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Research Paper on Vaping Behavior Modification
Josie Koebel
Department of Psychology, Liberty University
PSYC 320: Behavior Modification
Professor Caroline Thornhill
April 8, 2024
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Vaping as a Behavior Modification
This study will be to decrease the behavioral surplus of vaping in the participant through
methods of behavioral modification. For this study, the decrease in vaping will be defined by
how much the participant decreases the number of puffs (hits) taken per day. The number of
puffs will be collected during the baseline phase. In the treatment phase, the number of puffs
taken will be added and divided by the number of days in the baseline to find the mean. The
mean will then be multiplied by 30%. The behavioral modification will be for the participant to
decrease her vaping puffs a day by 30% throughout the treatment phase.
The participant proposed for this study will be a female online college student living in
her own home and working a part-time job. The participant will need access to vape during the
modification period. The participant will also carry a counter clicker to track each puff she takes
daily. The purpose of this study will be to decrease a little over a quarter of the number of puffs
taken a day when the treatment is implemented.
The participant will be chosen with these demographics because vaping negatively
affects one’s health, finances, social life, and academic domains (Amato et al., 2021). College-
age adults are the most common demographic that extensively uses vapes. Due to the variety of
flavors, this leads to an increase in vaping behavioral habits. Vaping affects each area mentioned
above significantly. Vaping negatively affects health because of the harmful chemicals breathed
into the lungs with each puff, not to say that nicotine is very addictive, which also affects the
brain. Habits started during this time of life can be extremely hard for a person to break if they
continue using them for several years. Vaping can also create a financial bind in a college
student’s life because the price for one vape is approximately $20, which typically only lasts for
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about two weeks for a regular user. Breaking vaping habits during this stage of life will
significantly benefit one’s future before there are long-term effects.
Research on Target Behavior
Extensive research studies have been conducted on vaping. With this being said, there is
an increase in research that has been done on the health effects of vaping than on the behavioral
side. A probable reason for less research on the behavioral side of vaping is that vaping is a
relatively new habit that emerged when Juul Laboratories was founded in 2020 (Jonas, 2022).
However, studies on the health effects of vaping are still very crucial because they allow users to
understand the severe effects that vaping can have on the respiratory and cardiovascular systems.
These studies highlight connections between health effects and vaping cessation, which make
them essential and relevant in this study.
Palmer et al. (2022) conducted a pilot study on behavioral intervention for nicotine
vaping cessation. This study was conducted through telehealth on 27 young adults ranging from
ages 17 to 21 who resided in Charleston, SC. They recruited these participants through social
media and other digital advertisements. Palmer et al. divided the participants into two groups,
with 22 in Contingency Management and 4 in the Monitoring control group. The Contingency
Management or CM group used DynamiCare Health’s phone app for four weeks, allowing them
to receive financial incentives for staying abstinent from nicotine. Palmer et al. had them submit
cotinine samples from day 7 to day 28 to determine if the participants had abstained. The Control
group received incentives for submitting samples, regardless of their absence. After the
treatment, they had a one-month follow-up. The results showed high favorability in the app, and
the incentives helped many users abstain from vaping during the treatment. During the one-
month checkup, the study showed that 7 of the 27 participants had continued to abstain from
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vaping. Palmer et al. considered the six participants who did not show up to the follow-up to be
vaping and not quit. With this being said, there were still fourteen participants who did report a
decrease in vaping habits.
Graham et al. (2021) conducted a study on young adult e-cigarette users in the United
States. The participants she gathered were US residents aged between 18 and 24 who owned a
mobile device with an active text messaging plan. The purpose of the study was to determine the
effectiveness of a text messaging program for vaping cessation among young adults versus
assessment-only control. The participants had to report a 30-day e-cigarette report with the intent
of wanting to quit in the next 30 days. These participants were divided into two parallel groups:
the assessment-only control arm and the active intervention arm. The assessment-only arm
consisted of 1284 participants who received monthly assessments, but no additional intervention.
In contrast, the active intervention arm consisted of 1304 participants who also received an
automated text messaging program. This program was called This is Quitting, and its program
was for vaping cessation, which delivers social support and cognitive and behavioral coping
skills (Graham et al., 2021). This study showed the majority of young adults (82.3%) vaped
within thirty minutes of waking up. The study also showed that 24% of intervention participants
had stayed abstinent, whereas in the control group, it was 18%. The data collected demonstrated
that interactive text messaging interventions affected vaping cessation in young adults.
In 2022, Thapa et al. conducted a survey to assess the hypothesized relationship using a
covariance-based structural equation model. She collected data from 232 young vapers, primarily
Generation Z and Millennials. The idea of this survey was to investigate the factors of both
intrinsic and extrinsic motivation that influence young adolescents’ excessive vaping behaviors
and their desires to quit. The findings of this study found that the “realization of excessive
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vaping” is negatively linked to being less likely to seek excitement and positively linked to being
influenced by “deal proneness,” “environmental cues,” and “negative repercussions.” The
intention to quit vaping is less likely influenced by marketing cues but positively influenced by
alternate ways to quit. Overall, Thapa et al. found there was a link behavior to excessive and
cessation of vaping.
Research on Treatment Method
The treatment for this behavioral modification entails the use of a token economy.
Bonfonte et al. state that token economies are one of the most used behavior interventions.
Miltenberger's (2016) definition of the token economy as a conditioned reinforcer. The token is a
reinforcer that one can give to another person or to themselves if the desirable behavior is
achieved. Desirable behaviors are likely to decrease if said tokens are given every time the
desired behavior happens. One unique thing is that tokens, once accumulated, can be exchanged
for backup reinforcers, making the desired behavior more incentivizing.
For the purpose of this behavior modification, the participant and her friend will keep
track of the token earned and taken away during the treatment phases. The initial token will be
printed token cards that symbolize ten dollars for each day the desired behavior is achieved:
vaping 55 times or less a day. These token cards will be redeemed at the end of the current
treatment phase. The backup reinforcer in this treatment is that if the desirable behavior is
achieved each day, they can buy themselves a treat, like coffee or ice cream, the following day.
Bonfonte et al. conducted a study to compare the reinforcing efficacy of tokens and
primary reinforcers. The participants in the study consisted of two young teenage men who each
had a diagnosis of autism spectrum disorder. The participants’ skills and developmental
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functions were relatively similar, around the same age. The procedure of the study consisted of
each child receiving a token board and showing how many tokens they had received. One child
received a laminated board with laminated tokens, and the other received a board with a dry-
erase maker that was used to put Xs to represent tokens. The response measurement was based
on how fast each child would touch one colored card and the second colored card. In order to
receive a token, the child had to touch the second card within five seconds of the first. After
receiving the tokens, the child could use his tokens for a low-preference edible item. After doing
so, he was asked if he wanted to continue doing more rounds of cards and exchange his tokens
for a high-preference edible, known as the backup reinforcer. The results showed that both
children chose to do one more round of cards to get the high-referenceable.
Conclusion
The modification of the behavioral surplus of vaping has been chosen for the participant
because she wants to gradually quit vaping in general due to the financial and health domains it
affects. The participant vapes approximately eighty times a day and has realized how much this
behavioral habit negatively affects different areas of her life. If she were to let this habit
continue, it may result in health complications as she gets older. Gradually decreasing the
number of hits she takes a day can help slowly wean her off of nicotine itself. By doing this, she
will stop the habit before it is too late; this would greatly affect her academic, financial, and
health positively if she quits.
The proposed method of treatment will be a token economy. The token economy will be
used to incentivize desirable behaviors of hitting her vape 30% less a day and decrease the
behavior of hitting it excessively. The initial token will be printed token cards that symbolize ten
dollars for each day the desired behavior is achieved: vaping 55 times or less a day. These token
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cards will be redeemed at the end of the current treatment phase. The backup reinforcer in this
treatment is that if the desirable behavior is achieved each day, they can buy themselves a treat
the following day. In using this treatment method, the participant will be incentivized to decrease
vaping habits, enabling her to be able to quit eventually.
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References
Amato, M. S., Bottcher, M. M., Cha, S., Jacobs, M. A., Pearson, J. L., & Graham, A. L. (2021).
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Jonas, A. (2022). Impact of vaping on respiratory health. BMJ: British Medical Journal (Online),
378 https://doi.org/10.1136/bmj-2021-065997
Palmer, A. M., Tomko, R. L., Squeglia, L. M., Gray, K. M., Carpenter, M. J., Smith, T. T.,
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Thapa, S., Pandey, S. C., Panda, S., Paswan, A. K., & Ghimire, A. (2022). Vaping among youth:
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Pub. https://doi.org/10.1108/YC-12-2021-1429
Bonfonte, S. A., Bourret, J. C., & Lloveras, L. A. (2020). Comparing the reinforcing efficacy of
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Miltenberger, R. G. (2016). Behavior Modification: principles and procedures (sixth). Cengage
Learning. (Original work published 2012)
