Fighting addiction by tipping the scales

August 31, 2008

The other day I wrote about a study of cigarette smokers, claiming that the pros and cons of having a cigarette skew one way (toward the con) when addicts aren’t craving, but skew the other way when they are.

As I put it, it’s the difference between “cigarettes are bad, but I’ll have one anyway” (decision is the same but the smoker chooses to give in) and “well, cigarettes aren’t so bad after all” (decision skews and the smoker makes a logical choice – this is what the researchers concluded).

This Good Magazine piece on tricking people into doing the right thing mentions a couple of strategies that seem to work for addicts. You could see them as skewing that pro/con decision – adding enough “con” to overwhelm the overinflated “pro”.

Here’s one for smokers:

Quit smoking without a patch. Committed Action to Reduce and End Smoking is a savings program offered by the Green Bank of Caraga in Mindanao, Philippines. A would-be nonsmoker opens an account with a minimum balance of one dollar. For six months, the client deposits the amount of money she would otherwise spend on cigarettes into the account. After six months, the client takes a urine test to confirm that she has not smoked recently. If she passes the test, she gets her money back. If she fails the test, the account is closed and the money is donated to a charity. MIT’s Poverty Action Lab found that opening up an account makes those who want to quit 53 percent more likely to achieve their goal. No other antismoking tactic, not even the nicotine patch, appears to be so successful.

So the decision is no longer “I really want it” vs. “someday I might get lung cancer” – it’s “someday I might get lung cancer AND I’ll lose the money that is actually sitting in my banking account right now”.

The other approach I found interesting is one that enforces the decision you made when you weren’t craving:

Stop compulsive gambling. Over the past decade, several states, including Illinois, Indiana, and Missouri, have enacted laws enabling gambling addicts to put themselves on a list that bans them from entering casinos or collecting gambling winnings. The underlying thought is that many people who have self-control problems are aware of their shortcomings and want to overcome them. Sometimes recreational gamblers can do this on their own or with their friends; sometimes private institutions can help them. But addicted gamblers might do best if they have a way to enlist the support of the state.

Decide when you’re “cold” that you don’t want to gamble; then when you’re “hot”, the casino enforces the decision for you. You’re essentially turning over your judgment to your more rational side.

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