These data suggest that increased therapeutic contact is helpful for smokers with a depression history. More than one therapeutic approach may be useful, and the best therapeutic content needs to be determined. Mechanisms of action underlying the increased effectiveness of more intensive, supportive treatments with depressed smokers have been suggested. Possibilities include increased or better sustained motivation or less increase in the poor mood that frequently accompanies quitting smoking. Matching Interventions to Special Subgroups of Smokers .
Some data suggest that smokers differ widely in readiness to quit.
These data are especially relevant to smokers diagnosed with substance abuse or psychiatric problems, since such samples probably contain a relatively high proportion of smokers who are not ready to enter a traditional treatment program for smoking cessation. Such programs usually require a high and sustained degree of motivation to quit. Other data show that psychological interventions can be successfully tailored to the individual smoker's readiness to quit. Computerized expert system interventions have been developed that are targeted at a smoker's self-professed level of interest in quitting, which may range from precontemplation, a stage at which the smoker has no interest in quitting, to contemplation, to preparation for action, to action itself. In at least one study, expert systems developed by this group have shown efficacy in increasing readiness to quit and improving abstinence rates.