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G.J. HYMAN et al.
cessation research is the problem of the measurement of smoking behaviour. A number
of excellent reviews of measurement in smoking research have appeared (Epstein &
McCoy, 1975; Frederikson, Martin, & Webster, 1979; Jeffrey, 1975) and, therefore, a
general discussion of this area will not be included here. A number of points however,
need to be made in evaluating smoking modification programmes.
The criteria adopted for measuring smoking vary from study to study. They may be
classified simplistically into subjective and objective measures. The most frequently
used subjective measure is that of the self-report of smoking and the simplest form of
self-report is the questionnaire method. With this technique, the smoker is simply
asked to estimate the number of cigarettes they are typically smoking per day. This
method has the advantage of being an easy, efficient procedure; however, it does rely
on the subject’s memory and is open to either accidental or deliberate distortion (Fred-
erikson et al., 1979).
The second self-report measure is referred to as self-monitoring and involves the sub-
ject recording their own smoking habits at the time of each cigarette. The advantages
of self-monitoring include its flexibility and potential accuracy. On the other hand,
such a technique may be burdensome for the subject who may as a result simply fail to
record accurately.
A number of different objective measures of smoking behaviour have been devel-
oped. These include the use of carbon monoxide levels in expired air, carboxyhaemo-
globin in the blood, nicotine levels in the blood, saliva and urine, and thiocyanate in
the blood, saliva and urine. The objective measures are potentially the most accurate
measures of smoking behaviour. One of the limiting factors in the use of these measures
is the lack of experimental studies demonstrating their relationship to self-monitored or
observed smoking rates. Whilst studies are beginning to appear, no assumption can yet
be made that these measures all reliably measure smoking behaviour.
In summary, it may be that no effective treatment of smoking behaviour has emerged,
due to uncontrolled variables and inaccurate measures. Therefore, the aim of the present
study was to compare, with appropriate controls, a number of smoking cessation treat-
ments. Specifically, this study compared treatment groups, attention placebo and no-
treatment groups to assess the contribution of active treatment effects in smoking cessa-
tion. The second purpose was to compare the methods of assessing smoking behaviour.
METHOD
Subjects
The subjects who participated were drawn from two sources. Half of the 60 people
were referred through a public hospital, whilst the other half responded to an adver-
tisement placed in a daily newspaper. Ail interested subjects were sent an information
letter explaining the general nature of the study, the different available treatment ap-
proaches and the requirement of a $50 deposit, refundable upon completion of the pro-
gramme. The refund was not contingent on successful smoking cessation. Of the 97
persons who were sent this information, 64 indicated their wish to enter into the pro-
gramme. Four of the subjects did not wish to continue in the study after the first inter-
view. The sample therefore consisted of 17 males and 43 females with a mean age of
34.9 years (SD = 9.93). They reported that they smoked an average of 29.9 cigarettes a
day (SD = 11.40). Trying to quit was not new to the majority; only a relatively small
number (13%) having made no prior attempt to stop smoking. This finding is com-
patible with other studies (Kuetzer, 1968).