Rubbing snuff, like other forms of tobacco use, is an addictive behavior that poses a serious challenge to individuals who want to change their habits. Perhaps an even greater challenge looms for those whose partners would like to change their behaviors! Paul’s habit of rubbing snuff is the ideal opportunity to enact a well-planned behavior plan intended to motivate lasting change.
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The frequency of Paul’s dipping is estimated around 5-8 times per day with the frequency of swallows much greater. Dipping is described as replacing or adding additional tobacco to the mouth. Intensity increases with the progression of the day, starting with smaller amounts in the upper lip and ending with larger quantities in the lower lip by nighttime. The intensity of swallowing also rises with this increase in use. The duration of Paul’s tobacco use holds the greatest possibility for change.
At baseline, he dips constantly from the moment of waking to seconds before retiring to bed. The latency of Paul’s dipping of additional interest in the development of an intervention. At baseline, he began dipping approximately 2. 5 seconds after opening his eyes in the morning. The latency of Paul’s first swallow of tobacco averages approximately 2 minutes after waking. The action of concern, swallowing of tobacco juice, is a behavior excess. Any swallowing greater than 0 times per day qualifies as the presence of this behavior in excess.
The intervention selected to extinguish Paul’s swallowing behavior was the use of a pop bottle for spitting. Paul established a reasonable goal of less than 3 swallows per day for one week followed by less than 2 the next week. This decreasing trend would continue for several weeks until complete extinction is achieved. With the decrease in swallowing, it will be important to document the increase in spitting behavior. Paul will document the number of times he spits for two 30 minute intervals throughout the day.
As he begins changing his behavior, it is hoped that increased spitting will aid the decrease in swallowing. A few ground rules will also be established to enforce the intervention. Paul should have his spit bottle, spittoon, and/or other spitting place on hand wherever he goes throughout the day. Along with targeting the decrease of swallowing tobacco juice, this intervention should also serve to increase the behavior of spitting. The reaction of poor Paul’s wife to this change is yet to be determined! The effectiveness of this intervention was assessed on a daily and then weekly basis.
By the third week, Paul experienced complete swallowing cessation and had increased his frequency of spitting from relatively nothing to dozens of times a day. The result was the elimination of vomiting behavior, a perceived increase in energy, and self-reported decreases in fatigue. According to subjective and objective reports, Paul accomplished significant behavioral change. To improve the likelihood Paul would maintain his behavioral change, one final reporting and documentation measure was used two months after the start of the intervention.
Hidden cameras were placed in Paul’s home and place of work to record each and every time he demonstrated the primary target behavior (swallowing tobacco juice) and the secondary desired replacement behavior (spitting in the bottle). The results were encouraging. Paul had completely stopped swallowing, but had also decreased the frequency of his need to spit throughout the day. With careful review, this was related to a decrease in duration of Paul’s dipping habit during the day
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