Abstract
Relapse to smoking continues to be among the most urgent global health concerns. Novel, accessible, and minimally invasive treatments to aid in smoking cessation are likely to improve the reach and efficacy of smoking cessation treatment. Encouraging prospection by decreasing delay discounting (DD) is a new therapeutic target in the treatment of smoking cessation. Two early-stage interventions, delivered remotely and intended to increase prospection, decrease DD and promote cessation are Episodic Future Thinking (EFT) and Future Thinking Priming (FTP). EFT and FTP have demonstrated at least modest reductions in delay discounting, but understanding whether these interventions are internally valid (i.e., are accomplishing the stated intention) is key. This study examined the internal validity of EFT and FTP. Participants (n = 20) seeking to quit smoking were randomly assigned to active or control conditions of EFT and FTP. Linguistic Inquiry Word Count (LIWC2015) was used to examine the language participants used while engaged in the tasks. Results revealed significant differences in the language participants used in the active and control conditions. Women employed more words than men, but no other demographic differences were found in language. The active conditions for both tasks showed a greater emphasis on future orientation. Risk-avoidance was significantly higher in the active vs. control condition for EFT. Remote delivery of both EFT and FTP was valid and feasible as participants adhered to instructions in the remote prompts, and trends in DD were in the expected directions.
Highlights
Smoking tobacco remains one of the greatest preventable causes of death and disease today [1]
The language used by participants the active conditions for both methods showed greater future orientation assigned than the to the active for conditions, both methods showed greater future orientation than the language usedconditions in the control indicating that both experimental manipulations language used in the control conditions, indicating that both experimental manipulations support prospection
Strengths include the diversity of the sample; the innovative nature of using language as evidence of prospection; analyzing the linguistic content of Episodic Future Thinking (EFT) in 3 ways; and an replicable design focusing on remote delivery. The findings of this small-scale pilot study are encouraging in that participants in this remotely conducted study took the assigned tasks seriously, regardless of active or control assignment; the experimental manipulation was successful; and there was little evidence of a reduction in text quality over time. Both EFT and Future Thinking Priming (FTP) can be remotely delivered, providing a low-cost, high-reach alternative to one-on-one counseling sessions which can be applied in Quitline settings
Summary
Smoking tobacco remains one of the greatest preventable causes of death and disease today [1]. Most cigarette smokers express the desire to stop smoking and over half attempt to quit each year [2]. More than 90% relapse within 12 months [2,3], choosing the immediate satisfaction from smoking over the temporally distant benefits and rewards achieved from not smoking. The conundrum of continued smoking despite the expressed and demonstrated desire to quit continues to be a significant public health challenge. Benefits and rewards lose perceived value the longer we wait to receive them, there is considerable variability in the temporal window within which we make these determinations. The degree to which one discounts or devalues delayed reinforcers is called the delay discounting (DD) rate [4,5,6,7]. DD rates are reliably associated with many aspects
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