Journal of Consulting and Clinical Psychology

doi: 10.1037/0022-006X.61.5.715pmid: N/A

Although tobacco smoking is becoming less common in the United States, it remains perhaps the most important behavioral problem treated by psychologists. Research interest in smoking has greatly increased among psychologists, but success rates of formal treatment programs for smoking cessation have remained stubbornly low. This article introduces a series of 9 reviews that examine the current status of several diverse areas of research in smoking cessation and provide directions for future efforts in these areas in an effort to promote more innovative investigations.

Perkins, Kenneth A.

doi: 10.1037/0022-006X.61.5.715pmid: N/A

Although tobacco smoking is becoming less common in the United States, it remains perhaps the most important behavioral problem treated by psychologists. Research interest in smoking has greatly increased among psychologists, but success rates of formal treatment programs for smoking cessation have remained stubbornly low. This article introduces a series of 9 reviews that examine the current status of several diverse areas of research in smoking cessation and provide directions for future efforts in these areas in an effort to promote more innovative investigations.

doi: 10.1037/0022-006X.61.5.718pmid: N/A

This article argues that, although smoking rates are declining and quit rates are rising, research on behavioral approaches to smoking cessation is stagnant. Despite an increase in publications on smoking cessation, few innovative approaches have been introduced in the past decade. Furthermore, average treatment outcomes have not improved over this period. Treatment innovations may come from research that aims at fundamental new insights regarding smoking behavior and smoking behavior change rather than from incremental improvements of current approaches.

Shiffman, Saul

doi: 10.1037/0022-006X.61.5.718pmid: N/A

This article argues that, although smoking rates are declining and quit rates are rising, research on behavioral approaches to smoking cessation is stagnant. Despite an increase in publications on smoking cessation, few innovative approaches have been introduced in the past decade. Furthermore, average treatment outcomes have not improved over this period. Treatment innovations may come from research that aims at fundamental new insights regarding smoking behavior and smoking behavior change rather than from incremental improvements of current approaches.

doi: 10.1037/0022-006X.61.5.723pmid: N/A

Because initial reinforcement consequences set the stage for subsequent nicotine use, elucidation of the contribution of environmental and inherited factors is crucial to an understanding of nicotine dependence as well as of individual differences in susceptibility to cigarette smoking. A review of some recent animal research and laboratory studies of smokers and never-smokers suggests that vulnerability to nicotine dependence is related to high initial sensitivity to nicotine and that the development of acute pharmacodynamic tolerance in these individuals—particularly to effects of nicotine that are toxic or aversive—may be an adaptation for protecting homeostasis.

Pomerleau, Ovide F.; Collins, Allan C.; Shiffman, Saul; Pomerleau, Cynthia S.

doi: 10.1037/0022-006X.61.5.723pmid: N/A

Because initial reinforcement consequences set the stage for subsequent nicotine use, elucidation of the contribution of environmental and inherited factors is crucial to an understanding of nicotine dependence as well as of individual differences in susceptibility to cigarette smoking. A review of some recent animal research and laboratory studies of smokers and never-smokers suggests that vulnerability to nicotine dependence is related to high initial sensitivity to nicotine and that the development of acute pharmacodynamic tolerance in these individuals—particularly to effects of nicotine that are toxic or aversive—may be an adaptation for protecting homeostasis.

doi: 10.1037/0022-006X.61.5.732pmid: N/A

This article focuses on measures used to assess smoking patterns and motives. Self-report typology scales demonstrate a remarkably stable factor structure and good reliability. However, self-monitoring studies suggest that typology scales do not accurately assess smoking patterns and do not provide a good basis for treatment planning. Nevertheless, typology scores are correlated with variables such as smoking rate, craving, and cessation outcomes. These correlations may largely be accounted for by a common underlying factor, here labeled smoking drive, which may serve as a measure of dependence. Finally, the article briefly introduces new methods for assessing smoking patterns using palmtop computers to track smoking and other stimuli in real time. These methods may provide more valid assessment of smoking patterns.

Shiffman, Saul

doi: 10.1037/0022-006X.61.5.732pmid: N/A

This article focuses on measures used to assess smoking patterns and motives. Self-report typology scales demonstrate a remarkably stable factor structure and good reliability. However, self-monitoring studies suggest that typology scales do not accurately assess smoking patterns and do not provide a good basis for treatment planning. Nevertheless, typology scores are correlated with variables such as smoking rate, craving, and cessation outcomes. These correlations may largely be accounted for by a common underlying factor, here labeled smoking drive, which may serve as a measure of dependence. Finally, the article briefly introduces new methods for assessing smoking patterns using palmtop computers to track smoking and other stimuli in real time. These methods may provide more valid assessment of smoking patterns.

Henningfield, Jack E.; Keenan, Robert M.

doi: 10.1037/0022-006X.61.5.743pmid: N/A

It is well established that nicotine meets all criteria of a highly addictive drug. However, as recognized by the U.S. surgeon general, the nicotine delivery system itself is an important determinant of the toxic and addictive effects engendered by nicotine use. Therefore, altering the form of nicotine dosing may allow for selective therapeutic action in efforts to develop safer and less addictive nicotine replacement therapies. While it is the case that initial tobacco use often escalates to compulsive use accompanied by tolerance and physical dependence, this is not usually observed with nicotine replacement therapies. These observations are consistent with laboratory data indicating that (a) nicotine polacrilex and transdermal systems deliver nicotine more slowly and at lower dose levels than tobacco-based forms, and (b) human data suggesting that the abuse liability of these systems is substantially lower than that of the tobacco-based nicotine delivery systems. Because the drug dosage form can be systematically manipulated and evaluated, further research in developing alternative nicotine delivery forms may hold substantial promise in the treatment of tobacco dependence. Psychological research methods can play an important part in their evaluation.

doi: 10.1037/0022-006X.61.5.743pmid: N/A

It is well established that nicotine meets all criteria of a highly addictive drug. However, as recognized by the U.S. surgeon general, the nicotine delivery system itself is an important determinant of the toxic and addictive effects engendered by nicotine use. Therefore, altering the form of nicotine dosing may allow for selective therapeutic action in efforts to develop safer and less addictive nicotine replacement therapies. While it is the case that initial tobacco use often escalates to compulsive use accompanied by tolerance and physical dependence, this is not usually observed with nicotine replacement therapies. These observations are consistent with laboratory data indicating that (a) nicotine polacrilex and transdermal systems deliver nicotine more slowly and at lower dose levels than tobacco-based forms, and (b) human data suggesting that the abuse liability of these systems is substantially lower than that of the tobacco-based nicotine delivery systems. Because the drug dosage form can be systematically manipulated and evaluated, further research in developing alternative nicotine delivery forms may hold substantial promise in the treatment of tobacco dependence. Psychological research methods can play an important part in their evaluation.