Extended Cognitive Behavior Therapy for Cigarette Smoking Cessation

Addiction. 2008 Aug;103(8):1381-90. doi: 10.1111/j.1360-0443.2008.02273.x.

Abstract

PRIMARY AIM: Examine the effectiveness of extended cognitive behavior therapy (CBT) in promoting longer-term smoking abstinence.

Design: Open-label treatment phase followed by extended treatment phase. Randomization conducted prior to entry into open-label treatment phase; analysis based on intention-to-treat to avoid threat of selection bias.

Setting: Community smoking cessation clinic.

Participants: A total of 304 adult smokers (> or = 18 years of age; > or = 10 cigarettes/day).

Intervention: Open-label (8 weeks): all participants received bupropion SR, nicotine patch, CBT. Extended treatment (12 weeks): participants received either CBT + voicemail monitoring and telephone counseling or telephone-based general support.

Measurements: Seven-day point prevalence abstinence, expired-air carbon monoxide.

Results: At week 20 follow-up, CBT produced a higher 7-day point prevalence abstinence rate: 45% versus 29%, P = 0.006; at 52 weeks the difference in abstinence rates (31% versus 27%) was not significant. History of depression was a moderator of treatment. Those with a positive history had a better treatment response at 20 weeks when assigned to the less intensive telephone support therapy (P < 0.05).

Conclusion: The superiority of CBT to 20 weeks suggests that continued emphasis on the development of cognitive and behavioral strategies for maintaining non-smoking during an extended treatment phase may help smokers to maintain abstinence in the longer term. At present, the minimum duration of therapy is unknown.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Bupropion / administration & dosage*
  • Carbon Monoxide / analysis
  • Cognitive Behavioral Therapy / methods*
  • Counseling
  • Dopamine Uptake Inhibitors / administration & dosage*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nicotine / administration & dosage*
  • Nicotinic Agonists / administration & dosage*
  • Patient Compliance
  • Smoking Cessation / methods*
  • Substance Withdrawal Syndrome / drug therapy

Substances

  • Dopamine Uptake Inhibitors
  • Nicotinic Agonists
  • Bupropion
  • Nicotine
  • Carbon Monoxide