A multi-level analysis of non-significant counseling effects in a randomized smoking cessation trial

Journal Article

Print(0)

Addiction (Abingdon, England)

Addiction

Dec

105

2195

2208

LR: 20141202; CI: (c) 2010 The Authors, Addiction (c) 2010; GR: K05 CA139871/CA/NCI NIH HHS/United States; GR: P50 CA084724/CA/NCI NIH HHS/United States; GR: P50 CA084724-010003/CA/NCI NIH HHS/United States; GR: P50 DA019706/DA/NIDA NIH HHS/United States;

England

1360-0443; 0965-2140

PMID: 20840173

eng

Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; IM

10.1111/j.1360-0443.2010.03089.x [doi]

Unknown(0)

20840173

AIMS: To determine, in the context of a trial in which counseling did not improve smoking cessation outcomes, whether this was due to a failure of the conceptual theory identifying treatment targets or the action theory specifying interventions. DESIGN: Data from a randomized clinical trial of smoking cessation counseling and bupropion SR were submitted to multi-level modeling to test whether counseling influenced real-time reports of cognitions, emotions and behaviors, and whether these targets predicted abstinence. SETTING: Center for Tobacco Research and Intervention, Madison, WI. PARTICIPANTS: A total of 403 adult, daily smokers without contraindications to bupropion SR use. Participants were assigned randomly to receive individual counseling or no counseling and a 9-week course of bupropion SR or placebo pill. Cessation counseling was delivered in eight 10-minute sessions focused on bolstering social support, motivation, problem-solving and coping skills. MEASUREMENTS: Pre- and post-quit ecological momentary assessments of smoking behavior, smoking triggers, active prevention and coping strategies, motivation to quit, difficulty quitting and reactions to initial lapses. FINDINGS: Counseling prompted avoidance of access to cigarettes, improved quitting self-efficacy, reduced perceived difficulty of quitting over time and protected against guilt and demoralization following lapses. Results also supported the importance of limiting cigarette access, receiving social support, strong motivation and confidence and easing withdrawal distress during cessation efforts. Quitting self-efficacy and perceived difficulty quitting may partially mediate counseling effects on abstinence. CONCLUSIONS: Smoking cessation counseling may work by supporting confidence about quitting and reducing perceived difficulty quitting. Counseling did not affect other targets that protect against relapse.

Adolescent, Adult, Bupropion/administration & dosage, Combined Modality Therapy, Counseling, Delayed-Action Preparations, Dopamine Uptake Inhibitors/administration & dosage, Female, Humans, Male, Medical Records, Motivation, Multilevel Analysis, Placebos, Secondary Prevention, Self Efficacy, Smoking/prevention & control/psychology, Smoking Cessation/methods/psychology/statistics & numerical data, Treatment Outcome

Society for the Study of Addiction

McCarthy,D. E., Piasecki,T. M., Jorenby,D. E., Lawrence,D. L., Shiffman,S., Baker,T. B.

Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA. demccart@rci.rutgers.edu

20100915

PMC2975757

http://vp9py7xf3h.search.serialssolutions.com/?charset=utf-8&pmid=20840173

2010