Tuesday, July 12, 2011

Prevention and addiction, with tipping points

In the Tipping Point, that I mentioned a couple of times in previous posts, Malcolm Gladwell has a Freakonomics-like approach to different societal problems. That is to say, we should probably take what he says with pinches of salt. This being said, he mentions two things about prevention and addiction that are quite interesting.
The first thing that caught my attention was the study of Leventhal and Singer(1965) who looked at how they could better convince university students to get a tetanus vaccine. The students were given either a "high-fear" booklet or a "low-fear" booklet, that could be put in parallel with a low-fear cigarette pack and a FDA-approved cigarette pack. The students in the "high-fear" treatment were significantly more convinced to go take the shot. However, when the authors actually considered who took the shot, there was no difference between the two groups.
They also provided some of the students with a map giving the directions to the health-center where to get the shot, and they got a 28% increase in the number of students getting the vaccine. Interestingly, once again, there was no difference between the high-fear and low-fear treatment in the response to the "map-treatment".

That's all nice for prevention, but what about addiction? The second part that I found interesting was focused on smoking(yep, that's original). There were two things there:

  • First, Gladwell mentions studies showing that you get a high success rate in making people quit when you treat smokers for depression. Apparently, the biological reason comes as follows: "Bupropion(an antidepressant) does two things. I t increases your dopamine, so smokers don't have the desire to smoke, then it replaces some of the norepinephrine, so they don't have the agitation, the withdrawal symptoms".
  • Second, Gladwell argues that nicotine addiction is not linear, though he might be a bit biased here since with linearity, you would have no Tipping Point. Basically, he argues that every person has an individual threshold(different for everybody) in the number of cigarettes they can smoke before being addicted. Though he's not mentioning it clearly, it seems that that would lead him to advocate a really gradual reduction in the level of nicotine in cigarettes: you need to make the change non-perceptible, so you need graduation, but the more you lower it, the less addicted people you'll get.

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