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A behavioral smoking treatment based on perceived risks of quitting: A preliminary feasibility and acceptability study with female smokers.

ABSTRACT: INTRODUCTION:Even treatments showing proven efficacy leave the majority of female smokers unable to quit. In response, there has been a special call for novel behavioral treatments, particularly those that target barriers to quitting faced by women. Significant barriers for women who smoke include perceived "risks" associated with cessation (e.g., managing stress and cravings). The purpose of this treatment development study is to test a novel, individualized smoking intervention for female smokers targeting risk perceptions. METHODS:Twenty treatment-seeking female daily cigarette smokers were randomly assigned to receive either standard counseling based on the Mayo Clinic's "Smoke Free and Living It" manual or a new manualized treatment based on individual perceived risks of quitting. Primary outcomes were point prevalence smoking abstinence at the end of treatment and at a one month follow-up, and changes in smoking from baseline to one month follow-up. RESULTS:The manualized perceived risk treatment demonstrated good acceptability and more participants receiving this treatment were abstinent at the end of the trial than participants in the standard counseling condition. Among participants who did not quit smoking, those receiving the perceived risk counseling reported a greater reduction in smoking at the one month follow up (Cohen's d=0.67). CONCLUSIONS:This initial study demonstrated that an intervention targeting perceived risks of quitting was feasible to administer, acceptable to female smokers, and showed promise with regard to smoking outcomes, thus warranting further testing through Stage II clinical trials. Reducing perceived risks of quitting may represent a critical target for smoking treatment development.

SUBMITTER: Weinberger AH

PROVIDER: S-EPMC4402999 | biostudies-literature | 2015 Apr

REPOSITORIES: biostudies-literature

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A behavioral smoking treatment based on perceived risks of quitting: A preliminary feasibility and acceptability study with female smokers.

Weinberger Andrea H AH Pittman Brian B Mazure Carolyn M CM McKee Sherry A SA

Addiction research & theory 20150401 2

<h4>Introduction</h4>Even treatments showing proven efficacy leave the majority of female smokers unable to quit. In response, there has been a special call for novel behavioral treatments, particularly those that target barriers to quitting faced by women. Significant barriers for women who smoke include perceived "risks" associated with cessation (e.g., managing stress and cravings). The purpose of this treatment development study is to test a novel, individualized smoking intervention for fem ...[more]

PMID: 25904837

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Project description:BackgroundMost smokers are ambivalent about quitting-they want to quit someday, but not now. Interventions are needed that can engage ambivalent smokers, build their motivation for quitting, and support future quit attempts. Mobile health (mHealth) apps offer a cost-effective platform for such interventions, but research is needed to inform their optimal design and assess their acceptability, feasibility, and potential effectiveness.ObjectiveThis study aims to assess the feasibility, acceptability, and potential impact of a novel mHealth app for smokers who want to quit smoking someday but are ambivalent about quitting in the near term.MethodsWe enrolled adults across the United States who smoked more than 10 cigarettes a day and were ambivalent about quitting (n=60). Participants were randomly assigned to 1 of 2 versions of the GEMS app: standard care (SC) versus enhanced care (EC). Both had a similar design and identical evidence-based, best-practice smoking cessation advice and resources, including the ability to earn free nicotine patches. EC also included a series of exercises called experiments designed to help ambivalent smokers clarify their goals, strengthen their motivation, and learn important behavioral skills for changing smoking behavior without making a commitment to quit. Outcomes were analyzed using automated app data and self-reported surveys at 1 and 3 months post enrollment.ResultsParticipants who installed the app (57/60, 95%) were largely female, White, socioeconomically disadvantaged, and highly nicotine dependent. As expected, key outcomes trended in favor of the EC group. Compared to SC users, EC participants had greater engagement (mean sessions 19.9 for EC vs 7.3 for SC). An intentional quit attempt was reported by 39.3% (11/28) of EC users and 37.9% (11/29) of SC users. Seven-day point prevalence smoking abstinence at the 3-month follow-up was reported by 14.7% (4/28) of EC users and 6.9% (2/29) of SC users. Among participants who earned a free trial of nicotine replacement therapy based on their app usage, 36.4% (8/22) of EC participants and 11.1% (2/18) of SC participants requested the treatment. A total of 17.9% (5/28) of EC and 3.4% (1/29) of SC participants used an in-app feature to access a free tobacco quitline. Other metrics were also promising. EC participants completed an average of 6.9 (SD 3.1) out of 9 experiments. Median helpfulness ratings for completed experiments ranged from 3 to 4 on a 5-point scale. Finally, satisfaction with both app versions was very good (mean 4.1 on a 5-point Likert scale) and 95.3% (41/43) of all respondents would recommend their app version to others.ConclusionsAmbivalent smokers were receptive to the app-based intervention, but the EC version, which combined best-practice cessation advice with self-paced, experiential exercises, was associated with greater use and evidence of behavior change. Further development and evaluation of the EC program is warranted.Trial registrationClinicalTrials.gov NCT04560868; https://clinicaltrials.gov/ct2/show/NCT04560868.

Project description:BACKGROUND:Smoking is highly prevalent in Pakistan claiming the lives of over 100,000 individuals every year. A significant proportion of smokers (24.7%) make an attempt to quit each year but 97.4% fail to quit successfully. Little is known about the reasons for, and experiences of, failed quit attempts. This study was carried out to explore the experiences of young male smokers in quitting smoking in the twin cities of Pakistan METHOD: A qualitative study was carried out using a phenomenological approach in Rawalpindi and Islamabad. A total of 11 participants were interviewed. All study participants were male and had made at least one quit attempt. Study participants were a mix of smokers who failed to quit smoking, intermittent smokers and successful quitters. Streubert's (1991) method of phenomenology was followed during data analysis. RESULTS:The experiences of smokers while smoking "the smoking phase" have major effects on their journey towards quitting smoking. The smoking phase consists of three major stages: contact with initial smoking stimuli, the journey from first puff to enjoying smoking and then finally smoking becoming part of life. However, the journey towards quitting smoking is not as simple as the journey towards becoming a smoker. Instead, smokers get trapped in three overlapping cycles of smoking and quit attempts: smoking & forced quitting, smoking & intentional quitting, and smoking & intermittent smoking before successful quitting. Breaking the cycle is not easy in the presence of trapping factors (addiction, high availability, easy affordability, conducive social setup and low perceived risks of smoking). Three factors play a major role in breaking these cycles which are strong will power, continuous peer support and avoidance of smokers' company. CONCLUSION:A young smoker, during his experience of quitting smoking gets entrapped in several overlapping cycles of smoking & quit attempts before successful quitting. There are known entrapping factors as well as factors which help in breaking these cycles. Targeted interventions are needed to facilitate smoking cessation among young smokers in Pakistan.

Dataset Information

A behavioral smoking treatment based on perceived risks of quitting: A preliminary feasibility and acceptability study with female smokers.

Publications

A behavioral smoking treatment based on perceived risks of quitting: A preliminary feasibility and acceptability study with female smokers.

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