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Attitudinal approaches should be accompanied by simple behavioral modification techniques (eg, relaxation response, oral substitutes) that move beyond the pharmacologic methods of the conventional nicotine addiction model (ie, the patient as an addict) and toward a consumerist approach-the thinking patients technique. The consumerist model (Table 1) places less emphasis on the physiologic aspects of nicotine addiction and related cessation strategies and more emphasis on a linguistic-based approach In which sociocultural factors are considered and the individual who smokes is encouraged to think in new ways about his or her behavior and how it might be modified

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The United States government has a longstanding history of policies designed to destroy American Indian culture

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