Evaluating four motivation-phase intervention components for use with primary care patients unwilling to quit smoking: a randomized factorial experiment.

Aims: To assess the effectiveness of intervention components designed to increase quit attempts and promote abstinence in patients initially unwilling to quit smoking.

Design: A four-factor, randomized factorial experiment.

Setting: Sixteen primary care clinics in southern Wisconsin.

Time-varying effects of 'optimized smoking treatment' on craving, negative affect and anhedonia.

Aims: To identify when smoking cessation treatments affect craving, negative affect and anhedonia, and how these symptoms relate to abstinence, to help evaluate the effects of particular intervention components in multi-component treatments and accelerate treatment refinement.

Design: Secondary analysis of data from a two-arm randomized controlled trial.

Setting: Seven primary care clinics in Wisconsin, United States.

Electronically Monitored Nicotine Gum Use Before and After Smoking Lapses: Relationship With Lapse and Relapse.

Introduction: Greater use of nicotine replacement therapy (NRT) is related to smoking cessation success, but the causal direction is unclear. This study characterized the relationship between NRT use and smoking lapse and relapse.

Methods: Participants (N = 416 smokers; 57% female, 85% White) were recruited from primary care for a smoking cessation factorial experiment and analyzed if abstaining ≥1 day in the first 2 weeks post-target quit day (TQD).

Predictors of Smoking Cessation Attempts and Success Following Motivation-Phase Interventions Among People Initially Unwilling to Quit Smoking.

Introduction: Most people who smoke cigarettes are not willing (ie, not ready) to make a quit attempt (QA) at any given time. Unfortunately, interventions intended to increase QAs and the success of QAs are only modestly effective. Identifying processes leading to QAs and quitting success could guide intervention development.

Predictors of adherence to nicotine replacement therapy: Machine learning evidence that perceived need predicts medication use.

Background: Nonadherence to smoking cessation medication is a frequent problem. Identifying pre-quit predictors of nonadherence may help explain nonadherence and suggest tailored interventions to address it.

Aims: Identify and characterize subgroups of smokers based on adherence to nicotine replacement therapy (NRT).

Playing Around with Quitting Smoking: A Randomized Pilot Trial of Mobile Games as a Craving Response Strategy.

Strong cravings to smoke are an obstacle to cessation success. Unfortunately, cessation medication and counseling only modestly quell craving. This pilot study was designed to examine the feasibility of mobile games as a response strategy to craving and whether a fully powered trial is warranted.

Anxiety Sensitivity and Distress Tolerance in Smokers: Relations With Tobacco Dependence, Withdrawal, and Quitting Success†.

Introduction: This study examined relations of two affective vulnerabilities, high anxiety sensitivity (AS) and low distress tolerance (DT), with tobacco dependence, withdrawal, smoking cessation, and pharmacotherapy response.

Methods: Smokers interested in quitting (N = 1067; 52.2% female, 28.

Effects of motivation phase intervention components on quit attempts in smokers unwilling to quit: A factorial experiment.

Background: Smoking reduction treatment is a promising approach to increase abstinence amongst smokers initially unwilling to quit. However, little is known about which reduction treatment elements increase quit attempts and the uptake of cessation treatment amongst such smokers.

Methods: This study is a secondary analysis of a 4-factor randomized factorial experiment conducted amongst primary care patients (N = 517) presenting for regular healthcare visits in Southern Wisconsin who were unwilling to quit smoking but willing to cut down.

A Randomized Controlled Trial of an Optimized Smoking Treatment Delivered in Primary Care.

Background: The effectiveness of smoking cessation treatment is limited in real-world use, perhaps because we have not selected the components of such treatments optimally nor have treatments typically been developed for and evaluated in real-world clinical settings.

Purpose: To validate an optimized smoking cessation treatment package that comprises intervention components identified as effective in factorial screening experiments conducted as per the Multiphase Optimization Strategy (MOST).

Methods: Adult smokers motivated to quit were recruited from primary care clinics (N = 623).

Can we increase smokers' adherence to nicotine replacement therapy and does this help them quit?

Objective: To examine the effects of five intervention components on smokers' adherence to combined nicotine patch and nicotine gum during a quit attempt and assess whether adherence is related to cessation.

Method: Smokers interested in quitting (N = 513; 59% female; 87% White) received nicotine patch plus nicotine gum and participated in a 2x2x2x2x2 randomized factorial experiment (i.e.

Offering smoking treatment to primary care patients in two Wisconsin healthcare systems: Who chooses smoking reduction versus cessation?

Smokers unwilling to make a quit attempt can still benefit from smoking intervention. However, it is unclear what proportion of smokers will enter such a Motivation phase intervention, and whether such an intervention attracts different types of smokers than does abstinence oriented treatment. We conducted a study from June 2010 to October 2013 based on a chronic care model of tobacco treatment among study eligible primary care patients (N=1579; 58% women, 89% White) presenting for regular health care visits in southern Wisconsin, U.

Toward precision smoking cessation treatment I: Moderator results from a factorial experiment.

Background: The development of tobacco use treatments that are effective for all smokers is critical to improving clinical and public health. The Multiphase Optimization Strategy (MOST) uses highly efficient factorial experiments to evaluate multiple intervention components for possible inclusion in an optimized tobacco use treatment. Factorial experiments permit analyses of the influence of patient characteristics on main and interaction effects of multiple, relatively discrete, intervention components.

Toward precision smoking cessation treatment II: Proximal effects of smoking cessation intervention components on putative mechanisms of action.

Background: Understanding how smoking cessation treatments exert their effects can inform treatment development and use. Factorial designs allow researchers to examine whether multiple intervention components affect hypothesized change mechanisms, and whether the affected mechanisms are related to cessation.

Methods: This is a secondary data analysis of smokers recruited during primary care visits (N=637, 55% women, 87% white) who were motivated to quit.

Identifying effective intervention components for smoking cessation: a factorial screening experiment.

Aims: To identify promising intervention components intended to help smokers to attain and maintain abstinence in their quit smoking attempts.

Design: A fully crossed, six-factor randomized fractional factorial experiment.

Setting: Eleven primary care clinics in southern Wisconsin, USA.

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

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.

Enhancing the effectiveness of smoking treatment research: conceptual bases and progress.

Background And Aims: A chronic care strategy could potentially enhance the reach and effectiveness of smoking treatment by providing effective interventions for all smokers, including those who are initially unwilling to quit. This paper describes the conceptual bases of a National Cancer Institute-funded research program designed to develop an optimized, comprehensive, chronic care smoking treatment.

Methods: This research is grounded in three methodological approaches: (1) the Phase-Based Model, which guides the selection of intervention components to be experimentally evaluated for the different phases of smoking treatment (motivation, preparation, cessation, and maintenance); (2) the Multiphase Optimization Strategy (MOST), which guides the screening of intervention components via efficient experimental designs and, ultimately, the assembly of promising components into an optimized treatment package; and (3) pragmatic research methods, such as electronic health record recruitment, that facilitate the efficient translation of research findings into clinical practice.

Comparative effectiveness of intervention components for producing long-term abstinence from smoking: a factorial screening experiment.

Aims: To identify promising intervention components that help smokers attain and maintain abstinence during a quit attempt.

Design: A 2 × 2 × 2 × 2 × 2 randomized factorial experiment.

Setting: Eleven primary care clinics in Wisconsin, USA.

Anhedonia as a component of the tobacco withdrawal syndrome.

Animal research suggests that anhedonia is a tobacco withdrawal symptom, but this topic has not been addressed definitively in research with humans. This research sought to determine whether anhedonia is (a) an element of the tobacco withdrawal syndrome in humans and (b) an impediment to successful tobacco cessation. Data were from 1,175 smokers (58.

Smokers' physical activity and weight gain one year after a successful versus unsuccessful quit attempt.

Objective: To examine whether smokers' physical activity is related to weight change following a quit attempt.

Method: Data were analyzed for participants (n=683) of a randomized controlled trial comparing the efficacy of different smoking cessation pharmacotherapies (Wisconsin, 2005-2008). Activity (assessed via pedometry) and body weight were measured in the days surrounding the quit day and again one year later, at which time 7-day point-prevalence abstinence from smoking was assessed.

Recruiting and engaging smokers in treatment in a primary care setting: developing a chronic care model implemented through a modified electronic health record.

Almost 35 million U.S. smokers visit primary care clinics annually, creating a need and opportunity to identify such smokers and engage them in evidence-based smoking treatment.

Interventions for tobacco smoking.

Around 19% of US adults smoke cigarettes, and smoking remains the leading avoidable cause of death in this country. Without treatment only ~5% of smokers who try to quit achieve long-term abstinence, but evidence-based cessation treatment increases this figure to 10% to 30%. The process of smoking cessation comprises different pragmatically defined phases, and these can help guide smoking treatment development and evaluation.

Psychiatric diagnoses among quitters versus continuing smokers 3 years after their quit day.

Background: People with psychiatric disorders are more likely to smoke and smoke more heavily than the general population, and they suffer disproportionally from smoking-related illnesses. However, little is known about how quitting versus continuing to smoke affects mental health and the likelihood of developing a psychiatric diagnosis. This study used data from a large prospective clinical trial to examine the relations of smoking cessation success with psychiatric diagnoses 1 and 3 years after the target quit day.