Restricted environmental stimulation therapy and aversive conditioning in smoking cessation: active and placebo effects.

An aversive smoking treatment, either alone or followed by 24 hr of restricted environmental stimulation therapy (REST, lying on a bed in a dark, silent chamber with occasional smoking-related messages presented over an intercom), was administered to 74 smokers. The subtractive expectancy placebo technique, where an active treatment is described as inert, was used to evaluate the role of the expectancy placebo component. The combined treatments were more effective than aversive conditioning alone, but less so than REST by itself. Expectancy contributed substantially to the success of the aversion treatment through the 6-month follow-up, and less so to the early success of REST. These components faded by the end of 12 months. The implications for designing follow-up periods for studies in this area are obvious. The results also supported hypotheses that Ss who undergo REST are less likely to relapse once they have quit smoking, and that other REST Ss who do not quit show success in controlled (reduced) smoking. For the first time, REST did not potentiate another treatment with which it was combined, perhaps because this particular other treatment is not in itself of proven effectiveness. The results also show that the impact of REST does not depend on the client’s expectations concerning its effects. Data concerning smoking behavior and attitudes, some of which predicted treatment success, are also presented.