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Randomized Controlled Trial
. 2019 Nov 9;53(12):1032-1044.
doi: 10.1093/abm/kaz014.

Six Month Abstinence Heterogeneity in the Best Quit Study

Harold S Javitz  1 , Terry M Bush  2 , Jennifer C Lovejoy  3 , Alula J Torres  2 , Tallie Wetzel  1 , Ken P Wassum  2 , Marcia M Tan  4 , Nabil Alshurafa  4 , Bonnie Spring  4
Affiliations
Randomized Controlled Trial

Six Month Abstinence Heterogeneity in the Best Quit Study

Harold S Javitz et al. Ann Behav Med. .

Abstract

Background: Understanding the characteristics of smokers who are successful in quitting may help to increase smoking cessation rates.

Purpose: To examine heterogeneity in cessation outcome at 6 months following smoking cessation behavioral counseling with or without weight management counseling.

Methods: 2,540 smokers were recruited from a large quitline provider and then randomized to receive proactive smoking cessation behavioral counseling without or with two versions of weight management counseling. A Classification and Regression Tree (CART) analysis was conducted to identify the individual pretreatment and treatment characteristics of groups of smokers with different quitting success (as measured by point prevalence of self-reported smoking of any amount at 6 months).

Results: CART analysis identified 10 subgroups ranging from 25.5% to 70.2% abstinent. The splits in the CART tree involved: the total number of counseling and control calls received, whether a smoking cessation pharmacotherapy was used, and baseline measures of cigarettes per day, confidence in quitting, expectation that the study would help the participant quit smoking, the motivation to quit, exercise minutes per week, anxiety, and lack of interest or pleasure in doing things. Costs per quitter ranged from a low of $US270 to a high of $US630. Specific treatment recommendations are made for each group.

Conclusions: These results indicate the presence of a substantial variation in abstinence following treatment, and that the total extent of contact via counseling calls of any type and baseline characteristics, rather than assigned treatment, were most important to subgroup membership and abstinence. Tailored treatments to subgroups who are at high risk for smoking following a quit attempt could increase successful smoking cessation.

Trial registration: ClinicalTrials.gov NCT01867983.

Keywords: Abstinence; CART; Cost per quitter; Intentions; Relapse; Smoking cessation; Weight management.

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Figures

Fig. 1.
Fig. 1.
CART tree for 30 day observed abstinence at 6 months.
See this image and copyright information in PMC

References

    1. Bush T, Levine MD, Deprey M, et al. Prevalence of weight concerns and obesity among smokers calling a quitline. J Smok Cessat. 2008;4:74–78. - PMC - PubMed
    1. Perkins KA, Marcus MD, Levine MD, et al. Cognitive-behavioral therapy to reduce weight concerns improves smoking cessation outcome in weight-concerned women. J Consult Clin Psychol. 2001;69:604–613. - PubMed
    1. Bush T, Levine MD, Beebe LA, et al. Addressing weight gain in smoking cessation treatment: A randomized controlled trial. Am J Health Promot. 2012;27:94–102. - PMC - PubMed
    1. Spring B, Pagoto S, Pingitore R, Doran N, Schneider K, Hedeker D. Randomized controlled trial for behavioral smoking and weight control treatment: Effect of concurrent versus sequential intervention. J Consult Clin Psychol. 2004;72:785–796. - PMC - PubMed
    1. Bush T, Lovejoy J, Javitz H, et al. Simultaneous vs. sequential treatment for smoking and weight management in tobacco quitlines: 6 and 12 month outcomes from a randomized trial. BMC Public Health. 2018;18:678. - PMC - PubMed

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