Robert H. Shipley

Smoking in Vietnam combat veterans with post‐traumatic stress disorder

The present study investigated smoking prevalence, smoking motives, demographic variables and psychological symptoms in 124 help-seeking, male Vietnam combat veterans with post-traumatic stress disorder (PTSD). A high percentage of these veterans smoked (60%). Vietnam veterans with PTSD who smoked were more likely than those who did not smoke to report higher levels of PTSD symptoms, depression and trait anxiety. Increased depression was associated with increased automatic smoking. Smokers reported a high frequency of smoking in response to military memories. Implications for smoking interventions, cessation, and relapse prevention efforts are discussed.

Smoking withdrawal symptoms in response to a trauma-related stressor among vietnam combat veterans with posttraumatic stress disorder☆

This study investigated the relationship between a trauma-related stressor and smoking withdrawal symptoms in 25 male Vietnam combat veterans with posttraumatic stress disorder (PTSD) using a within-subjects design. All subjects were smokers. The stressor involved a modified Stroop task, in which the veterans color-named either anxiety-related or neutral control words. Anxiety-related words produced more withdrawal symptoms than neutral control words, including increased craving, negative affect symptoms, somatic symptoms, and lack of alertness.

Effect of the Johnson & Johnson Live for Life program on employee smoking

Smoking-cessation programs at the worksite hold the potential to reduce the national prevalence of smoking. This article presents the 2-year results of a broad-spectrum smoking-cessation initiative that was part of the comprehensive Johnson & Johnson LIVE FOR LIFE wellness program. In a quasi-experimental design, four companies offered the complete LIVE FOR LIFE program to their employees, and three comparison companies offered only annual health screen assessments. Smoking status was assessed by self-report and serum thiocyanate at baseline and at a 2-year follow-up. At the LIVE FOR LIFE companies, 22.6% of all smokers quit versus 17.4% of smokers at the health screen only companies. The LIVE FOR LIFE program was particularly effective with smokers at high risk for coronary heart disease: 32% of all high-risk smokers quit at the LIVE FOR LIFE companies versus 12.9% at the health screen only companies. These results demonstrate that a company-wide smoking-cessation initiative can produce significant changes in smoking behavior.

Worksite smoking cessation initiatives: Review and recommendations

Offering health lifestyle change assistance in the workplace represents a major challenge for behavioral scientists and behavior therapists in the 1980s. Business and industry are showing special interest in employee smoking cessation. This paper reviews a wide range of worksite smoking cessation activities and related research. Six types of intervention are discussed: educational campaigns; policies restricting workplace smoking; self-help programs; physical examination and physician advice; incentive programs; and actual smoking cessation services. Existing research is critically reviewed. Practical recommendations for improving and systematically evaluating worksite quit smoking initiatives are presented.

PERSONALITY CHARACTERISTICS OF WOMEN SEEKING BREAST AUGMENTATION: Comparison to Small-Busted and Average-Busted Controls

The results of a study, contrasting 28 women seeking cosmetic breast augmentation with 28 small-busted control women and 28 average-busted controls, suggest the average woman desiring surgical breast augmentation is as psychologically stable as other women. She differs from other women only in limited areas--primarily in her negative evaluation of her breasts and her greater emphasis on dress and physical attractiveness.

Clinical trials using ascorbic acid aerosol to aid smoking cessation

Sensory aspects of cigarette smoke are important for providing smoking satisfaction. In previous studies, we have found that substitution of the sensory cues of smoking with a citric acid aerosol significantly reduces craving for cigarettes and enhances smoking reduction and cessation with people trying to quit smoking cigarettes. In the current study, we conducted two clinical smoking cessation trials using an ascorbic acid aerosol as a sensory substitute. The cigarette substitute consisted of a cigarette-sized tube which delivered a fine aerosol of ascorbic acid (approx. 1 mg/puff, up to a maximum of 300 mg/day). Study 1 examined the overall effectiveness of the ascorbic acid smoking substitute device. One group of subjects which used the device and received clinical counseling was compared with another group which received only clinical counseling. The group using the device showed significantly greater abstinence rates at 3 weeks post-cessation. After the subjects stopped using the device, no difference in abstinence was detected. Study 2 was conducted to focus specifically on the role of tracheobronchial sensations in relieving craving for cigarettes. Two closely matched ascorbic acid delivery systems were compared. One device delivered fine particles of ascorbic acid that were targeted to reach the trachea, while the other delivered coarser particles of ascorbic acid that were not expected to reach the trachea or lower airways. An initial enhancement in smoking reduction was found for subjects using the fine particle device relative to those using the coarse particle device. However, by the end of treatment (5 weeks) both groups showed similar degrees of smoking reduction. For those who were abstinent from smoking at the end of treatment, craving for cigarettes and negative mood were both significantly lower for those using the fine particle device. Also, hunger for food was significantly lower in the fine particle device group. These results suggest that ascorbic acid delivered from a cigarette substitute may be effective in reducing smoking and promoting smoking abstinence.

A stage analysis of self-initiated smoking reductions

Most smoking cessation treatments are predicated on the assumption that the course of smoking reduction is psychologically homogeneous. The present study tested an alternative model incorporating three distinct stages: initial decision, initial control, and maintenance. Three measures (perceived health locus of control, desire to stop, and self-esteem) were used to predict self-initiated smoking reduction in 61 regular smokers. Criterion smoking change measures (one for each stage) were obtained at follow-up. Multiple regression analyses of the criteria showed a different set of predictors were significant for each: desire to stop predicted the decision to reduce smoking, self-esteem predicted initial smoking reduction, and the combination of internal health locus of control beliefs and strong desire to stop predicted successful maintenance of reduction. The differential success across criteria of the predictors shows the value of the stage analysis and suggests the development of smoking treatments varying by stage.

Flooding and implosive therapy: Are they harmful?

A mail survey was conducted to investigate in a preliminary way the widespread belief that implosive therapy and flooding may have “serious negative side effects”. The survey, returned by 83% of those polled, included 70 practitioners of these procedures representing 3,493 clients. Of the latter, two (.06%) clients with no known history of psychosis were reported to have experienced “acute psychotic reactions” during treatment. Two known psychotics were also reported to have had similar reactions. “Brief panic reactions” were reported to have occurred in another 0.14% of the sample. No other serious negative side effects were reported. Eighty-seven percent of the therapists judged implosive therapy and flooding to produce the same, or fewer, side effects as compared to other forms of therapy that they had used. It was concluded that implosive therapy and flooding are relatively “safe” procedures.

Behavioral approaches to smoking cessation—II. Topical bibliography 1969–1979☆

This topical bibliography covers that past decade of research into behavioral approaches to smoking cessation. Using multiple sources, including Psychological Abstracts, 335 reference were compiled from over 50 psychology, medicine, and related behavioral science journals. All references were comprehensively coded for each of 28 topical area of interest to behavioral researchers and clinicians. Topics include specific behavioral smoking cessation techniques (e.g. aversive smoking, relaxation techniques, stimulus control), treatment problems (e.g. maintenance problems and procedures, physiological correlates of smoking behavior, therapist and treatment factors influencing outcome). An index defining each topical and listing by number all articles related to each topic is included with the bibliography (Tables 1 and 2). With this index, users with specialized interests can quickly locate all citations concerning a particular topic or combination of topics. The preceding article (Orleans et al., 1981) gives guidelines for expanding this bibliography for personal reference use.

Effect of a pregroup collective project on the cohesiveness of inpatient therapy groups.

An attempt was made to increase the cohesion of inpatient therapy groups by having the group members work collectively on a creative art project immediately prior to their second therapy session. Ten short-term inpatient psychotherapy groups, having 6 to 8 members each, were randomly assigned either to this collective project or to an individual project on which group members worked individually on a similar art project. In the therapy session which followed, groups on the collective project showed a significant decrease in physical distance between group members relative to a baseline therapy session and relative to groups on the individual project. Groups on the collective project also scored significantly higher on a cohesion questionnaire than those in the individual project. The questionnaire and intermember-distance measures of group cohesion correlated highly (0.72). Intermember distance returned to baseline during a follow-up therapy session. No differences in the frequency of three types of verbal behavior were found during therapy. Collective art projects may be used to increase cohesion in short-term groups. Further exploration of intermember distance as a measure of group cohesion was suggested.