How to Prevent Cravings?
The power of situational cues
Posted Aug 08, 2016
Preventing cravings is one of the biggest challenges in the treatment of addiction, because they often cause ex-addicts to relapse into drug use (Kober and Mell, 2015). For instance, the loss of control over craving is a main culprit for relapse following abstinence among smokers and alcohol drinkers. Cue exposure and the experience of craving significantly influence and contribute to eating behavior and weight gain. Thus, the ability to manage craving is of key importance in preventing drug use and overeating.
A key lesson of behavioral economics is the power of the situation that influences behavior and overrides individuals’ intentions (MacKillop, et al., 2010). Temptations are triggered by situational cues (stimuli) that promise immediate satisfaction at the cost of significant long-term rewards. The inability to resist internal impulse leads to a mistaken decision - a gap between actual choice and preference (Laibson, 2001). That is, a person makes a choice despite expressing a desire to avoid this very option on a prior occasion. People are well aware that they are under the influence of the craving, but that knowledge will do little to curb their drive.
Our preferences are sensitive to cues like the smell of cookies baking, sounds of ice falling into a whiskey tumbler, and sight of a bowl of ice cream. These cues are associated with past consumption of habit-forming goods. For example, if the smell of baking cookies is associated with the past consumptions, then the current smell of baking cookies will increase one’s desire (valuation) for cookies. When an individual experiences a food cue (e.g., smell of freshly baked cookies), he will feel an urge to eat. The presence of craving shifts the individual’s preference for cookies, reversing an earlier resolution to avoid the extra calories.
Thus, environmental cues might serve as triggers for increased drug use or unhealthy foods consumption. The potential for addiction emerges as a result of repeated interactions between the user and their environments. For example, nearly 75 percent of those who reside in metropolitan Las Vegas gamble (Schull, 2012). For an ex-addict, a simple walk through a casino to lunch can become an agonizing ordeal. The atmospheric features of casino trigger a powerful psychological and physiological reaction.
In short, cue exposure explains why relapses are frequently triggered by environmental cues, and why cue management can prevent a tempting impulse without using mental strain. Cue-management is a commonly observed behavioral and therapeutic technique (Duckworth et al 2016). This form of self-control refers to people’s attempts to choose situations that make it more (or less) likely that they will experience impulses. For example, ex-alcoholics avoid bars, dieters keep snack food out of view, and parents choose the candy-free checkout aisles at supermarkets.
Duckworth AL. et al (2016) Situational Strategies for Self-Control Perspectives on Psychological Science 2016 11 (1) 35-55
Kober, H. & Mell, M.M. (2015). Neural Mechanisms Underlying Craving, and the Regulation of Craving. Handbook on Cognitive Neuroscience of Addiction. Wiley Blackwell.
Laibson, David I. 2001. A cue-theory of consumption. Quarterly Journal of Economics 116(1): 81-119.
MacKillop, J., O’Hagen, S., Lisman, S. A., Murphy, J. G., Ray, L. A.,McGeary, J. E.,Tidey, J. W., & Monti, P. M. (2010). Behavioral economic analysis of cue-elicited craving for alcohol. Addiction, 105, 1599-1607.
Schüll Natasha (2012) Addiction by Design: Machine Gambling in Las Vegas. Princeton: Princeton University Press