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Randomized Controlled Trial
. 2011 Dec;101(12):2349-56.
doi: 10.2105/AJPH.2010.300084. Epub 2011 Jun 8.

Using extended cognitive behavioral treatment and medication to treat dependent smokers

Sharon M Hall  1 , Gary L Humfleet, Ricardo F Muñoz, Victor I Reus, Judith J Prochaska, Julie A Robbins
Affiliations
Randomized Controlled Trial

Using extended cognitive behavioral treatment and medication to treat dependent smokers

Sharon M Hall et al. Am J Public Health. 2011 Dec.

Abstract

Objectives: We evaluated smoking-cessation efficacy of an extended course of sustained-release bupropion (bupropion SR) and cognitive-behavioral treatment (CBT).

Methods: Participants who smoked at least 10 cigarettes per day and who smoked within 30 minutes of arising (n = 406) completed a 12-week smoking-cessation treatment including group counseling, nicotine-replacement therapy, and bupropion SR. Participants were then randomly assigned to 1 of 5 conditions: (1) no further treatment, (2) active bupropion SR for 40 weeks, (3) placebo for 40 weeks, (4) active bupropion SR and 11 sessions of CBT for 40 weeks (A-CBT), or (5) placebo and 11 sessions of CBT for 40 weeks. Participants were assessed at baseline and at weeks 12, 24, 52, 64, and 104.

Results: A-CBT was not superior to the other 3 extended treatments. From weeks 12 through 104, all extended treatment conditions were superior to standard treatment. At weeks 64 and 104, the 2 CBT conditions produced significantly higher abstinence rates than did the other 3 conditions.

Conclusions: Brief contact with providers can increase abstinence during treatment. CBT may increase long-term abstinence after extended treatment is terminated.

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Figures

FIGURE 1
FIGURE 1
Design of study evaluating smoking-cessation treatment: San Francisco, CA, February 2003–November 2007. Note. A-CBT = active cognitive-behavioral treatment; A-MM = active medical management; NRT = nicotine-replacement therapy; P-CBT = placebo cognitive-behavioral treatment; P-MM = placebo medical management; ST = standard treatment.
FIGURE 2
FIGURE 2
Recruitment and follow-up for evaluation of smoking-cessation treatment: San Francisco, CA, February 2003–November 2007. Note. A-CBT = active cognitive-behavioral treatment; A-MM = active medical management; P-CBT = placebo cognitive-behavioral treatment; P-MM = placebo medical management.
FIGURE 3
FIGURE 3
Participants’ biochemically verified cigarette-abstinence rates, by treatment condition: San Francisco, CA, February 2003–November 2007. Note. A-CBT = active cognitive-behavioral treatment; A-MM = active medical management; P-CBT = placebo cognitive-behavioral treatment; P-MM = placebo medical management.
See this image and copyright information in PMC

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