Annals of Behavioral Medicine

, Volume 41, Issue 2, pp 192–207 | Cite as

New Methods for Tobacco Dependence Treatment Research

  • Timothy B. Baker
  • Robin Mermelstein
  • Linda M. Collins
  • Megan E. Piper
  • Douglas E. Jorenby
  • Stevens S. Smith
  • Bruce A. Christiansen
  • Tanya R. Schlam
  • Jessica W. Cook
  • Michael C. Fiore
Original Article



Despite advances in tobacco dependence treatment in the past two decades, progress has been inconsistent and slow. This paper reviews pervasive methodological issues that may contribute to the lack of timely progress in tobacco treatment science including the lack of a dynamic model or framework of the cessation process, inefficient study designs, and the use of distal outcome measures that poorly index treatment effects. The authors then present a phase-based cessation framework that partitions the cessation process into four discrete phases based on current theories of cessation and empirical data. These phases include: (1) Motivation, (2) Precessation, (3) Cessation, and (4) Maintenance.


Within this framework, it is possible to identify phase-specific challenges that a smoker would encounter while quitting smoking, intervention components that would address these phase-specific challenges, mechanisms via which such interventions would exert their effects, and optimal outcome measures linked to these phase-specific interventions. Investigation of phase-based interventions can be accelerated by using efficient study designs that would permit more timely development of an optimal smoking cessation treatment package.


Tobacco dependence treatment Motivation Precessation Cessation Maintenance Methodology 


Funding: This research was supported by a grant 9P50CA143188-11 from the National Cancer Institute. Dr. Baker was supported via NCI 1K05CA139871. Dr. Collins was supported via grant P50DA10075, from the National Institute on Drug Abuse. Dr. Piper was supported by grant 1UL1RR025011 from the Clinical and Translational Science Award (CTSA) program of the National Center for Research Resources (NCRR), National Institutes of Health (NIH). Dr. Cook was supported by K08DA021311.

Potential conflicts of interest: Timothy B. Baker, Robin Mermelstein, Linda M. Collins, Megan E. Piper, Stevens S. Smith, Bruce A. Christiansen, Tanya R. Schlam, and Jessica W. Cook have no potential conflicts of interest to disclose. Douglas E. Jorenby has received research support from the National Institute on Drug Abuse, the National Cancer Institute, Pfizer, Inc., Sanofi-Synthelabo, and Nabi Biopharmaceuticals. He has received support for educational activities from the National Institute on Drug Abuse and the Veterans Administration, and consulting fees from Nabi Biopharmaceuticals. Over the last 3 years, Michael C. Fiore served as an investigator on research studies at the University of Wisconsin that were funded by Nabi Biopharmaceuticals.


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Copyright information

© The Society of Behavioral Medicine 2010

Authors and Affiliations

  • Timothy B. Baker
    • 1
  • Robin Mermelstein
    • 1
  • Linda M. Collins
    • 1
  • Megan E. Piper
    • 1
  • Douglas E. Jorenby
    • 1
  • Stevens S. Smith
    • 1
  • Bruce A. Christiansen
    • 1
  • Tanya R. Schlam
    • 1
  • Jessica W. Cook
    • 1
  • Michael C. Fiore
    • 1
  1. 1.University of WisconsinMadisonUSA

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