"• To determine the proportion of people achieving abstinence by trial arm, risk ratios (RRs) will be calculated with corresponding 95% CIs. Those reported as lost-to-follow up will be counted as non-abstinent, as is standard in the reporting of smoking cessation trials [39,65]. "
[Show abstract][Hide abstract] ABSTRACT: Smokers attend preferentially to cigarettes and other smoking-related cues in the environment, in what is known as an attentional bias. There is evidence that attentional bias may contribute to craving and failure to stop smoking. Attentional retraining procedures have been used in laboratory studies to train smokers to reduce attentional bias, although these procedures have not been applied in smoking cessation programmes. This trial will examine the efficacy of multiple sessions of attentional retraining on attentional bias, craving, and abstinence in smokers attempting cessation.
This is a double-blind randomised controlled trial. Adult smokers attending a 7-session weekly stop smoking clinic will be randomised to either a modified visual probe task with attentional retraining or placebo training. Training will start 1 week prior to quit day and be given weekly for 5 sessions. Both groups will receive 21 mg transdermal nicotine patches for 8-12 weeks and withdrawal-orientated behavioural support for 7 sessions. Primary outcome measures are the change in attentional bias reaction time and urge to smoke on the Mood and Physical Symptoms Scale at 4 weeks post-quit. Secondary outcome measures include differences in withdrawal, time to first lapse and prolonged abstinence at 4 weeks post-quit, which will be biochemically validated at each clinic visit. Follow-up will take place at 8 weeks, 3 months and 6 months post-quit.
This is the first randomised controlled trial of attentional retraining in smokers attempting cessation. This trial could provide proof of principle for a treatment aimed at a fundamental cause of addiction.Trial registration: Current Controlled Trials: ISRCTN54375405.
BMC Public Health 12/2013; 13(1):1176. DOI:10.1186/1471-2458-13-1176 · 2.26 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To evaluate effectiveness of an Internet-based smoking cessation program as part of a comprehensive health risk reduction initiative in a large, geographically dispersed employee population.
A financial incentive for participation was offered during 2003 health benefits enrollment. The primary cessation outcome was 7-day point prevalence abstinence at 12 months.
A total of 1776 employees used the Internet program. Among those surveyed, the response rate was 32%. Quit rates ranged from 13% using intention to treat analysis (nonresponders counted as smokers) to 43% among survey responders. Higher Web site utilization was associated with better cessation outcomes, even after controlling for baseline motivation.
The Internet program was successful at reaching a large number of geographically dispersed employees. The range of quit rates suggests that Internet cessation programs can be effective in promoting cessation and preventing relapse in a worksite setting.
Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 09/2007; 49(8):821-8. DOI:10.1097/JOM.0b013e3180d09e6f · 1.63 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To conduct an exploratory, comparative study of the utilisation and effectiveness of tobacco cessation quitlines among aboriginal and non-aboriginal Canadian smokers.
Population based quitlines that provide free cessation information, advice and counselling to Canadian smokers.
First time quitline callers, age 18 years of age and over, who called the quitline between August 2001 and December 2005 and who completed the evaluation and provided data on their ethnic status (n = 7082).
Demographic characteristics and tobacco behaviours of participants at intake and follow-up; reasons for calling; actions taken toward quitting, and 6-month follow-up quit rates.
7% of evaluation participants in the time period reported aboriginal origins. Aboriginal participants were younger than non-aboriginals but had similar smoking status and level of addiction at intake. Concern about future health and current health problems were the most common reasons aboriginal participants called. Six months after intake aboriginals and non-aboriginals had taken similar actions with 57% making a 24-hour quit attempt. Quit rates were higher for aboriginals than non-aboriginals, particularly for men. The 6-month prolonged abstinence rate for aboriginal men was 16.7% compared with 7.2% for aboriginal women and 9.4% and 8.3% for non-aboriginal men and women, respectively.
This exploratory analysis showed that even without targeted promotion, aboriginal smokers do call Canadian quitlines, primarily for health related reasons. We also showed that the quitlines are effective at helping them to quit. As a population focused intervention, quitlines can reach a large proportion of smokers in a cost efficient manner. In aboriginal communities where smoking rates exceed 50% and multiple health risks and chronic diseases already exist, eliminating non-ceremonial tobacco use must be a priority. Our results, although exploratory, suggest quitlines can be an effective addition to aboriginal tobacco cessation strategies.
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