Maladaptive habits, such as substance use, that are highly ingrained and automatized behaviors with negative long-term health consequences need effective interventions to promote change towards more healthful behaviors. Implementation intentions, the structured linking of critical situations and alternative, healthier responses, have been shown to improve health-benefiting behaviors such as eating more fruits and vegetables and being more physically active (Sheeran, Milne, Webb, and Gollwitzer, 2005). Here, a laboratory analogue for smoking relapse and a pilot clinical trial of alcohol use are assessed using implementation intention interventions to reduce these health risk behaviors.

In Study 1, heavy smokers completed a smoking resistance task that is a candidate analogue for smoking relapse. Participants were exposed to an in-laboratory implementation intention and/or monetary incentive condition during each of four experimental sessions. The combined implementation intention and monetary incentive condition resulted in the greatest delay to smoking initiation. In Study 2, individuals with alcohol use disorder completed an active or control implementation intention treatment condition. Remotely, both treatment groups received a daily ecological momentary intervention, thrice daily biologic breath alcohol ecological momentary assessments, and once daily self-report ecological momentary assessment of alcohol consumption during the intervention period. The active implementation intention group was associated with a greater reduction in alcohol consumption compared to the control group.

Together, these studies provide experimental and initial clinical evidence for implementation intentions, in conjunction with other effective treatments (Study 1) and technological advancements (Study 2), to intervene on and reduce substance use. This project is the first to use implementation intentions in a laboratory evaluation of smoking resistance and in an initial clinical trial to reduce alcohol consumption in a naturalistic community sample using both ecological momentary assessments and ecological momentary interventions.