© 2000 by European Journal of Public Health
Behavioural support programmes for smoking cessation: needs and opportunities
Robert West**Correspondence: Robert West PhD, Professor of Psychology, Department of Psychology, St George's Hospital Medical School, University of London, Cranmer Terrace, London SW17 ORE, UK, tel. +44 181 7255603, fax +44 181 7672741, e-mail: sgjt600{at}sghms.ac.uk
Dependence on cigarettes involves a learned association between smoking behaviour and both brain reward circuitry and the relief of nicotine withdrawal symptoms. This process is overlaid by conditioning, beliefs and motives, which contribute towards keeping people smoking even when they want to stop. Nicotine replacement therapy (NRT), used to combat the craving and discomfort caused by nicotine withdrawal, goes a significant way towards helping smokers to recover from their dependence, but it is only part of the quitting process. Behavioural support programmes can be an effective aid to maintaining willpower and motivation. These programmes can range from intensive, face-to-face counselling and telephone counselling to self-help printed materials and videos. Low levels of access to, and demand for, intensive methods limit their reach, while generic self-help materials appear to have a small but significant impact in the absence of other interventions. There is some evidence that tailored support materials may be more effective than generic materials. The Committed QuittersTM programme offered by SmithKline Beecham is a set of highly tailored materials designed to supplement their NRT products. Evidence from clinical trials to date is encouraging and opens up the possibility of a new era in terms of getting cost-effective behavioural support to smokers on a large international scale.
Keywords: smoking, smoking cessation, nicotine replacement therapy, behavioural treatment