Changing Addictive Behaviors: A Process Perspective

What does it take to achieve suc cessful modification of addictive be haviors? Social pressure, social pol icy, or social support? An adequate coping repertoire? Given that re lapse is so extensive a phenomenon, could relapse prevention be the key component of success? Or does change require medical, marital, be havioral, cognitive, or emotional strategies? Each of these perspectives has supporters and some empirical support.1,2,3 Addictive behaviors like cigarette smoking, excessive alcohol con sumption, and cocaine use pose a significant challenge to our under standing of the process of change. Addicted individuals are hard to reach and engage. Often, they are not convinced of the presence of the problem or the need to change. Even when smokers, alcoholics, or drug addicts make an attempt to change their behavior, they are quite unsuc cessful on the whole. Yet more than 50 million Americans have success fully quit smoking cigarettes since the 1964 Surgeon General's report linking smoking to lung and heart disease. Some individuals with alco hol and drug problems have been able to modify their behavior with minimal interventions, and others have used the support of self-help groups like Alcoholics or Cocaine Anonymous to achieve sobriety. Although the possibility of sue cessful modification of addictive be