Elias M Klemperer1,2,3, John R Hughes1,2,3, Laura J Solomon4, Peter W Callas5, James R Fingar2. 1. Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA. 2. Department of Psychiatry, University of Vermont, Burlington, VT, USA. 3. Department of Psychological Science, University of Vermont, Burlington, VT, USA. 4. Department of Family Medicine, University of Vermont, Burlington, VT, USA. 5. Department of Biostatistics, University of Vermont, Burlington, VT, USA.
Abstract
AIMS: To test whether, in comparison to usual care, brief motivational or reduction interventions increase quit attempts (QA) or abstinence among smokers who are not ready to quit. DESIGN: A parallel-group randomized controlled trial of brief motivational (n = 185), reduction (n = 186) or usual care (n = 189) telephone interventions delivered over the course of 4 weeks. Outcomes were assessed at 6- and 12-month follow-ups. No medication was provided. SETTING: United States. PARTICIPANTS: A total of 560 adult smokers of ≥ 10 cigarettes per day who were not ready to quit in the next 30 days. MEASUREMENTS: The primary outcomes were whether participants made a QA that lasted ≥ 24 hours and whether they made a QA of any length between baseline and 6 months. Secondary outcomes included 7-day point-prevalence abstinence at 6 and 12 months. The 12-month follow-up was added after the study began. FINDINGS: A priori-defined comparisons were between motivational versus usual care and reduction versus usual care conditions. The probability of making a QA that lasted ≥ 24 hours was not significantly different between the motivational (38%) or the reduction (31%) conditions and the usual care (34%) condition [motivational versus usual care odds ratio (OR) = 1.19, 95% confidence interval (CI) = 0.78-1.82; reduction versus usual care OR = 0.89, 95% CI = 0.57-1.36]. Bayes factors ranged from 0.13 to 0.18. Findings regarding a QA of any length were similar. At 6 months, the motivational condition had marginally more abstinence than usual care (11 versus 5%, OR = 2.17, 95% CI = 0.99-4.77), but the reduction condition was not significantly different from usual care (8 versus 5%, OR = 1.57, 95% CI = 0.69-3.59). At 12 months, the motivational condition had significantly more abstinence than usual care (10 versus 4%, OR = 2.80, 95% CI = 1.14-6.88) and the reduction condition had marginally more abstinence than usual care (9 versus 4%, OR = 2.45, 95% CI = 0.98-6.09). CONCLUSIONS: Among adult smokers who are not ready to quit, both logistic regression and Bayesian analysis indicate that neither motivational nor reduction-based telephone interventions increased the odds of making a quit attempt in comparison to usual care at 6 months. The motivational intervention appeared to increase abstinence at 6 months and did increase abstinence at 12 months. The reduction intervention did not increase abstinence at 6 months but appeared to increase abstinence at 12 months.
RCT Entities:
AIMS: To test whether, in comparison to usual care, brief motivational or reduction interventions increase quit attempts (QA) or abstinence among smokers who are not ready to quit. DESIGN: A parallel-group randomized controlled trial of brief motivational (n = 185), reduction (n = 186) or usual care (n = 189) telephone interventions delivered over the course of 4 weeks. Outcomes were assessed at 6- and 12-month follow-ups. No medication was provided. SETTING: United States. PARTICIPANTS: A total of 560 adult smokers of ≥ 10 cigarettes per day who were not ready to quit in the next 30 days. MEASUREMENTS: The primary outcomes were whether participants made a QA that lasted ≥ 24 hours and whether they made a QA of any length between baseline and 6 months. Secondary outcomes included 7-day point-prevalence abstinence at 6 and 12 months. The 12-month follow-up was added after the study began. FINDINGS: A priori-defined comparisons were between motivational versus usual care and reduction versus usual care conditions. The probability of making a QA that lasted ≥ 24 hours was not significantly different between the motivational (38%) or the reduction (31%) conditions and the usual care (34%) condition [motivational versus usual care odds ratio (OR) = 1.19, 95% confidence interval (CI) = 0.78-1.82; reduction versus usual care OR = 0.89, 95% CI = 0.57-1.36]. Bayes factors ranged from 0.13 to 0.18. Findings regarding a QA of any length were similar. At 6 months, the motivational condition had marginally more abstinence than usual care (11 versus 5%, OR = 2.17, 95% CI = 0.99-4.77), but the reduction condition was not significantly different from usual care (8 versus 5%, OR = 1.57, 95% CI = 0.69-3.59). At 12 months, the motivational condition had significantly more abstinence than usual care (10 versus 4%, OR = 2.80, 95% CI = 1.14-6.88) and the reduction condition had marginally more abstinence than usual care (9 versus 4%, OR = 2.45, 95% CI = 0.98-6.09). CONCLUSIONS: Among adult smokers who are not ready to quit, both logistic regression and Bayesian analysis indicate that neither motivational nor reduction-based telephone interventions increased the odds of making a quit attempt in comparison to usual care at 6 months. The motivational intervention appeared to increase abstinence at 6 months and did increase abstinence at 12 months. The reduction intervention did not increase abstinence at 6 months but appeared to increase abstinence at 12 months.
Authors: Saul Shiffman; John R Hughes; Stuart G Ferguson; Janine L Pillitteri; Joseph G Gitchell; Steven L Burton Journal: Nicotine Tob Res Date: 2007-11 Impact factor: 4.244
Authors: Russell E Glasgow; Bridget Gaglio; Paul A Estabrooks; Alfred C Marcus; Debra P Ritzwoller; Tammy L Smith; Arnold H Levinson; Anna Sukhanova; Colin O'Donnell; Erica F Ferro; Eric K France Journal: Med Care Date: 2009-01 Impact factor: 2.983
Authors: Francisco I Salgado García; Karen J Derefinko; Zoran Bursac; Sarah Hand; Robert C Klesges Journal: Contemp Clin Trials Date: 2018-03-13 Impact factor: 2.226
Authors: Mary F Brunette; Joelle C Ferron; Delbert Robinson; Daniel Coletti; Pamela Geiger; Timothy Devitt; Vanessa Klodnick; Jennifer Gottlieb; Haiyi Xie; Mary Ann Greene; Douglas Ziedonis; Robert E Drake; Gregory J McHugo Journal: Nicotine Tob Res Date: 2018-09-04 Impact factor: 4.244
Authors: Andrea H Weinberger; Raina D Pang; Michelle Ferrer; Rachel S Kashan; David R Estey; Kate S Segal; Hannah Esan Journal: Psychol Addict Behav Date: 2021-06-03
Authors: Elias M Klemperer; Robin Mermelstein; Timothy B Baker; John R Hughes; Michael C Fiore; Megan E Piper; Tanya R Schlam; Douglas E Jorenby; Linda M Collins; Jessica W Cook Journal: Nicotine Tob Res Date: 2020-08-24 Impact factor: 4.244