A cognitive developmental approach to smoking prevention

The present paper presents a formulation of smoking prevention programs based upon a cognitive-developmental view of the process of becoming a smoker. There are two critical components to this perspective. The first is that becoming a smoker involves an extended developmental history that, for convenience, can be divided into a series of stages: preparation for smoking, initiation and initial trials, becoming a smoker (experimenting and adopting the habit), and maintenance or addiction. The second key point is that the experience of smoking is the product of a complex set of underlying processes involved in the 'interpretation' (perception and understanding) of the act of smoking, and the skills available for controlling cigarette use and for achieving aims through means other than smoking. The smoking prevention program being tested attempts to alter the way information is processed and smoking is experienced at each developmental step. By altering the way sensations and actions which are part of smoking are perceived, the child's experience becomes an integral part of the anti-smoking intervention, rather than a violation of an anti-smoking rule imposed by adult authorities. In the following paragraphs, this approach will be briefly compared with the approach of other smoking prevention programs, and then will be described in detail.