CBT for Nicotine Addiction (DP IB Psychology): Revision Note

Cognitive behavioural therapy (CBT) for nicotine addiction

• CBT aims to change the faulty thinking patterns that maintain smoking behaviour and, by extension, nicotine addiction

• If CBT is successful, these faulty thoughts are replaced with more adaptive ways of thinking through functional analysis

  • E.g., the therapist and client identify high-risk situations where smoking is likely

  • The therapist challenges the client's cognitive distortions (e.g., 'I need to smoke' / 'I can’t control my smoking')

  • Clients complete homework (e.g., journaling daily smoking thoughts) to reinforce progress

Coping skills & strategies in CBT

• Nicotine-refusal skills - strategies to resist both the physical temptation and social pressure to smoke

• Cognitive restructuring - examining thought patterns that precede smoking and replacing them with healthier alternatives

• Relapse prevention training – long-term focus on maintaining new thought patterns and giving clients control over addiction.

• CBT also develops general skills (e.g., problem-solving, assertiveness, relaxation) to strengthen relapse prevention

Research support for CBT & nicotine addiction

Thurgood et al. (2015)

Aim:

• To investigate the effectiveness of therapies for nicotine addiction in adult smokers

 Method:

• A literature review of 17 randomised controlled trials on adult smokers

 Results:

• NRT (e.g., patches, gum) reduced cravings over time

• CBT also reduced cravings over time

• CBT and NRT combined was most effective, sustaining reduced cravings longer than either treatment alone

 Conclusion:

• Combining CBT with NRT appears to be the most effective approach to reducing nicotine addiction

Evaluation of cognitive behaviour therapy for nicotine addiction

Strengths

• CBT avoids the ethical issues associated with aversion therapy (e.g., inducing sickness) so people are more willing to continue treatment

• CBT is effective as it addresses causes, not just symptoms, which helps prevent relapse by tackling underlying thought processes, unlike drug therapy which mainly treats symptoms

Limitations

• High drop-out rates for CBT than other forms of therapy, as clients may lose motivation, skip homework or stop attending sessions

  • This makes it difficult to assess effectiveness of CBT in reducing nicotine addiction

• CBT can be delivered face-to-face, online or by phone using a mixture of techniques

  • This variety makes it hard to pinpoint which elements of CBT are most effective in reducing smoking

Link to concepts

Bias

• People from collectivist cultures may not respond as readily to CBT as those from individualistic cultures

  • This is because CBT focuses on the individual and on how they can achieve their own behaviour change, which is at odds with the collectivist attitude that the group looks after and supports the individual

    • Thus, CBT may be culture-biased

Responsibility

• A CBT therapist must be mindful of the possibly fragile nature of clients with addiction

  • This is a socially sensitive issue which may cause embarrassment, shame or feelings of low self-worth in the addicted person

  • Therapists should adhere to the ethical standards of their position and be sure to reduce any stress for their clients during (and beyond) the therapy sessions