Comparative effectiveness of motivation phase intervention components for use with smokers unwilling to quit: a factorial screening experiment.

ABSTRACT: AIMS:To screen promising intervention components designed to reduce smoking and promote abstinence in smokers initially unwilling to quit. DESIGN:A balanced, four-factor, randomized factorial experiment. SETTING:Eleven primary care clinics in southern Wisconsin, USA. PARTICIPANTS:A total of 517 adult smokers (63.4% women, 91.1% white) recruited during primary care visits who were willing to reduce their smoking but not quit. INTERVENTIONS:Four factors contrasted intervention components designed to reduce smoking and promote abstinence: (1) nicotine patch versus none; (2) nicotine gum versus none; (3) motivational interviewing (MI) versus none; and (4) behavioral reduction counseling (BR) versus none. Participants could request cessation treatment at any point during the study. MEASUREMENTS:The primary outcome was percentage change in cigarettes smoked per day at 26?weeks post-study enrollment; the secondary outcomes were percentage change at 12 weeks and point-prevalence abstinence at 12 and 26 weeks post-study enrollment. FINDINGS:There were few main effects, but a significant four-way interaction at 26?weeks post-study enrollment (P?=?0.01, ??=?0.12) revealed relatively large smoking reductions by two component combinations: nicotine gum combined with BR and BR combined with MI. Further, BR improved 12-week abstinence rates (P?=?0.04), and nicotine gum, when used without MI, increased 26-week abstinence after a subsequent aided quit attempt (P?=?0.01). CONCLUSIONS:Motivation-phase nicotine gum and behavioral reduction counseling are promising intervention components for smokers who are initially unwilling to quit.

SUBMITTER: Cook JW 

PROVIDER: S-EPMC4681585 | biostudies-literature | 2016 Jan

REPOSITORIES: biostudies-literature