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Randomized Controlled Trial
. 2017 Aug;112(8):1451-1459.
doi: 10.1111/add.13806. Epub 2017 May 2.

Extended treatment for cigarette smoking cessation: a randomized control trial

Jennifer R Laude  1   2 , Steffani R Bailey  3 , Erin Crew  1 , Ann Varady  1 , Anna Lembke  4 , Danielle McFall  5 , Anna Jeon  6 , Diana Killen  1 , Joel D Killen  1   7 , Sean P David  1
Affiliations
Randomized Controlled Trial

Extended treatment for cigarette smoking cessation: a randomized control trial

Jennifer R Laude et al. Addiction. 2017 Aug.

Abstract

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.

Keywords: Abstinence; adaptive treatment; bupropion SR; clinical trial; cognitive behavioral therapy; extended treatment; nicotine dependence; nicotine replacement therapy smoking cessation; smoking cessation; varenicline.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1. Timing of behavioral and pharmacological therapy and follow-up assessments
CBT = cognitive behavioral therapy. Expired-air carbon monoxide was checked only for persons reporting abstinence. NRT = nicotine replacement therapy.
Figure 2
Figure 2
Consort diagram
See this image and copyright information in PMC

Comment in

References

    1. Smith AL, Chapman S. Quitting smoking unassisted: the 50-year research neglect of a major public health phenomenon. JAMA. 2014;311:137–138. - PubMed
    1. Cahill K, Stevens S, Perera R, Lancaster T. Pharmacological interventions for smoking cessation: an overview and network meta-analysis. Cochrane Database Syst Rev. 2013;5:CD009329. - PMC - PubMed
    1. Cahill K, Stevens S, Lancaster T. Pharmacological treatments for smoking cessation. JAMA. 2014;311:193–194. - PubMed
    1. Volkow ND, Koob GF, McLellan AT. Neurobiologic Advances from the Brain Disease Model of Addiction. N Engl J Med. 2016;374:363–371. - PMC - PubMed
    1. Volkow ND, Morales M. The Brain on Drugs: From Reward to Addiction. Cell. 2015;162:712–725. - PubMed

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