Covert sensitization for smoking: In search of efficacy

Four procedural formats of CS were tested in a multiple baseline design with six persons wanting to quit smoking. Format one employed the standard nausea aversion. Format two selected aveisive themes and varied trial duration according to electrodermal arousal criteria. Format three replicated the second one excepting that an actual cigarette was substituted for its imaginal representation. The fourth format replicated the third except that the five treatment sessions were presented on consecutive days instead of twice weekly. This last format was the most effective one resulting in an 80.5% smoking reduction compared to 12.5%, 28.5%, and 44.0% for formats one, two, and three, respectively. With minor exception, treatment effects for all subjects washed out by two months follow-up. Electrodermal arousal (but not EMG or EKG) and self-report anxiety jointly predicted smoking reduction, R = 40. Methodological limitations were pointed out which limit the power of the conclusions drawn. The advantages of utilizing physiological arousal indices and concentrated session scheduling were discussed. It was emphasized that procedural variations of CS merit further investigation to develop CS as a reliably effective technique.