Can targeting automatic approach tendencies really improve long-term smoking cessation outcomes?

What is it about?

Quitting smoking is very difficult. Even with professional support, many people relapse within months. Researchers are therefore looking for new interventions to improve smoking cessation treatments. One idea is to focus on so-called “automatic processes.” These are processes that happen very quickly, are difficult to control, and often take place without us even noticing them. In people who smoke, one such automatic reaction is a tendency to approach smoking-related cues. For example, seeing a cigarette pack, a lighter, or someone else smoking can trigger an almost automatic approach toward cigarettes. This reaction is thought to happen fast and largely outside conscious awareness, which can make it harder to resist the urge to smoke. In this study, we tested whether a computer-based training designed to reduce this automatic approach tendency, improves long-term abstinence as an add-on to cognitive-behavioral smoking cessation. The training uses a simple joystick task in which people repeatedly push away smoking-related images and pull closer positive, non-smoking images. The goal is to reduce automatic approach tendencies and make smoking cues less tempting. This approach has shown promising results in people with alcohol use disorder, but its benefits for smoking were unclear. The results of our study showed that the new computer training did not improve quit rates compared to the standard smoking cessation program alone.

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Photo by John Cardamone on Unsplash

Photo by John Cardamone on Unsplash

Why is it important?

Smoking is one of the leading causes of preventable death and is associated with serious health consequences. Yet, despite these risks, long-term success rates of current smoking cessation treatments remain relatively low. This creates an urgent need to improve existing treatment approaches. In our study, we tested an innovative and easily accessible computer-based training aimed at changing automatic approach tendencies to smoking cues. However, we did not find evidence that it improved long-term quit rates when added to standard smoking cessation treatment. These findings suggest that methods effective in other substance use disorders, such as alcohol dependence, cannot automatically be transferred to smoking. Future research should further investigate which psychological processes maintain smoking and how treatments can be better tailored to individual needs.

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