title: Randomized trial of telephone-delivered acceptance and commitment therapy versus cognitive behavioral therapy for smoking cessation: a pilot study.
abstract: OBJECTIVE
  We conducted a pilot randomized trial of telephone-delivered acceptance and commitment therapy (ACT) versus cognitive behavioral therapy (CBT) for smoking cessation.
  
  
  METHODS
  Participants were 121 uninsured South Carolina State Quitline callers who were adult smokers (at least 10 cigarettes/day) and who wanted to quit within the next 30 days. Participants were randomized to 5 sessions of either ACT or CBT telephone counseling and were offered 2 weeks of nicotine replacement therapy (NRT).
  
  
  RESULTS
  ACT participants completed more calls than CBT participants (M = 3.25 in ACT vs. 2.23 in CBT; p = .001). Regarding satisfaction, 100% of ACT participants reported their treatment was useful for quitting smoking (vs. 87% for CBT; p = .03), and 97% of ACT participants would recommend their treatment to a friend (vs. 83% for CBT; p = .06). On the primary outcome of intent-to-treat 30-day point prevalence abstinence at 6 months postrandomization, the quit rates were 31% in ACT versus 22% in CBT (odds ratio [OR] = 1.5, 95% confidence interval [CI] = 0.7-3.4). Among participants depressed at baseline (n = 47), the quit rates were 33% in ACT versus 13% in CBT (OR = 1.2, 95% CI = 1.0-1.6). Consistent with ACT's theory, among participants scoring low on acceptance of cravings at baseline (n = 57), the quit rates were 37% in ACT versus 10% in CBT (OR = 5.3, 95% CI = 1.3-22.0).
  
  
  CONCLUSIONS
  ACT is feasible to deliver by phone, is highly acceptable to quitline callers, and shows highly promising quit rates compared with standard CBT quitline counseling. As results were limited by the pilot design (e.g., small sample), a full-scale efficacy trial is now needed.
authors.affiliation: Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Psychology, University of Washington, Seattle, WA; jbricker@fhcrc.org.
authors.forename: Jonathan B
authors.initials: JB
authors.lastname: Bricker
authors.affiliation: Alere Wellbeing, Seattle, WA.
authors.forename: Terry
authors.initials: T
authors.lastname: Bush
authors.affiliation: Alere Wellbeing, Seattle, WA.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Zbikowski
authors.affiliation: Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA;
authors.forename: Laina D
authors.initials: LD
authors.lastname: Mercer
authors.affiliation: Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA;
authors.forename: Jaimee L
authors.initials: JL
authors.lastname: Heffner
mesh_terms: D064869:Acceptance and Commitment Therapy / Q000379:methods*; D000293:Adolescent; D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012907:Smoking / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology*; D013022:South Carolina / Q000453:epidemiology; D013689:Telephone