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

Jessica W. Cook, Linda M. Collins, Michael C. Fiore, Stevens S. Smith, David Fraser, Daniel M. Bolt, Timothy B. Baker, Megan E. Piper, Tanya R. Schlam, Douglas Jorenby, Wei Yin Loh, Robin Mermelstein

Research output: Contribution to journalArticle

21 Citations (Scopus)

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 26weeks 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 26weeks post-study enrollment (P=0.01, β=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.

Original languageEnglish (US)
Pages (from-to)117-128
Number of pages12
JournalAddiction
Volume111
Issue number1
DOIs
StatePublished - Jan 1 2016

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Motivation
Counseling
Motivational Interviewing
Nicotine
Smoking
Primary Health Care
Tobacco Use Cessation Products
Withholding Treatment
Tobacco Products

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Psychiatry and Mental health

Cite this

Cook, Jessica W. ; Collins, Linda M. ; Fiore, Michael C. ; Smith, Stevens S. ; Fraser, David ; Bolt, Daniel M. ; Baker, Timothy B. ; Piper, Megan E. ; Schlam, Tanya R. ; Jorenby, Douglas ; Loh, Wei Yin ; Mermelstein, Robin. / Comparative effectiveness of motivation phase intervention components for use with smokers unwilling to quit : A factorial screening experiment. In: Addiction. 2016 ; Vol. 111, No. 1. pp. 117-128.
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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 26weeks 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 26weeks post-study enrollment (P=0.01, β=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.",
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Cook, JW, Collins, LM, Fiore, MC, Smith, SS, Fraser, D, Bolt, DM, Baker, TB, Piper, ME, Schlam, TR, Jorenby, D, Loh, WY & Mermelstein, R 2016, 'Comparative effectiveness of motivation phase intervention components for use with smokers unwilling to quit: A factorial screening experiment', Addiction, vol. 111, no. 1, pp. 117-128. https://doi.org/10.1111/add.13161

Comparative effectiveness of motivation phase intervention components for use with smokers unwilling to quit : A factorial screening experiment. / Cook, Jessica W.; Collins, Linda M.; Fiore, Michael C.; Smith, Stevens S.; Fraser, David; Bolt, Daniel M.; Baker, Timothy B.; Piper, Megan E.; Schlam, Tanya R.; Jorenby, Douglas; Loh, Wei Yin; Mermelstein, Robin.

In: Addiction, Vol. 111, No. 1, 01.01.2016, p. 117-128.

Research output: Contribution to journalArticle

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AU - Cook, Jessica W.

AU - Collins, Linda M.

AU - Fiore, Michael C.

AU - Smith, Stevens S.

AU - Fraser, David

AU - Bolt, Daniel M.

AU - Baker, Timothy B.

AU - Piper, Megan E.

AU - Schlam, Tanya R.

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AU - Loh, Wei Yin

AU - Mermelstein, Robin

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N2 - 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 26weeks 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 26weeks post-study enrollment (P=0.01, β=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.

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