Behavioral counseling and varenicline treatment for smoking cessation.
BACKGROUND
Smoking remains the primary preventable cause of death and illness in the U.S. Effective, convenient treatment programs are needed to reduce smoking prevalence.


OBJECTIVE
This study compared the effectiveness of three modalities of a behavioral smoking-cessation program in smokers using varenicline.


METHODS
Current treatment-seeking smokers (n=1202) were recruited from a large healthcare organization between October 2006 and October 2007. Eligible participants were randomized to one of three smoking-cessation interventions: web-based counseling (n=401); proactive telephone-based counseling (PTC; n=402); or combined PTC and web counseling (n=399). All participants received a standard 12-week FDA-approved course of varenicline. Self-report determined the primary outcomes (7-day point prevalent abstinence at 3- and 6-month follow-ups); the number of days varenicline was taken; and treatment-related symptoms. Behavioral measures determined utilization of both the web- and Phone-based counseling.


RESULTS
Intent-to-treat analyses revealed relatively high percentages of abstinence at 3 months (38.9%, 48.5%, 43.4%) and at 6 months (30.7%, 34.3%, 33.8%) for the web, PTC, and PTC-web groups, respectively. The PTC group had a significantly higher percentage of abstinence than the web group at 3 months (OR=1.48, 95% CI=1.12, 1.96), but no between-group differences in abstinence outcomes were seen at 6 months.


CONCLUSIONS
Phone counseling had greater treatment advantage for early cessation and appeared to increase medication adherence, but the absence of differences at 6 months suggests that any of the interventions hold promise when used in conjunction with varenicline.
Swan
Gary E
GE
SRI International, Menlo Park, California 94025, USA. gary.swan@sri.com
McClure
Jennifer B
JB
Jack
Lisa M
LM
Zbikowski
Susan M
SM
Javitz
Harold S
HS
Catz
Sheryl L
SL
Deprey
Mona
M
Richards
Julie
J
McAfee
Timothy A
TA
D000328:Adult; D001552:Benzazepines / Q000627:therapeutic use*; D003376:Counseling / Q000379:methods*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D018722:Nicotinic Agonists / Q000627:therapeutic use*; D017063:Outcome Assessment, Health Care; D011810:Quinoxalines / Q000627:therapeutic use*; D016540:Smoking Cessation / Q000379:methods*; D013689:Telephone; D000068580:Varenicline; D014861:Washington
D001552:Benzazepines; D018722:Nicotinic Agonists; D011810:Quinoxalines; D000068580:Varenicline
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