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Evaluating nicotine replacement therapy and stage-based therapies in a population-based effectiveness trial
Wayne F Velicer1, Robert H Friedman, Joseph L Fava
1Cancer Prevention Research Center, University of Rhode Island, Kingston, RI 02881, USA. velicer@uri.edu
Journal of Consulting and Clinical Psychology
|December 13, 2006
Summary
This study evaluated smoking cessation interventions for a large veteran population. Adding nicotine replacement therapy (NRT) and advanced support systems to manuals did not significantly improve quit rates.
Area of Science:
- Public Health
- Behavioral Science
- Clinical Trials
Background:
- Smoking cessation interventions are often evaluated in efficacy trials with volunteers.
- Effectiveness trials using population-based samples are crucial for real-world application.
- Nicotine replacement therapy (NRT) and behavioral interventions are common smoking cessation aids.
Purpose of the Study:
- To evaluate the effectiveness of NRT combined with behavioral interventions for smoking cessation in a population-based sample.
- To compare different intervention strategies including manuals, NRT, expert systems, and automated counseling.
- To assess long-term cessation rates at 30 months.
Main Methods:
- A population-based sample of 2,054 smokers from a Veterans Affairs Medical Center was recruited.
- Participants were randomized into four groups: manuals only, NRT + manuals, expert system + NRT + manuals, and automated counseling + expert system + NRT + manuals.
- Follow-up assessments were conducted at 10, 20, and 30 months to determine point prevalence cessation rates.
Main Results:
- Point prevalence cessation rates at 30 months were: manuals (20.3%), NRT + manuals (19.3%), expert system + NRT + manuals (17.6%), and automated counseling + expert system + NRT + manuals (19.9%).
- Stage-matched manuals alone achieved cessation rates comparable to previous studies.
- The addition of NRT, expert systems, and automated telephone counseling did not significantly enhance cessation rates compared to manuals alone.
Conclusions:
- Stage-matched manuals are an effective smoking cessation intervention.
- Adding nicotine replacement therapy, expert systems, or automated counseling to manuals does not appear to increase effectiveness in this population.
- Further research may be needed to optimize combination interventions for smoking cessation.
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