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Extended treatment for cigarette smoking cessation: a randomized control trial
Author(s) -
Laude Jennifer R.,
Bailey Steffani R.,
Crew Erin,
Varady Ann,
Lembke Anna,
McFall Danielle,
Jeon Anna,
Killen Diana,
Killen Joel D.,
David Sean P.
Publication year - 2017
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.13806
Subject(s) - medicine , bupropion , randomized controlled trial , smoking cessation , abstinence , varenicline , nicotine patch , nicotine replacement therapy , cognitive behavioral therapy , odds ratio , confidence interval , physical therapy , nicotine , psychiatry , placebo , alternative medicine , pathology
Aim To test the potential benefit of extending cognitive–behavioral therapy (CBT) relative to not extending CBT on long‐term abstinence from smoking. Design Two‐group parallel randomized controlled trial. Patients were randomized to receive non‐extended CBT ( n = 111) or extended CBT ( n = 112) following a 26‐week open‐label treatment. Setting Community clinic in the United States. Participants A total of 219 smokers (mean age: 43 years; mean cigarettes/day: 18). Intervention All participants received 10 weeks of combined CBT + bupropion sustained release (bupropion SR) + nicotine patch and were continued on CBT and either no medications if abstinent, continued bupropion + nicotine replacement therapy (NRT) if increased craving or depression scores, or varenicline if still smoking at 10 weeks. Half the participants were randomized at 26 weeks to extended CBT (E‐CBT) to week 48 and half to non‐extended CBT (no additional CBT sessions). Measurements The primary outcome was expired CO‐confirmed, 7‐day point‐prevalence (PP) at 52‐ and 104‐week follow‐up. Analyses were based on intention‐to‐treat. Findings PP abstinence rates at the 52‐week follow‐up were comparable across non‐extended CBT (40%) and E‐CBT (39%) groups [odds ratio (OR) = 0.99; 95% confidence interval (CI) = 0.55, 1.78]. A similar pattern was observed across non‐extended CBT (39%) and E‐CBT (33%) groups at the 104‐week follow‐up (OR = 0.79; 95% CI= 0.44, 1.40). Conclusion Prolonging cognitive–behavioral therapy from 26 to 48 weeks does not appear to improve long‐term abstinence from smoking.