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Comparative effectiveness of intervention components for producing long‐term abstinence from smoking: a factorial screening experiment
Author(s) -
Schlam Tanya R.,
Fiore Michael C.,
Smith Stevens S.,
Fraser David,
Bolt Daniel M.,
Collins Linda M.,
Mermelstein Robin,
Piper Megan E.,
Cook Jessica W.,
Jorenby Douglas E.,
Loh WeiYin,
Baker Timothy B.
Publication year - 2016
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.13153
Subject(s) - abstinence , medicine , smoking cessation , nicotine gum , nicotine patch , nicotine , intervention (counseling) , psychological intervention , randomized controlled trial , relapse prevention , physical therapy , psychiatry , alternative medicine , pathology , placebo
Aims To identify promising intervention components that help smokers attain and maintain abstinence during a quit attempt. Design A 2 × 2 × 2 × 2 × 2 randomized factorial experiment. Setting Eleven primary care clinics in Wisconsin, USA. Participants A total of 544 smokers (59% women, 86% white) recruited during primary care visits and motivated to quit. Interventions Five intervention components designed to help smokers attain and maintain abstinence: (1) extended medication (26 versus 8 weeks of nicotine patch + nicotine gum); (2) maintenance (phone) counseling versus none; (3) medication adherence counseling versus none; (4) automated (medication) adherence calls versus none; and (5) electronic medication monitoring with feedback and counseling versus electronic medication monitoring alone. Measurements The primary outcome was 7‐day self‐reported point‐prevalence abstinence 1 year after the target quit day. Findings Only extended medication produced a main effect. Twenty‐six versus 8 weeks of medication improved point‐prevalence abstinence rates (43 versus 34% at 6 months; 34 versus 27% at 1 year; P = 0.01 for both). There were four interaction effects at 1 year, showing that an intervention component's effectiveness depended upon the components with which it was combined. Conclusions Twenty‐six weeks of nicotine patch + nicotine gum (versus 8 weeks) and maintenance counseling provided by phone are promising intervention components for the cessation and maintenance phases of smoking treatment.