Harry A. Lando

Relapse and risk perception among members of a smoking cessation clinic.

Assessed perceptions of the health risks associated with smoking in comparison with not smoking among members of smoking cessation clinics. We measured these perceptions at three different time periods during the clinic, and then again at a 6-month follow-up. Results indicated that members who were abstinent at the follow-up had lowered their perceptions of the likelihood of contracting smoking-related illnesses (e.g., emphysema) if they were not smoking. In contrast, those who had relapsed lowered their perceptions of the health risks associated with smoking, but not their perceptions of nonsmoking disease vulnerability. The implications of these changes in risk perception for therapy involvement are discussed.

Nicotine fading as a nonaversive alternatative in a broad-spectrum treatment for eliminating smoking

The present investigation assessed the effectiveness of nicotine fading as a non-aversive alternative to oversmoking. Subjects (66 women and 64 men) were randomly assigned to oversmoking, nicotine fading, nicotine fading/smokeholding, and a nonmaintenance control. Results failed to indicate the expected superiority of nicotine fading/maintenance over the control condition. Instead, the addition of smokeholding appeared to produce a significant incremental effect over nicotine fading alone. Unfortunately, 12-month follow-up revealed considerable relapse across conditions and no significant treatment effects. Even so, absolute outcome for nicotine fading/smokeholding was encouraging. This procedure is both safe and apparently very acceptable to subjects. If the current results can be replicated, a clinically effective technique will have been established with applicability in both clinic and self-help settings.

Effects of preparation, experimenter contact, and a maintained reduction alternative on a broad-spectrum program for eliminating smoking☆

Abstract The present investigation compared the successful two-stage treatment reported by Lando (1977) against an intensified version of a less successful three-stage program (Lando, 1978). Minimal experimenter contact and maintained reduction for nonabstinent subjects were also assessed. Subjects were 44 males and 56 females. Although there was a consistent trend for two-stage treatment to produce better results than three-stage treatment, differences between these conditions were significant only at 12-month follow-up. Intensive contact was superior to minimal contact only at Week 1. The maintained reduction procedure was not successfully implemented. Significant interactions were evident between experimenter contact and treatment stages throughout the follow-up period, with two-stage subjects appearing to benefit from intensive contact and three-stage subjects actually doing better under minimal contact. Results supported the efficacy of the two-stage aversion and maintenance program first reported by Lando (1977). Results also contradicted the assumption that more complex is necessarily better and pointed to the inadequacy of simple post hoc alternatives for nonabstinent subjects.

An objective check upon self-reported smoking levels: A preliminary report.

The present study undertook a preliminary assessment of the efficacy of measures of carbon monoxide concentration as an objective check upon self-reported smoking consumption. Breath samples were taken from 20 subjects who had completed an anti-smoking program two months previously. Results tentatively suggest that the carbon monoxide test is a valid and nonreactive technique.

A factorial analysis of preparation, aversion, and maintenance in the elimination of smoking

The present investigation initiated a dismantling strategy in which subjects were assigned to treatment stages (preparation, aversion, maintenance) or to combinations of stages in a factorial design. It was hypothesized that multistage conditions would be superior to single stage conditions and that maintenance would retard relapse. Forty men and 33 women were randomly assigned to one of seven conditions. Results supported both hypotheses although significant effects were no longer evident at 12-month follow-up. Considerable relapse occurred in all conditions. Specific treatment components appeared to be of limited importance as indicated by generally very similar results for preparation and aversion. Booster sessions appeared to be ineffective. Interpretation of the findings is limited, however, by a relatively small subject enrollment in each condition. It was concluded that attempts to isolate extremely precise treatment elements are unlikely to be successful. Suggestions for further research included adoption of more structured maintenance strategies emphasizing coping skills and a more systematic focus upon potentially important process variables, notably group cohesiveness.

Lay facilitators as effective smoking cessation counselors

The present study assessed the relative effectiveness of doctoral counseling students and lay facilitators in conducting smoking cessation programs. Subjects (55 women and 61 men) were randomly assigned to doctoral or to lay facilitators. Consistent with prediction, lay facilitators were at least as effective as doctoral students. Overall results were comparable to those obtained in previous work in this laboratory. Allowing a choice of preparation technique may in itself enhance treatment outcome. The ability of lay facilitators to achieve clinically effective results provides further support for the generalizability of treatment to community settings.

Three-year data on a behavioral treatment for smoking: A follow-up note

A study reported by Lando (1981) compared two-stage treatment (aversion, maintenance) against three-stage treatment (preparation, aversion, and maintenance) under conditions of either intensive or minimal experimenter contact. One-year follow-up data indicated the superiority of the two-stage intensive contact procedure. The present article reports additional follow-up data at 12, 18, 24, and 36 months. Results continued to favor two-stage intensive contact. Long-term abstinence in this condition consistently exceeded 40% as opposed to less than 25% in the other conditions.

The effects of a model's success or failure on subsequent aggressive behavior

Abstract It was of interest in the present study to examine the influence of both aggressive and nonaggressive models who are successful or nonsuccessful in reducing aggression from an aggressive opponent. Male and female subjects viewed a same-sexed model interact with an aggressive opponent in a reaction time task. Half the subjects observed an aggressive model while the remaining subjects observed a nonaggressive model. For half the subjects the model was successful in reducing the aggressiveness of the opponent. Results indicated that both the models behavior and the consequences to the model (success/nonsuccess) were important determinants of subsequent aggression by the subject. Results are discussed in terms of current research and theory in aggression control.

Behavioral self-help materials as an adjunct to nicotine gum☆

The present study assessed the incremental effectiveness of behavioral self-help materials specifically written to accompany nicotine gum. Subjects (187 women and 117 men) were randomly assigned either behavioral self-help booklets or a factual information pamphlet. All subjects received prescriptions for Nicorette from study physicians. Contrary to prediction, subjects provided self-help booklets fared no better than did subjects provided comparison pamphlets. Overall abstinence levels were encouraging, however. Nicotine gum users were far more likely than nonusers to maintain abstinence through 6-month follow-up. Perhaps self-help materials could be improved by condensing and simplifying content and by adopting a more attractive multicolored pictorial format.

Inexpensive methods for recruiting subjects to smoking cessation programs

Researchers in the area of smoking cessation have often been plagued with difficulties in securing adequate subject samples. The present investigation assessed the effectiveness of specific publicity techniques (e.g., standard news releases, taped public service announcements, posters, letters to employers) in recruiting subjects. Studies were conducted in a metropolitan area of approximately 250,000 residents and in a university community of approximately 40,000 residents. Results were extremely encouraging, with the greatest impact apparently resulting from new releases, letters to employers, and word of mouth.