ABSTRACT
A prominent scientist (Saul Shiffman, 1993b) recently concluded that compared with the 1960s and 1970s “research on behavioral approaches to smoking is stagnant … [that] few innovative approaches have been introduced over the past decade. … [and that] average treatment outcomes have not improved over this period” (p. 718). He proposed that the lack of clinical innovation and at best modestly effective treatments have resulted in part from the near universal use of multicomponent programs, with the outcome that all programs look alike. Furthermore, programs are generally ineffective with the growing percentage of smokers who are disposed to psychopathology, impulsivity, and social alienation (Shiffman, 1993b; see Chapter 7). This lack of treatment efficacy with high-risk groups may largely reflect a failure to develop interventions individualized for specific high-risk smokers. Improvement in abstinence outcomes will require that individualized interventions consider differences in biological, psychological, and social and environmental factors as dominant treatment features. This chapter proposes individualized treatment for smoking based on the empirical and theoretical bases of preceding chapters.
