1. The Promising Efficacy of Stimulus
Control to Recalibrate Tobacco Use with
Healthful Behaviors
Jeff Spitz
The New School
Spring 2013

2. Presentation Outline
The Cognitive Behavioral Model (Exp. Condition)
– Stress Response Process (Girdano, Dusek & Everly,
2009, p. 39)
– Stimulus Control Intervention Model (Taylor,
2012p. 58, 66)
Intervention
– Variables, Factors
– Data
– Results

3. Presentation (cont’d)
• Conclusions
– NOTE: All raw data, statistics, and figures can be
found on the excel spreadsheet handout
accompanying this presentation.

4. THE COGNITIVE-BEHAVIORAL
MODEL

5. Cognitive-Behavioral Model
• This Health Psychology framework posits that
behavioral changes can be solicited by
cognitive changes (i.e. increased sense of
control, self-efficacy, self-reliance,
commitment to change) about a given activity.

6. The Stress Response Pathway
(Girdano, Dusek, & Everly, 2009, p. 39)

7. Types of Stress
• Eustress
– Benign stressor (exercise)
• Distress
– Malignant stressor (fear, tobacco)

8. Experimental Condition
• “Stimulus-control interventions with patients
who are attempting to alter their health habits
take two approaches: ridding the environment
of discriminative stimuli and creating new
discriminative stimuli, signaling that new
response will be reinforced.” (Taylor, 2012, p.
62)

9. Experimental Condition
• Self-control & Self-reinforcement
– Discriminative Stimuli (p. 62) help systematically
reward oneself to improve and eventually,
eradicate the target behavior (smoking)
– Overtime, this feedback loop increases self-
control by recalibrating the target behavior with
discriminative stimuli, such as:
• Exercise
• Yoga/Stretching
• Art/Spiritual Practice

10. Experimental Condition
• Based on the cognitive behavioral model, it is
possible for one to recalibrate the stimulus-
response (or stress-response) relationship by
replacing the maladaptive response to
perceived stress (smoking) with those which
are productive and healthful (discriminative
stimuli)

11. STIMULUS-CONTROL
INTERVENTION
Variables/Factors
Data
Results

12. Exercise, Yoga/Stretch, Art/Spiritual
• Physical Exercise (Aerobic, Resistance) is a benign,
healthful activity that improves maladaptive
reactions to stress in addition to constituting a
reaction to stress in and of itself
• Yoga/Stretching is a relaxation activity that
improves bodily awareness and propioceptive
ability (space-time control over body parts)
• Art (for me) represents a creative venture that
induces a meditative (spiritual) state, which
allows me to process, reflect upon my life

13. Operationalizing the Variables
• Independent Variable (Smoking)
– tobacco consumption (# of Cigarettes per day)
• Dependent Factors (Daily)
– Exercise (Yes = 1; No = 0)
– Yoga/Stretch/Myofascial Roller (Yes = 1; No = 0)
– Art/Spiritual Practice (# hrs)

14. Destructive Effects of Cigarette
Smoking
• Decreased self-esteem, self-concept,
threshold for pain (Journal Entry 1)
• Deteriorations in attentional ability, physical
health (allergies, cancers, respiratory
problems/asthma)

15. Tobacco Consumption v. Time
0
2
4
6
8
10
12
14
16
4-Feb 11-Feb 18-Feb 25-Feb 4-Mar 11-Mar 18-Mar 25-Mar 1-Apr 8-Apr 15-Apr 22-Apr 29-Apr
# Cigarettes

16. Results
• The graph clearly shows that tobacco
consumption decreased throughout the duration
of the intervention.
• To quantify the association between consumption
of tobacco and the various dependent factors, I
subjected the data to correlational analyses (r)
– DISLCAIMER: CORRELATION DOES NOT CONSTITUTE
CAUSATION

17. Correlation (r coefficient)
Factor (Y)
• Stress Type
• Stress Level
• Exercise
• Yoga/Stretch
• Art Spiritual
r value
-0.124582920
0.02329267
-0.22881033
0.06215949
0.12233604

18. Results
• The obtained r values fall within +/- .2 and their vicinity
to zero indicates that the factors studied were not
correlated with the amount of tobacco consumed.
• However, this does not necessarily mean there were
not significant interactions between dependent factors
that played an influential role in reducing tobacco
consumption over time.
• Evaluating interactions of this sort requires a more
elaborate testing measure (ANOVA) which exceeds the
purview of material covered in our course.

19. Conclusions
• While we know that my tobacco consumption
decreased over time, it remains unclear as to
why exactly that reduction transpired.
• Technically, because I did not completely
eradicate my tobacco consumption, the case
study failed due to time constraints. But in
the long term, I feel much more grounded in
my commitment to follow through with this
goal.

20. Conclusions
• I also believe that the dependent factors
(healthful behaviors) were helpful for improving
my ability to deal with stress and the impulse to
smoke.
• My journal entries do not discuss art/spirituality
whatsoever, but I wanted to include this in my
presentation because it is an activity that re-
emerged during my intervention after about a
year long hiatus from work on any on-going
projects.

21. Conclusions
• This intervention was helpful because it not
helped me significantly reduce the amount of
tobacco I consume, but also more frequently
engage in other healthful behaviors.
– Healthy eating
– Semi-Regular exercise
– Self-care

22. BIBLIOGRAPHY
Girdano, Daniel A., Dusek, Dorothy E., & Everly
Jr., George S. (2009). Controlling Stress and
Tension (8th Ed.). San Francisco: Pearson
Education, Inc.
Taylor, Shelley, E. (2012). Health Psychology (8th
Ed.). [Nook e-book version] Retrieved from
http://www.bn.com.