Our previous two posts at AddictionNews have examined the subjects of habit and habit formation, particularly as they relate to addiction and addiction treatment. Today’s post will take a closer look at habit disruption and, in particular, habit substitution. Once again, we will make our way through Dr. Benjamin Gardner’s monumental review “Developing habit-based health behaviour change interventions: twenty-one questions to guide future research,” in the journal Psychology & Health.

Dr. Gardner breaks down the techniques for habit disruption into four categories:

• Habit inhibition
• Habit discontinuation
• Habit degradation
• Habit substitution

Habit inhibition is suppressing the urge in the moment. It works well when applied persistently, but there is impulse control fatigue over time, and old habitual behavior returns.

Habit discontinuation involves purposefully avoiding cues such as not going to the bar for a drink after work, not taking a cigarette break, and avoiding certain people or places. Again, there is a problem with returning to triggering places or activities, which can cause relapse.

Habit degradation happens naturally over time by ceasing to engage in the habit.

Habit substitution is perhaps the most interesting area to explore. Many researchers feel that habit degradation is only sustainable if there is habit substitution: replacing the position the bad habit previously took up in your life with a new, health-enhancing habit. Dr. Gardner cites a significant body of work that suggests inhibition, discontinuation, and degradation will not endure without some habit substitution.

“Inhibiting a habit relies on self-regulation at the moment that a habit impulse is activated,” writes Dr. Gardner. Behavior change techniques that work in the moment include distraction and preplanned defensive responses. Habit discontinuation includes such techniques as going “cold turkey,” complete withdrawal (either gradually or quickly), avoidance, and abstinence.

Habit substitution involves hijacking the habitual nature of compulsive behavior and using it to break a habit and/or adopt a beneficial habit. This approach involves substituting healthy eating for unhealthy eating; chewing gum for cigarette smoking; and going for a walk instead of going to the bar. You substitute a new activity in the time you used to fill with a bad habit, in approximately the same increments and intervals.

“Habit substitution has been proposed as the optimal strategy for lasting disruption of habits,” writes Dr. Gardner. However, 

Little is known about the real-world longevity of healthy habits that have newly supplanted prior, unhealthy habits, and factors that may influence the recovery of old, unhealthy habitual responses.

In addition, little is known about how much relapses set back habit disruption, or how successful habit moderation is compared with habit cessation. Dr. Gardner cites a study that shows people are not very good at forming good habits or sticking to them without a little guidance and ongoing support.

The goal of Dr. Gardner’s fairly rigorous grilling of his colleagues in psychology on the subject of habit formation was to “facilitate development of interventions to promote formation of healthy habits or disruption of unhealthy habits, and so engender lasting real-world behaviour change.” His 21 questions to guide future research will help us design and evaluate interventions that can sustain the change.

Written by Steve O’Keefe. First published March 14, 2024.

Sources:

“Developing habit-based health behaviour change interventions: twenty-one questions to guide future research,” Psychology & Health, November 2021.

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