title: Extended interactive voice response telephony (IVR) for relapse prevention after smoking cessation using varenicline and IVR: a pilot study.
abstract: BACKGROUND
  There is a significant resumption of smoking following smoking cessation using varenicline. Both smoking cessation medications and counseling have been shown to increase smoking quit rates at one year. Thus, the combination of varenicline and interactive voice response (IVR) telephony followed by extended IVR may further improve smoking cessation rates at one and two years.
  
  
  METHODS
  101 participants were recruited from the community via newspaper advertisement. They attended a group counseling session and were given smoking information booklets from the Canadian Cancer Society. After 12 weeks of varenicline and 9 IVR calls, all participants who had quit smoking were randomized into 2 groups matched by levels of motivation and addiction as per baseline questionnaire score. The intervention group continued to receive bi-weekly IVR support for weeks 13-52. The control group no longer received IVR. The primary end-point was self-reported abstinence and exhaled carbon monoxide levels of less than 10 ppm for weeks 12, 52 and 2 years. Data were analyzed by Fisher's exact test or Wilcoxon rank-sum test.
  
  
  RESULTS
  Of the 101 participants, 44 (43%) had stopped smoking after 12 weeks of varenicline and 9 IVR calls. Of these, 23 (52%) were randomized to receive IVR calls from weeks 13 to 52.At 52 weeks, 26 (59%) participants remained smoke-free. Of the 23 with IVR, 12 (52.2%) stopped smoking compared to 14 of 21 (66.7%) without IVR. At 2 years, 40 of the 44 (90.9%) randomized participants were contacted and 24 of the 44 (54.5%) came in for testing. Fourteen (13% of the original cohort, 30% who were abstinent at 12 weeks and 53% who were abstinent at 52 weeks) remained smoke-free. Five of the 23 (21.7%) randomized to IVR and 9 of the 21 (42.9%) randomized to no IVR remained smoke-free at 2 years.
  
  
  CONCLUSIONS
  In this pilot study of an apparently healthy population, extended IVR did not affect abstinence rates. There was no relapse prevention benefit in offering 9 months of continued IVR to subjects who had stopped smoking after receiving 3 months of varenicline and IVR treatment.
  
  
  BACKGROUND
  ClinicalTrial.gov: NCT00832806.
authors.affiliation: Healthy Heart Program, Providence Health Care, St, Paul's Hospital, 1081 Burrard Street, Vancouver B,C, V6Z 1Y6, Canada. bmcnaughton@providencehealth.bc.ca.
authors.forename: Bonnie
authors.initials: B
authors.lastname: McNaughton
authors.forename: Jiri
authors.initials: J
authors.lastname: Frohlich
authors.forename: Amy
authors.initials: A
authors.lastname: Graham
authors.forename: Quincy-Robyn
authors.initials: QR
authors.lastname: Young
mesh_terms: D000328:Adult; D001552:Benzazepines / Q000008:administration & dosage*; D002170:Canada; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018722:Nicotinic Agonists / Q000008:administration & dosage; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011810:Quinoxalines / Q000008:administration & dosage*; D017010:Reminder Systems / Q000295:instrumentation*; D018570:Risk Assessment; D055502:Secondary Prevention; D012907:Smoking / Q000188:drug therapy*; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D018709:Statistics, Nonparametric; D013689:Telephone / Q000706:statistics & numerical data*; D013997:Time Factors; D016896:Treatment Outcome; D000068580:Varenicline; D055815:Young Adult
chemical_list: D001552:Benzazepines; D018722:Nicotinic Agonists; D011810:Quinoxalines; D000068580:Varenicline
references.citation: J Pers Soc Psychol. 1985 May;48(5):1279-89
references.pmid: 3998990
references.citation: J Consult Clin Psychol. 1991 Apr;59(2):318-24
references.pmid: 2030194
references.citation: Tob Control. 2014 Sep;23(5):437-42
references.pmid: 23748188
references.citation: Eur J Public Health. 2005 Jun;15(3):262-9
references.pmid: 15755781
references.citation: Addict Behav. 1990;15(3):271-83
references.pmid: 2378287
references.citation: Vasc Health Risk Manag. 2008;4(4):837-45
references.pmid: 19066000
references.citation: Nicotine Tob Res. 2011 Apr;13(4):255-60
references.pmid: 21330278
references.citation: Br J Addict. 1991 Sep;86(9):1119-27
references.pmid: 1932883
references.citation: Thorax. 2008 Aug;63(8):717-24
references.pmid: 18263663
references.citation: J Cardiovasc Nurs. 2007 Nov-Dec;22(6):525-34
references.pmid: 18090195
references.citation: JAMA. 2006 Jul 5;296(1):47-55
references.pmid: 16820546
references.citation: Cochrane Database Syst Rev. 2009 Jan 21;(1):CD003999
references.pmid: 19160228
references.citation: Am J Public Health. 1992 Jun;82(6):816-20
references.pmid: 1585961
references.citation: Addiction. 2011 Dec;106(12):2110-21
references.pmid: 21752135
references.citation: Transl Behav Med. 2012 Mar;2(1):93-101
references.pmid: 22448205
references.citation: JAMA. 2006 Jul 5;296(1):56-63
references.pmid: 16820547
references.citation: Can J Cardiol. 2006 Jul;22(9):775-80
references.pmid: 16835672
references.citation: Prog Behav Modif. 1992;28:183-218
references.pmid: 1620663