1. The efficacy of music as an aidThe efficacy of music as an aid
to smoking cessationto smoking cessation
TR 310 Field Study 2007TR 310 Field Study 2007
Shaun CavanaghShaun Cavanagh
Southern Institute of TechnologySouthern Institute of Technology
Bachelor of Health ScienceBachelor of Health Science
(Therapeutic Recreation)(Therapeutic Recreation)

2. IntroductionIntroduction
 Welcome!Welcome!
 Thanks for the opportunity to rely on agency resourcesThanks for the opportunity to rely on agency resources
to complete requirements of the paper.to complete requirements of the paper.
 Disclosure..Disclosure..
 Purpose of presentation:Purpose of presentation:
Year 3 SIT Recreation Therapy (or ‘TR’) students onYear 3 SIT Recreation Therapy (or ‘TR’) students on
placement are required to summarise details of researchplacement are required to summarise details of research
conducted as part of the TR 310 Field Study paper…conducted as part of the TR 310 Field Study paper…

3. Presentation PreviewPresentation Preview
 IntroductionIntroduction
 Acknowledge people presentAcknowledge people present
 ““Hi there”Hi there”
 Purpose of presentation/PreviewPurpose of presentation/Preview
 ContentContent (We are here)(We are here)
 Purpose of research/hypothesisPurpose of research/hypothesis
 Rationale for studyRationale for study
 Goals/objectivesGoals/objectives
 MethodsMethods
 Benefits to Public Health South/Cessation providersBenefits to Public Health South/Cessation providers
 LimitationsLimitations
 Recommendations/Future Directions/Now what?Recommendations/Future Directions/Now what?
 Other relevant informationOther relevant information
 ConclusionConclusion
 (Review; Questions)(Review; Questions) (Excerpt: British Invasion)(Excerpt: British Invasion)

4. Purpose ofPurpose of research/hypothesisresearch/hypothesis
• What role can music ‘play’ in assisting heavily addictedWhat role can music ‘play’ in assisting heavily addicted
smokers to quit, or move through the stages ofsmokers to quit, or move through the stages of
readiness to quit?readiness to quit?
• The efficacy may extend to preventing relapse, andThe efficacy may extend to preventing relapse, and
enhancing compliance following a quit attempt.enhancing compliance following a quit attempt.
• If music caused no internal response perceived as beneficial, people wouldn’t listen to it. AsIf music caused no internal response perceived as beneficial, people wouldn’t listen to it. As
for tobacco, without a perceived benefit, there would be no consumption. If the perceivedfor tobacco, without a perceived benefit, there would be no consumption. If the perceived
benefits of music transcend tobacco, then over time, people may come to depend on what isbenefits of music transcend tobacco, then over time, people may come to depend on what is
healthy rather than what is harmfulhealthy rather than what is harmful (Reflection, 8/3/07)(Reflection, 8/3/07)

5. StudyStudy rationalerationale
 Music and substances – postulated similaritiesMusic and substances – postulated similarities
(‘Substance’ and ‘Substantial’)(‘Substance’ and ‘Substantial’)
- originate outside the ‘consumer’- originate outside the ‘consumer’
- produce an internal response- produce an internal response
- effects ‘collected’ over time- effects ‘collected’ over time
- comparison with exercise physiology “FITT”- comparison with exercise physiology “FITT”
- stimulate cognition- stimulate cognition
- provide feelings of pleasure/security- provide feelings of pleasure/security
- sense experience/role of nervous system- sense experience/role of nervous system
- preference relates to stage of development..- preference relates to stage of development..

6. Re: StudyRe: Study rationalerationale
Lev Vygotsky, Developmentalist (1896-1934)Lev Vygotsky, Developmentalist (1896-1934)
 Like tool systems, sign systems (language, writing, number systems)
are created by societies over the course of human history and change
with the form of society and the level of it’s cultural development…
the internalisation of culturally produced sign systems brings about
behavioural transformations and forms the bridge between early and
later forms of human development
(Cole and Scribner,(Cole and Scribner, Mind in SocietyMind in Society,, 1978, p. 6)1978, p. 6)
• Music cannot be neutral in its effects.Music cannot be neutral in its effects.

7. Goals/ObjectivesGoals/Objectives
• To discover the efficacy of music in smoking cessationTo discover the efficacy of music in smoking cessation
• To discover a potentially healthier alternative to smokingTo discover a potentially healthier alternative to smoking
• To follow ethical proceduresTo follow ethical procedures
• To respect applicable Treaty principlesTo respect applicable Treaty principles
• To serve as a basis for further studyTo serve as a basis for further study
• To introduce student to conducting basic researchTo introduce student to conducting basic research
• To yield potentially useful information for agenciesTo yield potentially useful information for agencies

8. MethodsMethods
 Application through NEAC – SDHB patientsApplication through NEAC – SDHB patients
 Consent formConsent form
 Participants de-identified: pseudonymsParticipants de-identified: pseudonyms
 The British InvasionThe British Invasion (Radio NZ)(Radio NZ) – sets the scene– sets the scene
 1 week, 3 days1 week, 3 days
 3x Half hour on 3 days (1.5 hrs total)3x Half hour on 3 days (1.5 hrs total)
 Recording sheets: tunes/artistsRecording sheets: tunes/artists
 14 item questionnaire14 item questionnaire
 Participant kit, including tips for music listeningParticipant kit, including tips for music listening (www.soundfeelings.com)(www.soundfeelings.com)
 Search of CINAHL database: ‘Music therapy’ 1100+ articlesSearch of CINAHL database: ‘Music therapy’ 1100+ articles
 SelectionSelection waswas to be according to Fagerstrom assessment:to be according to Fagerstrom assessment:
(31+ per day/Lighting up within 5 mins of waking(31+ per day/Lighting up within 5 mins of waking))
Eventually regular smokers, up to this amount.Eventually regular smokers, up to this amount.

9. Results/OutcomesResults/Outcomes
 Research approved by Regional Ethics Committee and Smokefree Support (June)Research approved by Regional Ethics Committee and Smokefree Support (June)
 Positive feedback from people in discussion about research topicPositive feedback from people in discussion about research topic
 Anticipated: Participants would find a potentially healthier alternative to smoking, andAnticipated: Participants would find a potentially healthier alternative to smoking, and
the research would discover something about the effects of music onthe research would discover something about the effects of music on ‘quitability’‘quitability’
 6 Participants found (1 other unable to take part)6 Participants found (1 other unable to take part)
 Participants indicated a broad range of music preferencesParticipants indicated a broad range of music preferences
 Combination of stimulating and relaxing effects. Relief of either boredom or anxiety;Combination of stimulating and relaxing effects. Relief of either boredom or anxiety;
Habit; To think, concentrate or remain calmHabit; To think, concentrate or remain calm
 Music tended not to be given as a factor in smoking commencement…Music tended not to be given as a factor in smoking commencement…
……nor was lack of music considered to contribute to ongoing smokingnor was lack of music considered to contribute to ongoing smoking
 Participants tended to place greater emphasis on personal responsibility forParticipants tended to place greater emphasis on personal responsibility for
smoking-related illnesssmoking-related illness
 Despite 5/6 regarding nicotine as more addictive than either heroin or cocaine, 4/6Despite 5/6 regarding nicotine as more addictive than either heroin or cocaine, 4/6
indicated that to quit smoking was simply a matter of personal choice.indicated that to quit smoking was simply a matter of personal choice.

10. Benefits to agenciesBenefits to agencies
 Music potentially provides substitute resources (such as awareness,Music potentially provides substitute resources (such as awareness,
enjoyment) to perform the function that clients have traditionally ‘depended’enjoyment) to perform the function that clients have traditionally ‘depended’
on substances (cigarettes) to meet.on substances (cigarettes) to meet.
 Public Health South: May be applicable to other populations beyondPublic Health South: May be applicable to other populations beyond
cigarettes that are examples of ‘dependency’ (for example: alcohol, gambling,cigarettes that are examples of ‘dependency’ (for example: alcohol, gambling,
other drugs)other drugs)
 Cessation Support providers (with/without NRT) :Cessation Support providers (with/without NRT) :
Potential ability to enhance quit rates/stages progression.Potential ability to enhance quit rates/stages progression.
 Further exposure to the concept of Recreation therapy, and it’s role inFurther exposure to the concept of Recreation therapy, and it’s role in
educating for productive leisure:educating for productive leisure:
To be able to fill leisure intelligently is the last product of civilisationTo be able to fill leisure intelligently is the last product of civilisation
- Arnold Toynbee- Arnold Toynbee (Datillo, 2000)(Datillo, 2000)

11. LimitationsLimitations
 ““Aspects of the study that cannot be controlled, that represent weaknesses toAspects of the study that cannot be controlled, that represent weaknesses to
the study, and that may negatively affect the results”the study, and that may negatively affect the results”
(Baumgartner/Hensley, 2006, p. 30)(Baumgartner/Hensley, 2006, p. 30)
 If efficacy is being measured, validity could be influenced by the frequencyIf efficacy is being measured, validity could be influenced by the frequency
and duration of research (design consideration)and duration of research (design consideration)
 Variations in amounts smoked for people on/not on NRTVariations in amounts smoked for people on/not on NRT
 Time constraints influence decisions on study designTime constraints influence decisions on study design
 NEAC: waiting for response (approval received 20NEAC: waiting for response (approval received 20thth
June)June)
 Novice research: influence on questionnaire design.Novice research: influence on questionnaire design.
 Not included in the literature review are examples of tunesNot included in the literature review are examples of tunes
(words put to music)(words put to music)
 The extent to which participants have followed instructions:The extent to which participants have followed instructions:
 Whole half hour?Whole half hour?
 Complete questionnaire correctly?Complete questionnaire correctly?
 All available for interview?All available for interview?

12. Recommendations…Recommendations…
Future research into efficacy of music as a smoking cessation aid could look at:Future research into efficacy of music as a smoking cessation aid could look at:
 The nature of the research design (also in line with ‘FITT’)The nature of the research design (also in line with ‘FITT’)
 Music as a cessation aid due to particular tunes lasting longer than the time it takes to smoke aMusic as a cessation aid due to particular tunes lasting longer than the time it takes to smoke a
cigarette?cigarette?
 What is the impact of different types of music and artists performing (different vocal styles,What is the impact of different types of music and artists performing (different vocal styles,
instrumentation)instrumentation)
 Music as aMusic as a universal languageuniversal language: does the enduring quality of tunes indicate common preferences: does the enduring quality of tunes indicate common preferences
(despite individual differences), and does this relate to the enduring ‘quality’ of various types of(despite individual differences), and does this relate to the enduring ‘quality’ of various types of
tobacco? (eg. ‘Hey Jude’ by the Beatles cf ‘Marlboro’ by PM)tobacco? (eg. ‘Hey Jude’ by the Beatles cf ‘Marlboro’ by PM) “SENSE EXPERIENCE”“SENSE EXPERIENCE”
 The role of the Nervous system: in-depth consideration (ANS: sympathetic/parasympathetic)The role of the Nervous system: in-depth consideration (ANS: sympathetic/parasympathetic)
 Efficacy of music to treat other substance use / behaviours (Alcohol, Cannabis and other drugs,Efficacy of music to treat other substance use / behaviours (Alcohol, Cannabis and other drugs,
Gambling).Gambling).
 Music’s role in contributing to smoking uptake and prevalence (social learning)Music’s role in contributing to smoking uptake and prevalence (social learning)
 Does music contribute to or compete with smoking prevalence?Does music contribute to or compete with smoking prevalence?
(eg., 7 second rule = immediacy)(eg., 7 second rule = immediacy)

13. Learning drives development..Learning drives development..
It is during the young adult stage of life that leisure routines andIt is during the young adult stage of life that leisure routines and
lifestyle appear to become more stable and set for most people.lifestyle appear to become more stable and set for most people.
Likewise, if conscious awareness of leisure and a valuing of theLikewise, if conscious awareness of leisure and a valuing of the
phenomenon occurs, it most likely takes place at this stage ofphenomenon occurs, it most likely takes place at this stage of
human developmenthuman development (Peterson and Stumbo, 2001, p. 37)(Peterson and Stumbo, 2001, p. 37)
Compared with:Compared with:
Internalisation: a set of social relationships, transposed inside, and havingInternalisation: a set of social relationships, transposed inside, and having
become functions of personalitybecome functions of personality and the forms of its structureand the forms of its structure
- Vygotsky (again, with emphasis added)Vygotsky (again, with emphasis added)
((Excerpt SST; Tr L tune; St Home Vid excerpt)Excerpt SST; Tr L tune; St Home Vid excerpt)

14. Future directions/Now what?Future directions/Now what?
 ‘‘Pleasure pathway’ (look for similarities on effects of each:Pleasure pathway’ (look for similarities on effects of each:
cigarettes and music in key areas of Ventral Tegmental Area,cigarettes and music in key areas of Ventral Tegmental Area,
nucleus accumbens)nucleus accumbens)
 Re: ‘FITT’ principle and expectations: How do isolated,Re: ‘FITT’ principle and expectations: How do isolated,
individual situations impact on motivation to continue/quit?individual situations impact on motivation to continue/quit?
 What are the implications of small, seemingly insignificantWhat are the implications of small, seemingly insignificant
events on health status? (as exemplified by smoking)events on health status? (as exemplified by smoking)
 What are the effects of different voices, instrumentation… onWhat are the effects of different voices, instrumentation… on
people’speople’s ‘quitability?‘quitability?’ and smoking prevalence?’ and smoking prevalence?

15. Other relevant informationOther relevant information
 www.bbc.co.ukwww.bbc.co.uk (Reith Lectures)(Reith Lectures)
- The Brain – 2004 (V.K. Ramachandran)- The Brain – 2004 (V.K. Ramachandran)
- Music – 2005 (D. Barenboim)- Music – 2005 (D. Barenboim)
 www.mcgill.cawww.mcgill.ca (D. Levitin)(D. Levitin)
 NZ Assoc of Music Therapy.NZ Assoc of Music Therapy.
 Fair Go: Annual Ad awards (music factor)Fair Go: Annual Ad awards (music factor)
 Music and LyricsMusic and Lyrics (movie) starring Hugh Grant, Drew Barrymore(movie) starring Hugh Grant, Drew Barrymore
 Jim Jarmusch (1995)Jim Jarmusch (1995) Coffee and CigarettesCoffee and Cigarettes (movie):(movie):
The Earth is a conductor of acoustical resonanceThe Earth is a conductor of acoustical resonance
(Nikola Tesla, inventor)(Nikola Tesla, inventor)
 Blood, A.J. and Zatorre, R.J. (2001, Sept 25Blood, A.J. and Zatorre, R.J. (2001, Sept 25thth
)) Intensely pleasureable responses to musicIntensely pleasureable responses to music
correlate with activity in brain regions implicated in reward and emotion.correlate with activity in brain regions implicated in reward and emotion. McGillMcGill
University, Montreal: CanadaUniversity, Montreal: Canada
 Smith, N. (2006, November 11) Counting the beat.Smith, N. (2006, November 11) Counting the beat. The Listener,The Listener, p. 24p. 24
…….There is so much out there.There is so much out there

16.  The hypothesis is maintainedThe hypothesis is maintained::
(ie., due to the involvement of different brain regions, and subsequent physiological responses to(ie., due to the involvement of different brain regions, and subsequent physiological responses to
both music listening and cigarette smoking, music’s efficacy as a cessation aid will vary,both music listening and cigarette smoking, music’s efficacy as a cessation aid will vary, dependingdepending
on factors such as the frequency, intensity, time and type of music listened to, interacting withon factors such as the frequency, intensity, time and type of music listened to, interacting with
personal levels of engagement with cigarette smoking).personal levels of engagement with cigarette smoking).
 It is not simply a matter of playing any tune for any person over any length of time, but ratherIt is not simply a matter of playing any tune for any person over any length of time, but rather
sequencing various types of music in such a way that their effects combine to supersede thesequencing various types of music in such a way that their effects combine to supersede the
perceived benefits of smoking.perceived benefits of smoking.
Efficacy:Efficacy: ((L. efficaxL. efficax)) a.a. producing or able to produce the desired effect. (Thompson, 1992)producing or able to produce the desired effect. (Thompson, 1992)
Related toRelated to efficiency.efficiency. Three examples: Mgmt, Stats, TRThree examples: Mgmt, Stats, TR
 Presentation ReviewPresentation Review
 QuestionsQuestions
 SummarySummary
ConclusionConclusion

17. AcknowledgementsAcknowledgements::
Participants,Participants,
Public Health South,Public Health South,
Smokefree Support Service,Smokefree Support Service,
SDHB,SDHB,
Waihopai Runaka,Waihopai Runaka,
Nga Kete Matauranga,Nga Kete Matauranga,
Baillie and Corkill,Baillie and Corkill,
Sherry Elton,Sherry Elton,
Radio NZ,Radio NZ,
www.soundfeelings.comwww.soundfeelings.com
My Mum, Dad, and the Academy…My Mum, Dad, and the Academy…
(Thanks very much!)(Thanks very much!)

18. ReferencesReferences
 Baumgartner, T. and Hensley, L.Baumgartner, T. and Hensley, L. (2006)(2006) Conducting and reading research in health and socialConducting and reading research in health and social
sciences.sciences. New York: McGraw-HillNew York: McGraw-Hill
 Cole, M. and Scribner, S.Cole, M. and Scribner, S. (1978) Introduction. In: L.S. Vygotsky,(1978) Introduction. In: L.S. Vygotsky, Mind in SocietyMind in Society
(Cambridge, MA: Harvard University Press)(Cambridge, MA: Harvard University Press)
 Datillo, J.Datillo, J. (2000?)(2000?) Facilitation techniques in therapeutic recreationFacilitation techniques in therapeutic recreation
State College, PA: Venture publishing (Toynbee quote)State College, PA: Venture publishing (Toynbee quote)
 Peterson, C.A., and Stumbo, N.J.Peterson, C.A., and Stumbo, N.J. (2001)(2001) Therapeutic Recreation: principles and procedures.Therapeutic Recreation: principles and procedures.
Needham heights, MA: Allyn and BaconNeedham heights, MA: Allyn and Bacon
 Vygotsky, L.Vygotsky, L. (1960, p. 198) In Linzey, T. (1991, p. 242)(1960, p. 198) In Linzey, T. (1991, p. 242) Growing up: the politics of humanGrowing up: the politics of human
learning.learning. Auckland: Longman PaulAuckland: Longman Paul
 Radio NZRadio NZ (2001/2002)(2001/2002) The British Invasion -The British Invasion - Simon Morris, presenterSimon Morris, presenter (Tape)(Tape)
 Kampmann, S., and Aldis, W.Kampmann, S., and Aldis, W. (1988)(1988) Stealing homeStealing home (Warner home video)(Warner home video)