This project will develop and implement a sereies of smoking cessation and maintenance programs designed specifically for women. Based on research on the psychology of women, specific issues related to degree of peer support and general competence will be studied. Four separate studies are being proposed over a five year period. In the first study, subjects will participate in cessation and maintenance programs modeled after the ALA group cessation clinics. However, special emphasis will be placed on peer support in some groups, while other groups will receive competence training. Blechman (1981) has presented a model of competence in adult women in which both a rich problem solving repertoire and situational freedom were identified as necessary and sufficient conditions for competence. She has postulated that competence training may be especially effective in treating addictive behaviors. In a second study, a survey will be developed for """"""""self-quitters"""""""" to assess salient procedures in their continued abstinence. These will be incorporated into a revised and enhanced self-help manual to be compared in the third study, to the ALA self-help manual that is used currently. In the final demonstration study, women will be recruited form natural groups or populations (e.g., a large employer of women and an HMO). A program will be developed to enhance the ALA group cessation clinics for specific use with women. Information regarding peer support and competence training from the first study will be incorporated to enhance these groups. Women will be given the choice of attending these enhanced groups or of receiving the enhanced self-help manuals (developed from the second study and evaluated in the third study). Finally, a model will be developed to assess the impact of the two procedures (i.e., the enhanced self-help manuals and the enhanced group cessation clinics) taking into account the percent of subjects recruited from the population for each treatment, the percent of subjects who initially achieve success, and the percent of subject who maintain abstinence at six month and one year follow-up.
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