Recent data from epidemiological surveys, reviews of experimental studies, as well as research conducted by Health Innovations, suggest that self-help smoking cessation programs are less successful for heavy smokers than for their lighter smoking counterparts. Unfortunately, as Shiffman noted, there are currently no behavioral treatments that provide differential recommendations on the basis of degree of nicotine dependence. There is, therefore, a need for treatment programs that meet the special needs of heavy smokers. The LifeSign computer assisted smoking treatment program provides a structured, gradual withdrawal program that has proven to be na effective and commercially viable smoking cessation program. One strength of computer assisted programs is that they allow for precise quantification of treatment parameters and are thus readily amenable to modification and experimental testing of their impact. The present proposal describes modifications to the LifeSign program that are likely to improve outcome rates with heavy smokers. Modifications of the program include changes in length and rate of the withdrawal curve and a user interface to further alter the pace of withdrawal. A small-scale outcome trial comparing the modified program with the original LifeSign program will allow us to assess the impact of the modifications and to make final program changes in preparation for solicitation of Phase II funding for a large-scale efficacy trial.
