Psychological interventions: state of the art.

The usefulness of psychological interventions in smoking cessation is well established. Ongoing efforts are aimed at establishing interventions for specific diagnostic groups, developing interventions that are targeted at smokers who do not seek treatment, and combining psychological and pharmacological treatment. There is emerging evidence that useful treatments have been developed for smokers with a depression history, and that expert system interventions based upon a stage model can be useful in changing the smoking behavior of smokers who are not yet ready to quit. Psychological interventions add to the efficacy of nicotine replacement therapy, but whether they add to the efficacy of other pharmacotherapies is not known. There is a need to determine whether psychological interventions are useful for diagnostic groups other than depressive disorder, and if so, whether they need be specific for that group. Additional research is needed on interventions for smokers who are not ready to quit, both in developing new techniques, and determining the need and usefulness of adaptations of those in existence to specific populations.