Current issues in behavioral and pharmacological approaches to smoking cessation

Over the last 15 years or so, innovative research in behavioral treatments (BT) has given way to research in nicotine replacement treatments (NRT), and there is a growing gap in scientific status between the two. There is little evidence that one BT is more effective than any other, while there is little doubt about the specific efficacy of NRT. Adding NRT to BT leads to large increases in efficacy, while adding BT to NRT is of uncertain value. In the clinical context, new BT ideas seem to have dried up, while vigorous research in NRT and other pharmacological treatments is currently underway. It is proposed that most BT have not been adequately examined and developed, and this and other reasons for their apparently poor record are explored. Some possible ways forward are discussed.