Analyzing milestones in smoking cessation: illustration in a nicotine patch trial in adult smokers.
Tests of addiction treatments seldom reveal where treatment exercises its effect (i.e., promoting initial abstinence, preventing lapses, and/or impeding progression from lapse to relapse). The authors illustrate analyses distinguishing effects on these milestones in a randomized trial of high-dose nicotine patch (35 mg; n = 188) versus placebo (n = 136) in adult smokers, who used electronic diaries to monitor smoking in real time during 5 weeks of treatment. High-dose patch promoted initial abstinence (hazard ratio [HR] = 1.3) and decreased the risk of lapsing among those who achieved abstinence (HR = 1.6). The biggest effect of treatment was to prevent progression to relapse among those who had lapsed (HR = 7.1). Analysis of effects by milestones may enhance understanding of cessation treatments and their mechanisms of action.
Shiffman
Saul
S
Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15213, USA. shiffman@pitt.edu
Scharf
Deborah M
DM
Shadel
William G
WG
Gwaltney
Chad J
CJ
Dang
Qianyu
Q
Paton
Stephanie M
SM
Clark
Duncan B
DB
D000279:Administration, Cutaneous; D000328:Adult; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D009538:Nicotine / Q000008:administration & dosage / Q000627:therapeutic use*; D018722:Nicotinic Agonists / Q000008:administration & dosage / Q000627:therapeutic use*; D012907:Smoking / Q000628:therapy*; D016540:Smoking Cessation / Q000379:methods*
D018722:Nicotinic Agonists; D009538:Nicotine