Controlled smoking

The health risks of smoking are related to the interaction of what is smoked, smoking rate, and the topography of consumption. Assessment and treatment efforts should take all three of these factors into account. A working model of smoking behavior is proposed which involves the consideration of antecedents, concomitants, and consequences of smoking on cognitive, behavioral, situational and physiological levels. Further, the relative importance of these factors is not assumed to be the same across individuals. An approach to smoking risk reduction, called controlled smoking, is proposed which includes the elements of: (1) comprehensive assessment, (2) individualized goals, (3) emphasis on regulation, and (4) a skill development approach to treatment. Finally, some possible commonalities among behavioral approaches to substance abuse are presented.