The Effect of AAT Training in Smokers

Study Overview
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Brief Summary
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The purpose of this research study is to investigate the effect of a brief computer task (Approach Avoidance Task) on smoking cessation. The investigators will use a novel training protocol that works to target automatic thoughts and tendencies that occur outside of conscious control. Previous research suggests that these automatic tendencies may have a direct effect on certain health behaviors- like continuing to smoke despite having previous quit attempts. The investigators hypothesize that individuals in the AAT training condition will evidence a greater decrease in reaction times to avoid smoking-related stimuli & approach positive stimuli relative to those in the control condition. The investigators also expect that individuals in the AAT condition will exhibit superior outcomes on several quit-related variables as evidenced by an increase in motivation to quit smoking, an increase in number of days abstinent following a self-guided quit attempt, an increase in self-efficacy, and a decrease in urge to smoke compared to those in the SHAM training condition.

Official Title
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The Effect of AAT Training in Smokers

Conditions
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Tobacco Use

Intervention / Treatment
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* Other: Approach Avoidance Training
* Other: SHAM Training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Male and female patients ages 18-65 capable of providing informed consent Willing and able to provide informed consent, attend all study visits, and comply with the protocol Daily smoker for at least 6 months Currently smoke an average of at least 8 cigarettes per day Report a motivation to quit smoking of at least 5 on a 10-point scale Interest in making a serious quit attempt within the next month (without professional assistance or nicotine therapy) Have not decreased their number of cigarettes by more than half in the last six months Exclusion Criteria: Visual or hand-motoric impairments Current use of nicotine replacement therapy Current use of tobacco products other than cigarettes Insufficient command of the English language

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: AAT Training Group<br>Individuals in this condition will receive four sessions of AAT training in which they are instructed to approach (pull the joystick) images tilted to the right and avoid (push the joystick) images tilted to the left. They will be told that the training may weaken automatic cigarette-approach and strengthen automatic cigarette-avoidance. Furthermore, they will be told that the opposite effect will be true for the stimuli not related to cigarettes (i.e., the positive stimuli). | Other: Approach Avoidance Training<br>* The Approach Avoidance Task (AAT) used for this experiment is an implicit, computerized paradigm in which participants respond to visually presented pictures on a computer screen displaying either 1) smoking-related images or 2) positive images, by pulling a joystick either towards their body (approach movement) or pushing it away from their body (avoidance movement). By pulling the joystick towards their body, the picture grows in size; by pushing the joystick away, the picture shrinks and then disappears from the screen. Participants are instructed to pull upon seeing an image tilted to the right and to push upon seeing a left-tilt image, while ignoring the image content and responding as quickly and as accurately as possible.<br>|
| Sham Comparator: SHAM Training Group<br>Individuals in this condition will receive four sessions of SHAM training in which they are instructed to approach (pull the joystick) images tilted to the right and avoid (push the joystick) images tilted to the left. They will be told that the purpose of the training is to improve control over these automatic tendencies and that following the training sessions, they will easily be able to push or pull the stimuli regardless of content. | Other: SHAM Training<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Reaction Time on Approach Avoidance Task | The time between the start of the trial and the picture disappearing from the screen will be recorded. The investigators will look at the change in response times for each individual. The investigators hypothesize that there will be a greater decrease in reaction time for those in the AAT training group. | 2 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Motivation to Quit Smoking as assessed by having participants rate their motivation to quit smoking on a scale of 1 to 10 (1 being not motivated at all and 10 being extremely motivated to quit). | The investigators expect that individuals in the AAT training condition will have a greater motivation to quit smoking relative to those in the SHAM condition. | 2 weeks | 
| Number of Days Abstinent as assessed by daily cigarette count during a self-guided quit attempt. | The investigators hypothesize that individuals in the AAT training condition will be more likely to have a greater number of days abstinent following Quit Day relative to those in the SHAM condition. | 2 weeks | 
| Self Efficacy as assessed by the Relapse Situation Self-Efficacy questionnaire. | The investigators expect to see a greater increase in self-efficacy for the AAT training group relative to the SHAM training group. | 2 weeks | 
| Urge to Smoke as assessed by the QSU-brief (Questionnaire of Smoking Urges). | The investigators hypothesize that individuals in the AAT training condition will evidence a greater decrease in urge to smoke relative to those in the SHAM condition. | 2 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Tobacco Use, Nicotine Dependence