Does cue exposure treatment improve outcomes in smoking cessation treatment? A controlled trial

Abstract Introduction High rates of tobacco use among people with serious mental illness (SMI), along with their unique needs, suggest the importance of developing tailored smoking cessation interventions for this group. Previous early-phase work empirically validated the design and content of Learn to Quit, a theory-based app designed for this population. Methods In a pilot randomized controlled trial, we compared the feasibility, acceptability, and preliminary efficacy of Learn to Quit versus QuitGuide, an app designed for the general population. All participants received nicotine replacement therapy and technical assistance. Daily smokers with SMI (N = 62) participated in the trial with outcomes assessed at weeks 4, 8, 12, and 16. Results Compared to QuitGuide, Learn to Quit participants had similar number of days of app use (34 vs. 32, p = .754), but larger number of app interactions (335 vs. 205; p = .001), longer durations of app use (4.24 hrs. vs. 2.14 hrs; p = .044), and higher usability scores (85 vs. 79, p = .046). At week 16, Learn to Quit led to greater reductions in cigarettes per day (12.3 vs. 5.9 for QuitGuide; p = 0.10). Thirty-day point prevalence abstinence was verified in 12% of Learn to Quit participants versus 3% of QuitGuide participants (odds ratio = 3.86, confidence interval = 0.41 to 36, p = .239). Changes in psychiatric symptoms and adverse events were not clinically significant between conditions. Conclusions This pilot trial provides strong evidence of Learn to Quit’s usability, feasibility, and safety. Preliminary evidence suggests the app may be efficacious. A randomized controlled efficacy trial is needed to test the app in a larger sample of smokers with SMI. Implications This study suggests that the Learn to Quit app is a feasible approach to deliver smoking cessation treatment in patients with co-occurring tobacco use disorder and SMI. This means that, if found efficacious, this technology could be used to deploy smoking cessation treatment to larger segments of this population, hence improving public health. Therefore, a randomized controlled trial should be conducted to examine the efficacy of this digital intervention.

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Self‐help educational booklets for the prevention of smoking relapse following smoking cessation treatment: a randomized controlled trial

Addiction ◽

10.1111/add.13080 ◽

2015 ◽

Vol 110 (12) ◽

pp. 2006-2014 ◽

Cited By ~ 11

Author(s):

Vivienne Maskrey ◽

Annie Blyth ◽

Tracey J. Brown ◽

Garry R. Barton ◽

Caitlin Notley ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Smoking Cessation ◽

Controlled Trial ◽

Smoking Relapse ◽

Smoking Cessation Treatment ◽

Randomized Controlled ◽

Self Help ◽

Cessation Treatment

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Efficacy of a sleep health intervention to optimize standard smoking cessation treatment response: results from a pilot randomized controlled trial

The Journal of Smoking Cessation ◽

10.1017/jsc.2020.8 ◽

2020 ◽

Vol 15 (2) ◽

pp. 113-117

Author(s):

Freda Patterson ◽

Michael A. Grandner ◽

Susan K. Malone ◽

Ryan T. Pohlig ◽

Rebecca L. Ashare ◽

...

Keyword(s):

Smoking Cessation ◽

Treatment Response ◽

Sex Education ◽

Smoking Status ◽

Controlled Trial ◽

Treatment Seeking ◽

Sleep Health ◽

Smoking Cessation Treatment ◽

Cessation Treatment ◽

End Of Treatment

AbstractBackgroundWe tested if an adjunctive sleep health (SH) intervention improved smoking cessation treatment response by increasing quit rates. We also examined if baseline sleep, and improvements in sleep in the first weeks of quitting, were associated with quitting at the end of treatment.MethodsTreatment-seeking smokers (N = 29) aged 21–65 years were randomized to a SH intervention (n = 16), or general health (GH) control (n = 13) condition. Participants received six counseling sessions across 15-weeks: SH received smoking cessation + SH counseling; GH received smoking cessation + GH counseling. Counseling began 4-weeks before the target quit date (TQD), and varenicline treatment began 1-week prior to TQD. Smoking status and SH were assessed at baseline (week 1), TQD (week 4), 3 weeks after cessation (week 7), week 12, and at the end of treatment (EOT; week 15).ResultsSH versus GH participants had higher Carbon Monoxide (CO) -verified, 7-day point prevalence abstinence at EOT (69% vs. 54%, respectively; adjusted odds ratio (aOR) = 2.10, 95% confidence interval (CI) = 0.40–10.69, P = 0.77). Higher baseline sleep efficiency (aOR = 1.42, 95% CI = 1.03–1.96, P = 0.03), predicted higher EOT cessation. Models were adjusted for age, sex, education, and baseline nicotine dependence.ConclusionsImproving SH in treatment-seeking smokers prior to cessation warrants further examination as a viable strategy to promote cessation.

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Pattern of craving response among smokers exposed to virtual reality

European Psychiatry ◽

10.1016/s0924-9338(11)71802-8 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 91-91

Author(s):

I. Pericot-Valverde ◽

O. García-Rodríguez ◽

K.P. Cabas-Hoyos ◽

M. Ferrer-García ◽

J. Gutiérrez-Maldonado

Keyword(s):

Smoking Cessation ◽

Substance Use ◽

Virtual Reality ◽

Secondary Analysis ◽

Repeated Exposure ◽

Cue Exposure ◽

Exposure Treatment ◽

Long Duration ◽

Cue Exposure Treatment

IntroductionTobacco craving is an intense desire to smoke. Cue-induced craving is considered the main responsible for relapse after smoking cessation. Cue Exposure Treatment (CET) consists of controlled and repeated exposure to stimuli associated with substance use in order to reduce craving associated.ObjectiveTo analyze the pattern of craving response of smokers exposed to Virtual Reality environments.MethodsForty-six smokers were exposed randomly to complex virtual scenes of 6 minutes long duration with smoking related cues that reproduce typical situations where people use to smokes. Craving was assessed before each exposure and 6 times during navigation with a visual analogic scale. For this secondary analysis the evolution of craving response were explored for the environments that produced the most and the least craving responses.ResultsIn the environment that produced the highest craving level, the pattern of response remains similar after the second assessment during the exposure, that is, after two minutes. For the environment that trigger the lowest levels, the responses gradually increased during the exposure and the highest level appeared in the last craving assessment, after 6 minutes.ConclusionsThis study has several implications. In the first place, virtual reality environments are able to elicit craving. In the second, we found that differents patterns of craving response exist in response to VR environments. Furthermore, the results obtained in the present study may be useful for cessation programs that include CET, in which is it necessary to know the pattern of desire during the exposure.

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A Novel Smoking Cessation Smartphone App Integrated With a Mobile Carbon Monoxide Checker for Smoking Cessation Treatment: Protocol for a Randomized Controlled Trial (Preprint)

10.2196/preprints.12252 ◽

2018 ◽

Cited By ~ 1

Author(s):

Akihiro Nomura ◽

Hiroki Tateno ◽

Katsunori Masaki ◽

Tomoyasu Muto ◽

Shin Suzuki ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Smoking Cessation ◽

Nicotine Dependence ◽

Controlled Trial ◽

Smartphone App ◽

Smoking Cessation Treatment ◽

Randomized Controlled ◽

Cessation Treatment ◽

Co Concentration ◽

Continuous Abstinence

BACKGROUND Smoking cessation treatment programs have been widely available for patients with nicotine dependence. Despite intensive programs, the continuous abstinence rate (CAR) from weeks 9-12 is still about 50%. Recently, a smartphone app emerged as a novel tool for therapeutic interventions, including nicotine dependence. In this study, we developed “CureApp Smoking Cessation” (CASC), which consists of a smartphone app for patients and a Web-based patient management software for doctors with a mobile carbon monoxide (CO) checking device to improve the efficacy of the smoking cessation treatment. OBJECTIVE This study aims to evaluate whether the CASC app is effective for individuals with nicotine dependence in addition to standard smoking cessation programs. METHODS This will be a randomized, sham-controlled, open-label, multicenter trial. We will recruit participants with nicotine dependence, but are otherwise healthy adults. We will randomize and allocate participants 1:1 to the CASC treatment group or a control app group. Both groups will receive a 12-week standard smoking cessation program with pharmacotherapy and counseling. In addition, participants in the treatment group will have the CASC app installed on their smartphone, which will provide video tutorials, advice from an artificial intelligence nurse, a digital diary, and measure daily exhaled CO concentration. In contrast, the control group will have the control app installed on their smartphone, where all the functions that can potentially effect smoking cessation are removed. The primary outcome will be the biochemically validated CAR from weeks 9-24. The success of smoking cessation will be defined as self-reported continuous abstinence from weeks 9-24 and exhaled CO concentration ≤10 ppm both at weeks 12 and 24. The main secondary outcomes will be the CAR from weeks 9-12, weeks 9-52, and 7-day point prevalence abstinence at weeks 4, 8, 12, 24, and 52. RESULTS We will recruit 580 participants with nicotine dependence from October 2017 to September 2018 or until the recruitment process is complete. The final 52-week follow-up will be completed in October 2019. We expect all trial results to be available by the end of 2019. The trial is funded by CureApp, Inc. CONCLUSIONS This is the first randomized controlled trial to evaluate the efficacy of CASC. We expect that CASC, in addition to standard smoking cessation programs, has a significantly higher CAR during weeks 9-24 than the control app. CLINICALTRIAL University Hospital Medical Information Network Clinical Trials Registry UMIN000031589; https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000033555 INTERNATIONAL REGISTERED REPOR DERR1-10.2196/12252

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