance without onset of relief, and evokes hyper-sensitivity and psychophysiolog~cal inhibiton of smoking.

Abstract: The smoker by smoking a cigarette creates a certain level of 'self-induced stress' resulting from oral heat, bitter taste, and bronchio-pulmonary irritation. The termination of smoking a cigarette extinguishes this self-induced-stress and onsets a self-inducedrelief followed by some reduction in the general level of stress that existed prior to smoking. This positive experience of relief from stress has some survival value for the individual and reinforces and maintains the antecedent smoking behavior. The effective way to extinguish smoking is ro thwart or stamp out abruptly and completely the link berween self-induced stress and self-induced relief. Rapid smoking procedures have only required people to smoke 'until' tolerance ( 1, 2 ) . The present technique increases the self-induced stress to a level 'beyond' tolerance without onset of relief. One smokes until smoking is no longer a pleasurable experience. Treatment by this method of a 23-yr.-old male with a 10-yr. smoking history is described here. The treatment was given with the client's consent and after screening in a clinic. He was not aware of the treatment strategy. He was made to relax and to smoke, inhaling each puff and exhaling only through his nostrils while trying to enjoy each puff. He could not retain a feeling of 'pleasure' after the chird cigarette; he coughed on the fifth one, and vomited three times (eighth to tenth cigarettes), and lost consciousness on the fourteenth. The number of cigarettes and minutes per day to fall unconscious were 14/75, 10/36, 8/30, 45/19, 3/12, 2/9, 1/4 over one week. He spontaneously recovered consciousness after 10 to 15 min. The steep decline in the 'cigarette tolerance' was followed by an abrupt reduction in smoking outside the treatment, from 10 (pretreatment) to 1 on the first day of treatment and none from the fourth day onwards. Nonsmoking continued for seven months. Peer pressure to smoke led to a 'pleasureless/blaad' smoking experience. This STOP technique evokes hyper-sensitivity and psychophysiolog~cal inhibiton of smoking. This preliminaty work should be replicated with a large sample of heavy smokers.