An exploratory study of multicomponent treatment intervention for tobacco dependency

To conduct an exploratory study of two interventions to help smokers abstain over a period of 3 months. The specific aims were to describe the outcomes, test feasibility of the study design, and evaluate effect size.

A randomized experimental design was used in a sample of 42 patients who received multicomponent treatment intervention (MTI) or standard care (SC) in a midwestern city in the United States. Variables were behavioral (quit rate, self-efficacy, motivation), psychosocial (depression, partner interaction), and symptom management (use of nicotine replacement therapy [NRT]). Data analysis included descriptive statistics and repeated measures ANOVA.

The typical participant was Caucasian, middle aged, nicotine dependent, married or partnered, and employed, and had a high school education. Participants in the MTI group were more likely to use NRT and to have higher self-reported quit rates at follow-up. Statistically significant differences were found between groups over time for self-efficacy and positive to negative behavior ratio. Barriers to quitting were relapse, stress, weight gain, lack of support, and depression that were more frequent in the SC group. For effect size (0.25), probability level (.05), and power (.80), a sample size of 140 patients was calculated.

The MTI group had higher quit rates, more NRT, higher self-efficacy, and more positive behavioral interactions. Limitations of the study included self-report of tobacco use, small sample, and attrition. The investigators suggest a future study with a larger sample to test whether multicomponent interventions with telephone calls after discharge are more effective than is standard care in helping patients to quit and continue to abstain from smoking.