Open AccessLong-Term Effectiveness of a Clinician-Assisted Digital Cognitive Behavioral Therapy Intervention for Smoking Cessation: Secondary Outcomes From a Randomized Controlled Trial
Author(s) -
Jamie Webb,
Sarrah Peerbux,
Alfonso Ang,
Sarim Siddiqui,
Yusuf Sherwani,
Maroof Ahmed,
Hannah MacRae,
Hannah Puri,
Azeem Majeed,
Suzette Glasner
Publication year - 2022
Publication title -
nicotine and tobacco research
Language(s) - English
Resource type - Journals
eISSN - 1469-994X
pISSN - 1462-2203
DOI - 10.1093/ntr/ntac113
Subject(s) - smoking cessation , medicine , abstinence , randomized controlled trial , referral , intervention (counseling) , nicotine replacement therapy , clinical endpoint , physical therapy , psychiatry , family medicine , pathology
This study evaluated the secondary effectiveness outcomes for Quit Genius, a digital clinician-assisted cognitive behavioral therapy (CBT) intervention for smoking cessation. Methods Adult smokers (N=556) were randomly assigned to Quit Genius (n=277), a digital, clinician-assisted CBT intervention or Very Brief Advice (VBA) to stop smoking, an evidence-based, 30-second intervention designed to facilitate quit attempts, coupled with referral to a cessation service (n=279). Participants were offered combination nicotine replacement therapy (patches and gum) tailored to individual nicotine dependence. Analyses (N=530), by intention-to-treat, compared Quit Genius and VBA at 4, 26, and 52 weeks post-quit date. The primary outcome was self-reported seven-day point prevalence abstinence at 4 weeks post-quit date. Consecutive seven-day point-prevalence abstinence, defined as abstinent at two or more consecutive timepoints, was examined at weeks 26 and 52 to indicate long-term effectiveness. Abstinence was verified using a random sample of participants with carbon monoxide breath testing of <5 parts per million (n=280). Results Self-reported consecutive seven-day point prevalence abstinence at weeks 26 and 52 for Quit Genius was 27.2% and 22.6% respectively, compared to VBA which was 16.6% and 13.2% (RR=1.70,95% CI,1.22-2.37;p=0.003, 26 weeks; RR=1.71,95% CI,1.17-2.50; p=0.005, 52 weeks). Biochemically verified abstinence was significantly different at 26- (p=0.03) but not 52 weeks (p=0.16). Quit Genius participants were more likely to remain abstinent than those who received VBA (RR=1.71,95% CI 1.17-2.50;p=0.005). Conclusions This study provides secondary evidence for the long-term effectiveness of Quit Genius in comparison with VBA. Future trials of digital interventions without clinician support and comparisons with active treatment are needed. Implications The long-term effectiveness of clinician-assisted digital smoking cessation interventions has not been well-studied. This study established the long-term effectiveness of an extended CBT-based intervention; results may inform implementation of scalable approaches to smoking cessation in the health system.