title: Attentional bias retraining in cigarette smokers attempting smoking cessation (ARTS): study protocol for a double blind randomised controlled trial.
abstract: 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
  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.
  
  
  CONCLUSIONS
  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.
  
  
  BACKGROUND
  Current Controlled Trials: ISRCTN54375405.
authors: Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, UK Centre for Tobacco and Alcohol Studies, University of Oxford, Woodstock Road, Oxford OX2 6GG, UK. rachna.begh@phc.ox.ac.uk.
authors: Rachna
authors: R
authors: Begh
authors: Marcus R
authors: MR
authors: Munafò
authors: Saul
authors: S
authors: Shiffman
authors: Stuart G
authors: SG
authors: Ferguson
authors: Linda
authors: L
authors: Nichols
authors: Mohammed A
authors: MA
authors: Mohammed
authors: Roger L
authors: RL
authors: Holder
authors: Stephen
authors: S
authors: Sutton
authors: Paul
authors: P
authors: Aveyard
mesh_terms: D000328:Adult; D001288:Attention / Q000502:physiology*; D015928:Cognitive Behavioral Therapy; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012107:Research Design; D012907:Smoking / Q000523:psychology*; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D016896:Treatment Outcome