The Agency for Health Care Policy and Research Smoking Cessation Clinical Practice Guideline: Findings and implications for psychologists.

Abstract

Smoking is the leading cause of preventable morbidity and mortality in the United States, and the health benefits of quitting smoking are substantial. Nevertheless, over 25% of American adults (48 million individuals) continue to smoke, and the vast majority of quit attempts are unsuccessful. The Agency for Health Care Policy and Research recently addressed the smoking problem by conducting a 2-year research project that was published as the Smoking Cessation Clinical Practice Guideline (Fiore et al., 1996). This article reviews methods, analyses, and results from the Guideline project, and highlights major Guideline recommendations. Guideline findings and recommendations are discussed with respect to their implications for psychology.

A family consultation intervention for health-compromised smokers

“…Gender is of interest because female smokers appear more likely than men to relapse after quitting (Bjornson et al, 1995;Fiore et al, 1996;Wetter et al, 1998). Although intrapersonal variables such as perceived stress and appetite/ weight control expectancies do not appear to mediate associations between gender and abstinence (Wetter et al, 1998), there is some evidence that female smokers are more responsive than males to aspects of their social environment.…”

“…Fiore et al, 1996). Higher intensity clinical interventions appear to be most necessary for high-risk smokers such as patients with heart or lung disease or heavy smokers who have failed to benefit from less intensive approaches to quitting (Lichtenstein & Glasgow, 1992;Wetter et al, 1998). 0740 Curiously, cessation treatments that currently do have empirical support focus almost exclusively on the individual smoker, although substantial evidence indicates that social support provided by significant others, especially spouses, predicts whether smokers are able to quit and stay quit (Campbell & Patterson, 1995;Roski, Schmid, & Lando, 1996).…”

“…Although intrapersonal variables such as perceived stress and appetite/ weight control expectancies do not appear to mediate associations between gender and abstinence (Wetter et al, 1998), there is some evidence that female smokers are more responsive than males to aspects of their social environment. A spouse's smoking status, for example, appears to have more influence on abstinence by women than men (Homish & Leonard, 2005).…”

Psychologists and Smoking Cessation Intervention: Unrealised Potential

“…Potential barriers to the provision of smoking cessation intervention by psychologists have been reported to include: lack of training, lack of time, perceived costs of cessation intervention for the therapeutic relationship, perception that smoking cessation intervention is not a psychologists' responsibility or role, and beliefs that clients are uninterested or will be unreceptive to intervention (Akpanudo et al, 2009;Fiore et al, 2008;Leffingwell & Babitzke, 2006;Phillips & Brandon, 2004;Wetter et al, 1998).…”

“…Behavioural health providers such as psychologists seem especially well-suited to provide smoking cessation intervention for a multitude of reasons (Akpanudo et al, 2009;Wetter et al, 1998;Williams & Ziedonis, 2004). Nicotine dependence is recognised as a substance use disorder by the Diagnostic and Statistical Manual of Mental Disorders, (DSM-IV; American Psychiatric Association, 1994), and is often co-morbid with other psychological disorders with which patients are likely to present to psychologists (Access Economics, 2007;Australian Bureau of Statistics, 2010;Morissette et al, 2007).…”