Graduation Year

2011

Document Type

Dissertation

Degree

Ph.D.

Degree Granting Department

Psychology

Major Professor

Thomas H. Brandon

Keywords

cessation, cigarettes, coping, smoking, urge

Abstract

Most treatments for substance use disorders (SUDs) are based on a model that craving is a primary cause of relapse, and therefore they emphasize skills for preventing and reducing craving. Acceptance and Commitment Therapy (ACT) provides a theoretical rationale for "acceptance" of drug-related thoughts and cravings, and proscribes suppression, a more intuitive and commonly used coping strategy. However, it remains largely unknown whether various coping strategies differentially affect craving intensity, drug use behavior, or other relevant outcomes during a craving episode. Using a randomized, between-subjects design (acceptance-based coping, suppression-based coping, or no coping instructions/control), the current study compared the effect of acceptance versus suppression of cigarette craving on outcomes including craving intensity, affect, self-control (i.e., stamina on a physically challenging task), and number of thoughts about smoking in the laboratory, and smoking behavior and self-efficacy for cessation during a 3-day follow-up period. Contrary to the hypothesis that acceptance would be superior to suppression, results indicated that both strategies were associated with reduced craving intensity, decreased negative affect, and increased positive affect in the laboratory, and greater self-efficacy for cessation at 3-day follow-up, compared to the control group. There were no significant differences across groups in smoking behavior during the 3-day follow-up. Exploratory moderation analyses that must be interpreted cautiously suggested that the effects of acceptance and suppression on craving and affect may vary according to smoking rate and level of nicotine dependence. Overall, this study provides support for the value of acceptance-based coping strategies, but also suggests that more research is needed to differentiate their benefits compared to suppression-based coping.

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