Evaluating nicotine replacement therapy and stage-based therapies in a population-based effectiveness trial.
Pharmacological interventions for smoking cessation are typically evaluated using volunteer samples (efficacy trials) but should also be evaluated in population-based trials (effectiveness trials). Nicotine replacement therapy (NRT) alone and in combination with behavioral interventions was evaluated on a population of smokers from a New England Veterans Affairs Medical Center. Telephone interviews were completed with 3,239 smokers, and 2,054 agreed to participate (64%). Participants were randomly assigned to one of four conditions: stage-matched manuals (MAN); NRT plus manuals (NRT + MAN); expert system plus NRT and manuals (EXP + NRT + MAN); and automated counseling plus NRT, manuals, and expert system (TEL + EXP + NRT + MAN). Assessments were completed at baseline, 10, 20, and 30 months. The point prevalence cessation rates at final follow-up (30 months) were MAN, 20.3%; NRT + MAN, 19.3%; EXP + NRT + MAN, 17.6%; and TEL + EXP + NRT + MAN, 19.9%. Stage-matched manuals provided cessation rates comparable with previous studies. The addition of NRT, expert system interventions, and automated telephone counseling failed to produce a further increase in intervention effectiveness.
Velicer
Wayne F
WF
Cancer Prevention Research Center, University of Rhode Island, Kingston, RI 02881, USA. velicer@uri.edu
Friedman
Robert H
RH
Fava
Joseph L
JL
Gulliver
Suzy B
SB
Keller
Stefan
S
Sun
Xiaowu
X
Ramelson
Harley
H
Prochaska
James O
JO
D000328:Adult; D000368:Aged; D001521:Behavior Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D003376:Counseling; D005103:Expert Systems; D030141:Feedback, Psychological; D005260:Female; D006801:Humans; D008297:Male; D008370:Manuals as Topic; D008875:Middle Aged; D009538:Nicotine / Q000008:administration & dosage* / Q000009:adverse effects*; D011380:Programmed Instructions as Topic; D012008:Recurrence; D019233:Retreatment; D016540:Smoking Cessation / Q000379:methods*; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis / Q000534:rehabilitation*; D013685:Telecommunications; D014029:Tobacco Use Disorder / Q000534:rehabilitation*; D016896:Treatment Outcome; D014728:Veterans / Q000523:psychology*
D009538:Nicotine