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Randomized Controlled Trial
, 13, 1176

Attentional Bias Retraining in Cigarette Smokers Attempting Smoking Cessation (ARTS): Study Protocol for a Double Blind Randomised Controlled Trial

Randomized Controlled Trial

Attentional Bias Retraining in Cigarette Smokers Attempting Smoking Cessation (ARTS): Study Protocol for a Double Blind Randomised Controlled Trial

Rachna Begh et al. BMC Public Health.


Background: 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.

Methods/design: 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.

Discussion: 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.


Figure 1
Figure 1
Flow diagram of participants through trial.

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    1. Ferguson J, Bauld L, Chesterman J, Judge K. The English smoking treatment services: one-year outcomes. Addiction. 2005;13:59–69. - PubMed
    1. Hajek P, Stead LF, West R, Jarvis M, Lancaster T. Relapse prevention interventions for smoking cessation. Cochrane Database Syst Rev. 2009;13:CD003999. - PubMed
    1. Marlatt A, Gordon J. Relapse Prevention. New York: Guilford Press; 1985.
    1. Fiore MC, Jaen CR, Baker TB, Bailey WC, Bennett G, Benowitz NL. et al. A Clinical Practice Guideline for Treating Tobacco Use and Dependence: 2008 Update - A US Public Health Service report. Am J Prev Med. 2008;13:158–176. - PMC - PubMed
    1. Stacy AW, Wiers RW. Implicit Cognition and Addiction: A Tool for Explaining Paradoxical Behavior. Palo Alto: Annual reviews; 2010. - PMC - PubMed

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