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Types of intervention and their effectivenessBiologicalSmokingDescription of Nicotine Replacement Therapy (NRT)
NICOTINE REPLACEMENT THERAPY (NRT) is an agonist substitute. Nicotine is addictive, but much less damaging to the body than the other components of cigarettes (such as tars). One strategy for reducing smoking is therefore to replace the nicotine obtained through smoking with a safer nicotine source. Nicotine replacement therapy is available in a number of forms including patches, gum, nasal spray and inhalers.
Types of intervention and their effectivenessBiologicalSmokingEffectiveness research of NRT
SELBY (2012) found that a 21.4% who called a helpline to receive a free 5 week course of NRT were still non-smokers after six months, compared to 11.6% of the control group. (+) large sample – 14000(-) high drop out rate – only 2600 completed all follow up materials(-) Canadian study so may not be generalisable(+) but studies in other countries have found similar success rates with NRT(-) only follows up for 6 months so doesn’t monitor long term effectiveness
Types of intervention and their effectivenessBiologicalSmokingEvaluative Comments of NRT
(-) Side effects – common side effects of NRT include disturbed sleep, dizziness and headaches.(+) Availability – can be bought over the counter or on prescription from the smoker’s GP. (-) May not be effective in long term – 1/3 of smokers relapse after a period of abstinence. No difference in relapse rates amongst those who used NRT. (-) The individual may become dependent on the NRT(+) However, the risk of dependence on NRT is small, and only a small minority of patients (about 5%) who quit successfully continue to use NRT regularly in the longer term. (-) Doesn’t address the CAUSE of addiction – People may smoke to relieve life stress. NRT does not treat this, so relapse may be more likely than with psychological therapies.(+) Can be combined with psychological therapies – such as cognitive behavioural therapy to improve long term effectiveness.
Types of intervention and their effectivenessPsychologicalSmokingDescription of Aversion Therapy
AVERSION THERAPY is based on the principles of classical conditioning. It creates a negative association with the addictive behaviour. This may be achieved by administering drugs which cause nausea when the substance (e.g. alcohol) is consumed or by means of painful (but relatively mild) electric shocks when the behaviour is carried out.
Types of intervention and their effectivenessPsychologicalSmokingEffectiveness Research of Aversion Therapy
SMITH (1988) gave 327 smokers a five day course of treatment involving aversion therapy and therapy sessions. The participants self-administered shocks though a wristband when taking part in smoking behaviour, such as opening a pack of cigarettes or placing one in the mouth. They were asked not to inhale any of the smoke so that there were no positive associations with the behaviour. A telephone interview checked on progress 13 months later. 52% had abstained from smoking for 12 months. (-) self-report method – prone to social desirability bias, although this may have been reduced because it was a telephone interview rather than face to face(-) difficult to separate the effects of the therapy and the aversion therapy – may have been that the combination of the two was most effective
Types of intervention and their effectivenessPsychologicalSmokingEvaluative Comments of Aversion Therapy
(-) Ethical issues – the patient is being subjected to a unpleasant substance or shock – psychological harm?(+) Client perceptions – drop-out rates are low; many addicts report they find aversion therapy less unpleasant than psychological ‘talking’ therapies. (-) Relapse rates are high – aversive link weakens over time, meaning that the patient may relapse. (-) Other factors – Smith (1988) found that relapse was much more likely when reformed smokers returned to a household where others smoked. This suggests that learning and environmental factors are also important considerations in the success of interventions for addiction.
Types of intervention and their effectivenessPublic HealthSmokingDescription of Legislation
LEGISLATION such as ‘Smoking in public places’ was banned in the UK in July 2007. Although the primary objective of this legislation was to protect workers and the general public from the harmful effects of second-hand smoke, evidence suggests that smokers have also found that the law has created a more supportive environment for them to quit smoking.
Types of intervention and their effectivenessPublic HealthSmokingEffectiveness Research of Legislation
Information Centre for Health & Social Care statistics show that nearly a quarter of million people quit smoking with the help of local NHS Stop Smoking Services between April and December 2007. (-) Social desirability bias – participants may not want to admit to their smoking behaviours as they are not generally socially acceptable traits.
Types of intervention and their effectivenessPublic HealthSmokingEvaluative Comments of Legislation
(-) Rebound effect - West (2009) found that there was a decline in the percentage of people smoking in the UK following the ban on smoking, but attempts to stop smoking were actually greater in the nine months before the ban.(-) Organisations have found ways around the smoking ban, such as creating areas outside of pubs for people to smoke. (-) Not really helping the indivdiual quit; just making it more difficult to smoke.
Types of intervention and their effectivenessBiologicalGamblingDescription of Naltrexone
NALTREXONE is an opium antagonist – meaning that it blocks the action of endorphins in the brain, thus reducing the rush of pleasure felt by the addict when they indulge in the addictive behaviour. The drug has been used for some time to treat chemical addictions such as alcoholism, but is now also being used to treat behavioural addictions such as gambling. Grant and Kim (2006) suggest that gamblers experience a rush of excitement akin to that of heroin users.
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