The failure to increase social support: it just might be time to stop intervening (and start rigorously observing)

In 1986, Lichtenstein et al. (Behav Ther. 17(5):607-19, 1986) presented the results of five studies focused on enhancing social support for smoking cessation in community-based clinic and worksite interventions. The manuscript was titled Social Support in Smoking Cessation: In Search of Effective Interventions and its main conclusion was that "attempts to both increase social support and to enhance treatment effectiveness have not been successful." Thirty years later, the paper by Cutrona et al. (Transl Behav Med. 6(4):546-57, 2016) draws a similar conclusion from a study focused on providing social support through an online social network for smoking cessation. In reviewing these findings - and based on our knowledge of the extensive literature on social support interventions that has been published over the past 30+ years - we believe there is a need for a fundamental shift in research on social support. Our focus here is largely on smoking cessation, but our comments are applicable to other areas of behavior change.