Self-Control and Adult Cigarette Smokers
Phase: NA
Conditions: Smoking
Sponsor: Yeshiva University

 
 
PI: Weinberger  - IRB # 2015-5479  
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IRB Protocol # 2015-5479 
 
Date: 3.05.19 
 
Title of Research Project:  Self-Control and Adult Cigarette Smokers 
 
Principal Investigator:  Andrea H. Weinberger, Ph.D. 
Assistant Professor, Ferkauf Graduate School of Psychology, Yeshiva University 
Mailing Address: 1165 Morris Park Ave, Room # 132; Bronx, NY 10461 
Phone: (718) 430-3946; Fax: (718) 430-3960 
Email: andrea.weinberger@einstein.yu.edu 
 
Study Personnel:  
Hannah Esan; Ferkauf Graduate School of Psychology, Yeshiva University 
Rachel Kashan; Ferkauf Graduate School of Psychology, Yeshiva University 
Michelle Ferrer, Ferkauf Graduate School of Psychology, Yeshiva University 
David Estey, Ferkauf Graduate School of Psychology, Yeshiva University 
Kate Segal, Ferkauf Graduate School of Psychology, Yeshiva University 
Jennifer Birchwale, Ferkauf Graduate School of Psychology, Yeshiva University 
Ester Yadgaran, Ferkauf Graduate School of Psychology, Yeshiva University 
Lisa Cruz, Ferkauf Graduate School of Psychology, Yeshiva University 
Joun Lee, Ferkauf Graduate School of Psychology, Yeshiva University 
Natacha Gordon, Ferkauf Graduate School of Psychology, Yeshiva University 
Joseph Friedman, Ferkauf Graduate School of Psychology, Yeshiva University 
Silvana Agterberg, Ferkauf Graduate School of Psychology, Yeshiva University 
Jung-Yun Min, Ferkauf Graduate School of Psychology, Yeshiva University  
Jacob Levin, Ferkauf Graduate School of Psychology, Yeshiva University 
 
BACKGROUND/SIGNIFICANCE 
 
Cigarette smoking is the single largest preventable cause of morbidity and mortality in Western 
countries [1]. The majority of smokers want to quit, but are unable to succeed at long term 
abstinence [2, 3]. The pharmacological and behavioral treatments with the best clinical outcomes 
still leave more than two-thirds of smokers unsuccessful at abstinence[3]. Further, while recent 
advances have been made in pharmacological treatments [4], few behavioral smoking treatments 
have been introduced [5, 6].  
 
Self-control is “the capacity for altering one’s own responses…to support the pursuit of long-
term goals” [7] (p. 351). Self-control requires deliberate and conscious personal effort [7]. As 
both a trait (individual differences in personality) and state (which represents situational 
fluctuations), self-control plays an important role in self-regulation activities [8-12]. Self-control 
is a promising but underexplored area for behavioral treatment development. 
 
Self-control is a key mechanistic factor in addictive behaviors, including the inability to stop 
using nicotine and other addictive substances [13-15]. Self-control is a limited resource that 
becomes depleted when used. This depletion impairs the continued use of self-control [7, 11, 16]. 

 
 
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For example, the depletion of self-control makes it more difficult for one to resist smoking 
cigarettes [17], eating sweets [18], and consuming alcohol [19]. Extremely high and enduring 
levels of self-control are required to resist smoking during a quit attempt in the face of intense 
withdrawal symptoms, environmental and emotional triggers, and the desire to smoke [2, 15]. 
The majority of smokers are unable to maintain self-control and relapse to smoking within days 
of the quit attempt [2]. The inability to maintain a high and constant level of self-control plays a 
critical role in smoking cessation failure. 
 
While self-control becomes weakened through use, it can be strengthened through practice. 
Given that impaired self-control has a detrimental effect on smoking cessation outcomes, 
increasing self-control through practice may help smokers resist smoking, thereby improving 
cessation outcomes [13, 14, 17]. Different tasks that demand self-control appear to share a 
common resource [16] suggesting that improving self-control related to one behavior can have a 
positive impact on self-control related to another behavior. In fact, a body of research has shown 
that paradigms involving the daily practice of general self-control tasks (e.g., avoiding sweets, 
using the non-dominant hand) improves both state and trait self-control [7, 12, 20-23]. Self-
control is crucial in the success of smoking cessation efforts and can be strengthened with 
practice; however, self-control remains an understudied area in the field of smoking.  
 
Only one study has used the self-control paradigm described above to test the impact of 
strengthening self-control on smoking behavior. Muraven [24] randomly assigned 122 smokers 
to practice either a general self-control task (Avoiding Sweets, Hand-Grip) or a control task 
(keeping a diary of sweets, math problems) daily for 2 weeks prior to a smoking quit attempt. 
Participants who practiced general self-control tasks, compared to control tasks, had a greater 
mean number of days before relapsing to smoking (Self-Control Tasks, Ms=12.10 and 12.32; 
Control Tasks, Ms=7.43 and 6.90; p<0.05) and were more likely to be abstinent from smoking at 
the end of one month (Self-Control Tasks, 27%; Control Tasks, 12%, p<0.05). While it can be 
hypothesized that self-control improvement led to a decreased likelihood of smoking lapse, 
Muraven [24] did not assess changes in self-control over the practice period. Further, general 
self-control tasks (e.g., instructing smokers to avoid sweets) were used rather than one focused 
on smoking (e.g., instructing smokers to avoid smoking). A self-control task that is specific to 
smoking could yield stronger outcomes than a self-control task not related to smoking due to the 
match between the target of the self-control practice and the target behavior. The self-control 
procedure holds promise for cessation efforts; however, a self-control task focused on smoking 
has yet to be tested to determine its impact on smoking behavior. 
 
The purpose of this pilot study is to examine a smoking-related self-control task and smoking 
behavior in adult smokers who are not motivated to quit smoking. Information from this study 
will be used to design a larger trial to examine the impact of self-control task practice on 
smoking quit outcomes in treatment-seeking smokers (smoking reduction, smoking cessation). 
 
STUDY DESIGN 
 
This pilot study will have a between-subjects design. All participants will be asked to complete 
two study appointments. First, they will complete a baseline appointment where they will review 
consent procedures. Participants who complete the consent forms will then be asked to fill out 

 
 
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measures of demographics, smoking, and self-control. Smoking will be confirmed using expired 
breath carbon monoxide (CO) levels taken using a CO monitor. At that appointment participants 
will be randomly assigned to complete one of two self-control tasks: a task that is related to 
smoking (e.g., giving instructions to delay smoking when they have a craving) or a task that is 
not related to smoking (e.g., participants will be instructed to try to maintain the best posture 
possible (e.g., sit up straight, walk with good posture) as much as possible throughout each day 
[20]). Random assignment will be done using a random number generator and 50% of 
participants will be assigned to the smoking task while the other 50% will be assigned to the 
non-smoking task. Study staff will received standardized instructions to read to each participant 
about the task that they are assigned to practice during the week. Participants will be asked to 
practice their assigned self-control task every day for a week and to complete a brief series of 
questions about the effort and time spent practicing the task that day along with the number of 
cigarettes they smoked that day. After one week, participants will return for the second study 
appointment where they will report on their effort and time spent practicing the self-control tasks 
and complete additional measures of smoking and self-control. Study staff will be asked to 
complete a checklist to be sure that all parts of the two study appointments have been completed. 
 
Measures 
 
Independent Variables 
 
Demographics, mood, and individual difference variables. Participants will be asked to report 
demographics including age, gender, race, ethnicity, sexual orientation, and education as well as 
past-week mood. In addition, past-three month racial and ethnic discrimination will be assessed 
using the 17-item Perceived Ethnic Discrimination Questionnaire (PEDQ; [25]). 
 
Current Smoking Behavior. Questions related to smoking behavior will include age of smoking 
onset, frequency and quantity of cigarette smoking, use of non-cigarette tobacco products, 
nicotine dependence (Fagerström Test for Nicotine Dependence, FTND, [26]), and motivation to 
quit smoking (Thoughts About Abstinence Scale, TAAS, [27]). Beliefs about quitting smoking 
will be assessed using the Perceived Risks and Benefits Questionnaire [28]. 
 
Self-Control. Aspects of self-control will be measured using the Self-Control Scale [9], the 
Delaying Gratification Scale [29], the Barrett Impulsiveness Scale, and the Distress Tolerance 
Scale. The hand-grip will be used as a behavioral measure of self-control (see below for more 
details). 
 
Dependent Variables 
 
The first dependent variable for this study will be the change in self-control from the first study 
appointment to the second appointment. Change in self-control will be primarily measured 
behaviorally using the hand-grip procedure. The hand-grip is a measure of self-control rather 
than one of bodily strength (e.g., [30]) and the most commonly used dependent measure in self-
control research [11]. Following the procedure used in other self-control studies (e.g., [20, 31]), 
participants will be instructed to squeeze a hand-grip exerciser as long as possible and research 
staff will use a stopwatch to time the length of time that the hand-grip is squeezed. A wad of 

 
 
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paper will be inserted between the handles of the hand-grip and timing will stop when the paper 
falls from the hand-grip indicating that the participant has released the hand-grip. The hand-grip 
will be held before and after a thought suppression exercise that is meant to diminish self-control 
in order to control for individual hand strength (see [20]). Self-control will be measured as the 
difference in the length of time holding the hand-grip before and after the thought suppression 
exercise. Change in self-control due to task practice will be measured as [self-control at the 
second study appointment] minus [self-control at the first study appointment]. Secondary 
measures of self-control change will be calculated using self-report questions of self-control 
ability. 
 
The second dependent variable will be the change in cigarettes smoked per day from the first 
study appointment to the second study appointment. Average number of cigarettes smoked per 
day will be assessed by self-report at each of the study appointments using a standard timeline 
followback procedure [32, 33]. 
 
Additional Measures 
 
Research staff will be asked to complete a checklist to ensure that all parts of the study 
appointments have been completed. 
 
STUDY POPULATION 
 
Participants in this study will be 150 adults who are current cigarette smokers. Data from 
Muraven (1999) in a general population of smokers suggested a medium effect size (d=0.59) for 
practicing self-control tasks and large effects (d range: 2.2-3.4) for the impact of practicing self-
control tasks on smoking behavior. Using G*Power, it was calculated that recruiting 80 
participants (40 who practice a smoking-related task and 40 who practice a non-smoking-related 
task) will provide more than 80% power to detect a medium effect size difference between the 
task conditions. 
 
Inclusion Criteria: To be eligible, participants must: 
1. Be adults who are 18 years of age or older 
2. Currently smoke ≥10 cigarettes per day biochemically confirmed by an expired breath carbon 
monoxide (CO) level ≥8 
3. Report that they are not currently attempting to quit smoking and not currently receiving 
smoking cessation treatment (e.g., counseling, nicotine replacement therapy, bupropion, 
varenicline) 
4. Have the capacity to give informed consent 
5. Be English- or Spanish-speaking. 
 
Children under the age of 18, non-English or non-Spanish speakers, and those who do not have 
the capacity to consent will be excluded from this study.  
 
Research material will only consist of self-report survey responses. No other materials (e.g., 
blood, tissue) will be collected. 
 

 
 
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PARTICIPANT RECRUITMENT 
 
Potential participants will be recruited from the community using advertisements on multiple 
media including Craigslist, flyers, radio, newspaper, and television. The advertisement will 
include the phone number of the PI’s research laboratory. Research staff will talk to potential 
participants by phone to assess initial inclusion criteria (e.g., confirm that they are older than 18, 
confirm that they currently smoke cigarettes), give a brief description of the study (e.g., that it 
will consist of two in-person appointments during which they will be asked to fill out 
questionnaires and to complete practice tasks at home between the appointments), answer 
questions, and schedule the in-person baseline appointment. Potential participants will have the 
chance to ask the research staff as many questions as they want and will have as much time as 
they want to decide if they would like to participate in the study. Participants will also be able to 
decline to participate in the study, to end their participation at any time, and to decline answering 
any specific questions on the survey. Participants who speak and read English will complete the 
study materials in English. Participants who speak and read Spanish will complete the study 
materials in Spanish and work with a member of the research staff who speaks Spanish. 
 
INFORMED CONSENT 
 
The Albert Einstein College of Medicine at Yeshiva University Documentation of Informed 
Consent and HIPAA Authorization will be used to obtain consent to participate in the research 
study. At the beginning of the first study appointment, potential participants will be consented in 
the PI’s research laboratory with a member of the research staff. The staff member will read the 
consent form aloud with the participant. The participant will be encouraged to stop the staff 
member and ask questions along the way.  In addition, the staff member will describe anything 
that seems unclear in more detail.  After reading the consent form, the participant will be asked 
again if he/she has any questions.  Any questions will be answered.  Then the participant will be 
asked by the staff member whether he/she wishes to participate in the study.  This procedure will 
enhance independent decision-making by never assuming the participant automatically wants to 
participate after reading the consent form.  
 
 RISK/BENEFIT 
 
There are minimal risks associated with the study procedures which include attending two study 
appointments, completing questionnaires, and completing the hand-grip self-control assessment. 
There are also minimal risks associated with practicing the self-control tasks at home between 
the study appointments. Some of the survey questions (e.g., smoking, desire to quit smoking, 
mood) may cause stress. The research staff will be able to contact the Principal Investigator, a 
clinical psychologist who is licensed by the state of New York (License # 020388), by cell phone 
at any time that they are meeting with participants for the study with questions and/or concerns. 
Participants who report that they are interested in quitting smoking will receive information 
about quit smoking resources such as the phone number for the New York Smokers Quitline (1-
866-NYQUITS; 1-866-697-8487). 
 
Participants will receive $20 as payment for completing the first study appointment either in cash 
or gift cards (e.g., Amazon) and $40 for completing the second study appointment either in cash 

 
 
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or gift cards (e.g., Amazon). The money for participant payments will come from the Principle 
Investigator’s research funds through the Ferkauf Graduate School of Psychology. 
 
DATA ANALYSIS 
 
Differences in demographics, smoking behavior, mood, and self-control (assessed at the first 
study appointment) will be compared by practice task condition (smoking-related versus non-
smoking-related). Variables that differ significantly between the two groups will be considered 
as covariates for all analyses. 
 
Changes in self-control will be calculated by (1) the difference in the hand-grip procedure (in 
seconds) from the first study appointment to the second study appointment and (2) the difference 
in scores on the self-report questionnaires from the first study appointment to the second study 
appointment. Differences in self-control changes will be compared by practice task condition 
(smoking-related versus non-smoking-related).  
 
Changes in the number of cigarettes smoked per day will be calculated by the difference in the 
average number of cigarettes smoked per day over the previous week as assessed at the first 
study appointment and the average number of cigarettes smoked per day over the previous week 
as assessed at the second study appointment. Differences in smoking changes will be compared 
by practice task condition (smoking-related versus non-smoking-related). 
 
DATA QUALITY CONTROL AND DATABASE MANAGEMENT  
 
Participants will be identified using participant numbers on all research materials. The Principal 
Investigator will maintain a master list with the participants’ names and contact information. 
This data will be kept in a locked file cabinet in the Principal Investigator’s office and will not be 
linked with any research material (which will be kept in binders labeled only with participant ID 
numbers in the research laboratory). The data obtained from this study may be published, but 
will not identify any participants by name.  After surveys have been completed, data will be 
entered into data analysis programs (e.g., Excel, SPSS). Data will be cleaned by the PI and the 
research staff by checking for missing data and outliers.  Data will be stored on password-
protected computers. After the study is complete, the research data will be retained in 
compliance with state and national requirements. Data will continue to be protected by storage in 
locked file cabinets and password-protected computers (for entered data). Identifiable data will 
not be linked to or stored with non-identifiable research data. 
 
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